Being maladaptive and frequently unresponsive to pharmacotherapy, chronic pain presents a major unmet clinical need. While an intact central nervous system is required for conscious pain perception, nociceptor hyperexcitability induced by nerve injury in the peripheral nervous system (PNS) is sufficient and necessary to initiate and maintain neuropathic pain. The genesis and propagation of action potentials is dependent on voltage-gated sodium channels, in particular, Nav1.7, Nav1.8 and Nav1.9. However, nerve injury triggers changes in their distribution, expression and/or biophysical properties, leading to aberrant excitability. Most existing treatment for pain relief acts through non-selective, state-dependent sodium channel blockage and have narrow therapeutic windows. Natural toxins and developing subtype-specific and molecular-specific sodium channel blockers show promise for treatment of neuropathic pain with minimal side effects. New approaches to analgesia include combination therapy and gene therapy. Here, we review how individual sodium channel subtypes contribute to pain, and the attempts made to develop more effective analgesics for the treatment of chronic pain.

Background: Previous studies focusing on high-income countries have shown that young people often face greater barriers to accessing healthcare than older adults.However, in low-middle income countries (LMICs), there have been a paucity of cross-country, quantitative studies highlighting these barriers.Aim: This exploratory study aims to provide a scoping review of the publicly available Demographic and Heath Survey (DHS) data with a view to form the basis for further work.Materials and methods: Data on insurance coverage, agency, and access to evidence-based family planning from 30 countries in the DHS were compared between age groups. Data on 586,250 participants 15-24 years (33% male) and 854,660 participants 25-49 years (16% male) from 30 LMICs were analyzed.Results: Significantly greater barriers to accessing healthcare were observed across six variables in younger population when compared to older adults across all survey questions with an average of 8.4% point difference. Also, there was wide countrylevel variation: the maximum differences between age groups were 33% points; Rwanda was the only country with no age differences.Discussion: This study highlights several possible themes for future research into improving access to healthcare for young people. These themes include more detailed evaluation of country-specific policies to reduced barriers to healthcare for young people and further research into the causative factors that can influence healthcare utilization by young people. Conclusion:Our analysis showcases increased barriers to healthcare access for young people in LMICs. We argue that they can only be improved by targeted policies and direct community engagement.

Modern ventilators are increasingly compact and able to deliver a wide range of ventilator modes and sophisticated monitoring capabilities. However, the global availability of ventilators is woefully short of demand. Data on intensive care units (ICUs), a proxy measure for hospital ventilator capacity in low and middle‐income countries (LMIC's), suggest that capacity is extremely limited where it exists at all. In LMIC's, the four most common indications for mechanical ventilation (MV) in ICUs are post‐surgical care, sepsis, trauma, and maternal peripartum or neonatal complications. A significant majority of these cases can be managed with intervention involving a short course of MV. Widespread and timely access to MV can thus effectively be used to help patients in these settings and improve outcomes. This paper implores this need and highlights the requirements for a low‐cost ventilator or a respiratory support device.

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PurposeThe ageing population is a global phenomenon that is occurring in many countries around the world, including the UK. According to the Office for National Statistics (ONS), the proportion of the UK population aged 65 years and over is projected to increase, reaching 25% by 2045. This increase will have a significant impact on a range of social and economic issues. One of the ways to reduce this impact is to improve self-care.Design/methodology/approachThe availability of simple assistive devices can facilitate physical activity and help complete daily living activities. These devices can also help in the self-management of long-term health and well-being. To encourage self-care, it is essential to create awareness about these assistive products. Simple assistive products such as shoe horns, magnifying glasses or a sphygmomanometer that are readily available to buy from shops were grouped into four boxes or kits. The authors provided these simple devices to 175 community-dwelling older adults in deprived areas and followed them up via a phone survey after 4–6 weeks.FindingsThe authors recorded overall positive feedback on individual products and the kit. The results indicate that there was a sense of empowerment and ability by the recipients to take control of their health and well-being and management of their health condition using items contained in the kit provided.Practical implicationsThe study results show that simple assistive products empower older adults to self-care and can provide a positive impact on their activities of daily living.Originality/valuePrevious studies have shown that regular exercise can enhance both physical and mental abilities and reverse certain chronic health issues. Simple household devices can aid in increasing physical activity. This work highlights how these devices enable older adults to take care of themselves, with a focus on capturing their personal perspectives and experiences.