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OBJECTIVES: Genetic disorders are the main causes of many other diseases. Integrating genetic data into Electronic Health Records (EHRs) can facilitate the management of genetic information and care of patients in clinical practices. The aim of this study was to identify the main requirements for integrating genetic data into the EHR system from the medical geneticists' perspectives. METHODS: The research was completed in 2018 and consisted of two phases. In the first phase, the main requirements for integrating genetic data into the EHR system were identified by reviewing the literature. In the second phase, a 5-point Likert scale questionnaire was developed based on the literature review and the results derived from the first phase. Then, the Delphi method was applied to reach a consensus about the integration requirements. RESULTS: The findings of the first phase showed that data elements, including patients' and healthcare providers' personal data, clinical and genetic data, technical infrastructure, security issues and functional requirements, should be taken into account before data integration. In the second phase, a consensus was reached for most of the items (mean ≥3.75). The items with a mean value of less than 2.5 did not achieve a consensus and were removed from the final list. CONCLUSIONS: The integration of genetic data into the EHRs can provide a ground for increasing accuracy and precision in the diagnosis and treatment of genetic disorders. Such integration requires adequate investments to identify users' requirements as well as technical and non-technical issues.
Subject(s)
Humans , Consensus , Delivery of Health Care , Diagnosis , Electronic Health Records , Genetics , Investments , Medical Informatics , MethodsABSTRACT
Background: According to previous studies, probiotic and prebiotic supplementation have desirable effects on glycemic parameters. Thus far, the effect of supplementation on the glycemic parameters and adipokines in non-alcoholic fatty liver disease [NAFLD] has not been assessed. Therefore, the aim of this study was to determine the effects of supplementation with probiotic and prebiotic on adiokines and glycemic parameters in the patients with NAFLD
Methods: In the present randomized, double-blind, placebo-controlled trial, 89 patients with NAFLD were randomly divided into three groups to receive one probiotic capsule + 16 g/d maltodextrin [probiotic group] or 16 g/d oligofructose powder + one placebo capsule [prebiotic group], and one placebo capsule + 16 g/d maltodextrin [control group] for 12 weeks. All the subjects in the study were advised to follow the weight loss diet and physical activity recommendations during the intervention. Fasting blood samples were taken at baseline and after the intervention to measure leptin, adiponectin, insulin, and fasting blood sugar
Results: At the end of the study, serum concentrations of leptin, insulin, and HOMA-IR decreased significantly in the probiotic and prebiotic groups compared with the control group. Despite the changes within the groups, serum concentrations of adiponectin did not change significantly between the three groups. Also, fasting blood sugar did not change between the groups, but decreased in the prebiotic group. Quantitative insulin-sensitivity check index [QUICKI] increased significantly in probiotic and prebiotic groups compared with the control group
Conclusion: Probiotic and prebiotic supplementation along with lifestyle intervention has a favorable impact on glycemic parameters and leptin levels compared with lifestyle intervention alone
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Background: Raw [fresh] vegetables are an important ingredient of healthy diet. Many enteric bacterial, parasitic and viral pathogens could be transmitted by vegetables. Mazandaran province is located in northern Iran with a coastal area and extensive fields for vegetable cultivation. The current study is designed to evaluate the parasitic contamination of fresh vegetables
Methods: A total of 150 samples of fresh vegetables obtained from markets were examined for parasitic infections using standard methods
Results: Out of 104 samples [60.3%] were contaminated with parasites. Parsley and radish with prevalence rates of 90% [18/20] and 39.1% [9/23] were the most and least contaminated vegetables. Free living larva and Trichostrongylus were the most and least common parasites in our results
Conclusion: It can be concluded that parasitological contamination of raw vegetables may be a health threat to consumers of such products
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Background and Aim: the association between some micronutrients deficiency and mood disorders has been demonstrated in several studies. But, the results of clinical trial regarding the effects of multivitamin complex on mood disorders are inconclusive. The aim of the present study was to investigate the effect of multivitamin complex supplementation on mood disorder, anxiety and depression in elderlies over 60 years old
