Procedural pain distraction

2021 ◽  
pp. 547-554
Author(s):  
Lindsey L. Cohen ◽  
Laura A. Wright ◽  
Sarah R. Martin ◽  
Sharon Shih ◽  
Matthew Donati
Keyword(s):  
Venous Access ◽  
Procedural Pain ◽  
Clinical Settings ◽  
Painful Procedure ◽  
Cancer Treatments ◽  
Theoretical Rationale ◽  
Conducting Research

This chapter focus on distraction as an intervention for children’s acute medical pain. We start by highlighting the consequences of untreated procedural pain for children. Next, we discuss the theoretical rationale for distraction and its anesthetic qualities. Subsequently, we present the literature examining the effectiveness of distraction for lowering children’s distress associated with immunizations, venous access, burn debridement, and cancer treatments. Then we synthesize the distraction for procedural pain literature, and we highlight some of the issues to consider when conducting research or applying distraction in clinical settings. We conclude the chapter with a vignette, which illustrates some of the nuances to consider when applying and personalizing distraction for a child undergoing an acute painful procedure.

Procedural pain distraction

2013 ◽  
pp. 553-559 ◽  
Author(s):  
Lindsey L. Cohen ◽  
Laura A. Cousins ◽  
Sarah R. Martin
Keyword(s):  
Pain Management ◽  
Venous Access ◽  
The Other ◽  
Procedural Pain ◽  
Cancer Treatments ◽  
Management Intervention ◽  
Behavioural Approach ◽  
Children's Pain

This chapter provides a brief overview of paediatric procedural pain, highlighting some of the negative repercussions of untreated pain. The behavioural approach of distraction is covered in depth, starting with the theoretical underpinnings of this pain management intervention and then summarizing the distraction literature across children’s pain during immunizations, venous access, burn debridement and treatment, and cancer treatments. The chapter concludes with a discussion of some of the other reviews of this literature as well as clinical and research considerations when examining distraction for paediatric pain management.

Practical Steps to Community Engaged Research: From Inputs to Outcomes

2012 ◽  
Vol 40 (4) ◽  
pp. 904-914 ◽  
Author(s):  
Malika Roman Isler ◽  
Giselle Corbie-Smith
Keyword(s):  
Research Process ◽  
Multidisciplinary Teams ◽  
Clinical Settings ◽  
Recruitment Strategies ◽  
Research Paradigm ◽  
Culturally Appropriate ◽  
Community Settings ◽  
Community Members ◽  
Community Engaged Research ◽  
Conducting Research

For decades, the dominant research paradigm has included trials conducted in clinical settings with little involvement from communities. However, concerns about the relevance and applicability of the processes or outcomes of such research have led to calls for greater community engagement in the research process. As such, there has been a shift in emphasis from simply recruiting research participants from community settings to engaging community members more broadly in all aspects of the research process. The move toward community engaged research (CEnR) is in part driven by the recognition that inclusion of diverse perspectives in multidisciplinary teams is essential to addressing complex problems. Investigators have come to recognize the inherent value of engaging community members as collaborators in multidisciplinary teams that are conducting research on issues of concern to communities. The insider perspective from community members is now recognized as essential in designing effective and well-received recruitment strategies, culturally appropriate measures, and identifying meaningful and broad-reaching venues for dissemination.

scholarly journals Experimental surgical protocol for continuous femoral venous access in the rat

2019 ◽  
Vol 22 (3) ◽  
pp. 322-329
Author(s):  
Y. A. Goranova ◽  
I. M. Samnaliev ◽  
S. N. Nikolov ◽  
O. D. Zlatev ◽  
G. R. Kesov ◽  
...  
Keyword(s):  
Continuous Monitoring ◽  
Femoral Vein ◽  
Circulatory System ◽  
Monitoring And Evaluation ◽  
Venous Access ◽  
Systemic Circulation ◽  
Clinical Settings ◽  
Surgical Model ◽  
Experimental Pharmacology

