Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Pain beliefs predict pain intensity and pain status in children: usefulness of the pediatric version of the survey of pain attitudes.
Pain attitudes and beliefs are hypothesized to influence pain and adjustment to pain. Valid and reliable measures of these beliefs are necessary to test their hypothesized associations with outcomes. The Pediatric version of the Survey of Pain Attitudes (Peds-SOPA) is a new measure with limited evidence regarding its psychometric properties. This study sought to: 1) evaluate the predictive validity, reliability, and factor structure of the Peds-SOPA; and 2) determine if there are sex- or age-related differences in children's attitudes toward pain. ⋯ The current findings provide additional support for the reliability and validity of the Peds-SOPA, and suggest that children's pain attitudes and beliefs might be important intervention targets in pain treatment.
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Previous studies have shown that inflammatory pain at the neonatal stage can produce long-term structural and functional changes in nociceptive pathways, resulting in altered pain perception in adulthood. However, the exact pattern of altered nociceptive response and associated neurochemical changes in the spinal cord in this process is unclear. ⋯ These results indicate that neonatal inflammation produces sensory modality-specific changes in nociceptive behavior and alters neurochemistry in the spinal cord of adult rats. These results also suggest that a prior history of inflammatory pain during the developmental period might have an impact on clinical pain in highly susceptible adult patients.
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In the absence of a suitable reference standard, diagnostic local anesthetic blocks cannot be validated in the manner conventionally used for diagnostic tests. Consequently, diagnostic blocks are vulnerable to criticism for lacking validity, or being "not proven." ⋯ The eight criteria provide an axiomatic, philosophical basis for diagnostic blocks in general, and serve to show what empirical evidence needs to be gathered in order to validate a particular block. The associated metric allows the scientific evidence for different blocks to be quantified and compared.
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Randomized Controlled Trial
The effect of cognitive load and patient race on physicians' decisions to prescribe opioids for chronic low back pain: a randomized trial.
To test the hypothesis that racial biases in opioid prescribing would be more likely under high levels of cognitive load, defined as the amount of mental activity imposed on working memory, which may come from environmental factors such as stressful conditions, chaotic workplace, staffing insufficiency, and competing demands, one's own psychological or physiological state, as well as from demands inherent in the task at hand. ⋯ Physician gender affected the way in which patient race and cognitive load influenced decisions to prescribe opioids for chronic pain. Future research is needed to further explore the potential effects of physician gender on racial biases in pain treatment, and the effects of physician cognitive load on pain treatment.