scholarly journals Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Marina C. Evangelista ◽  
Ryota Watanabe ◽  
Vivian S. Y. Leung ◽  
Beatriz P. Monteiro ◽  
Elizabeth O’Toole ◽  
...  
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Rater Reliability ◽  
Analgesic Treatment ◽  
Naturally Occurring ◽  
Total Pain ◽  
Excellent Internal Consistency ◽  
Development And Validation ◽  
Validated Instrument ◽  
Control Study

AbstractGrimace scales have been used for pain assessment in different species. This study aimed to develop and validate the Feline Grimace Scale (FGS) to detect naturally-occurring acute pain. Thirty-five client-owned and twenty control cats were video-recorded undisturbed in their cages in a prospective, case-control study. Painful cats received analgesic treatment and videos were repeated one hour later. Five action units (AU) were identified: ear position, orbital tightening, muzzle tension, whiskers change and head position. Four observers independently scored (0–2 for each AU) 110 images of control and painful cats. The FGS scores were higher in painful than in control cats; a very strong correlation with another validated instrument for pain assessment in cats was observed (rho = 0.86, p < 0.001) as well as good overall inter-rater reliability [ICC = 0.89 (95% CI: 0.85–0.92)], excellent intra-rater reliability (ICC > 0.91), and excellent internal consistency (Cronbach’s alpha = 0.89). The FGS detected response to analgesic treatment (scores after analgesia were lower than before) and a cut-off score was determined (total pain score > 0.39 out of 1.0). The FGS is a valid and reliable tool for acute pain assessment in cats.

Development and Validation of an Instrument to Assess Horseback Mobility in Hippotherapy

2021 ◽  
pp. 003151252110365
Author(s):  
Alessandra V. Prieto ◽  
Kênnea Martins Almeida Ayupe ◽  
Ana C. A. Abreu ◽  
Paulo J. B. Gutierres Filho
Keyword(s):  
Correlation Coefficient ◽  
Factor Structure ◽  
Internal Consistency ◽  
Rater Reliability ◽  
Intra Class Correlation ◽  
Exploratory Factor Analyses ◽  
Excellent Internal Consistency ◽  
Development And Validation ◽  
Functional Gain ◽  
Intra Class Correlation Coefficient

Improvement in rider mobility represents an important functional gain for people with disabilities undergoing hippotherapy. However, there is no validated measuring instrument to track and document the rider's progress in riding activities. In this study, we aimed to develop and establish validity evidence for an instrument to assess hippotherapy participants’ mobility on horseback. We report on this development through the stages of: (a) content validation, (b) construct validation, (c) inter- and intra-rater reliability and (d) internal consistency analysis. We evaluated its factor structure with exploratory factor analyses, calculated values for inter- and intra-rater reliability using the intra-class correlation coefficient, and calculated its internal consistency using Cronbach's alpha. We followed recommendations by the Guidelines for Reporting Reliability and Agreement Studies. We found good inter-rater reliability (intra-class correlation coefficient – ICC = 0.991–0.999) and good intra-rater reliability (ICC = 0.997–1.0), and there was excellent internal consistency (Cronbach's α = 0.937–0.999). The instrument’s factor structure grouped its three domains into one factor. As this instrument is theoretically consistent and has been found to be appropriate and reliable for its intended use, it is now available for the measurement of horseback mobility among hippotherapy riders.

scholarly journals Acute pain in cats: Recent advances in clinical assessment

2018 ◽  
Vol 21 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Paulo V Steagall ◽  
Beatriz P Monteiro
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Pain Scale ◽  
Treatment Standards ◽  
Future Directions ◽  
Recent Advances ◽  
Pain Scales ◽  
Species Specific ◽  
Pain Recognition ◽  
Development And Validation

