6 responses for dq1 and 2 topic4 @ 80 words


1 ) G.S   Re: Topic 4 DQ 1
Good morning Ms. Floren and Class,
  Low back pain induced by fasciitis and facets mostly in a world wide grouping problem affecting the quality of life of 30% of the population, with 85% cases categorized as nonspecific low back pain(Hu,2021).With 8% cases developed into chronic nonspecific low back pain(CNSLBP),this can last for 3 months, and could lead to life inconvenience and psychological problems,such as pain-related disability,poor sleep, depression,and anxiety.
With Ken issue the  alternative way to  cure his low back pain is the Acupuncture, as traditional Chinese treatment can help Ken for his lower back pain. Silver needle therapy is similar to traditional acupuncture, but has some difference, Silver needle is placed in muscles,tendons and fascia instead of at acupoints, and the needle is heated using a special machine to eliminate aseptic inflammation to relieve pain(Hu,2021).With Silver needle therapy it decrease the pain mainly through 3 mechanisms that can  help  lower back pain such as the elimination of sterile inflammation, improvement of blood circulation, and relief of muscle spasms(Hu,2021)
Hu, X., Dong, S., Zhang, B., Wang, X., Yin, Y., Liu, C., Yu, J., Wu, X., Xu, F., & Meng, C. (2021). Efficacy of silver needle therapy for the treatment of chronic nonspecific low back pain: a prospective, single-center, randomized, parallel-controlled clinical trial. Trials, 22(1). https://doi-org.lopes.idm.oclc.org/10.1186/s13063-021-05040-y

2) J.M    Re: Topic 4 DQ 1
I completely understand Ken’s doctor’s reluctance in prescribing pain relievers because they are highly addictive and do not aid in long-term pain management. With a proper program set up, Ken can manage to live a more comfortable life. Some of the alternative approaches include yoga, acupuncture, massages, hypnotherapy, and herbal medicine. Studies have shown that patients with neck pain that consistently see a Chiropractor are more than twice as likely to be pain-free than those who just took pain medication. One of the non-surgical options could be computerized spinal decompression systems, which stretches the spine to relieve pressure where the source of pain is and allows for natural healing. Massage therapy could supplement spinal decompression with managing pain. This could also help Ken become more active which also aids in alleviating pain. Treating pain stems from knowing the underlying issue. Stress inoculation therapy is another option and it uses a blend of cognitive and behavioral-based elements and emphasizes helping patients with stressful situations. It incorporates helping patients cope with pain by changing the way patients think about pain and helps them focus on more positive aspects of life which can change the way the body responds to pain.
Login. (n.d.). https://digital-films-com.lopes.idm.oclc.org/p_ViewVideo.aspx?xtid=168093.
Vallis, T.M. A complete component analysis of Stress Inoculation for pain tolerance. Cogn Ther Res 8, 313–329 (1984). https://doi.org/10.1007/BF01173001

3) T.A   Re: Topic 4 DQ 1
There are several complementary/alternative medicines (CAM) Ken could use to seek relief with his lower-back problems. First, we will look at some alternative medicine options. Using this option means he will choose to not ingest traditional prescribed medication by his physician. He will stop taking the opioids, and seek alternative measures. Some of these measures could include: acupuncture, electromyography biofeedback, low-level laser therapy, mindfulness-based stress reduction, progressive muscle relaxation, spinal manipulation, tai chi, and yoga. Among the above choices, Ken should be educated that each of these options will require multiple appointments or classes, and he should not expect to see differences in the first visit. Many of these treatments take several weeks and even months to see a change in the pain level. Many alternative treatments such as acupuncture, low-level laser therapy, electromyography biofeedback each have a low-quality of evidence being successful (nccam.nih.gov). Since many alternative methods used in medicine require so many visits, it is not uncommon to see a large percentage of patience  be non-adherence to their program. In an observational study performed in UK, which included 324 participants, only 51% of them maintained 100% of their scheduled appointments (Bishop et al., 2017). Perhaps this is one reason why alternative medicines are perceived to be low-quality in evidence. According to the National Center for Complementary and Integrative Health’s website (www.nccih.nih.gov), areas of higher-quality evidence shown consist of spinal manipulation, yoga, tai chi, massage therapy, and dry needling.
As for seeking complementary medicine, Ken would be looking for a combined treatment consisting of the traditional prescription medication he is prescribed ( opioids) in addition to a non-traditional method of relieving his lower-back pain. Each of the above treatments could work as a complementary method for Ken. I would imagine the doctor would eventually like to see Ken weaned off the opioids and eventually be pain free and rely on only alternative medicine in the future to reduce the addiction to the opioids. 
Have a great day!
Bishop, F. L., Yardley, L., Cooper, C., Little, P., & Lewith, G. (2017). Predicting adherence to acupuncture appointments for low back pain: a prospective observational study. BMC Complementary and Alternative Medicine, 17(1), 5. https://doi-org.lopes.idm.oclc.org/10.1186/s12906-016-1499-9 
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DQ 2
4) G.S   Re: Topic 4 DQ 2
 Good morning Ms. Floren and Class,
  Psychophysiology is the study of mental or emotional process as reflected by changes they produce in physiological activity(LYKKEN,2004).One Psychophysiological measure uses for assessing pain is called electromyography(EMG),to measure the electrical activity in muscles, which reflect their tension. The advantages of Psycho physiological measure it provide objective assessment of bodily changes the occur in responses to pain,however, the disadvantages is the it can also affected by others, such as attention,diet, and stress(Chapman et al.,1985).
In Behavioral assessment a person is likely to show different types and patterns of behavior if the pain is intense as compared to moderate, there are two assessment that psychologist developed for assessing pain behavior. Everyday activities and structured clinical session.The advantages is identifying what kind of behavioral patients has with using the two assessment (Sarafino,& Smith,2017). The disadvantages however, is that same patients might push themselves to do the activity in a painful way that might hurt them.
Self-report is to  measure peoples pain by asking them to describe the discomfort either in their own words or filling out a questionnaire .The advantages of self-report is easy to uses, and it can be a motivation to have a note to self so that when seeking health care,they will know what is the issue on their health .The disadvantages is that some patients can lie about their  medical history and it might that be accurate information(Sarafino,& Smith,2017). An example with this  that I might say the pain that I’m having on my right foot in scale of 10, will be  more 10, or I can say that I do not know how I feel .
            Sarafino, E., & Smith, T. (2017). Health psychology: Biopsychosocial interactions (9th ed.). Hoboken, NJ: Wiley.                ISBN-13: 9781119299486 http://www.gcumedia.com/digital-resources/wiley-and-sons/2016/health-                                   psychology_biopsychosocial-interactions_9e.php

