European journal of pain : EJP
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Review Practice Guideline
Standards for the management of cancer-related pain across Europe. A position paper from the EFIC Task Force on Cancer Pain.
Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Evidence from meta-analyses suggests that pain remains poorly controlled for a large proportion of patients; barriers to good management include poor assessment of pain, inadequate support for patient self-management and late or inadequate access to strong opioid analgesia in those with advanced disease. ⋯ Pain affects up to 40% of cancer survivors and affects at least 66% of patients with advanced progressive disease, many of whom experience poor pain control. These 10 standards are aimed to improve cancer pain management, promote the quality of care of patients and reduce variation across Europe.
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Comparative Study
The type of sport matters: Pain perception of endurance athletes versus strength athletes.
Studies assessing athletes' pain sensitivity yield inconsistent data, which demonstrate either increased pain threshold and tolerance in athletes than controls or similar thresholds. This inconsistency may result from the variability in the type of sport practiced by the athletes and its effect on pain perception. For example, endurance athletes perform continuous intense exercise for prolonged durations, whereas strength athletes perform short bouts of extreme efforts. Consequently, endurance athletes may tolerate and modulate pain better than strength athletes. This hypothesis was tested by comparing pain perception of endurance athletes with that of strength athletes. ⋯ This study shows that different sport types are associated with different characteristics of pain perception and modulation, as well as of thoughts towards pain.
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Review
Body movements as pain indicators in older people with cognitive impairment: A systematic review.
Pain assessment tools for cognitively impaired older people, unable to self-report pain, are commonly founded upon observation of pain behaviour, such as facial expressions, vocalizations and body movements. The scientific basis for claiming that body movements may indicate pain has not formerly been investigated in a systematic review. The objective was to explore research evidence for body movements being pain indicators in older people with cognitive impairment. ⋯ Pain assessment tools for older people with cognitive impairment or dementia should include valid pain behaviour items. Our review shows strong scientific evidence for the following body movements indicating pain: restlessness (agitation), rubbing, guarding, rigidity and physical aggression.
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Randomized Controlled Trial Comparative Study
The relative efficacy of mindfulness versus distraction: The moderating role of attentional bias.
This study investigated whether the ability to disengage quickly from pain-related stimuli moderated the relative efficacy of a mindfulness-based intervention versus distraction in response to an experimental pain task. ⋯ This study demonstrated the efficacy of a novel, exposure-based mindfulness technique for pain tolerance and showed that those who disengaged easily from pain stimuli benefited most. This brief task could be clinically useful, particularly for those who are not overly focused on their pain symptoms.
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Hypersensitivity and altered sweating are often present in neuropathy patients. Nerve lesions are known to produce sudomotor dysfunctions but also patients suffering from complex regional pain syndrome, CRPS1-a condition without a nerve lesion-present with sweating disorders. ⋯ Sweat output changes in mice after bone trauma, potentially indicative of posttraumatic processes leading to CRPS in humans.