Articles of interest in other scholarly journals.
Miriam J Johnson, Laura Sheard, Anthony Maraveyas, Simon Noble, Hayley Prout, Ian Watt and Dawn Dowding
Using think aloud exercises and interviews of oncologists, palliative physicians and general practitioners, this study explored why clinicians did not always use low molecular weight heparin for cancer associated thrombosis, despite high level evidence. It found that clinicians are concerned with the patients’ prognosis, increased bleeding risk and burden of self-injection. Furthermore, the diagnosis and management of cancer associated thrombosis can be complex and should be individualised on the risks/benefit for the patient. It was also found that, logistic and organisational issues also influenced investigation and treatment with low molecular weight heparin and the authors suggest that services are optimised to ensure that these do not hinder the appropriate investigation and management of patients.
Dissociable influences of opiates and expectations on pain
Lauren Y. Atlas, Robert A. Whittington, Martin A. Lindquist, Joe Wielgosz, Nomita Sonty and Tor D. Wager
The relationship between expectations and opioid analgesia were evaluated in healthy volunteers using a thermal pain model. Remifentanil was administered and participants’ knowledge of drug delivery was manipulated using an open-hidden design. Although remifentanil and expectancy both reduced pain, the effects of remifentanil on pain and fMRI activity did not interact with expectancy. fMRI activity showed opioid-induced modulation during both open and hidden conditions, with no differences in the effect of opioid caused by expectation, which followed a different time course from the opioid. The authors conclude that both opioids and placebo influence pain reports and fMRI activity but that the effects of opioids and expectations did not interact.
Harvey M. Chochinov, Patricia J. Martens, Heather J. Prior, Maia S. Kredentser
Using the data repository at the Manitoba Centre for Health Policy, patients with and without schizophrenia in the last six months of life were compared for usage of the health care services, including palliative care. Compared to a matched cohort, schizophrenics were over twice as likely to be in a nursing home and for over twice as long, they had more visits to general practitioners and psychiatrists but had less visits to other specialists, including palliative care and were less likely to be prescribed opioids, indicating poor end-of-life care for patients with schizophrenia.