Much research has assessed methods of pain control for cattle castration, but there remains a lack of consensus regarding best practice. We conducted a systematic review and meta-analysis of published research including both an untreated control (i.e. castrated without pain mitigation) and at least one unimodal or multimodal analgesia treatment (i.e. castrated with a local anaesthetic alone, or in combination with a non-steroidal anti-inflammatory drug) to summarise findings on castration pain management. Studies were included if they castrated by surgery, elastration or crushing, and reported at least one of the following outcomes: cortisol, change in bodyweight, foot stomping, wound licking, a subjective assessment of pain using a visual analogue scale, or stride length. Our search identified 383 publications, of which 17 were eligible for inclusion. Most publications focused on surgical castration (n = 14), and the most frequently reported outcome was blood cortisol (n = 13). None of the included studies were assessed as having a low risk of bias, mostly due to a lack of reporting blinding procedures and reasons for missing data. Using a three-level random effect model, we concluded that multimodal analgesia reduced blood cortisol concentrations in the first hour following surgical castration in comparison to the control group; this effect was diminished but still evident at 3 and 4 h, but not beyond at 6, 12 and 24 h. Too few data were available to meaningfully assess other outcomes and methods. Variability in methods and outcomes between studies, and risks of bias, hinder our capacity to provide science-based recommendations for best practice.

Galen’s most deeply held professional values included clarity of expression and the epistemological importance of clinical experience. Therefore, it is not surprising that he thought and wrote about communication with patients. His stories about patients show that he questioned them about their symptoms and history, and some stories explicitly teach the lesson that this type of questioning is important. His stories often quote patients indirectly or directly; they are often told partly from the patient’s perspective, and some contain constructions indicating that Galen paid attention to an individual patient’s exact words. In On the Affected Parts, his discussion of the vocabulary of pain – a problem in medical communication still important today – he privileges the common usage of patients over the technical vocabulary invented by Archigenes. He argues that only by listening to patients and their words can we construct a useful vocabulary of metaphors for pain that can bridge the gap in experience between physician and patient. He does not dismiss the words of women or enslaved patients; on the other hand, in a few stories where the patriarch of a family is present and the patient is female or enslaved, Galen’s dialogue tends to engage the head of the household rather than the patient. While some of his stories show off his ability to diagnose patients without talking to them, and others raise the problem of the lying patient, none of these stories would have meaning unless the patients’ words were normally crucial to clinical practice.

Cannabis has a long history as a medicine and was a part of medical practice until the late 19th century. The discovery of cannabidiol (CBD) and ∆9-tetrahydrocannabinol (THC) in the mid-20th century, and then the various components of the endocannabinoid system (ECS) over the following decades has again brought cannabis back into the public eye as a potential therapeutic agent. At present, cannabis is being used in the community across the world for both recreational and medical purposes. In the case of medical usage, it may be prescribed by a medical doctor or purchased either legally or illicitly for medical purposes such as symptom relief. Evidence for cannabis as a medicine is still an emerging field, and while potential mechanisms of action for a variety of conditions have been elucidated, including cancer, epilepsy, and chronic pain, high-quality randomized controlled trials in humans are still lacking. Despite popular beliefs, cannabis, like all other medicines, has potential benefits and harms, and long-term consumption of cannabis, even for medical reasons, may not be risk-free. In addition, consumption via modes of administration such as smoking or using a bong may increase the risk of negative health outcomes.

Growing evidence suggests that psychedelic-assisted therapies can alleviate depression, anxiety, posttraumatic stress, and substance use disorder, offering relatively safe profiles, enhanced efficacy, and lasting effects after a few applications. Athletes often experience high levels of stress and pressure, making them susceptible to these psychiatric conditions. However, the effects of psychedelic substances on athletic performance remain largely unknown. Before potential acceptance, evaluating their impact on physical and physiological measures beyond mental health outcomes is crucial. Here, we aim to explore this topic and highlight research directions to advance our understanding. Preclinical studies suggest that psilocybin/psilocin, lysergic acid diethylamide (LSD), N,N-dimethyltryptamine (DMT), and ayahuasca possess anti-inflammatory and anti-nociceptive properties. Studies investigating the effects of classical psychedelics or 3,4-methylenedioxymethamphetamine (MDMA) on factors such as muscle strength, motor coordination, locomotion, endurance, fluid and electrolyte balance, hormonal regulation, and metabolism are still scarce. While adhering to regulatory frameworks, further research in animal models, athletes, and non-athletes is needed to address these gaps, compare psychedelics with commonly used psychoactive drugs, and explore the potential prophylactic and regenerative benefits of specific interventions.

Pain is a highly salient and attention-demanding experience that motivates people to act. We investigated the effect of pain on decision making by delivering acute thermal pain to participants’ forearm while they made risky and intertemporal choices involving money. Participants (n = 107) were more risk seeking under pain than in a no-pain control condition when decisions involved gains but not when they involved equivalent losses. Pain also resulted in greater preference for immediate (smaller) over future (larger) monetary rewards. We interpret these results as a motivation to offset the aversive, pain-induced state, where monetary rewards become more appealing under pain than under no pain and when delivered sooner rather than later. Our findings add to the long-standing debate regarding the role of intuition and reflection in decision making.

Japanese patients often describe their pain with ideophones (sound-symbolic, imitative words), such as biribiri ‘having a continuous electric shock’. However, some manuals for healthcare workers recommend avoiding using these words in their interactions with patients, assuming that they are too subjective. We examined how reliable pain ideophones are in comparison with pain metaphors, such as denki-ga hashiru-yoona itami ‘pain like an electric current running through one’s body’. In Experiment 1, Japanese speakers rated visually presented pain ideophones and metaphors on 15 semantic-differential scales (e.g., strong–weak, momentary–continuous). It was found that the ratings of ideophones and metaphors equally varied between participants. In Experiment 2, Japanese speakers did the same rating task for a selected set of pain ideophones and metaphors presented auditorily in sentence frames. The results show that ideophones were rated more consistently than metaphors across participants, and this was true for various prosodic/morphological variants of ideophones (e.g., biriiit-to ‘having a sudden, great electric shock’, biribirit-to ‘having a momentary repetitive electric shock’). These findings indicate that ideophones can be more reliable than metaphors in health communication, especially when placed in proper context.