Access to the circulatory system is essential for continuous monitoring and long-term experimental study. One of the commonest methods for venous access is femoral vein cannulation. The aim of the presented protocol was to elaborate a surgical model for cannulation of femoral vein in rat. Temporary cannulae such as butterfly needles can be used in short-term procedures, whereas long-term monitoring required surgical implantation of a biocompatible cannula. The protocol allows direct venous access, continuous monitoring and evaluation of the tested compounds in experimental pharmacology and toxicology – the tested compounds reach the systemic circulation immediately and the dose can be accurately titrated against response. The protocol can be applied as an alternative for venous access in experimental clinical settings.

scholarly journals Performing arts medicine: A research model for South Africa

2014 ◽  
Vol 10 (2) ◽  
Author(s):  
Karendra Devroop
Keyword(s):  
South Africa ◽  
Performing Arts ◽  
Sports Medicine ◽  
Clinical Settings ◽  
Research Model ◽  
Medical Problems ◽  
Performing Arts Medicine ◽  
Performing Artists ◽  
Conducting Research ◽  
Research Studies

Performing Arts Medicine has developed into a highly specialised field over the past three decades. The Performing Arts Medical Association (PAMA) has been the leading proponent of this unique and innovative field with ground-breaking research studies, symposia, conferences and journals dedicated specifically to the medical problems of performing artists. Similar to sports medicine, performing arts medicine caters specifically for the medical problems of performing artists including musicians and dancers. In South Africa there is a tremendous lack of knowledge of the field and unlike our international counterparts, we do not have specialised clinical settings that cater for the medical problems of performing artists. There is also a tremendous lack of research on performance-related medical problems of performing artists in South Africa. Accordingly the purpose of this paper is to present an overview of the field of performing arts medicine, highlight some of the significant findings from recent research studies and present a model for conducting research into the field of performing arts medicine. It is hoped that this research model will lead to increased research on the medical problems of performing artists in South Africa.

scholarly journals Ultrasound probe grip: the afternoon tea technique

2017 ◽  
Vol 18 (3) ◽  
pp. 258-260 ◽  
Author(s):  
Luke McMenamin ◽  
Stephen Wolstenhulme ◽  
Max Hunt ◽  
Stuart Nuttall ◽  
Asoka Weerasinghe
Keyword(s):  
Teaching Method ◽  
Central Venous Access ◽  
Venous Access ◽  
Clinical Settings ◽  
Ultrasound Probe ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Intravenous Access ◽  
Teaching Technique ◽  
Peripheral Intravenous Access

Background Globally, ultrasound is being used to assist in central venous and difficult peripheral intravenous access in a variety of emergency and non-emergency clinical settings. Context After reading Flood’s paper on safe central venous access and noting the difficulties clinicians find in probe stabilisation whilst performing dynamic intravenous access, we decided to share our teaching technique. Innovation The purpose of this correspondence is to highlight the ‘afternoon tea technique’ as a potential teaching method for probe stabilisation. Implications It is hoped that this technique will improve the image quality in dynamic procedures and increase the success rate of ultrasound-guided intravenous access in clinical practice.

scholarly journals Lung cancer organoids analyzed on microwell arrays predict drug responses of patients within a week

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Yawei Hu ◽  
Xizhao Sui ◽  
Fan Song ◽  
Yaqian Li ◽  
Kaiyi Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Patient Specific ◽  
Clinical Settings ◽  
Cancer Treatments ◽  
Drug Responses ◽  
Tumor Tissues ◽  
Sensitivity Tests ◽  
Anti Cancer ◽  
Genetic Features ◽  
Low Efficiency