Materials and Methods: in this clinical trial, 120 aged people with mild depression were randomly allocated to receive multivitamin complex tablet or placebo once daily with their meal for twelve weeks. At the beginning and end of the study, dietary intake, anthropometric indices and scores of depression, anxiety and mood disorders were assessed
Results: this trial was completed by 114 elderlies after 12 weeks. The mean depression score was not different in two groups after intervention. The mean score of anxiety and mood disorders after intervention did not differ between groups. Similar results were obtained for weight and Body Mass Index. Significant enhancement of energy intake was illustrated by the measurement of participants' dietary intake
Conclusion: the present study revealed that consuming a multivitamin complex in tablet form for 12 weeks had no effect on depression, anxiety and mood disorders in elderlies but can increase their appetite resulting in increase of their energy intake
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Helicobacter pylori infection, the most common chronic bacterial infection in the world, and an important cause of gastrointestinal disorders, may be involved in the pathogenesis of some extra-gastrointestinal disturbances, as well as an increase in blood levels of certain inflammatory markers. Anti-bacterial activity against Helicobacter pylori and anti-inflammatory properties of omega-3 fatty acids have been studied in several research studies. The purpose of the present study was the comparison of the effects of Eicosapentaenoic Acid and Docosahexaenoic Acid supplementation on Helicobacter pylori eradication, serum levels of some inflammatory markers and total antioxidant capacity. In a randomized, double-blind, placebo-controlled clinical trial, 97 Helicobacter pylori positive patients [64 patients in the two intervention groups and 33 in the control group], received 2 grams daily of Eicosapentaenoic Acid, Docosahexaenoic Acid or Medium Chain Triglyceride oil as placebo, along with conventional tetra-drug Helicobacter pylori eradication regimen, for 12 weeks. Helicobacter pylori eradication test and measurement of concentration of interleukine-6, interleukine-8, high-sensitivity C-reactive protein and total antioxidant capacity were performed after the intervention. There was no significant difference in eradication rate of the infection, levels of interleukine-6 and total antioxidant capacity among the three groups, while the levels of interleukine-8 and high-sensitivity C-reactive protein were statistically different. Eicosapentaenoic Acid or Docosahexaenoic Acid supplementation had no significant differential impact on the eradication of Helicobacter pylori infection, and serum levels of interleukine-6 and total antioxidant capacity. However, it had a desirable effect on the levels of interleukine-8 and high-sensitivity C-reactive protein in Helicobacter pylori positive patients
Subject(s)
Humans , Female , Male , Helicobacter pylori , Eicosapentaenoic Acid/pharmacology , Docosahexaenoic Acids/pharmacology , Inflammation , Antioxidants , Double-Blind Method , Interleukin-6 , Interleukin-8 , C-Reactive ProteinABSTRACT
Vesicoureteral Reflux [VUR] is a congenital defect of the urinary tract which has been reported in approximately 1% of children. Several immunological and genetic factors are listed as major causes of this problem. The C825T polymorphism of the GNB3 gene is among the genetic factors that may be involved in the development or progression of the disease. Participatory role of this polymorphism has been reported in several diseases, but its role in the development or progression of this disease is still not set correctly. This study, based on a Case-Control analysis, was carried out in Kerman province. A total of 80 children with VUR and 80 healthy children were selected and frequency of C825T polymorphism of the GNB3 gene was examined by using PCR-RLFP. The overall prevalence of heterozygous CT genotype of GNB3 gene in patients with VUR was significantly higher compared to the control group [P = 0.012, OR = 1.92]. These results suggest that the C825T polymorphism may be involved in establishing the initial VUR. However, further studies to determine the role of this gene as a marker for predicting the likelihood of VUR is required
Subject(s)
Humans , Case-Control Studies , Prevalence , Polymorphism, Genetic , ChildABSTRACT
Assessing learners' needs is an integral part of any curriculum and course design, namely English for specific purposes [ESP], syllabus design, materials development, teaching methods and testing issues. Critical approach to needs analysis, which is a relatively recent approach, acknowledges the rights of different stakeholders including teachers, students and administrators in the process of needs analysis. However, there has been no formal need analysis for syllabus design at postgraduate level in Medical Universities affiliated to the Ministry of Health in Iran. This study, conducted in 2011, was an attempt to assess the reading and writing needs of postgraduate students in ESP courses on the basis of critical approach to needs analysis. The study population consisted of 67 people: 56 postgraduate students, 5 heads of departments, 5 ESP instructors and 1 executive manager at the Ministry of Health in Iran. Ethical and demographic forms, needs analysis questionnaires, and a form of semi-structured interview were the instruments of the study. According to the findings, there was a discrepancy between students' and instructors' perception of learners' needs and the assumed needs appearing in the syllabi prescribed by the Ministry of Health in Iran. This study showed that a call for critical needs analysis in which the rights of different stakeholders are acknowledged is necessary for meeting the requirements of any ESP classes especially at postgraduate level where the instructors and learners are fully aware of learners' needs
