The heightened interest in pain management is making the need for appropriate boundary setting within the clinician-patient relationship even more apparent. Unfortunately, it is impossible to determine before hand, with any degree of certainty, who will become problematic users of prescription medications. With this in mind, a parallel is drawn between the chronic pain management paradigm and our past experience with problems identifying the "at-risk" individuals from an infectious disease model. By recognizing the need to carefully assess all patients, in a biopsychosocial model, including past and present aberrant behaviors when they exist, and by applying careful and reasonably set limits in the clinician-patient relationship, it is possible to triage chronic pain patients into three categories according to risk. This article describes a "universal precautions" approach to the assessment and ongoing management of the chronic pain patient and offers a triage scheme for estimating risk that includes recommendations for management and referral. By taking a thorough and respectful approach to patient assessment and management within chronic pain treatment, stigma can be reduced, patient care improved, and overall risk contained.

Methadone at relatively low doses seems to be useful in the treatment of neuropathic pain.

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Foreword organisations' performance will be assessed not just on whether they are meeting national targets, but increasingly on whether they are delivering high quality services across a range of areas, including National Service Frameworks.

The factors impacting life expectancy (LE) are important to a country as LE reflects the essential quality of its population. Previous studies showed that other than economic factors, health status and resources (HSR) and sociodemographic (SD) also affect LE. This area has not been previously studied in Bahrain, especially in the past five decades. Hence, this study aims to develop an explanatory model for HSR, macroeconomic (ME), and SD factors on LE in Bahrain. The research was a retrospective, time-series design that collected the annual published data on SD, ME, HSR, and LE in Bahrain's population from 1971 to 2020. The data were analyzed using the partial least squares-structural equation modeling (PLS-SEM) method. The result shows that ME (0.463, P < .001) and HSR (0.595, P < .001) have significant direct effects on LE. ME has an indirect effect (0.488, P < .001) on LE via SD and HSR, and SD has an indirect effect (0.496, P < .001) on LE through HSR. During the socioeconomic downturn, the health resources provision should not be reduced as it directly affects LE. An integrated policy addressing socioeconomic and health-related factors could protect the future of Bahrain's population health outcomes.

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