Dissertations / Theses on the topic 'Numerical Rating Scale'

Orientador: Fernanda Bono Fukushima<br>Resumo: Introdução: A dor aguda é um fenômeno universal. O tratamento desse evento, entretanto, ainda é visto através de diversos vieses culturais, sociais e econômicos. Em situação de dor aguda pós-operatória estima-se que 40% dos pacientes apresentam controle inadequado da dor (intensidade moderada a intensa). O presente trabalho visa analisar a percepção de pacientes recém operados quanto à analgesia pós-operatória que receberam em um hospital escola terciário de natureza pública, bem como descrever as medidas prescritas e realizadas para analgesia pós-operatória de acordo com seu registro em prontuário. Método: Estudo transversal, descritivo, realizado em pacientes internados, submetidos a procedimentos cirúrgicos cardiovasculares, gastrointestinais, ginecológicos, hemodinâmicos, mastológicos, neurológicos, ortopédicos, torácicos, urológicos ou vasculares no período de junho a dezembro de 2017 no Hospital das Clínicas da Faculdade de Medicina da UNESP, em Botucatu. Os pacientes foram entrevistados no 2º dia pós-operatório (2º PO) sobre sua experiência no 1º dia pós-operatório (1º PO) quanto ao controle da dor. Através de entrevista semiestruturada o paciente foi inquerido quanto a intensidade da sua dor, a satisfação quanto a analgesia recebida, e sua impressão geral do atendimento prestado pela equipe de saúde assistente. Foi realizada revisão dos prontuários e registrados dados quanto a frequência do registro de avaliação da dor, analgesia prescrita e fornecida, bem como sobre ... (Resumo completo, clicar acesso eletrônico abaixo)<br>Abstract: Justifications and Objectives: Acute pain is a universal phenomenon. However, the treatment of this event still has a diversity of cultural, social and economical biases. It is estimated that 40% of patients present inadequate management of pain (moderate to severe intensity) in a situation of acute postoperative pain. The aim of the present study is to analyze the perception of patients, who recently operated, regarding postoperative analgesia in a public tertiary hospital school. In addition, to describe the prescribed and performed postoperative analgesia according to registration in medical records. Methods: A cross-sectional, descriptive study was performed in hospitalized patients submitted to cardiovascular, gastrointestinal, gynecological, hemodynamic, mastological, neurological, orthopedic, thoracic, urological or vascular surgical procedures from June 2017 to December 2017 at Hospital das Clínicas, Faculdade de Medicina da UNESP, Botucatu, Brazil. Patients were interviewed on the second day of the postoperative period about their experience on the first day postoperative as to their pain control. Through a semi-structured interview, patients were asked about the intensity of pain, satisfaction as to the analgesia, and general impression of the process. Medical records were reviewed, and data were recorded as to the frequency of recorded pain, analgesia prescription and its administration, and side effects as well. Results: 159 patients met the criteria established t... (Complete abstract click electronic access below)<br>Mestre

Numerical calculations were performed over a variety of two-dimensional rib roughness configurations in which the ratio of flow depth to roughness height was varied from 1.1 to 40. Periodically fully developed flow was achieved by employing periodic boundary conditions and the effect of turbulence was accounted for by a two-layer model. These calculations were used to test the hypothesis that any rough wall resistance may be reduced to an equivalent wall shear stress located on a plane wall. The position of the plane wall is determined by a novel method of prediction obtained by consideration of strearnwise force moments. The resistance is then determined by three dynamically significant length scales: the first (yo) specifies the position of the equivalent plane wall, the second is the depth of flow h and the third is similar to Nikuradse's sand grain roughness k,,. The latter length scale is however depth dependent and a universal relationship is postulated: ks y,, -,= F(Tkwhere ksw is the asymptotic value of ks at very large flow depths. For the calculation of friction factor, a resistance equation is proposed of the form typical of fully rough flows. These postulates are supported by the numerical model results though further work including physical experiments is required to confirm them. Before applying the two-layer model to this problem it was tested on smooth rectangular duct flows and Schlichting's (1936) long angle roughness experiments. The opportunity was taken to further explore these flows, and in addition calculations were carried out for Grass et al's ( 199 1) open channel rib roughness experiments. The periodic boundary conditions were also applied to a larninar counter-flow plate-fin heat exchanger.A novel source-sinka rrangemenfto r heat flux was developedi n order to implement these boundary conditions.

