The Clinical journal of pain
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Current models of chronic pain recognize that psychosocial factors influence pain and the effects of pain on daily life. The role of such factors has been widely studied on English-speaking individuals with chronic pain. It is possible that the associations between such factors and adjustment may be influenced by culture. This study sought to evaluate the importance of coping responses, self-efficacy beliefs, and social support to adjust to chronic pain in a sample of Portuguese patients, and discuss the findings with respect to their similarities and differences from findings of studies on English-speaking individuals. ⋯ The findings provide support for the importance of the psychosocial factors studied in terms of adjustment to chronic pain in Portuguese patients, and also suggest the possibility of some differences in the role of these factors due to culture.
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Comparative Study
Self-regulation (Recovery) From Pain: Association Between Time-based Measures of Infant Pain Behavior and Prenatal Exposure to Maternal Depression and Anxiety.
Capacities for self-regulation that influence infant adaptation to noxious stimulation require investigation of changes in behavior over time. Prenatal exposure to maternal depression and anxiety (MDA) has been linked to altered infant pain reactivity; however, findings are inconclusive about MDA dynamic impacts on recovery. This study quantified the temporal profile of behavioral response and recovery to routine heel lance (HL) of infants with and without prenatal-MDA exposure. Aims were to examine whether MDA were associated with alterations in time-based measures of infant behavior and sequential patterning in pain expression. ⋯ Temporal measures can further help in understanding of infant complex behavioral responses to pain. Delayed recovery in MDA-exposed infants suggested diminished capacities for self-regulation of noxious distress.
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Prescription opioid analgesics play an important role in managing moderate to severe pain. An unintended consequence of the availability of these drugs is nonmedical use. We report rates and methods of nonmedical use of the analgesic tapentadol immediate release (IR) and other commonly prescribed opioid analgesics among US college students following the launch of tapentadol IR in June 2009. ⋯ Since its launch, rates of nonmedical tapentadol IR use by college students have been low and have decreased over time. The initial levels of reported nonmedical use may represent a brief period of experimentation after introduction.
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As long-term opioid analgesic therapy has gained increasing clinical and societal acceptance over the past 2 decades, morbidity and mortality related to the misuse of these drugs have increased in lockstep. Hence, monitoring for opioid-related problems, largely through urine drug testing, has become a central component of risk mitigation in long-term opioid therapy. Despite the increasing use of urine drug testing, little has been written about the ethical aspects of its application. In this paper, we analyze multiple aspects of drug testing-rationale for testing, specimen collection, ordering and interpretation, and response to inappropriate test results-through the principlist lens, using the ethical principles of beneficence, nonmaleficence, justice, and autonomy.