Barriers to effective pain management in sickle cell disease

Sickle cell disease (SCD) is a long-term condition that would benefit from a long-term conditions approach to its care and management. SCD is growing in prevalence, affecting 10,000-12,000 people in the UK, with SCD sufferers having an increased life expectancy from in the past. The most problematic aspect of managing SCD is management of the pain from vaso-occlusive crises. Vaso-occlusive pain is the most common reason for hospital admissions in people with SCD and accounts for large numbers of accident and emergency (A&E) attendances. A literature review was carried out to examine the management of vaso-occlusive pain in SCD. The review identified three main barriers to effective pain management in SCD: the manifestation of vaso-occlusive pain, the sociocultural factors affecting pain assessment, and the concerns regarding addiction and pseudo-addiction. Addressing these barriers will allow people with SCD to have their pain managed more effectively, improve their quality of life and potentially reduce A&E attendances and admissions to hospital.

Female rape: an ongoing concern: strategies for improving reporting and conviction levels

Considers the reasons for the low rate of reported female rape. Examines statistics on reported rape and rape convictions. Reviews reasons for the low rate of reported rape progressing to trial and low conviction rates. Comments on substantive and evidential measures introduced to improve conviction rates and on measures to improve the level of reported rape and reported cases progressing to trial. Assesses the impact of the measures. [From Legal Journals Index]

Female frequent internet gamblers: a qualitative study of their gambling, its impact and their views on treatment and policy

Aims: to study the gambling history and stories of participants, motivations, impact and helpseeking. Method: Details were advertised on websites and newspapers. 30 frequent gamblers were interviewed over the telephone for approximately one hour. Verbatim transcriptions were analysed using NVIVO and grounded theory. Results/conclusions: Not all women had gambled before. However, internet accessibility meant prolonged periods were spent gambling to the neglect of other life areas. Some were originally motivated by excitement but others gambled to escape from current difficulties. Depression, anxiety, panic attacks and suicide ideation were common. The women were ambivalent towards their gambling and receiving help.