Syftet med denna masterstudie var att jämföra den smärtlindrande effekten av fullständig utrensning och desinfektion av rotkanalsystemet med enbart utrymning av pulpakavum, utan instrumentering av rotkanalerna, som akutbehandling hos tänder med symtomatisk apikal parodontit. Materialet utgjordes av 16 patienter insamlade på Tandvårdshögskolans jourmottagning. Patienter med svullnad och allmänpåverkan exkluderades. Patienterna valdes slumpmässigt ut till att genomgå någon av behandlingarna. Den preoperativa smärtnivån och ev. analgetikaintag registrerades. Tre till fem dagar efter utförd behandling kontaktades patienterna per telefon och fick då gradera sin postoperativa smärtnivå samt analgetika- och/eller antibiotikaintag. Resultatet visade att 100% av patienterna som behandlades med fullständig utrensning erhöll tillfredställande smärtlindring jämfört med 71% av de patienter som behandlades med enbart utrymning av pulpakavum. Skillnaden var inte statistiskt signifikant. 44% av patienterna som behandlades med fullständig utrensning hade tagit smärtstillande postoperativt medan 29% av patienterna i utrymningsgruppen hade gjort det. Skillnaden var inte signifikant. Ingen av patienterna oavsett behandling hade tagit antibiotika efter behandlingen. Ingen skillnad förelåg i andelen patienter som blev tillräckligt smärtlindrade mellan fullständig utrensning och enbart utrymning av pulpakavum hos tänder med symtomatisk apikal parodontit. Det var inte heller någon skillnad i smärtsänkning mellan de två behandlingarna.<br>The aim was to compare the pain relieving effect of complete chemo mechanical disinfection of the root canal system with removal of necrotic tissue in the pulp chamber without instrumentation of the root canals as emergency treatment in teeth with symptomatic apical periodontitis. The material consisted of 16 patients collected at the emergency clinic at Malmö University. Patients with swelling and/or systemic involvement were excluded. The patients were randomized to either treatment. The preoperative pain level and intake of analgesics was registered. Three till 5 days postoperatively the patients were contacted and asked to grade the current pain level and intake of analgesics and/or antibiotics. The results showed that 100% of the patients treated with complete chemo mechanical disinfection of the root canal system obtained satisfying pain relief compared to 71% for patients treated with removal of necrotic tissue in the pulp chamber. 44% of the patients treated with chemo mechanical disinfection of the root canal system had some kind of analgesics postoperatively compared to 29% for those treated with removal of necrotic tissue in the pulp chamber. No patients in either group reported use of antibiotics postoperatively. The conclusion was that both complete chemo mechanical disinfection and removal of necrotic tissue implied a significant pain relief as emergency treatment in teeth with symptomatic apical periodontitis. There was no difference between the two treatments concerning the number of patients who obtained sufficient pain relief or in pain relieving effect.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2004 74 leaves ; 30 cm<br>The purpose of this study was to determine concurrent validity of the Zulu translations of the English Numerical Pain Rating Scale-101 and the Patient Specific Functional Scale. The Numerical Pain Rating Scale-101 and the Patient Specific Functional Scale (ENRS-101 and the EPSFS) were translated into Zulu (ZNRS-101 1.0 and ZPSFS1.0) and were tested for face validity by means of a focus group session.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2009.<br>Title from title screen (site viewed January 5, 2010). PDF text: viii, 65 p. : ill. ; 507 K. UMI publication number: AAT 3360158. Includes bibliographical references. Also available in microfilm and microfiche formats.

