Electronic Health Record Recording of Patient Pain: Challenges and Discrepancies.

PURPOSE OF REVIEW: In the present review, various categories of pain, clinician-observed pain scales, and patient-reported pain scales are evaluated to better understand factors that impact patient pain perceptions. Additionally, the expansion of areas that require further research to determine the optimal way to evaluate pain scale data for treatment and management are discussed. RECENT FINDINGS: Electronic health record (EHR) data provides a starting point for evaluating whether patient predictors influence postoperative pain. There are several ways to assess pain and choosing the most effective form of pain treatment. Identifying individuals at high risk for severe postoperative pain enables more effective pain treatment. However, there are discrepancies in patient pain reporting dependent on instruments used to measure pain and their storage in the EHR. Additionally, whether administered by a physician or another healthcare practitioner, differences in patient pain perception occur. While each scale has distinct advantages and limitations, pain scale data is a valuable therapeutic tool for assisting clinicians in providing patients with optimal pain control. Accurate assessment of patient pain perceptions by data extraction from electronic health records provides a potential for pain alleviation improvement. Predicting high-risk postoperative pain syndromes is a difficult clinical challenge. Numerous studies have been conducted on factors that impact pain prediction. Postoperative pain is significantly predicted by the kind of operation, the existence of prior discomfort, patient anxiety, and age.

Why, and where, is commercial fishing gear lost? A global review and case study of Pacific Canada.

Derelict fishing gear is a global problem, damaging marine ecosystems via habitat degradation and trapping marine life, thereby impacting fisheries. We conducted a global review of reasons for commercial gear loss, and used the findings to design a survey focused on coastal British Columbia (BC), Canada. We conducted dockside and on-line surveys of commercial fishers to record their experiences with lost gear across net, line, and trap gear types. The most common reasons for gear loss from the global review were interactions with other fishing vessels and their gear, marine weather, and snagging on submerged features. Survey results of 29 fishers in BC indicated that snagging gear on rough substrate was the most important reason for loss across all gear categories, followed by seafloor type. Other reasons for gear loss varied by net, line, and trap gear type. Understanding reasons for gear loss is important to reduce losses.