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When writing your abstract fildena 150 mg low cost, put your most concise and important sentences on a page order 50mg fildena fast delivery, join them into an abstract and then count the words. Some journals such as Science and Nature that are very well regarded in scientific circles request very short abstracts, which may be as low as 100 words. MEDLINE® accepts only 250 words before it truncates the end of the abstract and cuts off your most important sentences, that is the conclusion and interpretation in the final sentences. Other people can often be more objective and ruthless than you can be with your own writing. A friend of mine says that the first draft is the down draft – you just get it down. Anne Lamott1 Introductions should be short and arresting and tell the reader why you undertook the study. In essence, this section should be brief rather than expansive and the structure should funnel down from a broad perspective to a specific aim as shown in Figure 3. This should lead directly into the second paragraph that summarises what other people have done in this field, what limitations have been encountered with work to date, and what questions still need to be answered. This, in turn, will lead to the last paragraph, which should clearly state what you did and why. This sequence is logical and naturally provides a good format in which to introduce your story. Paragraph 1: What we know Paragraph 2: What we don’t know Paragraph 3: Why we did this study Figure 3. Topic sentences, especially for the first introductory sentence, are a great help. Richard Smith, editor of the BMJ, stresses the importance of trying as hard as you can to hook your readers in the first line. Few readers want to plough through a detailed history of your research area that goes over two or more pages. In the introduction section, you do not need to review all of the literature available, although you do need to find it all and read it in the context of writing the entire paper. In appraising the literature, it is important to discard the scientifically weak studies and only draw evidence from the most rigorous, most relevant, and most valid studies. Ideally, you should have done a thorough literature search before you began the study and have updated it along the way. This will be invaluable in helping you to write a pertinent introduction. You should avoid including a lot of material in the introduction section that would be better addressed in the discussion. You should never be tempted to put “text book” knowledge into your introduction because readers will not want to be told basic information that they already know. For example, the sentence, Asthma is the most common chronic disease of childhood, must be one of the most overused phrases in the last decade. All scientists working in asthma research and most people in the community already know this and don’t want to be told it yet again. Similarly, a phrase that defines the problem such as, Asthma is a condition in which the airways narrow in response to commonly occurring environmental stimuli, is not appropriate, except in a paper about the mechanisms of airway narrowing. It is much better to put your study in the context in which it will be published. For example, an introductory sentence such as, The mould Alternaria occurs ubiquitously in dry regions and is thought to be important in exacerbating symptoms of asthma, defines the background behind this particular research study. In this sentence, the focus of the study and the cause of the 52 Writing your paper exacerbations (Alternaria) rather than the disease itself (asthma) is the topic of the sentence, as it should be. Do not be tempted to begin your introduction by quoting the literature but omitting to say what was found. For example, an introduction that begins with, Previous studies have reviewed injury rates in Australian Army and RAAF recruits undergoing basic training.

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More- over buy 25mg fildena overnight delivery, a discussion of how psychological interventions can be applied with postsurgical and presurgical pain patients is included discount 100 mg fildena with visa. The last section of the volume focuses on current controversies and ethi- cal issues. Craig and Thomas Hadjistavropoulos reviews current controversies, including critical analyses of the definition of pain, frequent unavailability of psychological interventions for chronic pain, the use of self-report as a gold standard in pain assessment, fears about the implementation of certain biomedical interventions and others. The final chapter by Thomas Hadjistavropoulos presents a discussion of ethical standards put forth by organizations of pain researchers and psy- chological associations. The presentation of these standards is supple- mented by a discussion of ethical theory traditions on which such stan- dards are based. The chapter also provides coverage of various ethical concerns that are unique to the field of pain, as well as an overview of con- cerns that are especially relevant to psychologists. We hope that the views presented herein will provide both a better ap- preciation of state-of-the-art developments in the psychology of pain and a greater appreciation of the richness and complexity of the pain experience. Sex-related differences in the effects of morphine and stress on visceral pain. Prevalence of chronic pain in the British population: A telephone survey of 1037 households. Gender differences in pain ratings and pupil reactions to painful pressure stimuli. An application of behavior modification tech- nique to a problem of chronic pain. A theoretical framework for understanding self- report and observational measures of pain: A communications model. Sensitivity to cold pressor pain in dysmenorrheic and non-dysmenorrheic women as a function of menstrual cycle phase. Montreal: Canadian Consortium on Pain Mechanisms, Diagnosis and Management. Abdominal pain and ir- ritable bowel syndrome in adolescents: A community-based study. International Association for the Study of Pain Ad Hoc Subcommittee for Psychology Curricu- lum. The tragedy of dementia: Clinically assessing pain in the confused, non- verbal elderly. Sensory motivational and central controlled determinants of pain: A new conceptual model. An epidemiologic analysis of pain in the elderly: The Iowa 65+ Rural Health Study. Sex differences in the an- tagonism of swim stress-induced analgesia: Effects of gonadectomy and estrogen replace- ment. Gender differences in pain per- ception and patterns of cerebral activation during noxious heat stimulation in humans. Expressing pain: The communication and interpretation of facial pain signals. Some embryological, neurological, psychiatric and psychoanalytic impli- cations of the body scheme. CHAPTER 1 The Gate Control Theory: Reaching for the Brain Ronald Melzack Department of Psychology, McGill University Joel Katz Department of Psychology, Toronto General Hospital Theories of pain, like all scientific theories, evolve as a result of the accumu- lation of new facts as well as leaps of the imagination (Kuhn, 1970). The gate control theory’s most revolutionary contribution to understanding pain was its emphasis on central neural mechanisms (Melzack & Wall, 1965). The the- ory forced the medical and biological sciences to accept the brain as an ac- tive system that filters, selects, and modulates inputs. The dorsal horns, too, were not merely passive transmission stations but sites at which dynamic ac- tivities—inhibition, excitation, and modulation—occurred. The great challenge ahead of us is to understand how the brain functions.