5) T.A     2 postsRe: Topic 4 DQ 2
The advantages of the physiological measures are the data that derives from the testing. Methods used under physiological measures includes the use of electromyograph (EMG), autonomic activity, and electroencephalographs (EEG) (Sarafino & Smith, 2017). The disadvantage of the EMG is that it takes multiple readings to have reliable date. That can be costly to the patient, as well time consuming. The autonomic activity is not always reliable when it comes to detecting levels of pain because it utilizes a person’s heart rate and skin conductance to graph the person’s pain intensity. Since stress can also cause a person’s heart rate and skin conductance to change, it can be inconclusive on rating pain. EEG’s can also be useful because it too has data the doctor can read and compare. However, the disadvantage to this method is the patient can influence the data if they have taken any type of pain medication to reduce the feeling of pain. Other factors which make the physiological measures less appealing is the person’s diet, their stress and attention collaborated (Sarafino& Smith, 2017).
Behavioral assessments can be beneficial in the sense it provides the patients with options on how the data is collected. One option is in a structured clinical session, such as a hospital or clinic. The other option is in an everyday activity setting. This option requires the assistance of another person who can be easily trained to understand the data that needs to be collected. An example of this person would be a spouse, or caretaker (Sarafino & Smith, 2017). The person collecting the data in the structured clinical session would be the nurse who sees the patients during the morning rounds. The nurse would take into the account how much pain medication the patient used throughout the night to manage their pain. Then, the nurse might ask the patient if they can stand out of the bed, or if they can walk to the restroom by themselves. The nurse would then use the pain behavioral scale to evaluate the level of pain. When the patients opts to be evaluated in the everyday activity setting, the caretaker or spouse is responsible to watching the patient, looking for any signs or distress, and documenting it in a journal. For example, a person who is having chronic migraines. The caretaker would write down things such as the time it began, the intensity of pain (1-10), what they ate prior to the onset. The goal would be to find the triggers of the migraines while allowing the patient to remain in their home or familiar surroundings. This particular type of assessment can be beneficial too, because it can work for any age group. A child does not have to know how to talk sentences to show a parent they have a tummy ache or an ear infection. They can display the pain by tugging at their ear or holding their stomach. This is also helpful, because unlike the physiological measures, you can visually see where the pain is coming from by the patient.
The self-report utilizes questionnaires and pictures to help assess the pain and the level. One of the benefits is being able to utilize this cross culturally and amongst a variety of ages. While an adult can read and write to answer, a child can be read to, and say in their own words how it hurts, where it hurts, or how bad it hurts. Self-reports can be given by analog scale, box scale, or verbal ratings (Sarafino, & Smith, 2017). One of the disadvantages to self-assessment is you are relying on the patient to describe their pain not only accordingly to the specific words allotted on the questionnaire, but also truthfully.
Sarafino, E., & Smith, T. (2017). Health psychology: Biopsychosocial interactions (9th ed.). Hoboken, NJ: Wiley. ISBN-13: 9781119299486 http://www.gcumedia.com/digital-resources/wiley-and-sons/2016/health-psychology_biopsychosocial-interactions_9e.php

6)  T.A       Re: Topic 4 DQ 2
I think a fault of the self-report is the fact that people do not share the same level of pain. Perhaps they have the ability to endure higher tensity of pain than the average person. For example, I have taken a kick to the head by a horse, a hoof went through my abdomen, flipped over on in the starting gates, kicked in the knee sideways (crushing my ligaments and bones), and trampled on in different instances. A few years back, I was in the starting gates when the horse I was on flipped backwards, I was caught under him and we were pinned for about five minutes. Thankfully I believe in helmets and vest! Anyway, I was of course sore, but I took it as I was just going to be bruised a bit. I finished the day and the next day as well. By the third day, I was having difficulty breathing. I decided to go to a walk-in clinic for convenient care. At check in, they asked me why I was being seen. I told them shortness of breath. When the triage nurse came in to see me, I had a choice to make. I could have told her I was just having shortness of breath and she may have concluded it was allergies and sent me home with a prescription. When she asked me if I was in any pain, I said a little. she said, “Out of 10?” I said, “a 3.” When she listened to my breathing, she said she heard a little raspy noise. I decided to tell her what happened. I was hesitant, because I did not want to miss any races, or training. Turned out I had broken ribs, and one rib was poking my lung. I was in bad shape. But my pain was only a 3. A point I am making is, we have to rely on our patients to be honest and whole with us. We need the entire picture to help our patients to best of our ability. 
Have a great day!


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