Everyday pain, analgesic beliefs and analgesicbehaviours in Europe and Russia: An epidemiologicalsurvey and analysis

Беше проведено анкетно проучване в осем държави, в т.ч. Белгия, Германия, Великобритания, Италия, Полша, Русия и Испания. Оценена беше честотата на оплакване от болка при 8 506 души (52% жени), както и използването на аналгетици и нагласите спрямо тях. Предварителните анализи потвърждават високата честота на оплаквания от болка, като 70% от анкетираните посочват, че поне веднъж в месеца изпитват такава. Най-често се съобщава за главоболие и болки в гърба, a болшинството анкетирани лица - 77%, споделят, че използват аналгетични средства, когато страдат от болка. Предмет на по-нататъшните анализи бяха различията по пол, статус на заетост, държава по местоживеене и възраст. В сравнение с мъжете, жените по-често изпитват болка, употребата на аналгетици сред тях е по-голяма, както и притесненията им във връзка с тази употреба, като проявяват склонност да базират употребата върху своите познания относно лекарствените продукти. Безработните също съобщават за по-голямо използване на аналгетици и повече притеснения във връзка с това, сравнено със заетите лица. Като цяло при хората, живеещи в Русия и Полша, се отчита по-рядко болка и по-малко използване на обезболяващи средства в сравнение с останалата част на Европа. Те също така се тревожат повече във връзка с аналгетиците и по отношение на това, че използването на аналгетици от тяхна страна е слабо свързано с познания относно лекарствата. Отчитането на фактора „възраст` показва, че при по-младите епизодите на болка са по-малко, употребата на аналгетици - по-честа, a притесненията относно аналгетиците са по-слаби в сравнение с по-възрастните. Също така, по-младите са по-склонни да използват аналгетици въз основа на своите познания за продукта. Тези резултати повтарят съществуващи констатации във връзка с честотата на болката. Дават и нови сведения за различията при изпитването на болка, използването на аналгетици и нагласите към аналгетиците в Европа и Русия.

Evaluation of a group based cognitive behavioural therapy programme for menstrual pain management in young women with intellectual disabilities: protocol for a mixed methods controlled clinical trial

BACKGROUND: Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities. The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. METHODS/DESIGN: The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12 – 30 years who have a Mild - Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. DISCUSSION: Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. TRIAL REGISTRATION: Current Controlled Trials ISRCTN7556775

EIA and EMS integration : Not wasting the opportunity

Environmental tools such as environmental impact assessment (EIA) and environmental management systems (EMS) can be applied to ensure that major projects are constructed and operated using an approach that enables effective environmental protection. Previous research has shown that these tools are frequently applied in isolation at different stages of the project life cycle. The extent of EIA/EMS integration amongst nine of the biggest UK waste management companies was investigated through semi-structured interviews with environmental staff and thematic analysis of their responses. The research found that partial integration of EIA and EMS is widespread. Companies recognised a range of potential benefits to more closely integrating their processes such as system efficiencies, data availability and recognition from the regulator. However, significant barriers to further integration were identified in the form of cost, company structure and the size of the organisation. In a context where the regulation of the waste industry is increasingly aligned towards a risk-based approach, there is a new opportunity to use EIA outputs in an enhanced EMS. More generally, companies should seek to maintain continuity of personnel across the project life cycle and structure their environmental functions so that EIA and EMS staff can work more closely. This would help ensure that the greatest benefit is derived from both tools.Peer reviewe