Sex Differences in Pain and Pain‐Related Disability among Primary Care Patients with Chronic Musculoskeletal Pain
ABSTRACT Background. Although previous research suggests women report more severe pain than men, evidence for sex-related differences in pain-related disability is conflicting. Also, the impact of psychological factors on sex differences in disability is uncertain.Objective. The purpose of this study is to assess sex differences in pain-related disability and evaluate whether they are accounted for by psychological factors.Methods. Analysis of baseline data from the Stepped Care for Affective disorders and Musculoskeletal Pain study. Participants included 241 male and 249 female primary care patients with moderately severe persistent pain of the back, hip, or knee. Multivariable log-linear models were used to determine the association between sex and pain-related disability and whether sex differences persisted after adjustment for psychiatric comorbidity and potential psychological mediators.Results. Compared with men, women reported worse pain intensity, greater pain-related interference with function, and more disability days due to pain. They also had worse depression, anxiety, and self-efficacy. Sex differences in pain interference with function and pain disability days remained significant in multivariable models. Depression, poor self-efficacy, and fear of reinjury were independently associated with disability in both men and women.Conclusions. Women report greater pain-related disability than do men, even after controlling for depression, anxiety, and other psychological factors. Pain management strategies that target functional disability may be particularly important in the treatment of women with pain.
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ABSTRACT: This paper reports an assessment of the recently released subchannel code ASSERT-PV 3.2 for the prediction of flow-distribution in fuel bundles, including subchannel void fraction, quality and mass fluxes. Experimental data from open literature and from in-house tests are used to assess the flow-distribution models in ASSERT-PV 3.2. The prediction statistics using the recommended model set of ASSERT-PV 3.2 are compared to those from previous code versions. Separate-effects sensitivity studies are performed to quantify the contribution of each flow-distribution model change or enhancement to the improvement in flow-distribution prediction. The assessment demonstrates significant improvement in the prediction of flow-distribution in horizontal fuel channels containing CANDU bundles.Nuclear Engineering and Design 08/2014; 275:122-132. · 0.97 Impact Factor
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ABSTRACT: Chronic pain is common in HIV-infected individuals. Understanding HIV-infected patients' chronic pain experience not just from a biological, but also from a psychological perspective, is a critical first step toward improving care for this population. Our objective was to explore HIV-infected patients' perspectives on psychological aspects of chronic pain using in-depth qualitative interviews.PLoS ONE 11/2014; 9(11):e111765. · 3.53 Impact Factor
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ABSTRACT: To examine whether men and women with fibromyalgia syndrome (FMS) differ with respect to pain severity and functioning, pain-related beliefs, or pain-related coping. We hypothesized no significant sex differences in measures of pain and functioning, but that we would observe differences between men and women in how they view and how they cope with FMS-related pain.Clinical Journal of Pain 10/2014; · 2.70 Impact Factor