How an objective measure of pain could counter bias in medicine

By Naomi Elste: Complete Post through this link…

The science of pain is complex and its assessment subjective, leading to bias and health inequality. Now, researchers are searching for a reliable, objective measure of pain.

ow much does it hurt? You might think it’s one of the simplest questions in health and medicine. But in fact, it can be a remarkably difficult question to answer objectively.

Consider a doctor who has two patients who are grimacing and using similar words to describe their pain. Can the doctor be sure they are experiencing similar levels of pain? What if one habitually underestimates their suffering? What if one has been in pain for a long time and grown used to it? And what if the doctor has certain prejudices that mean they are more likely to believe one patient than the other?

Pain is a difficult beast to grapple with, hard to measure and therefore to treat. Pain can be an important distress signal and failing to investigate it could mean a missed opportunity to save a life – or it may be something much more minor. 

For such a universal experience, pain remains much of a mystery – especially the task of determining how much pain someone is in. “We understand it so poorly,” says Emma Pierson, a computer scientist at Stanford University researching pain. “In particular, the fact that human doctors are frequently left flummoxed by why a patient is in pain suggests that our current medical understanding of pain is quite bad.”

The gold standard for pain analysis currently relies on patients self-reporting how they feel, relying, in different places, on either a numerical scale (0 as no pain, 10 as worst pain), or a system of smiley faces.

(T)here is the problem about whether the patient’s rating is believed. One study found a widespread notion that people tend to exaggerate the level of pain they are in, despite little evidence to suggest such exaggeration is common.

You May Need That Procedure. But Do You Really Need an Escort?

By Paula Span: Complete Post through this link…

ngd-I consider this straight up disability discrimination and refusal to accommodate…

Robert Lewinger is tired of being berated by his gastroenterologist because he’s overdue for a colonoscopy. He’s perfectly willing to have one. And he’s more than ready for cataract surgery on his second eye.

The problem: Mr. Lewinger, 72, a retired lawyer who lives in Manhattan, can’t schedule either of these procedures, which involve anesthesia or sedation, unless he supplies the name and phone number of the person taking him home afterward. Otherwise, clinics and outpatient surgical centers refuse to make appointments.

Mr. Lewinger is also willing to undergo Mohs surgery, as his dermatologist has recommended, for two small skin cancers on his face. But the surgeons associated with her practice also insist on medical escorts, even though most Mohs surgery is performed under local anesthesia and doesn’t require them.

Transportation itself isn’t the difficulty; Mr. Lewinger could summon an Uber or a Lyft, call a car service or hail a cab. What he needs is “someone to escort me out of the building, take me back to my apartment and see me into it,” he explained. “It shouldn’t be so hard.”

It is, though. Mr. Lewinger is divorced and lives alone, like a growing number of older Americans.

Find your next DnD setting with this fanmade search engine

By Mollie Russell: Complete Post through this link…

ngd-DnD is one of the easier games to allow effective accommodation…

An online database allows you to search through nearly 300 third-party DnD settings so you can find the perfect place to start your next D&D 5e campaign.

A DnD fan from San Francisco has created a search engine that can help you pick your next campaign setting. The creator, who goes by ‘Lalato’, uses a website of the same name to recommend third-party DnD books with a variety of themes. As of writing, the website recommends 296 DnD settings, each labelled with categories and keywords to help you refine your search.

There’s a wide range of fantasy, sci-fi, urban, and apocalyptic settings to choose from. Plenty of the supplements also tread less beaten paths. Want to hunt cryptids, become an animal, or play a role in the Christian Bible? Lalato can recommend D&D books for each of these.

The website also signposts plenty of 5e books that adapt existing IPs. Steamforged’s Dark Souls: The Roleplaying Game and Cubicle 7’s Doctors & Daleks can be found on the database, as can Free League Publishing’s upcoming Lord of the Rings RPG. You can also find ‘unofficial’ supplements for media that’s already popular, ranging from Mass Effect to beloved children’s cartoon, the Moomins.

24 People Share What Depersonalization Really Feels Like

By Juliette V.: Complete Post through this link…

ngd-I experienced depersonalization when I was younger and took hallucinogens. The experiences were short (an hour to a couple of days), but I got a taste of what some people experience all or most of the time. ..

Like a number of mental health issues, depersonalization is a symptom that’s often shrouded in mystery. While it’s not a term we may hear all the time, depersonalization is more common than we might realize.

What Is Depersonalization?

Depersonalization is a type of dissociation that causes “a feeling of disconnection from oneself (eg, from one’s own feelings, thoughts, behavior, senses, or body),” according to Marlene Steinberg, M.D. You may feel as if you are observing yourself from outside of your body or feeling like things around you aren’t real. It’s a symptom that affects people who experience conditions ranging from depression to bipolar disorder to schizoid personality disorder or those who have survived trauma. 