At this stage 25mg fildena for sale, patients are frequently encouraged to monitor and re- 10 buy cheap fildena 100 mg on line. PSYCHOLOGICAL INTERVENTIONS AND CHRONIC PAIN 273 cord their behavior (e. Thereaf- ter, operant treatment is described as involving several ingredients includ- ing: (a) response prevention for escape/avoidance behaviors; (b) positive and negative reinforcement (e. The psychologist, however, may play an important role in monitoring these needs. According to Fordyce (1973), medications are at first provided to pa- tients on a prescribed-as-needed (PRN) basis for 2 to 4 days to establish the medication baseline. Baseline doses are then delivered on a fixed time schedule such that if patients had previously requested medication every 5 hours, medication would be delivered instead every 4 hours. With this method, medication is not contingent on soreness and therefore does not serve as positive reinforcer for pain or pain behavior; gradually over time medication is ultimately withdrawn. The role of the psychologist in time- contingent medication is to assist with monitoring of medication prior to adjustment and then with positive reinforcement and encouragement of ad- herence to the regimen. The operant methods are applied to each overt pain and well behavior across as many different conditions as possible, and when possible the pa- tient and family are encouraged to directly apply operant conditioning methods to behavior change (Sanders, 1996). Unique to operant condition- ing, the operant treatment principles are applied by all health care provid- ers involved in care, not exclusively the psychologist (van Tulder et al. Evidence The earliest evidence in support of operant conditioning for chronic pain came, not surprisingly, from Fordyce and colleagues in the form of a case study (Fordyce, Fowler, Lehmann, & DeLateur, 1968). In their study, pain medications were provided on a time-contingent rather than PRN basis in or- der to decrease the association of pain behavior and relief. Furthermore, nursing staff withheld social reinforcement when patients displayed pain be- 274 HADJISTAVROPOULOS AND WILLIAMS haviors, and provided extensive praise when patients showed well behav- iors. Positive treatment effects were observed following the inpatient pro- gram and at 22-month follow-up, including report of increased activity level and exercise tolerance, and decreased medication usage and pain ratings. Since the time of these earliest observations, several studies have been conducted along with reviews of operant therapy that have generally been encouraging (e. In an effort to improve the practice of psychotherapy, a number of task forces have reviewed the research literature and identified empirically sup- ported treatments. Chambless and Ollendick (2001) summarized the work of these task forces and reported that operant behavior therapy for hetero- geneous chronic pain patients has category II support, meaning that there is at least one RCT supporting the treatment, showing it as superior to a control condition or an alternative treatment. Our review of this area of research generally reveals that there are few research studies that address operant conditioning directly, and those that are carried out do not often follow the prototypical approach advocated by Fordyce (1976). Although there are a number of studies that address cogni- tive-behavioral treatment, or behavioral treatment that also includes relax- ation training, randomized control studies focused exclusively on operant conditioning are rare. Furthermore, because the operant approach involves numerous components it is difficult to clarify the extent to which psycho- logical intervention is crucial versus other components such as occupa- tional therapy and physiotherapy (Turk & Flor, 1984). Commentary The lack of studies addressing operant conditioning alone is perhaps a re- flection of our own direct experiences that, in practice, in clinical settings the prototypical operant approach is rarely used. Although this observa- tion is not made explicitly in the literature, systematic attempts at assess- ment of well behaviors and illness behaviors as well as contingencies be- tween overt pain behaviors and positive and negative reinforcers are infrequent in practice. Instead, clinicians routinely assume that certain pain behaviors are positive (e. Furthermore, it is often assumed that certain contingencies are always negative (e. Evidence is emerging that even some of the appar- ently simple relationships that were previously observed between pain be- havior and spouse solicitous behavior and facilitative behavior (Romano et al. Romano and colleagues (1995) reported, for instance, that spouse so- 10. PSYCHOLOGICAL INTERVENTIONS AND CHRONIC PAIN 275 licitous responses are predictive of pain behavior only among patients with high levels of pain and low mood. With respect to treatment protocol, in practice, we also expect that ethi- cal considerations largely prevent extensive use of response prevention for escape/avoidance behaviors. It is a mistaken belief that operant conditioning methods can be used to modify the behavior of the most resistant patients without their co- operation (Keefe & Bradley, 1984).

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