Development and usability testing of HEARTPA♀N: protocol for a mixed methods strategy to develop an integrated smartphone and web-based intervention for women with cardiac pain.

Introduction: More women experience cardiac pain related to coronary artery disease and cardiac procedures compared with men. The overall goal of this programme of research is to develop an integrated smartphone and web-based intervention (HEARTPA♀N) to help women recognise and self-manage cardiac pain.

Methods And Analysis: This protocol outlines the mixed methods strategy used for the development of the HEARTPA♀N content/core feature set (phase 2A), usability testing (phase 2B) and evaluation with a pilot randomised controlled trial (RCT) (phase 3).

An Online Cross-Sectional Comparison of Women With Symptoms of Persistent Genital Arousal, Painful Persistent Genital Arousal, and Chronic Vulvar Pain.

Background: Persistent genital arousal disorder (PGAD) is an understudied condition characterized by unwanted physiologic genital arousal in the absence of subjective sexual arousal. Markos and Dinsmore (Int J STD AIDS 2013;24:852-858) theorized that PGAD shares a number of similarities with vulvodynia (unexplained chronic vulvar pain [CVP]), including symptom characteristics and comorbidities.

Aim: To compare medical histories, symptom characteristics, pain characteristics, and daily functioning among women with persistent genital pain (PGA) (n = 42), painful PGA (n = 37), and CVP (n = 42) symptoms.

Symptom Characteristics and Medical History of an Online Sample of Women Who Experience Symptoms of Persistent Genital Arousal.

Persistent genital arousal disorder (PGAD; Leiblum & Nathan, 2001 ) is characterized by distressing symptoms suggestive of genital arousal in the absence of subjective feelings of arousal. Although awareness of PGAD is growing, there continues to be a lack of systematic research on it. This study characterized an online sample of women with symptoms of persistent genital arousal (PGA) in terms of their symptom characteristics, medical comorbidities, symptom triggers, management strategies, and predictors of distress.

Clitorodynia: A Descriptive Study of Clitoral Pain.

Introduction: Clitorodynia is classified as a type of localized vulvodynia. Our knowledge of this problem is limited to case studies and one published report.

Aims: The objective of the present study was to describe quantitatively the clinical characteristics of clitoral pain, to assess interference with sexual function, and to investigate whether clitoral pain is a unitary category.

iCanCope with Pain™: User-centred design of a web- and mobile-based self-management program for youth with chronic pain based on identified health care needs.

Background: While there are emerging web-based self-management programs for children and adolescents with chronic pain, there is currently not an integrated web- and smartphone-based app that specifically addresses the needs of adolescents with chronic pain.

Objectives: To conduct a needs assessment to inform the development of an online chronic pain self-management program for adolescents, called iCanCope with Pain™.

Methods: A purposive sample of adolescents (n=23; 14 to 18 years of age) was recruited from two pediatric chronic pain clinics in Ontario.

Development, implementation and evaluation of a pain management and palliative care educational seminar for medical students.

Background: Despite calls for the development and evaluation of pain education programs during early medical student training, little research has been dedicated to this initiative.

Objectives: To develop a pain management and palliative care seminar for medical students during their surgical clerkship and evaluate its impact on knowledge over time.

Methods: A multidisciplinary team of palliative care and pain experts worked collaboratively and developed the seminar over one year.

Persistent genital arousal in women with pelvic and genital pain.

Objective: Persistent genital arousal disorder (PGAD) has been identified as a condition of often unprovoked genital arousal associated with a significant level of distress. PGAD is not well understood, and no definitive cause has been determined. The aim of this study was to gain a better understanding of the disorder and to seek commonalities between cases of PGAD encountered in a chronic pain management clinic.

Music as a sleep aid in fibromyalgia.

Background: Interventions to improve sleep in fibromyalgia may generalize to improvements in multiple symptom domains. Delta-embedded music, pulsating regularly within the 0.25 Hz to 4 Hz frequency band of brain wave activity, has the potential to induce sleep.

Evaluation of the frequency and the association of sexual pain and chronic headaches.

Background: Sexual pain and chronic headaches are both complex conditions with associated high disability. Little research has examined whether there is a relationship between the 2. The aim of this survey-based study was to explore the frequency of sexual pain in a population of women being treated for chronic headache.

Understanding the information and service needs of young adults with chronic pain: perspectives of young adults and their providers.

Objective: To qualitatively explore the information and service needs of young adults (YAs) with chronic pain to inform the development of a web-based chronic pain self-management program.

Methods: A convenience sample of YAs (n=17; aged 18 to 29 y) with chronic pain was recruited from 2 adult tertiary care multidisciplinary chronic pain clinics in Ontario. Interdisciplinary health care professionals who had worked in chronic pain for at least 1 year were also recruited from these sites.

Intake assessment of problematic use of medications in a chronic noncancer pain clinic.

Background: The present article outlines the process of instituting an assessment of risk of problematic use of medications with new patients in an ambulatory chronic noncancer pain (CNCP) clinic. It is hoped that the authors' experience through this iterative process will fill the gap in the literature by setting an example of an application of the 'universal precautions' approach to chronic pain management.

Objectives: To assess the feasibility and utility of the addition of a new risk assessment process and to provide a snapshot of the risk of problematic use of medications in new patients presenting to a tertiary ambulatory clinic treating CNCP.

Examination of migraine management in emergency departments.

Background: Despite advances in treatment, patients with migraine have been underdiagnosed and undertreated, specifically in emergency departments. In addition, great variability exists with respect to the diagnosis, management and treatment of migraine patients in emergency departments. In particular, migraine-specific treatments, including serotonin receptor agonists, appear to be rarely used.

Gone South: why canadian nurses migrate to the United States.

The movement of Canadian nurses to the United States increased over the past decade and is an ongoing concern of health policy analysts. This study examines why Canadian nurses emigrate to the United States and whether there is interest in returning to work in Canada. A survey of Canadian-educated nurses in North Carolina showed that lack of full-time work opportunities played a key role in emigration.

Outcomes of interventions to improve hospital nursing work environments.

Objective: The impact of interventions designed to improve the nursing work environment on patient and nurse outcomes was examined.

Background: Nursing work environments have been characterized as contributing to patient outcomes as a result of organizational management practices, workforce deployment, work design, and organizational culture.

Methods: This quasi-experimental study involved 16 unit managers, 1,137 patients, and 296 observations from registered nurses over time.

Decision making for nurse staffing: Canadian perspectives.

The effectiveness of methods for determining nurse staffing is unknown. Despite a great deal of interest in Canada, efforts conducted to date indicate that there is a lack of consensus on nurse staffing decision-making processes. This study explored nurse staffing decision-making processes, supports in place for nurses, nursing workload being experienced, and perceptions of nursing care and outcomes in Canada.

Teaching and community hospital work environments.

The Institute of Medicine report suggests that nursing work environments experience threats to patient safety related to organizational management and workforce deployment practices, work design, and organizational culture. Organizational factors contribute to nursing and potentially patient outcomes, yet few studies have examined the differences in practices perceived by nurses employed in different settings. Nurses from 16 medical and surgical units in eight randomly selected acute care hospitals representing teaching and community organizations participated in this project.