AbstractWhile the potential of patient-derived organoids (PDOs) to predict patients’ responses to anti-cancer treatments has been well recognized, the lengthy time and the low efficiency in establishing PDOs hamper the implementation of PDO-based drug sensitivity tests in clinics. We first adapt a mechanical sample processing method to generate lung cancer organoids (LCOs) from surgically resected and biopsy tumor tissues. The LCOs recapitulate the histological and genetic features of the parental tumors and have the potential to expand indefinitely. By employing an integrated superhydrophobic microwell array chip (InSMAR-chip), we demonstrate hundreds of LCOs, a number that can be generated from most of the samples at passage 0, are sufficient to produce clinically meaningful drug responses within a week. The results prove our one-week drug tests are in good agreement with patient-derived xenografts, genetic mutations of tumors, and clinical outcomes. The LCO model coupled with the microwell device provides a technically feasible means for predicting patient-specific drug responses in clinical settings.

Outcome Measures for Evaluating Intimate Partner Violence Programs Within Clinical Settings: A Systematic Review of the Literature

2016 ◽  
Vol 18 (5) ◽  
pp. 508-522 ◽  
Author(s):  
Sheila Sprague ◽  
Paula McKay ◽  
Kim Madden ◽  
Taryn Scott ◽  
Diana Tikasz ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Outcome Measures ◽  
Partner Violence ◽  
Intimate Partner ◽  
Included Study ◽  
Risk Of Bias ◽  
Clinical Settings ◽  
Assistance Programs ◽  
Conducting Research

Background: Multiple intimate partner violence (IPV) identification and assistance programs have been implemented across clinical settings. The results of these studies are inconclusive and frequently conflicting, resulting in clinical uncertainty and controversy regarding the merits of IPV identification and assistance programs. We aimed to describe the choice of outcome measures used in previously published randomized trials of IPV identification and assistance programs. Method: A comprehensive literature search was conducted in the Medline, Embase, PyscInfo, and CENTRAL databases. The outcomes assessed in each included study were extracted and categorized, and the methodological quality of each eligible study was assessed using the Cochrane Risk of Bias tool. Results: Of 20 eligible studies, 6 evaluated IPV identification programs and 14 studies examined IPV assistance programs. The included studies used 48 different outcomes that we classified into 10 categories. For identification studies, the most commonly used outcome categories were IPV disclosure (66.7%) and resource use (66.7%). The most commonly used outcome categories for the IPV assistance studies included IPV recurrence and severity (64.3%) and health outcomes (50%). The included studies demonstrated a number of methodological limitations as identified by the Cochrane Risk of Bias instrument. Conclusions: IPV identification and assistance programs are evaluated using many different outcome measures. Although this diversity enriches the IPV literature, it makes it challenging to compare studies. The results of this review highlight the challenges of conducting research in the field of IPV and the complexity of selecting, measuring, and interpreting outcomes.

scholarly journals PPAR-γ Modulators as Current and Potential Cancer Treatments

2021 ◽  
Vol 11 ◽  
Author(s):  
Tiange Chi ◽  
Mina Wang ◽  
Xu Wang ◽  
Ke Yang ◽  
Feiyu Xie ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Clinical Settings ◽  
Peroxisome Proliferator ◽  
Multiple Cancer ◽  
Cancer Treatments ◽  
Ppar Γ ◽  
Cancer Field ◽  
Potential Applications ◽  
Causes Of Mortality ◽  
Peroxisome Proliferator Activated Receptors

Worldwide, cancer has become one of the leading causes of mortality. Peroxisome Proliferator-Activated Receptors (PPARs) is a family of critical sensors of lipids as well as regulators of diverse metabolic pathways. They are also equipped with the capability to promote eNOS activation, regulate immunity and inflammation response. Aside from the established properties, emerging discoveries are also made in PPAR’s functions in the cancer field. All considerations are given, there exists great potential in PPAR modulators which may hold in the management of cancers. In particular, PPAR-γ, the most expressed subtype in adipose tissues with two isoforms of different tissue distribution, has been proven to be able to inhibit cell proliferation, induce cell cycle termination and apoptosis of multiple cancer cells, promote intercellular adhesion, and cripple the inflamed state of tumor microenvironment, both on transcriptional and protein level. However, despite the multi-functionalities, the safety of PPAR-γ modulators is still of clinical concern in terms of dosage, drug interactions, cancer types and stages, etc. This review aims to consolidate the functions of PPAR-γ, the current and potential applications of PPAR-γ modulators, and the challenges in applying PPAR-γ modulators to cancer treatment, in both laboratory and clinical settings. We sincerely hope to provide a comprehensive perspective on the prospect of PPAR-γ applicability in the field of cancer treatment.