Purpose To investigate ocular surface sensations, specifically ocular discomfort using psychophysical and clinical techniques. The measurement of discomfort on the ocular surface has been limited to the use of traditional rating scales until recently. This thesis focuses on the scaling of discomfort using a psychophysical approach and also investigates the less explored area of the influence of blur on ocular discomfort. The specific aims of each chapter are: Chapter 2: To evaluate the difference thresholds of the central cornea in lens and non-lens wearers. Chapter 3: To devise a novel scale for ocular discomfort, relating subjective estimation of discomfort arising from contact lens wear to discomfort produced by the pneumatic stimuli delivered by a modified Belmonte esthesiometer. Chapter 4: To evaluate the influence of blur on ocular comfort while systematically manipulating vision using habitual refractive correction, induced spatial and optical blur, and under the absence of visual structure. Chapter 5: To examine if subjects rate discomfort and intensity of suprathreshold pneumatic stimuli differently when viewing clear and defocused targets and to examine the suprathreshold scaling of stimuli under the same visual conditions. Methods Chapter 2: The mechanical sensitivity of the central cornea was determined in 12 lens wearers and 12 non-lens wearers using a modified Belmonte pneumatic esthesiometer. The mechanical threshold of the central cornea was first estimated using the method of limits. Then, a series of systematically increasing stimuli were presented, with the first stimuli being 25% less than the threshold. The subjects were asked to compare the intensity of each stimulus with the preceding one and report if any difference in intensity was detectable. The intensities at which the subjects perceived an increased intensity from the previous was recorded. The difference threshold (DL) was the differences between the stimulus intensities at which an increase was perceived and five DLs were measured for each subject. Weber’s constants that relate the size of the difference thresholds to the stimulus intensity were derived for each DL level and repeated measures ANOVA was used to compare the Weber’s constants in the lens and non-lens wearing groups. Chapter 3: Twenty seven participants were enrolled for this magnitude matching study. Soft (HEMA) contact lenses of eight different lens designs varying in base curve and diameter were fit on all participants. The study was conducted on two separate days with four lenses randomly assigned on each day. The assigned soft contact lens was placed on the chosen eye and the sensations were measured using a numerical rating scale. Following this, the subjects were asked to regulate the intensity of the pneumatic stimulus using the control dial in order to match the discomfort from the stimulus to the discomfort from contact lens wear. At the completion of magnitude matching, ratings of sensations were again recorded. Pearson product moment correlation was used to correlate the objective esthesiometer matches to the subjective ratings of discomfort reported by each participant. The method of least log squares was used to derive the power exponents as defined by Stevens’ power law and analyze the psychophysical functions. Repeated measures ANOVA was used to investigate the effect of lens sequence and session on ocular discomfort with contact lens wear. The impact of lens type and time on discomfort was studied using linear mixed modeling. Chapter 4: Twenty emmetropic subjects rated ocular comfort, vision and sensation attributes (burning, itching and warmth) under conditions of normal vision, spatial blur and dioptric defocus, each session lasting for five minutes. Subjects viewed digital targets projected from a distance of 3m, and ocular surface sensations, vision were rated using magnitude estimation. Dioptric defocus was produced using +6.00DS contact lenses and equivalent spatial blur was created by spatially blurring the targets. Clear target images were used during dioptric defocus and blurred images during spatial blur session. Comfort was also rated under the absence of visual structure in fifteen of the participants using a ganzfeld and black occluders. Repeated measures ANOVA was used to compare vision and comfort ratings between the different experimental conditions. Chapter 5: Twenty one participants were enrolled. Ocular discomfort was produced by delivering mechanical stimuli from a pneumatic esthesiometer, and participants were asked to rate the intensity of stimulus and the discomfort induced by it under clear and defocused visual conditions. Esthesiometry was performed on one eye while the fellow eye viewed either a clear or blurred 6/60 fixation target through a trial lens. For the clear visual condition, the trial lens contained +0.25DS over their distance refractive correction and for the defocused condition, an additional +4.00DS was used. Mechanical thresholds from the central cornea were estimated using ascending methods of limits and then stimuli that were 25%, 50%, 75% and 100 % above threshold were presented in random order. Participants rated intensity and discomfort of each stimulus using a 0-100 numerical scale where 0 indicated no sensation and 100 indicated highest imaginable intensity/discomfort. There were 3 sessions with clear visual conditions and 3 sessions with defocus, in random order. Results Chapter 2: The functions relating Weber’s constants to stimulus intensities were slightly different in lens and non-lens wearing groups, although the absolute thresholds were similar. Repeated measures ANOVA revealed a significant main effect of DL level on Weber’s constant (p<0.001), with the Weber’s fraction at the first DL being higher than the following DLs. A significant main effect of the group type was also observed, with the lens wearers showing higher Weber’s constants than the non-lens wearers (p=0.02) However, there was no interaction between DL level and lens wearing group on Weber’s constants (p=0.38). Chapter 3: The average and individual psychophysical functions appeared to follow Stevens’ power function, with mechanical and chemical stimuli giving rise to different power exponents. Examination of the individual transducer functions revealed that only about half of the subjects were able to match the contact lens sensations to the pneumatic stimulus discomfort, with both mechanical and