HEALTH AND SOCIAL 2007 <414>
Database EMBASE
Accession Number 2008203674
Authors Liu W. Luo A. Liu H.
Institution
(Liu, Luo, Liu) Department of Anesthesia, Peking Union Medical College Hospital, Beijing, China.
Country of Publication
United Kingdom
Title
Overcoming the barriers in pain control: an update of pain management in China.
Source
European Journal of Pain Supplements. 1(1)(pp 10-13), 2007. Date of Publication: September 2007.
Publisher
W.B. Saunders Ltd
Abstract
China is a country with a long history of treating pain as a disease entity. However, the current status of pain relief is not optimal. Major barriers to pain management include historical reasons, differences between Chinese philosophy and Western countries, government policies of pain relief and drug availability, patients' fear of addiction and side effects, and professionals' lack of knowledge on pain control. Following the release of the 3-step analgesic ladder guideline for cancer pain relief in 1991, the government has made many approaches to encourage the treatment of cancer pain including adjustment of the national narcotics control policy, approval of new opioid analgesics for sale and distribution, increase of opioids manufacturing volumes, and streamlined procedures for hospitals to obtain sufficient opioids. At the same time, the government has made a lot of efforts in education and training medical professionals on pain control. In 2005, a clinical practice guideline for the management of chronic non-cancer pain was published. Utilization of potent opioids in non-malignant pain patients is described in detail. In addition, invasive interventions have also been introduced in chronic pain control. Although great improvements have been made during the past few years, three main aspects of improving pain control in China still remain to be undertaken, including (1) consistent training and education for health care workers to minimize the variation between cities and rural areas; (2) government support and development of an insurance system to minimize the economic burden of pain patients; (3) development new analgesic drugs with less side effects and new mechanisms of action. copyright 2007 European Federation of Chapters of the International Association for the Study of Pain.
ISSN 1754-3207
Publication Type Journal: Article
Journal Name European Journal of Pain Supplements
Volume 1
Issue Part 1
Page 10-13
Year of Publication 2007
Date of Publication September 2007
HEALTH AND SOCIAL 2007 <548>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 17892544
Status PubMed-not-MEDLINE
Authors Reece AS.
Authors Full Name Reece, Albert Stuart.
Institution
Southcity Family Medical Centre, 39 Gladstone Rd., Highgate Hill, Brisbane, Queensland, 4101, Australia.
Title
Evidence of accelerated ageing in clinical drug addiction from immune, hepatic and metabolic biomarkers.
Source
Immunity & Ageing [Electronic Resource]: I & A. 4:6, 2007.
Journal Name
Immunity & Ageing [Electronic Resource]: I & A
Other ID
Source: NLM. PMC2041948
Country of Publication
England
Abstract
BACKGROUND: Drug addiction is associated with significant disease and death, but its impact on the ageing process has not been considered. The recent demonstration that many of the items available in routine clinical pathology have applicability as biomarkers of the ageing process implies that routine clinical laboratory parameters would be useful as an initial investigation of this possibility. METHODS: 12,093 clinical laboratory results 1995-2006 were reviewed. To make the age ranges of the medical and addicted groups comparable the age range was restricted to 15-45 years. RESULTS: 739 drug addicted (DA) and 5834 general medical (GM) age matched blood samples were compared. Significant elevation of immune parameters was noted in the C-reactive protein, erythrocyte sedimentation rate, total lymphocyte count, serum globulins and the globulin:albumin ratio (P < 0.01). Alanine aminotranferase, creatinine, urea, and insulin like growth factor-1 were also significantly higher (P < 0.01) in the DA group. Albumin, body mass index and dihydroepiandrosterone sulphate were unchanged and cholesterol was lower (all P < 0.05). CONCLUSION: These data demonstrate for the first time that addiction is associated with an altered profile of common biomarkers of ageing raising the possibility that the ageing process may be altered in this group. Infective and immune processes may be centrally involved. They suggest that addiction forms an interesting model to further examine the contribution of immune suppression and hyperstimulation to the ageing process.
Publication Type Journal Article.
