1,721,009 research outputs found
Challenges in managing cancer pain
No full textEffective pain control is a key factor in cancer management, and is primarily achieved through drug therapy. Despite the World Health Organization (WHO) guidelines for cancer pain management, many cancer patients still do not receive adequate analgesia. Lack of knowledge and misconceptions about opioid treatment is a key contributing factor, along with shortcomings in the WHO guidelines themselves. Evidence shows that starting treatment with strong opioids can provide significantly greater benefits than being treated according to the WHO recommended “analgesic ladder” – a sequential escalation of treatment. There is, therefore, a need for alternative treatment strategies that optimize drug selection, dose and methods of administration. Although widely used, drug delivery through the oral routes is not always acceptable for cancer patients with oral and gastrointestinal problems, and as such a range of administration routes, including transdermal, transmucosal and intranasal routes should be considered. Promising clinical outcomes with treatment such as transdermal fentanyl and intranasal fentanyl spray lend support to the opinion that strong opioids, used in appropriate formulations and doses, play an important role in the care of patients with severe pain
Strong analgesics: working towards an optimal balance between efficacy and side effects
No full textInadequately treated chronic pain remains a major cause of suf-
fering. A recent survey found that moderate to severe chronic pain
affects 19% of adult Europeans. Other large
scale surveys in Australia, Denmark and Norway have given similar
results. These also represent a substantial socioeconomic burden.
Moreover, these surveys may underestimate the true incidence, because many patients paradoxically re-
port their analgesia to be satisfactory despite being in pain. One
study found that over 75% of patients declared themselves satisfied
or very satisfied with their overall pain management, despite al-
most 50% reporting recent moderate to severe pai
Assessment of chronic pain and access to pain therapy: a cross-sectional population-based study
No full textRosaria Del Giorno,1 Paolo Frumento,2 Giustino Varrassi,3 Antonella Paladini,3 Stefano Coaccioli1,4 1Department of Internal Medicine, Rheumatology and Medical Pain Therapy, “Santa Maria” General Hospital, Terni, Italy; 2Unit of Biostatistics, Institute of Environmental Medicine (IMM), Karolinska Institute, Stockholm, Sweden; 3Department of MESVA, University of L’Aquila. L’Aquila, Italy; 4Department of Internal Medicine, Perugia University School of Medicine, Perugia, Italy Background: Chronic pain (CP) has been shown as an important public health problem, and several studies emphasize the need to strengthen the health care and social systems to reduce its marginalization. This study aimed to: evaluate the epidemiology of CP in the general population in an Italian area; and assess the awareness of a specific law, unanimously approved in Parliament, which provides citizens the right to access pain management ­(Italian Law 38/2010). Methods: A cross-sectional population-based study carried out during the spring of 2014 at Narni, Umbria, Italy. All the citizens residing in that area, aged >18, were enrolled in the study. Outcome measures were: prevalence of CP and therapies. The awareness of the Italian Law 38/2010 was also recorded. Results: Data of 1293 questionnaires were analyzed. The prevalence of CP was 28.4%. In 51.5% of cases, pain was severe, with higher prevalence in females (p<0.001). Moreover, pain was generally increasing with age (p<0.001). The risk of suffering from severe pain was modeled using logistic regression. Significant predictors were female gender (OR 2.59; 95% CI: 1.77–3.79), living in an urban area (OR 0.63; 95% CI 0.45–0.88), and age (OR 1.06; 95% CI: 1.04–1.08). Among people with CP, 77.9% were receiving therapy; the proportion of individuals in therapy for severe pain significantly increased with age (OR 1.03; 95% CI: 1.02–1.05) and was smaller in individuals with light pain (OR 0.21; 95% CI: 0.07–0.66). The majority of subjects (61.9%) are not aware of the existence of a specific law stating their rights to receive pain management. Conclusion: CP, at least in the rural part of the community investigated in Italy, is not perceived as a chronic disease in its own right. A socio-cultural transformation in patients and in the health care system seems necessary. Keywords: cross-sectional study, chronic pain, palliative care, pain therapy, pain control 
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
AutodetectTM syringe for epidural anesthesia in elderly patients: a pilot randomized study
No full textDispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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