Across the world, pain is under-treated in emergency departments (EDs). We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under-treatment in the ED is due partly to (1) an epistemic preference for signs over symptoms on the part of some practitioners, and (2) some ED practices that themselves worsen pain by increasing patients' anxiety and fear.
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August 2007
In response to the threat of HIV transmission via drug injection with shared needles, Australia developed a needle and syringe exchange program that became one of the most comprehensive in the world. Originally health professionals and pharmacists were given the responsibility of implementing the program. However, community-based AIDS organizations were soon also funded to distribute sterile injecting equipment, alcohol swabs, puncture-proof disposable containers, condoms, and safe sex information.
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