Date of Publication 2007
Year of Publication 2007
Volume 4
Page 6
HEALTH AND SOCIAL 2007 <616>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 17391529
Status PubMed-not-MEDLINE
Authors Fielden SJ. Marsh DC.
Authors Full Name Fielden, Sarah J. Marsh, David C.
Title
It's time for Canadian community early warning systems for illicit drug overdoses.
Source
Harm Reduction Journal. 4:10, 2007.
Journal Name
Harm Reduction Journal
Other ID
Source: NLM. PMC1851954
Country of Publication
England
Abstract
Although fatal and non-fatal overdoses represent a significant source of morbidity and mortality, current systems of surveillance and communication in Canada provide inadequate measurement of drug trends and lack a timely response to drug-related hazards. In order for an effective early warning system for illicit drug overdoses to become a reality, a number of elements will be required: real-time epidemiologic surveillance systems for illicit drug trends and overdoses, inter-agency networks for gathering data and disseminating alerts, and mechanisms for effectively and respectfully engaging with members of drug using communities. An overdose warning system in an urban area like Vancouver would ideally be imbedded within a system that monitors drug trends and overdoses by incorporating qualitative and quantitative information obtained from multiple sources. Valuable information may be collected and disseminated through community organizations and services associated with public health, emergency health services, law enforcement, medical laboratories, emergency departments, community-based organizations, research institutions and people with addiction themselves. The present paper outlines considerations and conceptual elements required to guide implementation of such systems in Canadian cities such as Vancouver.
Publication Type Editorial.
Date of Publication 2007
Year of Publication 2007
Volume 4
Page 10
HEALTH AND SOCIAL 2007 <617>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 17291354
Status PubMed-not-MEDLINE
Authors Altaf A. Shah SA. Zaidi NA. Memon A. Nadeem-ur-Rehman. Wray N.
Authors Full Name Altaf, Arshad. Shah, Sharaf Ali. Zaidi, Najam A. Memon, Ashraf. Nadeem-ur-Rehman. Wray, Norman.
Institution
Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Title
High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan.
Source
Harm Reduction Journal. 4:7, 2007.
Journal Name
Harm Reduction Journal
Other ID
Source: NLM. PMC1800841
Country of Publication
England
Abstract
BACKGROUND: Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004-5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004-5 also indicate 104/395 (26.3%) IDUs HIV positive in the city. METHODS: We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October-November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA) method. Syphilis tests (RPR & TPHA) were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. RESULTS: Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5%) IDUs. Over half 94 (58.3%) reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%). 1 of 161 was HIV positive (0.6%). The prevalence of hepatitis B was 12 (7.5%), hepatitis C 151 (94.3%) and syphilis 21 (13.1%). IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom. CONCLUSION: Prudent measures such as access to sterile syringes, rehabilitation and opiate substitution therapies are required to reduce high risk behaviors of IDUs in Pakistan.
Publication Type Journal Article.
Date of Publication 2007
Year of Publication 2007
Volume 4
Page 7
HEALTH AND SOCIAL 2007 <813>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 17889978
Status MEDLINE
Authors Caprioli D. Celentano M. Paolone G. Badiani A.
Authors Full Name Caprioli, Daniele. Celentano, Michele. Paolone, Giovanna. Badiani, Aldo.
Institution
Department of Human Physiology and Pharmacology, University of Rome Sapienza, Rome, Italy.
Title
Modeling the role of environment in addiction. [Review] [270 refs]
Source
Progress in Neuro-Psychopharmacology & Biological Psychiatry. 31(8):1639-53, 2007 Nov 15.
Journal Name
Progress in Neuro-Psychopharmacology & Biological Psychiatry
Country of Publication
England
Abstract
The aim of this review is to provide an overview of the main types of animal models used to investigate the modulatory role of environment on drug addiction. The environment can alter the responsiveness to addictive drugs in at least three major ways. First, adverse life experiences can make an individual more vulnerable to develop drug addiction or to relapse into drug seeking. Second, neutral environmental cues can acquire, through Pavlovian conditioning, the ability to trigger drug seeking even after long periods of abstinence. Third, the environment immediately surrounding drug taking can alter the behavioral, subjective, and rewarding effects of a given drug, thus influencing the propensity to use the same drug again. We have focused in particular on the results obtained using an animal model we have developed to study the latter type of drug-environment interaction. [References: 270]
ISSN Print 0278-5846
Publication Type Journal Article. Review.