Practical relevance: Pain assessment has gained much attention in recent years as a means of improving pain management and treatment standards. It has become an elemental part of feline practice with ultimate benefit to feline health and welfare. Currently pain assessment involves mostly the investigation of sensory-discriminative (intensity, location and duration) and affective-motivational (emotional) domains of pain. Specific behaviors associated with acute pain have been identified and constitute the basis for its assessment in cats. Recent advances: The publication of pain scales with reported validation – the UNESP-Botucatu multidimensional composite pain scale and the Glasgow feline composite measure pain scale – and species-specific studies have advanced our knowledge on the subject. Facial expressions have also been shown to be different between painful and non-painful cats, and very recently the Feline Grimace Scale has been validated as a tool for acute pain assessment. Clinical challenges: Despite recent advances, several challenges still exist. For instance, the effects of disease and sedation on pain scoring/ assessment are unknown. Also, specific painful conditions (eg, dental pain) have not been systematically investigated. The development and validation of instruments for pain assessment by cat owners is warranted, as these tools are currently lacking. Aims: This article reviews the use, advantages, disadvantages and limitations of the two validated pain scales, and presents a practical, stepwise approach to feline pain recognition and assessment using a dynamic and interactive process. The authors also offer perspectives regarding current challenges and future directions.

scholarly journals Assessment for acute pain management in post-total knee replacement (TKR): a prospective cohort study in two Saudi Arabian medical centers

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mariam Ahmad Alameri ◽  
Syed Azhar bin Syed Sulaiman ◽  
Abdullah Moh’d Talaat Ashour ◽  
Ma’ad Faisal Al-Saati
Keyword(s):  
Cohort Study ◽  
Pain Management ◽  
Total Knee Replacement ◽  
Acute Pain ◽  
Joint Replacement ◽  
Acute Pain Management ◽  
Analgesic Treatment ◽  
Pain Management Index ◽  
Medical Centers ◽  
Total Knee

Abstract Background Acute pain in post joint replacement surgeries is common, which makes the management of acute pain following joint replacement surgeries to be very important. Thus, this study was conducted to evaluate acute pain management of post TKR surgeries. Results Patients with negative pain management index (PMI) scores were classified as receiving inadequate analgesic treatment for their pain. Zero PMI was the most frequent score among the others with 195 (80.6%). The rest were − 1 (11 (4.5%)), 1 (27 (11.2%)), and 2 (9 (3.7%)), respectively. Only 4.5% (11/242) patients have negative PMI score, which could be considered as inadequate pain management in which these patients received inadequate analgesic treatment. Conclusion Acute pain management in post-TKR surgeries in both medical centers achieved an acceptable level, and majority of patients received an adequate analgesia in post-TKR surgeries.

Reliability of three linguistically and culturally validated pain assessment tools for sedated ICU patients by ICU nurses in Finland

2018 ◽  
Vol 18 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Sanna-Mari Pudas-Tähkä ◽  
Sanna Salanterä
Keyword(s):  
Intensive Care ◽  
Internal Consistency ◽  
Pain Assessment ◽  
Assessment Tools ◽  
Endotracheal Suctioning ◽  
Icu Patients ◽  
Rater Reliability ◽  
Intensive Care Patients ◽  
Video Recordings ◽  
Test Retest Reliability

Abstract Background and aims: Pain assessment in intensive care is challenging, especially when the patients are sedated. Sedated patients who cannot communicate verbally are at risk of suffering from pain that remains unnoticed without careful pain assessment. Some tools have been developed for use with sedated patients. The Behavioral Pain Scale (BPS), the Critical-Care Pain Observation Tool (CPOT) and the Nonverbal Adult Pain Assessment Scale (NVPS) have shown promising psychometric qualities. We translated and culturally adapted these three tools for the Finnish intensive care environment. The objective of this feasibility study was to test the reliability of the three pain assessment tools translated into Finnish for use with sedated intensive care patients. Methods: Six sedated intensive care patients were videorecorded while they underwent two procedures: an endotracheal suctioning was the nociceptive procedure, and the non-nociceptive treatment was creaming of the feet. Eight experts assessed the patients’ pain by observing video recordings. They assessed the pain using four instruments: the BPS, the CPOT and the NVPS, and the Numeric Rating Scale (NRS) served as a control instrument. Each expert assessed the patients’ pain at five measurement points: (1) right before the procedure, (2) during the endotracheal suctioning, (3) during rest (4) during the creaming of the feet, and (5) after 20 min of rest. Internal consistency and inter-rater reliability of the tools were evaluated. After 6 months, the video recordings were evaluated for testing the test-retest reliability. Results: Using the BPS, the CPOT, the NVPS and the NRS, 960 assessments were obtained. Internal consistency with Cronbach’s alpha coefficient varied greatly with all the instruments. The lowest values were seen at those measurement points where the pain scores were 0. The highest scores were achieved after the endotracheal suctioning at rest: for the BPS, the score was 0.86; for the CPOT, 0.96; and for the NVPS, 0.90. The inter-rater reliability using the Shrout-Fleiss intraclass correlation coefficient (ICC) tests showed the best results after the painful procedure and during the creaming. The scores were slightly lower for the BPS compared to the CPOT and the NVPS. The test-retest results using the Bland-Altman plots show that all instruments gave similar results. Conclusions: To our knowledge, this is the first time all three behavioral pain assessment tools have been evaluated in the same study in a language other than English or French. All three tools had good internal consistency, but it was better for the CPOT and the NVPS compared to the BPS. The inter-rater reliability was best for the NVPS. The test-retest reliability was strongest for the CPOT. The three tools proved to be reliable for further testing in clinical use. Implications: There is a need for feasible, valid and reliable pain assessment tools for pain assessment of sedated ICU patients in Finland. This was the first time the psychometric properties of these tools were tested in Finnish use. Based on the results, all three instruments could be tested further in clinical use for sedated ICU patients in Finland.