chemical stimulation. The lens types did not have any impact (p=0.65) on the session or sequence in which the lens was presented, although an effect of session and sequence on discomfort was observed. The average discomfort ratings produced by the different lens types were similar. There appeared to be significant effects of time (p<0.001) on the reporting of discomfort with lens wear, with the discomfort upon lens insertion rated to be higher than after lenses settling. Chapter 4: Ratings of vision under spatial blur and dioptric defocus were significantly different (p<0.001) from normal vision condition. Vision with dioptric defocus was rated worse (p<0.001) than spatial blur. Significant differences in comfort were observed between normal vision and blur, including spatial blur (p=0.02) and dioptric defocus (p=0.001). However, there was no significant difference (p=0.99) in comfort between spatial blur and dioptric defocus. Comfort remained unchanged between normal vision, occluders and ganzfeld although vision was absent in the later two conditions. Chapter 5: There was no significant difference in mechanical thresholds under clear and defocused conditions with a paired t-test (p=0.66) and similar results were obtained with repeated measures ANOVA, with no significant difference in discomfort (p=0.10) and intensity (p=0.075) ratings between the two visual conditions. However, paired t-test between the derived exponents under clear and defocused conditions showed significant differences for discomfort (p=0.05) and no significant difference for the ratings of intensity (p=0.22). Comparison of exponents between discomfort and intensity showed a significant difference in both clear (p=0.02) and defocus conditions (p<0.001). Conclusions: Chapter 2: The differential sensitivity of the ocular surface can be successfully measured with a pneumatic esthesiometer and it appears that Weber’s law holds true for corneal nociceptive sensory processing. There are subtle differences in mechanical difference thresholds between lens and non-lens wearers suggesting the possibility of different neural activity levels in the two groups. Chapter 3: Subjective ratings of discomfort can be scaled by corneal esthesiometry in a selective group of people. In the subset of subjects with poorer correlations, perhaps the pneumatic mechanical stimulus was too localized and specific to match the complex sensations experienced while wearing contact lenses. However, there is also a group of subjects who are poor at making judgments about ocular comfort. Hence, the use of special sensory panels should be considered when ocular comfort is the primary outcome. Chapter 4: There does seem to be an association between clarity of vision and ocular comfort, although the pathways for pain and vision are perhaps exclusive. Interactions between vision and other senses have been reported, but a similar inter-sensory interaction between pain and vision is yet to be clearly demonstrated. The decreased comfort observed in this study might perhaps be due to nocebo or Hawthorne effects. Chapter 5: Suprathreshold scaling of pneumatic stimuli can vary with the viewing conditions, with defocus associated with higher exponents than clear visual conditions. However, the ratings of comfort appear to be similar under both the conditions. If defocus does affect comfort, it is subtle and does not affect the sensory components, but tiny effects through the affective aspect of pain can contribute to the differences in power exponents. The differences in the perception of comfort do not appear to be attributable to the differences in threshold or sensory intensity.

University of Technology Sydney. Faculty of Health.<br>Thirst is a common and burdensome symptom of chronic heart failure which adversely affects health related quality of life and compliance to self-care practices such as fluid restriction. Despite this, research on thirst remains scarce and there is no standard approach to identify patients with increased thirst and manage thirst in clinical practice. To date, previous studies have investigated various interventions to help alleviate thirst in chronic heart failure and other patient populations. While the other interventions such as artificial saliva showed differing results, chewing gum demonstrated promising outcomes in relieving thirst. Based on the comprehensive literature review and preliminary Bachelor Honours study, RELIEVE-CHF was developed. RELIEVE-CHF was a novel pilot intervention which sought to investigate the effect of chewing gum in the level of thirst of people with chronic heart failure in a single blind randomised controlled study. A total of 71 individuals with chronic heart failure, aged ≥ 18 years, on oral loop diuretics from the inpatient and outpatient clinic were enrolled in a two-arm trial. Participants were randomised to receive either chewing gum or no chewing gum for two weeks. The primary outcome of the study is the change in the level of thirst at Day 4. Secondary outcomes included changes in the level of thirst at Day 14, weight and health related quality of life. Participants’ level of thirst was measured using the Visual Analogue Scale (VAS) and the Numeric Rating Scale (NRS). The Kansas City Cardiomyopathy Questionnaire was used to assess health related quality of life. Participants were followed up at Day 28. This thesis presents the clinical trial methodology and analysis of 71 participants who completed the trial. All participants’ data were analysed based on the intention to treat principle. The results showed statistical significant improvements in the level of thirst of those in the intervention group compared to the control group at Day 4 (VAS: p=0.04 and NRS: p=0.019) and Day 14 (VAS: p=0.02 and NRS: p=0.021). There was no statistically significant difference observed between the intervention and control group in weight over the study period and health related quality of life at Day 28. The findings indicate that chewing gum provided relief from thirst but did not influence weight or health related quality of life during the study period. Although promising, these findings must be interpreted in light of the limitations encountered in this trial. Nonetheless, RELIEVE-CHF have provided additional data to inform future clinical intervention studies and insights into the challenge of implementing a non-traditional approach in relieving thirst in people with chronic heart failure.

