What's in a Name? Health Care Providers' Perceptions of Pediatric Pain Patients Based on Diagnostic Labels.

OBJECTIVES: Diagnostic labels can help patients better understand their symptoms and can influence providers' treatment planning and patient interactions. Recurrent pain is common in childhood; however, there are various diagnostic labels used. The objective of this study was to evaluate the influence of diagnostic labels on pediatric health care providers' perceptions of pediatric chronic pain patients. MATERIALS AND METHODS: Using an online survey, providers were randomly assigned to 1 of 2 vignette conditions (differing only in diagnostic label provided) and completed questionnaires about their perceptions of the vignette patient. RESULTS: Responses from 58 participants were analyzed. The 2 groups, based on diagnostic conditions used (fibromyalgia and chronic widespread pain) did not differ significantly on general demographics and health care providers' perceptions of the patient. Perceived origin of the pain influenced providers' perceptions; pain of a perceived medical origin was negatively correlated with stigmatization and positively correlated with sympathy. Perceived psychological origin was positively correlated with stigmatization and providers' age. DISCUSSION: Health care providers' perceptions of children's pain are more likely influenced by the presumed etiology rather than the diagnostic label used. Pain believed to be more medically based was associated with more positive reactions from providers (ie, less stigmatization). Older providers in particular perceived the patient more negatively if they believe the pain to be psychologically based. The findings of this pediatric study replicated findings from adult literature on chronic pain, suggesting that children and adults are subject to negative perceptions from health care providers when the providers believe the pain to be psychological in origin.

Trace elements in eggs of common eiders (Somateria mollissima) breeding in Nova Scotia, Canada.

We provide the first report on trace element concentrations in eggs of common eiders (Somateria mollissima), a coastal benthic foraging sea duck, from Nova Scotia, Canada, and compare those to known values from this species elsewhere. Most trace elements of toxicological concern (Hg, Se, Cd, Cu, Zn) were lower in eider eggs from Nova Scotia than from eider eggs collected farther north in Canada, although As was elevated. Our data provide strong support for a pattern of increasing Hg at higher latitudes for this species.