2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats

2021 ◽  
Vol 24 (1) ◽  
pp. 4-30
Author(s):  
Paulo V Steagall ◽  
Sheilah Robertson ◽  
Bradley Simon ◽  
Leon N Warne ◽  
Yael Shilo-Benjamini ◽  
...  
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Multimodal Analgesia ◽  
Evidence Base ◽  
Pharmacological Therapy ◽  
Assessment Tools ◽  
Mental Wellbeing ◽  
Team Approach ◽  
Analgesic Drugs

Practical relevance: Increases in cat ownership worldwide mean more cats are requiring veterinary care. Illness, trauma and surgery can result in acute pain, and effective management of pain is required for optimal feline welfare (ie, physical health and mental wellbeing). Validated pain assessment tools are available and pain management plans for the individual patient should incorporate pharmacological and non-pharmacological therapy. Preventive and multimodal analgesia, including local anaesthesia, are important principles of pain management, and the choice of analgesic drugs should take into account the type, severity and duration of pain, presence of comorbidities and avoidance of adverse effects. Nursing care, environmental modifications and cat friendly handling are likewise pivotal to the pain management plan, as is a team approach, involving the cat carer. Clinical challenges: Pain has traditionally been under-recognised in cats. Pain assessment tools are not widely implemented, and signs of pain in this species may be subtle. The unique challenges of feline metabolism and comorbidities may lead to undertreatment of pain and the development of peripheral and central sensitisation. Lack of availability or experience with various analgesic drugs may compromise effective pain management. Evidence base: These Guidelines have been created by a panel of experts and the International Society of Feline Medicine (ISFM) based on the available literature and the authors’ experience. They are aimed at general practitioners to assist in the assessment, prevention and management of acute pain in feline patients, and to provide a practical guide to selection and dosing of effective analgesic agents.

scholarly journals Development and Validation of a UHPLC-ESI-MS/MS Method for Quantification of Oleandrin and Other Cardiac Glycosides and Evaluation of Their Levels in Herbs and Spices from the Belgian Market

Toxins ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 243 ◽  
Author(s):  
Svetlana V. Malysheva ◽  
Patrick P. J. Mulder ◽  
Julien Masquelier
Keyword(s):  
Cardiac Glycosides ◽  
Solid Phase ◽  
Plant Secondary Metabolites ◽  
Naturally Occurring ◽  
Relative Standard ◽  
Liquid Chromatography Tandem Mass ◽  
Repeatability And Reproducibility ◽  
Culinary Herbs ◽  
The Mean ◽  
Development And Validation

Cardiac glycosides (CGs) are naturally occurring plant secondary metabolites that can be toxic to humans and animals. The aim of this work was to develop a targeted analytical method utilizing liquid chromatography—tandem mass spectrometry (LC-MS/MS) for quantification of these plant toxins in a herbal-based food and human urine. The method included oleandrin, digoxin, digitoxin, convallatoxin, and ouabain. Samples of culinary herbs were extracted with acetonitrile and cleaned using Oasis® MAX solid-phase extraction (SPE), while samples of urine were diluted with acidified water and purified on Oasis® HLB SPE cartridges. Limits of quantification were in the range of 1.5–15 ng/g for herbs and 0.025–1 ng/mL for urine. The mean recovery of the method complied with the acceptable range of 70–120% for most CGs, and relative standard deviations were at maximum 14% and 19% for repeatability and reproducibility, respectively. Method linearity was good with calculated R² values above 0.997. The expanded measurement uncertainty was estimated to be in the range of 7–37%. The LC-MS/MS method was used to examine 65 samples of culinary herbs and herb and spice mixtures collected in Belgium, from supermarkets and local stores. The samples were found to be free from the analyzed CGs.

