22 research outputs found
Effect of age, sex and gender on pain sensitivity: A narrative review
© 2017 Eltumi And Tashani. Introduction: An increasing body of literature on sex and gender differences in pain sensitivity has been accumulated in recent years. There is also evidence from epidemiological research that painful conditions are more prevalent in older people. The aim of this narrative review is to critically appraise the relevant literature investigating the presence of age and sex differences in clinical and experimental pain conditions. Methods: A scoping search of the literature identifying relevant peer reviewed articles was conducted on May 2016. Information and evidence from the key articles were narratively described and data was quantitatively synthesised to identify gaps of knowledge in the research literature concerning age and sex differences in pain responses. Results: This critical appraisal of the literature suggests that the results of the experimental and clinical studies regarding age and sex differences in pain contain some contradictions as far as age differences in pain are concerned. While data from the clinical studies are more consistent and seem to point towards the fact that chronic pain prevalence increases in the elderly findings from the experimental studies on the other hand were inconsistent, with pain threshold increasing with age in some studies and decreasing with age in others. Conclusion: There is a need for further research using the latest advanced quantitative sensory testing protocols to measure the function of small nerve fibres that are involved in nociception and pain sensitivity across the human life span. Implications: Findings from these studies should feed into and inform evidence emerging from other types of studies (e.g. brain imaging technique and psychometrics) suggesting that pain in the older humans may have unique characteristics that affect how old patients respond to intervention
A review of diagnostic and functional imaging in headache
The neuroimaging of
headache patients has revolutionised
our understanding of the pathophysiology
of primary headaches and provided
unique insights into these syndromes.
Modern imaging studies
point, together with the clinical picture,
towards a central triggering
cause. The early functional imaging
work using positron emission
tomography shed light on the genesis
of some syndromes, and has
recently been refined, implying that
the observed activation in migraine
(brainstem) and in several trigeminal-autonomic headaches (hypothalamic
grey) is involved in the pain
process in either a permissive or
triggering manner rather than simply
as a response to first-division nociception
per se. Using the advanced
method of voxel-based morphometry,
it has been suggested that there
is a correlation between the brain
area activated specifically in acute
cluster headache — the posterior
hypothalamic grey matter — and an
increase in grey matter in the same
region. No structural changes have
been found for migraine and medication
overuse headache, whereas
patients with chronic tension-type
headache demonstrated a significant
grey matter decrease in regions
known to be involved in pain processing.
Modern neuroimaging thus
clearly suggests that most primary
headache syndromes are predominantly
driven from the brain, activating
the trigeminovascular reflex and
needing therapeutics that act on both
sides: centrally and peripherally
Twenty years on: lesbian, gay and bisexual police officers' experiences of workplace discrimination in England and Wales
Twenty years ago Mark Burke's pioneering research into homosexuality and policing evidenced widespread prejudice and hostility toward lesbian, gay and bisexual police officers in nine forces across England and Wales. These serving officers were felt to represent the most serious kind of contamination and threat to the integrity of the British Police Service by their heterosexual colleagues. Twenty years on this research, which represents one of the largest ever surveys of LGB police officers in England and Wales (N=836), evidences that just under one-fifth reported experiencing discrimination, with those in small and large forces, those in senior ranks and non-uniformed positions, and those who identify as gay male and Black, Minority Ethnic experiencing the highest levels of victimisation in training, deployment and promotion. Like Brown and Woolfenden, the authors conclude that a central aim of the diversity reform agenda must be a renegotiation of the psychological contract between staff and the organisation. A relational setup must be sought where mutual expectations of exchange are established and efforts are made to create a rich working environment that draws upon and invests in the subjective and intersubjective identity characteristics of LGB police officers