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Once upon a time, paediatrics was involved with infectious disease
and acute disorders, but a new pattern of morbidity has emerged.
Social difficulties, behavioural problems, developmental
difficulties, disabilities and chronic disease have become main
parts of the scope of paediatric practice. Among adults, multiple
chronic disease is increasingly prevalent, whereas the prevalence
of impairment and disability remain stable, but substantial and
therefore, present day health professionals must be aware of
disability and chronic disease. Just a few decades ago, children
born with significant congenital anomalies or genetic and metabolic
diseases perished at an early age and very few survived into their
teens and even less into adulthood. Congenital heart disease, major
errors in metabolism, cancer, cystic fibrosis and many other major
diseases were fatal. Because of that, many physicians in adult
primary care did not have the opportunity to see patients with
these problems and thus were unable to learn how to care for them.
With major advancements in medical knowledge, technology, imaging
techniques, surgical skills and pharmaceutical products as well as
prosthetic devices, many of these patients now live much longer
lives and sometimes even close to the average life expectancy for
the country, at least in the developed world. With that, a new
medical care challenge has been created and we have to take a life
span approach.
Mental health is "a state of well-being in which the individual
realises his or her own abilities; can cope with the normal
stresses of life; can work productively and fruitfully; and is able
to make a contribution to his or her community". Mental illness is
defined as "collectively, all diagnosable mental disorders" or
"health conditions that are characterised by alterations in
thinking, mood, or behaviour (or some combination thereof)
associated with distress and/or impaired functioning." Mental
disorders, especially depressive disorders, are related to many
chronic diseases like diabetes, cancer, cardiovascular disease,
asthma and obesity. In recent years, there has been an alarming
number of school shootings with youth or adults involved who are
seriously mentally disturbed. There has also been an increase in
suicides and mental pathology in the military and in fact, many
professionals perceive that the increase in psychiatric drugs
negatively impacts our population. In spite of more people
receiving psychotropic medication at a large expense to the
individual and society, it does not seem that people are getting
better on the whole. As a result, there is a need to re-evaluate
our policy and interventions, but also a need for more accurate
data and information.
Since pain management became a speciality in its own right and
following the tremendous breakthroughs made by several pioneer
researchers, we have seen major developments in the field and a
growing international interest represented at the many national
conferences and the World Pain Congress and European Congress. But
there is still much to do, as there are still groups
under-represented in the research such as children, older adults
and people with intellectual and developmental disabilities. Also,
we do not have all the answers and pain is an area, where
traditional medicine may well be complemented by the field of
complementary and alternative therapies. In this book, we have
gathered recent papers related to many aspects of pain and pain
management and it is our hope that you will all benefit from the
wisdom in the many research papers.
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