scholarly journals Quantification of Pharmacokinetic Profiles of PD-1/PD-L1 Antibodies by Validated ELISAs

Pharmaceutics ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 595
Author(s):  
Sara Zalba ◽  
Ana M. Contreras-Sandoval ◽  
Eva Martisova ◽  
Reno Debets ◽  
Christian Smerdou ◽  
...  
Keyword(s):  
Drug Exposure ◽  
Checkpoint Inhibitors ◽  
Plasma Concentrations ◽  
Analytical Techniques ◽  
Critical Issue ◽  
Clinical Settings ◽  
Cancer Treatments ◽  
Time Profiles ◽  
Clinical Benefits ◽  
Report Data

Immunotherapy has changed the paradigm of cancer treatments. In this way, several combinatorial strategies based on monoclonal antibodies (mAb) such as anti (a)-PD-1 or anti (a)-PD-L1 are often reported to yield promising clinical benefits. However, the pharmacokinetic (PK) behavior of these mAbs is a critical issue that requires selective analytical techniques. Indeed, few publications report data on a-PD1/a-PD-L1 exposure and its relationship with therapeutic or toxic effects. In this regard, preclinical assays allow the time profiles of antibody plasma concentrations to be characterized rapidly and easily, which may help to increase PK knowledge. In this study, we have developed and validated two in-house ELISAs to quantify a-PD-1 and a-PD-L1 in plasma collected from tumor-bearing mice. The linear range for the a-PD-1 assay was 2.5–125 ng/mL and 0.11–3.125 ng/mL for the a-PD-L1 assay, whereas the intra-and inter-day precision was lower than 20% for both analytes. The PK characterization revealed a significant decrease in drug exposure after administration of multiple doses. Plasma half-life for a-PD-1 was slightly shorter (22.3 h) than for a-PD-L1 (46.7 h). To our knowledge, this is the first reported preclinical ELISA for these immune checkpoint inhibitors, which is sufficiently robust to be used in different preclinical models. These methods can help to understand the PK behavior of these antibodies under different scenarios and the relationship with response, thus guiding the choice of optimal doses in clinical settings.

Indications for Peripheral, Midline, and Central Catheters: Summary of the Michigan Appropriateness Guide for Intravenous Catheters Recommendations

2016 ◽  
Vol 21 (3) ◽  
pp. 140-148 ◽  
Author(s):  
Nancy Moureau ◽  
Vineet Chopra
Keyword(s):  
Treatment Plan ◽  
Central Venous Access ◽  
Venous Access ◽  
Clinical Settings ◽  
Intravenous Access ◽  
International Panel ◽  
Intravenous Catheters ◽  
Central Catheters ◽  
Venous Access Devices ◽  
Selection Of

Abstract Patients admitted to acute care frequently require intravenous access to effectively deliver medications and prescribed treatment. For patients with difficult intravenous access; those requiring multiple attempts; and those who are obese, have diabetes, or have other chronic conditions, determining the vascular access device (VAD) with the lowest risk that best meets the needs of the treatment plan can be confusing. Selection of a VAD should be based on specific indications for that device. In clinical settings, requests for central venous access devices are frequently precipitated simply by failure to establish peripheral access. Selection of the most appropriate VAD is necessary to avoid the potentially serious complications of infection and/or thrombosis. An international panel of experts convened to establish a guide for indications and appropriate use for VADs. This article summarizes the work and recommendations of the panel that created the Michigan Appropriateness Guide for Intravenous Catheters.

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