Date of Publication 2007 Nov 15
Year of Publication 2007
Issue/Part 8
Volume 31
Page 1639-53
HEALTH AND SOCIAL (PAIN ISSUES) 2007 <816>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 17969825
Status MEDLINE
Authors Kirsh KL. Jass C. Bennett DS. Hagen JE. Passik SD.
Authors Full Name Kirsh, Kenneth L. Jass, Carolyn. Bennett, Daniel S. Hagen, James E. Passik, Steven D.
Institution
Pharmacy Practice and Science, University of Kentucky, Lexington, Kentucky 40536-0082, USA.
Title
Initial development of a survey tool to detect issues of chemical coping in chronic pain patients. [Review] [38 refs]
Source
Palliative & Supportive Care. 5(3):219-26, 2007 Sep.
Journal Name
Palliative & Supportive Care
Country of Publication
England
Abstract
OBJECTIVE: Completely compliant drug-taking behavior is associated with opioid therapy that is usually highly beneficial to the pain patient, whereas frequent and severe aberrant behavior is generally associated with therapy that is potentially harmful to the patient and borders on addiction. There is a large group of patients in the middle between these two extremes: those who display aberrant behaviors periodically, who may additionally have a mixed response to opioid therapy, the overall results of which are less than satisfying (often in the domain of functionality) to the clinician. We have used the term chemical coping to describe this vast middle ground and seek to begin a line of research starting with the development of a clinically useful tool to identify this subset of patients. METHODS: A background review is provided to highlight the need for better understanding of chemical coping. In addition, the first steps in creating a chemical coping tool are discussed, including the results of focus group interviews to determine the clarity, understandability of the items, and to assure that they are not objectionable or offensive. A total of 15 patients and 15 professionals completed this phase of the project. RESULTS: Both the professionals and patients reported that the items were generally clear and understandable. In addition, although the items cover potentially sensitive topics and some were designed with a provocative edge, the respondents had few requested changes. The researchers are moving forward with the next phase of research. SIGNIFICANCE OF RESULTS: The middle ground between compliant medication use and addiction, which we call chemical coping, is poorly understood and woefully underresearched. Despite this gap in our knowledge base, it is an often observed phenomenon. Creating a tool to identify these characteristics can lead to better treatment outcomes and earlier interventions to help improve compliance with medication regimens. [References: 38]
ISSN Print 1478-9515
Publication Type Journal Article. Research Support, Non-U.S. Gov't. Review.
Date of Publication 2007 Sep
Year of Publication 2007
Issue/Part 3
Volume 5
Page 219-26
HEALTH AND SOCIAL 2007 <828>
Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)
Unique Identifier 17624780
Status MEDLINE
Authors Kelleher S.
Authors Full Name Kelleher, Sean.
Institution
Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland.
Title
Health care professionals' knowledge and attitudes regarding substance use and substance users. [Review] [34 refs]
Source
Accident & Emergency Nursing. 15(3):161-5, 2007 Jul.
Journal Name
Accident & Emergency Nursing
Country of Publication
Scotland
Abstract
In Ireland one in four (28%) of those attending hospital emergency departments have substance abuse-related injury/illness and one in eight (13%) present in a state of clinical intoxication. Health care professionals working in emergency departments are frequently exposed to patients with substance use problems and are in ideal positions to provide early diagnosis and treatment. The success rate in detecting these patients is however disturbingly low (25-50%) and as a result many substance use problems are misdiagnosed or remain undetected. International studies that focus on primary care and addiction within the mental health sector suggest that health care professionals' knowledge and attitudes regarding substance use and substance users may negatively influence the care that these patients receive. There is a dearth of empirical research, internationally, and particularly in Ireland that addresses health care professionals' knowledge and attitudes in relation to substance use and substance users with no empirical evidence to ascertain in particular, emergency department doctors' and nurses' knowledge and attitudes. [References: 34]