The endogenous opioid system is one of the most studied innate pain-relieving systems. This system consists of widely scattered neurons that produce three opioids: β-endorphin, the met- and leu-enkephalins, and the dynorphins. These opioids act as neurotransmitters and neuromodulators at three major classes of receptors, termed μ, δ, and κ, and produce analgesia. Like their endogenous counterparts, the opioid drugs, or opiates, act at these same receptors to produce both analgesia and undesirable side effects. This article examines some of the recent findings about the opioid system, including interactions with other neurotransmitters, the location and existence of receptor subtypes, and how this information drives the search for better analgesics. We also consider how an understanding of the opioid system affects clinical responses to opiate administration and what the future may hold for improved pain relief. The goal of this article is to assist clinicians to develop pharmacological interventions that better meet their patient's analgesic needs.

The authors reported the association between motivation and self-management behavior of individuals with chronic low back pain after adjusting control variables using hierarchical multiple regression (Jung & Jeong, 2016). This article describes details of the hierarchical regression applying the actual data used in the article by Jung and Jeong (2016), including how to test assumptions, run the statistical tests, and report the results.

Aim: This research is designed to establish and evaluate the effectiveness of a virtual reality simulation program using COVID‐19 scenario for nursing students.Design: This is a quasi‐experimental study using a non‐equivalent control group pre‐test‐posttest design.Methods: The participants were 65 students in their fourth year in nursing college. The knowledge about communicable infectious diseases in the respiratory system, self‐efficacy, clinical reasoning capacity and learning satisfaction was evaluated.Results: The experimental group showed a significantly higher learning satisfaction (t = 3.01, p = .004). Both groups presented statistically significant differences in knowledge on infectious respiratory diseases, self‐efficacy and clinical reasoning between pre‐test and posttest. However, knowledge (t = 0.47, p = .643), self‐efficacy (t = 0.70, p = .944) and clinical reasoning were not different between the groups.

No evidence to date shows that lateral hypothalamic (LH) stimulation produces orexin-A-mediated antinociception in the spinal cord dorsal horn (SCDH) in a model of neuropathic pain. We conducted experiments to examine the effect of orexin-A-mediated LH stimulation in female rats with chronic constriction injury (CCI) on thermal hyperalgesia. Rats receiving carbachol into the LH demonstrated antinociception on both the left CCI and right nonligated paws ( p < .05). Rats were given carbachol in the LH followed by intrathecal injection of the orexin-1 (OX₁) receptor antagonist SB-334867, which blocked LH-induced antinociception compared with control groups ( p < .05) in the left paw, but not in the right paw. These findings support the hypothesis that LH stimulation produces antinociception in rats with thermal hyperalgesia from neuropathic pain via an orexin-A connection between the LH and the SCDH. Identification of this pathway may lead to studies using orexins to manage clinical pain.