Topical Review: State of the Field of Child Self-Report of Acute Pain

2019 ◽  
Author(s):  
Lindsey L Cohen ◽  
Matthew R Donati ◽  
Sharon Shih ◽  
Soumitri Sil
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Comprehensive Evaluation ◽  
Clinical Care ◽  
Preschool Age ◽  
Self Report ◽  
Common Features ◽  
Topical Review ◽  
Review State ◽  
State Of The Field

Abstract Objective Children experience acute pain with routine and emergent healthcare, and untreated pain can lead to a range of repercussions. Assessment is vital to diagnosing and treating acute pain. Given the internal nature of pain, self-report is predominant. This topical review reflects on the state of the field of pediatric acute pain self-report, and proposes a framework for acute pain assessment via self-report. Method We examine self-report of acute pain in preschool-age children through adolescents, and we detail a three-step process to optimize acute pain assessment. Results The first step is to decide between a pain screening or assessment. Several 0–10 self-report scales are available for pain screenings. Assessment requires specification of the goals and domains to target. Core criteria, common features, modulating factors, and consequences of acute pain provide a framework for a comprehensive pain assessment. Whereas there are some measures available to assess aspects of these domains, there are considerable gaps. Last, it is important to integrate the data to guide clinical care of acute pain. Conclusions Self-report of acute pain is dominated by single-item intensity scales, which are useful for pain screening but inadequate for pain assessment. We propose a three-step approach to acute pain assessment in children. However, there is a need for measure development for a comprehensive evaluation of the core criteria, common features, modulating factors, and consequences of pediatric acute pain. In addition, there is limited guidance in merging data found in multifaceted evaluations of pediatric acute pain.

scholarly journals Development and Validation of a Liquid Chromatographic Method for the Simultaneous Determination of Estradiol, Estriol, Estrone, and Progesterone in Pharmaceutical Preparations

2009 ◽  
Vol 92 (3) ◽  
pp. 846-854 ◽  
Author(s):  
Phyllis Wilson
Keyword(s):  
Mobile Phase ◽  
Chromatographic Method ◽  
Pharmaceutical Preparations ◽  
Men And Women ◽  
Naturally Occurring ◽  
Vital Functions ◽  
Liquid Chromatographic Method ◽  
Development And Validation ◽  
Liquid Chromatographic

Abstract Progesterone and estrogens are hormones produced in the human body that are essential for regulating many vital functions. The three major estrogens produced by women are estriol, estradiol, and estrone. Progesterone is a naturally occurring hormone in both men and women. Pharmaceuticals containing estrogens alone or estrogens in combination with progesterone are commonly used in therapy. Patients requiring unique combinations of the drugs rely on pharmacies to compound the ingredients. In order to assess the potency of drugs containing combinations of estrogens and progesterone, a method was developed to determine all four ingredients simultaneously. The liquid chromatographic method utilized a Bondapak C18 column with an isocratic mobile phase of acetonitrilewater (50 + 50, v/v) at a flow rate of 1.0 mL/min and temperature of 30C. Under these conditions, the order of elution was estriol, estradiol, and estrone, followed by progesterone. UV detection was at 205 nm to monitor elution of the estrogens, then switched to 270 nm to monitor progesterone. The method was applied to the analysis of pharmacy-compounded drugs containing combinations of the hormones. Validation studies demonstrated that the method is accurate and precise.

Detecting Acute Pain is Enough: The Conundrum of Pain Assessment

Neonatal Pain ◽  
2017 ◽  
pp. 105-111
Author(s):  
C. V. Bellieni ◽  
G. Buonocore
Keyword(s):  
Acute Pain ◽  
Pain Assessment
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