Developing and implementing a pain management benchmark.

For most patients, pain is an inevitable part of the cancer journey. Pain may be acute or chronic, it may be related to the disease process or to treatments such as surgery, radiotherapy or chemotherapy. For 80-90 per cent of patients with cancer, effective pain relief could be attained using the analgesic guidelines outlined by the World Health Organization (1996). However, in routine practice this is not achieved (Portenoy and Lesage, 1999), which highlights the need to review and improve practice continuously.

The short term effects of breakfast on the cognitive functions of school children

A large sum of money is spent annually on school feeding programmes in developed and developing nations. However few of these programmes have been evaluated in developing countries. The short term effects of breakfast on cognitive functions were examined in 97 undernourished (weight-for-age) ó - 1.00 SD) and 100 adequately nourished (weight-for-age > - 1.00 SD) children attending grades three and four of four remote, rural schools in Jamaica. Half the children were given breakfast and the other half a quarter an orange as a placebo at 8.30 a.m. Treatment began at least one week prior to testing. Children were retested a few weeks later when the treatment order was reversed. The cognitive functions measured were sustained attention (Memory and Search), auditory short term memory (Digital Span), generation of ideas and motivation (Fluency), and reaction time and information processing (Number Choice). Girls performed better than boys in tasks of sustained attention and reaction time (p < 0.001 and 0.002 respectively), breakfast had a beneficial effect in scores of fluency in the undernourished children, and boys had higher scores in Digit Span with breakfast but the scores of girls declined (with breakfast). The results suggested that a breakfast program of this type can have some benefits on children's cognitive function. (AU)

School breakfast improves verbal fluency in undernourished Jamaican children

School feeding programs exist in many countries, but few have been properly evaluated. In this study, the short-term effects of breakfast on children's cognitive functions were examined. The subjects were 97 undernourished (weight-for-age < or = -1 SD of reference) and 100 adequately nourished (weight-for-age > -1 SD) children in four primary schools in rural Jamaica. The children were randomly assigned to a group provided with breakfast or a group given a quarter of an orange as a placebo, and the given a battery of four cognitive function tests. After a few weeks the treatments were reversed and the tests repeated. Undernourished children's performance improved significantly on a test of verbal fluency when they received breakfast, whereas that of the adequately nourished children did not change (breakfast x group interaction, P < 0.05). They were no other effects of breakfast on test scores. The findings extend those of a previous Jamaican study conducted under more controlled conditions, and support the targeting of school meals to undernourished children (AU)

The short-term effects of breakfast on the cognitive functions of school children - abstract

A large sum of money is spent annually on school feeding programmes in developed and developing countries. However, a few of these programmes have been evaluated in developing countries. The short-term effects of breakfast on cognitive functions were examined in 97 undernourished (weight-for age < 1 SD) and 100 adequately nourished (weight-for-age > - 1 SD) children attending grades three and four of four remote rural schools in Jamaica. Half of the children were given breakfast and the other half a quarter of an orange as a placebo at 8:30 a.m. Treatment began at least one week prior to testing. Children were retested a few weeks later when the treatment order was reversed. The cognitive functions measured were sustained attention (Memory and Search), auditory short-term memory (Digit Span), fluency and choice reaction time (Numbers). Girls performed better than boys in tasks of sustained attention and choice reaction time (p<0.001 and 0.002, respectively). Breakfast had a beneficial effect in scores of fluency in the undernourished group not in the adequately nourished group. Both adequately nourished and undernourished boys scored higher in test of digit span when given breakfast. The results suggest that breakfast programmes can have some benefits on children's cognitive functions (AU)