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A recent field of research in epigenetics is DNA methylation which involves the CpG island in the genome that subsequently controls transcription and translation of targeted genes. In the hepatitis B virus [HBV] genome, there are three CpG islands which tend to be methylated. The aim of the current study is to determine the methylation pattern of the HBV X gene in chronically infected HBV patients. Study participants comprised 45 chronically infected HBV patients. According to the presence of the HBeAg, patients were divided into two groups, HBeAg positive [n=24] and HBeAg negative [n=21]. Initially, viral DNA was treated with natrium bisulfate. Then, analysis was performed with two sets of methylated and non-methylated primers by the MSP method. The overall methylation rate in serum samples of hepatitis B infected patients was 35.5%; the rate in the HBeAg positive patients was 20.8%, whereas it was 52.3% in HBeAg negative patients. There was a significantly higher rate of methylation in serum samples of HBeAg negative patients compared to HBeAg positive patients [student's t-test; P=0.02]. Methylation of HBV can be used as a new mechanism to control the progression of viral infection. This methodology can be useful for determining the characteristics of clinical stages of this infection
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The main objective was to find association between basal cortisol and neighborhood-level stress. Systematic searches, including electronic and hand searches, were conducted. The most recent date of the search was July 26, 2013. Primary observational studies included if they considered stress related outcomes in the neighborhood context. Using the EndNote X7 advanced search option; the authors examined the abstracts and titles of the 18,092 articles to exclude obviously irrelevant studies, gray literature, discussion papers, reviews and, studies with no complete data. Two authors independently extracted data from the original reports into pre-designed data extraction forms based on the Data Extraction Template of the Cochrane Consumer and Communication Review Group [CCCRG]. Ten studies with a total of 2,134 participants were synthesized and analyzed. Two studies out of ten received expanded meta-analysis. The overall effect size [95% CI] for cortisol level for residents in neighborhoods with lower stress compared to inhabitants from higher was 0.12 [0.01, 0.23]. This review is demonstrating a link between psychosocial or physical stress and cortisol obtained from saliva. However, living in high disorder neighborhoods results in higher level of cortisol. This represents a biological indicator of psychosocial/physical stress exposure [i.e., neighborhood disorder] that reflects variances in stress exposure levels
Subject(s)
Residence Characteristics , Hydrocortisone , Meta-Analysis as TopicABSTRACT
Today, a CT scan examination play an important role in disease diagnosis and thus allocates a significant dose of medical X-ray examinations. One of the important principles in the use of ionizing radiations is to observe radiation protection principles. Evaluating patient's absorbed dose and implementing the strategies for reducing dose are prior in safety issues. To achieve this purpose, sufficient studies should be performed in this regard. Therefore, patient's absorbed dose and the factors affecting have been studied in this research. This study aims to present and develop an acceptable level of absorbed dose in CT scan examinations. Diagnostic reference dose level in the adult age group [older than 15 years] has been studied in eleven CT scan centers in Tehran. For this purpose, CT scan examinations prevalent in above-mentioned centers were chosen and Weighted Computed Tomography dose index [CTDIw] and dose length product [DLP] parameters were studied. Standard phantoms with 16 and 32 diameters of Polymethylmethacrylate [PMMA] origin have been used in the centers for CT scan calibration process. CTDIw third quartile has been considered as the diagnostic reference dose level [DRL]. Rate of diagnostic reference dose in the adult age group [older than 15 years] for the head, sinus, lungs, abdomen and pelvis are 50.87, 38.27, 8.05 and 9.11 mg, respectively. Dose measurements made in this survey have been used to set up local DRLs and can be used as a template for national DRLs. Value of diagnostic reference dose for the head examinations is more than the other parts and diagnostic reference dose in Tehran city in the Adult age group and the protocols compared is less than national reference dose.