Persistent pain after surgery in breast cancer has a significant impact on the patient’s survival. The value of escalating research on breast cancer in Malaysia cannot be underestimated. However, it is not known how many of these women experience persistent pain after surgery. This study surveyed previously unknown figures on prevalence, and explored the predictive factors of persistent pain women with breast cancer in Malaysia. There were three objectives. First, to assess the reliability of the already established investigative tools, namely, the Brief Pain Inventory, Distress Thermometer, and Resilience scale RS-14; second, to survey the prevalence of persistent pain; and thirdly to identify predictors of persistent pain in women after breast surgery, using the above measures. A test and retest design with no intervention and a recall period of 3 to 7 days was employed for assessment of the investigative tools. A cross-sectional study, with a prospective, correlational design, a retrospective review of medical records was used to identify predictors of persistent pain. These investigations were conducted in two phases –Section A and Section B – using separate data sets, with different inclusion and exclusion criteria. Participants were recruited from the University of Malaya Medical Centre, Malaysia. Descriptive statistics, a stepwise regression model for reliability testing, Cronbach alpha, and factor analysis were used. This study divided pain into categories 0 = no pain, 1–4 = mild pain, 5–6 = moderate pain, and 7–10 = severe pain. Section A: The tools were found reliable. Section B: A total of 123 participants were recruited; 119 participants remained because 4 of them did not meet the inclusion criteria. A total of 43% of the participants had persistent pain (n = 51). Pain interfered with their work, mood, and sleep. Based on a “Yes” answer for pain today (n = 51), data were analysed to determine predictors. The results revealed three predictors: distress, B = –.911, resilience, B = –.444, and pain interference, B = .309. The model was statistically significant, F (3, 41, 44) = 13.827, R2 = 0.267, .381, .467), and adjusted R2 = .250, .351, .467, p = 0.001. Significant P value ≤ .005. Pain prevalence was 43% in this Malaysian population. This study provided empirical evidence which is an important new knowledge to health care systems, health care providers, policy makers, and future research. The impact of persistent pain on work, mood, and sleep are justifiable medical concerns. The results obtained and identified predictors are catalysts for providing extra support for breast cancer women after surgery. Ideally, all women with breast cancer should have very good life satisfaction.

The main aim of the presented diploma thesis was to record objective and subjective changes after therapy with DNS concept in a group of 13 people with LBP. Moiré projection topography was used to record postural changes after 5.5 week therapeutic intervention. It was not clear, whether DNS exercise would help them to achieve visible postural changes and whether this technique is able to record these changes, which would mean that it is a suitable option for objectivisation of therapies focusing on correction of stabilisation and postural functions. Pedoscan was used for further objectivisation of the effect of DNS concept. The chosen correlate of the mentioned objective evaluation was Oswestry disability index, evaluating limitations of common everyday activities resulting from pain in the lower back, and the Numeric pain scale. Patients underwent 5 hour-long physiotherapeutic lessons, the recommended frequency of exercises in the household environment was 3-4 times per day. The probands exercised with the use of DNS concept according to the individual examination findings, especially in the area of the integrated spine stabilisation system. The data were statistically elaborated by Wilcoxon Signed-Rand test, which a non-parametric variant of the pair T-test. It is obvious from the results that...