Patients' perceptions of a chronic pain rehabilitation program: changing the conversation.

Objective Research supports the effectiveness of comprehensive approaches to chronic pain treatment, including behavioral management and physical reconditioning. However, less is known about patients' perceptions of this treatment approach. The current study evaluated patient perceptions and treatment outcomes utilizing both qualitative and quantitative data collection. Methods A total of 498 adult patients (≥18 years of age; Mage = 49.1) completed an intensive outpatient interdisciplinary chronic pain rehabilitation program, completed survey measures at admission and discharge, and were asked open-ended questions about their treatment experience at discharge. Results Patients reported significant decreases in pain severity, t(488) = 23.08, p < .001, and pain-related interference, t(488) = 24.28, p < .001, at discharge. Patients endorsed self-management strategies, particularly relaxation skills (85%), moderation and/or modification (47%), and exercise, stretching and/or physical therapy (39%) as the most important aspects of treatment. Conclusions Patients perceive behavioral skills to manage pain and physical reconditioning to be important components of a successful pain rehabilitation program. These findings can inform conversations with both physicians and patients about the importance of biopsychosocial approaches to pain management. Key limitations include a lack of racial/ethnic diversity, use of anonymous data that cannot be linked directly to patient outcomes, and reliance on self-report data.

Thermal evolution of the submonolayer near-surface alloy of ZnPd on Pd(111).

We have performed a high-resolution synchrotron radiation photoelectron spectroscopy study of the initial growth stages of the ZnPd near-surface alloy on Pd(111), complemented by scanning tunnelling microscopy data. We show that the chemical environment for surfaces containing less than half of one monolayer of Zn is chemically distinct from subsequent layers. Surfaces where the deposition is performed at room temperature contain ZnPd islands surrounded by a substrate with dilute Zn substitutions. Annealing these surfaces drives the Zn towards the substrate top-layer, and favours the completion of the first 1 : 1 monolayer before the onset of growth in the next layer.

Surface structure of Pd(111) with less than half a monolayer of Zn.

We have characterized the structural properties of submonolayer amounts of Zn on Pd(111) using scanning tunneling microscopy (STM) and spot-profile analysis low energy electron diffraction (SPA-LEED). Following room temperature deposition of ≈0.06 monolayers (ML) Zn onto Pd(111), we observe the substitution of Zn for Pd in the surface layer. At ≈0.20 ML of deposited Zn, STM reveals a locally ordered phase with a (2/√3 × 2/√3)R30° unit cell located near Zn substitutions; SPA-LEED patterns reveal the same periodicity. We attribute this phase to the metastable bonding of atoms or clusters predominantly in hollow sites surrounding Zn substitutions in the surface layer. At ≈0.4 ML, STM images reveal local (√3 × âˆš3)R30° and (2 × 1) ordering on surfaces annealed to 350 K. At coverages near 0.5 ML, both STM and SPA-LEED show the onset of the formation of the (2 × 1) ordering associated with the Zn : Pd 1 : 1 alloy phase. At all coverages, the surface is dominated by island growth; the islands' size and density is shown to depend critically on annealing at temperatures as low as 350 K. These results provide insight into the structural features of a Zn/Pd(111) coverage regime that has been much debated in recent years.

Ab initio simulation of carbon clustering on an Ni(111) surface: a model of the poisoning of nickel-based catalysts.

In this work, we studied the poisoning of a nickel surface due to carbon. Performing ab initio simulations, within the framework of density functional theory, we computed the surface energy of the nickel (111) surface as a function of carbon coverage. On the basis of these results, we can assert that the stable state of the nickel/carbon surface is either a clean nickel surface or a fully carbon-covered nickel surface, which has a graphitic configuration. The relative stability of the two states depends on the temperature and partial pressure of the carbon gas. At fixed nominal carbon coverage, the most stable configurations are those forming carbon clusters. However, the nickel sites hosting these clusters change from hexagonal close packed/face centered cubic (hcp/fcc) sites to on-top sites when going toward larger clusters. This indicates that poisoning due to graphitic patches occurs on on-top sites.

Structural and kinetic effects on a simple catalytic reaction: oxygen reduction on Ni(110).