Subject(s)
Humans , Adolescent , Reference Values , AdolescentABSTRACT
As regard to high prevalence of Helicobacter pylori infection and complications of it's persistence, as well as anti-bacterial activity against of Helicobacter pylori and anti-inflammatory properties of omega-3 fatty acids, this study was conducted to evaluate the effects of supplementation with Docosahexaenoic Acid [DHA] on the eradication of Helicobacter pylori infection, some serum inflammatory markers and total antioxidant capacity. In a double-blind, placebo-controlled clinical trial, 66 H. pylori positive patients [33 in the intervention group and 33 in the control group], along with tetradrugs H. pylori eradication regimen, randomly received daily two grams morDHA supplement or Medium Chain Triglyceride [MCT] oil as placebo for 12 weeks. Dietary intake data was collected by 24 hour food recall and analyzed by Nutritionist IV software. Sampling from fasting blood and measuring weight, height, body mass index [BMI] and level of physical activity were done at the first and the end of the study. As well as, eradication test of the infection was performed for all patients at the end of the intervention. Eradication rate of the infection, the level of interleukin-6 [IL-6], high sensitivity C-reactive protein [hs-CRP] and total antioxidant capacity [TAC] didn't have significant difference between two groups at the end of the study [P>0.05], while the level of interleukin-8 [IL-8] was different between two groups [P=0.008]. Difference of the concentration between the beginning and the end of the study was not significant in any factors between two groups [P>0.05]. Intake of morDHA supplement didn't have significant effect on the eradication of H. pylori, serum levels of IL-6, hs-CRP and TAC, while it was effective on the level of IL-8.
Subject(s)
Humans , Helicobacter pylori/drug effects , Helicobacter Infections/prevention & control , Disease Eradication , Interleukin-6/blood , Interleukin-8/blood , C-Reactive Protein , Double-Blind MethodABSTRACT
Type 2 diabetes melitus [DM] is highly prevalent worldwide. Evidence supports a role for royal jelly in reduction of serum glucose and lipids. The purpose of this study was to determine the effects of royal jelly intake on serum glucose, HbA1c, and Total Antioxidant Capacity [TAC] in type 2 diabetic patients. Fifty patients with type 2 DM participated in a double-blind, placebo-controlled, 8-weeks study. The patients with type 2 DM were divided randomly into placebo and royal jelly groups of 25 each. Both groups received the treatment for 8 weeks. In royal jelly group participants received three 1000 mg royal jelly capsules daily and placebo group received three 1000 mg placebo capsules daily. Blood samples were taken after 12 hours of fasting at the beginning and the end of the study. Serum glucose, HbA1c, and TAC were evaluated. Forty six participants completed the study. Royal jelly intake reduced FBS levels [p=0.006] and increased TAC [p=0.016] significantly after 8 weeks compared with placebo. Royal jelly did not affect serum HbA1c levels. This study shows that royal jelly has some benefits in type 2 diabetic patients
Subject(s)
Humans , Fatty Acids , Bees , Blood Glucose , Glycated Hemoglobin , Antioxidants , Double-Blind MethodABSTRACT
To determine the relationship between preterm birth and domestic violence against pregnant women in Iran. This cross-sectional study was carried out on 600 women who were hospitalized for giving birth in one of hospitals affiliated to Tehran Medical Science University in Iran, between September 9, 2010 and December 30, 2010. This study was approved by the Research Ethics Committee affiliated with Tehran University, Iran. We applied Abuse Assessment Screen [AAS] Questionnaire. A total of 338 participants [56.3%] declared to experience domestic violence during pregnancy. Psychological violence was the most common form of violence against these women in postpartum [51.3%], and followed by physical violence [5%]. Prevalence rate of premature labor was 37.7% among all women in this study which 63.3% of this rate belongs to abuse women. It is noted that healthcare providers with screening violence during pregnancy and assessing the prevalence, consequences, and possible interventions may help to reduce domestic violence against pregnant women
Subject(s)
Humans , Female , Pregnancy , Premature Birth , Cross-Sectional StudiesABSTRACT
Nursing students usually experience various types of stress. Lack of stress coping strategies result in more stress, incompatibility, manifestation of disorders, and mental health problems. This study carried out to assess the methods of coping with stress among nursing students. In this cross-sectional study, 358 male and female bachelor of nursing students studying at Tehran University of Medical Sciences during the first semester of 2011-2012 were selected. Data were collected using the Coping Inventory for Stressful Situation and a demographic questionnaire. The data was analyzed using descriptive and inferential statistics in the SPSS-14. There were 66.2% female and 33.8% male students in the study. The age of the students ranged 17-29 years. Most of the students aged 20-22 years [45%], were single [90.8%], were habitants of Tehran [53.1%], had an average