Because there is so little information out there about depersonalization, it can be easy for people to fear what they do not know or understand. It’s important to remember people who experience this symptom are in need of understanding and support just like anyone else going through a health-related struggle.

Edward Enninful says Vogue disability issue is ‘one of my proudest moments’

By Annabel Rackham: Complete Post through this link…

British Vogue editor Edward Enninful has said working on May’s issue, which has five disabled cover stars, was “one of the proudest moments of my career”.

Titled Reframing Fashion, the edition focuses on 19 disabled people in total from fashion, sport and the arts.

The magazine’s cover stars include actress Selma Blair, who has multiple sclerosis, and model Ellie Goldstein, who has Down’s syndrome.

Enninful, 51, said he had “learned so much” from producing the issue.

“My tenure here at Vogue has always been about inclusivity and diversity, and people forget how hard it is for the disabled community,” Enninful told the BBC.

He revealed last year in his memoir that he had visual and hearing impairments and a blood disorder, which he said present “challenges” in his role as editor-in-chief at British Vogue.

“It was so important I could relate – I felt real pride that people can actually speak up about disabilities and not have to hide it and how it impacts them.

“I think this is one of the most incredible issues I’ve had the privilege of editing in my tenure.”

Turning Down the Volume of Pain: How to Retrain Your Brain When You Get Sensitized

From Neuroscience news: Complete Post through this link…

Summary: For those with chronic pain, it may be possible to retrain your brain to help manage or reduce your symptoms when you become over-sensitized to other treatment methods.

Source: The Conversation

For every feeling we experience, there is a lot of complex biology going on underneath our skin.

Pain involves our whole body. When faced with possible threats, the feeling of pain develops in a split second and can help us to “detect and protect”. But over time, our nerve cells can become over-sensitized. This means they can react more strongly and easily to something that normally wouldn’t hurt or would hurt less. This is called “sensitization”.

Sensitization can affect anyone, but some people may be more prone to it than others due to possible genetic factors, environmental factors or previous experiences. Sensitization can contribute to chronic pain conditions like fibromyalgia, irritable bowel syndrome, migraine or low back pain.

But it might be possible to retrain our brains to manage or even reduce pain.

Effects of exercise intervention on psychotic symptoms

By Henrique N.P. Oliva,et al.: Complete Post through this link…

Despite the growing evidence supporting the benefits of exercise-based interventions in individuals with psychosis, it remains unclear how these interventions exert an effect, whether general fitness and mood improvements are solely responsible for the observed improvements in psychotic symptoms, or if exercise has specific, independent effects on different types of symptoms.

The present meta-analysis found that exercise is a good option as adjunct therapy to manage psychotic symptoms, having potential to improve positive, negative, and general symptoms. It is important to consider the challenges different settings may encounter for applying exercise treatment once it may face barriers of motivation, engagement, or infrastructure. As a future direction, more studies could further explore the hypothesis related to neurobiological mechanisms.

The gut microbiota contributes to the pathogenesis of anorexia nervosa in humans and mice

By Yong Fan, et al.: Complete Post through this link…

ngd- Not only interesting in itself, but as a potential model for investigaing the microbiome and a variety of humn diseases and conditions…

In conclusion, the present multi-omics study uncovers profound and complex disruptions of the gut microbiota in individuals with AN, with functional implications and altered serum metabolites. These compounds may act via the blood circulation or via gut-microbiota-brain neuronal signalling pathways affecting brain regulation of appetite, emotions and behaviour.

FMT from human AN donors to GF mice under energy-restricted feeding resulted in lower body weight gain and a number of changes in expression of hypothalamic and adipose tissue genes involved in controlling behaviour and energy homoeostasis. The combination of multi-omics and in vivo experiments complement our causal inference analyses to allow the identification of specific bacterial metabolites that potentially mediate human host AN traits.

Our findings lend support to the hypothesis that a severely disrupted intestinal microbiota contributes to some of the stages in the pathogenesis of AN.

#TechTuesday: AT For Gardening

From MATP: Complete Post through this link…

We hope you will join us for our fourth #TechTuesday Training this year.

Session 4 of the training series will be about AT For Gardening. You will learn about various Assistive Technology (AT) products and devices for gardening. We will be highlighting adaptation tips for accessible community gardens.

Tuesday, April 25th, 2023, 12 to 1:00 PMThis training is free.

CART captioning and ASL Interpreting will be provided.Register in advance for access to the live session and the recording for future viewing:
Click Here to Register