Oxygen hydrogenation at 100 K by gas phase atomic hydrogen on Ni(110) has been studied under ultrahigh vacuum conditions by temperature programmed desorption (TPD) and x-ray photoelectron spectroscopy (XPS). Formation of adsorbed water and hydroxyl species was observed and characterized. The coverage of the reaction products was monitored as a function of both temperature and initial oxygen precoverage. On the contrary, when high coverage oxygen overlayers were exposed to gas phase molecular hydrogen, no hydrogenation reaction took place. The results are compared to the inverse process, exposing the hydrogen covered surface to molecular oxygen. In this case, at 100 K, simple Langmuir-Hinshelwood modeling yields an initial sticking coefficient for oxygen adsorption equal to 0.26, considerably lower than for the clean surface. Moreover, formation of hydroxyl groups is found to be twice as fast as the final hydrogenation of OH groups to water. Assuming a preexponential factor of 10(13) s(-1), an activation barrier of 6.7 kcal/mol is obtained for OH formation, thus confirming the high hydrogenating activity of nickel with respect to other transition metals, for which higher activation energies are reported. However, oxygen is hardly removed by hydrogen on nickel: this is explained on the basis of the strong Ni-O chemical bond. The hydrogen residual coverage is well described including a contribution from the adsorption-induced H desorption process which takes place during the oxygen uptake and which is clearly visible from the TPD data.

Two-step reaction on a strained, nanoscale segmented surface.

By means of scanning tunneling microscopy and density functional theory calculations we demonstrate that on the Rh(110)-(10 x 2)-O surface, a prototypical multiphase surface of an oxidized transition metal model catalyst, water formation upon H2 exposure is a two-step reaction, with each step requiring special active sites. The 1st step initiates at (2 x 1)p2mg-O defect islands in the (10 x 2) structure and propagates across the surface as a reaction front, removing half of the adsorbed oxygen. The oxygen decorated Rh ridges of the (10 x 2) structure lose their tensile strain upon this reduction step, whereby nanoscale patches of clean Rh become exposed and act as special reaction sites in the 2nd reaction step, which therefore initiates homogeneously over the entire surface.

Spectroscopic link between adsorption site occupation and local surface chemical reactivity.

In this Letter we show that sequences of adsorbate-induced shifts of surface core level (SCL) x-ray photoelectron spectra contain profound information on surface changes of electronic structure and reactivity. Energy shifts and intensity changes of time-lapsed spectral components follow simple rules, from which adsorption sites are directly determined. Theoretical calculations rationalize the results for transition metal surfaces in terms of the energy shift of the d-band center of mass and this proves that adsorbate-induced SCL shifts provide a spectroscopic measure of local surface reactivity.

Atomic hydrogen interaction with Ru(1010).

The interaction of atomic hydrogen with clean and deuterium precovered Ru(1010) was studied by means of temperature-programmed desorption (TPD) spectroscopy. Compared to molecular hydrogen experiments, after exposure of the clean surface to gas-phase atomic hydrogen at 90 K, two additional peaks grow in the desorption spectra at 115 and 150 K. The surface saturation coverage, determined by equilibrium between abstraction and adsorption reactions, is 2.5 monolayers. Preadsorbed deuterium abstraction experiments with gas-phase atomic hydrogen show that a pure Eley-Rideal mechanism is not involved in the process, while a hot atom (HA) kinetics describes well the reaction. By least-squares fitting of the experimental data, a simplified HA kinetic model yields an abstraction cross section value of 0.5 +/- 0.2 angstroms2. The atomic hydrogen interaction with an oxygen precovered surface was also studied by means of both TPD and x-ray photoelectron spectroscopy: oxygen hydrogenation and water production take place already at very low temperature (90 K).

Distinct reaction mechanisms in the catalytic oxidation of carbon monoxide on Rh(110): scanning tunneling microscopy and density functional theory studies.

By means of scanning tunneling microscopy measurements and density functional theory calculations, we identify the reaction mechanism for the oxidation of carbon monoxide to carbon dioxide on the Rh(110) surface at 160 K, which appears to be completely different than the one active at room temperature. The reasons for these different behaviors are determined. Our results demonstrate that even for a very simple catalytic reaction, the microscopic mechanism can dramatically change with temperature, following pathways that differ for nucleation sites and surface propagation and involve different surface moieties.