economic status [72.1%], and were employed [20.9%]. Of all, 19.3% had experienced stressful events in the last three months. A small number of the students [4.7%] suffered from chronic diseases. The nursing students mostly used problem-oriented coping style [56%]. The emotion-oriented method was used among 45.99% of the students and the avoidance-oriented style was used among 39.34% of the students. There were no statistically significant relationship between the coping styles and the demographic characteristics. The problem-oriented, emotion-oriented, and avoidance-oriented styles were the most frequent styles used by the students, respectively. The mental health, particularly among nursing students who deal with patients and have important role in the health system, is important and requires special attention. The stress coping styles should be inserted in the educational curriculum of the nursing schools
Subject(s)
Humans , Male , Female , Students, Nursing/psychology , Adaptation, Psychological , Cross-Sectional StudiesABSTRACT
This study was designed to evaluate the incidence of uterine pathologies in infertile women with a history of two implantation failures after in vitro fertilization [IVF] and estimate the effect of hysteroscopic correction on achieving a pregnancy in these patients. The retrospective study population included 238 infertile women attended the outpatient infertility clinic between November 2007 and December 2008. Patients with at least two previous IVF failures were eligible for this study. All patients had normal findings on hysterosalpingography performed prior their first attempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopy were performed in patients before the subsequent IVF attempt. Out of 238 patients with previous IVF failure who underwent hysteroscopic evaluation, 158 patients [66.4%] showed normal uterine cavity. Abnormal cavity was found in 80 patients [33.6%]. We found polyp as the most common abnormality [19.7%] in the patients with previous history of IVF failure. The pregnancy rate was similar between IVF failure patients who treated by hysteroscopy for a detected uterine abnormality [24.6%] and similar patients with normal uterine cavity [21.2%] in hysteroscopic examinations. The intrauterine lesions diagnosed by hysteroscopy in patients with previous IVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polyp showed good outcome, similar to that achieved in patients with a normal hysteroscopy
Subject(s)
Humans , Female , Adult , Middle Aged , Hysteroscopy , Infertility, Female , Embryo Implantation , Uterus/pathology , Treatment Failure , Retrospective StudiesABSTRACT
Opioids are one of the most prevalent hygienic difficulties of the country and are causes of prevalence of some dangerous diseases such as AIDS and Hepatitis. Studies show relatively more prevalence of substance use in 15-35 years old students in the country. The purpose of the present study is investigation prevalence of substance use and the interrelated factors involved with third-year high school students in Nazarabad city. This is a cross sectional study done on 400 students including 204 female and 196 male of third-year of high school in Nazarabad city by random sampling. Research instruments were questionnaire Investigating substance use in young students and MMPI test. The methods of data analysis, were descriptive statistics methods, Pearson and Chi-Square tests, in the format of software program of SPSS 11/5. The findings of the study reveal that 24/5% students were users of substances such as: cigarette, alcohol, opium, psychoactive substances, heroin, heroin crack, LSD, cannabis and cocaine. Prevalence of substance use was expressively more in males [%69/7] than females [%26/2] and the most important cause of use was amusement [%42/5] and curiosity [%29/9]. Prevalence of substance use in suburban boys' high schools is more than urban boys' high schools. Prevalence of psychological disease was similar to usual individuals but some disease such as psychotic disorders, hysteric, adjustment disorders and OCD in substance users was more than usual students. The prevalence of substance use in teenagers is high and the most cause of use is entertainment and curiosity, Therefore some steps should be taken to resolve this problem
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Objective [s]: Polycystic ovary syndrome [PCOS] is a disorder of hyperandrogenemia and chronic anovulation which affects 5-10% of all women. The PCOS symptoms such as hirsutism, irregular menses, obesity and infertility are a major source of psychological morbidity and can negatively affect quality of life. In this study, we examined the health-related quality of life among Iranian women who suffering from PCOS
Study design: Quality of life was assessed in five domain separatively [menstrual disorders, hirsutism, infertility problems, emotions, and obesity] in 152 women who referred to Tehran selected infertility centers in Tehran, Iran in 2010-2011
Results: The findings showed that patients scored lower on menstrual disorders, hirsutism, infertility problems, emotions, and obesity
Conclusion: This study showed that menstural disorder is the most important domain that affects Iranian women's HR-QoL
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Endotracheal suctioning [ETS] is a common invasive nursing procedure. Hemodynamic parameters changes during and after the procedure. If appropriate strategies do not be applied during the ETS, hemodynamic changes can be significant and life threatening in critically ill patients. The purpose of this study was to assess the effect of education of endotracheal suctioning on patients' hemodynamic parameters. This was a non-equivalent quasi-experimental study conducted in two critical care units in Hazarat Rasool hospital. All nurses working in these two units participated in the study in a period of two weeks. Systolic blood pressure, diastolic blood pressure and mean blood pressure of all patients who needed suctioning were measured before and after the endotracheal suctioning. We analyzed the data using the SPSS. At baseline, the systolic, diastolic and mean arterial blood pressures increased significantly [P=0.02] in the first and third minutes post-suctioning. In post-education phase, diastolic and mean arterial blood pressure increased significantly [P<0.001] in the first minute post-suctioning. In the third minute post-suctioning, systolic, diastolic and mean arterial blood pressure decreased [P=0.43]. The study findings showed significant changes in hemodynamic parameters after post-endotracheal suctioning. In this study, conducting endotracheal suctioning education improved the outcomes of hemodynamic parameters in patients. Educational programs can improve nursing care outcomes by preventing and minimizing hemodynamic changes during and after the suctioning in critically ill patients
Subject(s)
Humans , Hemodynamics , Nurses , Nursing Education ResearchABSTRACT
Controlling occurrence of accidents in work place has been an interesting subject in all countries worldwide. Financial consequences of these accidents and their economic losses imposed on the involved companies is only one of the insignificant aspects of such damages and when the non-economic but intangible losses to the society are taken into consideration ,these economic damages will be marginalized. Purpose of this research is fitting the box-Jenkins model to time series of total number of accidents in work place and estimation of series1 missing values during fitting of this model. This longitudinal [time series] study, intends to model, estimate and forecast time series of total number of work place accidents for the insured people between 2000 and 2010 in Iran. Spline non-parametric regression methods to find the best interpolation and estimation of the series' missing value as well as box-Jenkins prediction method to find the best prediction on series have been used. Results: Smoothing spline method using some adjusts for seasonal time series in order to estimate missing values, shows better performance on the series. Then, suitable box-Jenkins model, SARIMA [0,1,1] x [0,1,1][12], was fitted to the series. Goodness of fit criterion of model, AIC, for prediction of the time series was equal to 1050.833. Estimation of the missing data in time series with regard to characteristics such as long period of missing data and exposure of values in tandem without any reliable middle points, is an appropriate method in order to leave situation of such gaps in the data. Looking at the goodness of fit of the model can be said that the error estimation and prediction model is rather low and hence, the model is well fitted to the series, Therefore, box-Jenkins model will be reliable for fitting to similar data
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Pain can detrimentally affect physical functioning, psychological well-being and social interaction. Various attitudinal factors may be associated with inadequate pain control. Hence, studies should be undertaken to gain a better understanding of association between pain control attitudes and use of analgesics and cancer pain intensity. This study aimed to determine relationship between pain control attitudes and use of analgesics and pain intensity in cancer patients with pain. A descriptive cross-sectional study was conducted with 200 cancer patients who underwent chemotherapy or radiotherapy and experienced pain in previous 24 hours. The pain control attitudes, use of analgesics, worrisome about using analgesics and physical and psychological impacts of pain were measured using questionnaires. The cancer pain intensity was measured using the visual analogue scale. Validity and reliability of the instruments were evaluated. Data were analyzed using independent t-test and ANOVA. About 58% of patients agreed that they would wait before asking for help. Beside, the findings indicated that willing to tolerate pain and perceived control over pain were associated with the time and frequency of taking analgesic and pain intensity in previous 24 hours and last week. Also concerns about addiction to pain-relieving medications were related to the analgesic type and pain intensity within last week [P=0.03], and fear of injection was related to analgesic use and pain intensity within last week [P<0.001]. Many cancer patients had attitudes which could interfere with pain relieving. Suggestions are made for developing patient education programs, accessing effective cancer pain controls and decision making for cancer pain relief