scholarly journals The Social, Professional, and Legal Framework for the Problem of Pain Management in Emergency Medicine

2005 ◽  
Vol 33 (4) ◽  
pp. 741-760 ◽  
Author(s):  
Sandra H. Johnson
Keyword(s):  
Emergency Medicine ◽  
Pain Management ◽  
Pain Relief ◽  
Legal Framework ◽  
Health Crisis ◽  
Integrated Environment ◽  
The Social ◽  
Complex Ecosystem ◽  
The Subject ◽  
Effective Pain Relief

The problem of harmful, unnecessary and neglected pain has been studied extensively in many health care settings over the past decade. Research has documented the incidence of untreated pain, and scholars and advocates have given the problem several names: “public health crisis,” “oligoanalgesia, and “moral failing,” among them. Articles have identified a litany of now familiar “obstacles” or “barriers” to effective pain relief. Each of these individual obstacles or barriers has been the subject of targeted remedial action in at least some context.The checklist approach to improving care for patients in pain, however, is likely to have only limited effect. What really appears to be operating is a complex ecosystem that supports ambivalence, denial, and even suspicion of the circumstance of patients in pain and efforts to treat them. Pain relief in emergency medicine, a relatively new setting for the study of challenges to treating pain, provides a revealing context for viewing discrete obstacles to effective pain management in medicine as part of an integrated environment into which patients with pain enter for treatment.

scholarly journals Prescription Of analgesia in Emergency Medicine (POEM): a multicentre observational survey of pain relief in patients presenting with an isolated limb fracture and/or dislocation

2019 ◽  
Vol 14 (4) ◽  
pp. 211-220
Author(s):  
James Robert Sheehan ◽  
Sarah Wilson ◽  
Jane Quinlan ◽  
Sally Beer ◽  
Melanie Darwent ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pain Management ◽  
Pain Relief ◽  
Pain Score ◽  
Acute Pain ◽  
Practice Guidelines ◽  
Best Practice ◽  
Patient Journey ◽  
Limb Fracture ◽  
Best Practice Guidelines

Background: Acute pain is one of the most commonly cited reasons for attendance to the emergency department (ED), and the Royal College of Emergency Medicine (RCEM) Best Practice Guideline (2014) acknowledged that the current management of acute pain in UK EDs is inadequate and has a poor evidence base. Methods: The Prescription Of analgesia in Emergency Medicine (POEM) survey is a cross-sectional observational survey of consecutive patients presenting to 12 National Health Service (NHS) EDs with limb fracture and/or dislocation in England and Scotland and was carried out between 2015 and 2017. The primary outcome was to assess the adequacy of pain management in the ED against the recommendations in the RCEM Best Practice Guidelines. Results: In all, 8346 patients were identified as attending the ED with a limb fracture and/or dislocation but adherence to RCEM guidelines could only be evaluated for the 4160 (49.8%) patients with a recorded pain score. Of these, 2409/4160 (57.9%) patients received appropriate pain relief, but only 1347 patients were also assessed within 20 minutes of their arrival in the ED. Therefore, according to the RCEM guidelines, only 16.1% (1347/8346) of all patients were assessed and had satisfactory pain management in the ED. Conclusions: The POEM survey has identified that pain relief for patients with an isolated limb fracture remains inadequate when strictly compared to the RCEM Best Practice Guidelines. However, we have found that some patients receive analgesia despite having no pain score recorded, while other analgesic modalities are provided that are not currently encompassed by the Best Practice Guidelines. Future iterations of these guidelines may wish to encompass the breadth of available modalities of pain relief and the whole patient journey. In addition, more work is needed to improve timely and repeated assessment of pain and its recording, which has been better achieved in some EDs than others.

scholarly journals DIRECTIONS OF DEVELOPMENT OF COOPERATION CRIMINAL-EXECUTIVE SYSTEM AND TRADITIONAL CONFESSIONS WHEN PERFORMING PUNISHMENTS RELATED TO ISOLATION FROM THE COMPANY

2018 ◽  
pp. 87-91
Author(s):  
Andrey Petrovich Skiba
Keyword(s):  
Social Impact ◽  
Legal Framework ◽  
Russian Orthodox ◽  
Orthodox Church ◽  
Russian Orthodox Church ◽  
Religious Influence ◽  
The Social ◽  
Penal Institutions ◽  
The Subject ◽  
The Right

The subject of the study is studying the interaction between the penitentiary system (MIS) and traditional confessions in the execution of sentences related to the isolation of the convict from society. The purpose of the study is to study the religious influence exerted by clergymen representing traditional confessions (the Russian Orthodox Church, etc.) as an integral part of the social impact, which, according to Art. 9 PEC of the RF refers to one of the main means of correcting convicts. The main results of the research, proceeding from the provisions of the penal enforcement legislation, reflect the directions for regulating the exercise of the right of convicts in penal institutions to freedom of conscience and freedom of religion associated with the establishment of restrictions on its implementation by convicts; inviting clergymen to the convicts, their communication and ensuring security in this communication; organization of religious ceremonies and ceremonies; development of the legal framework for the interaction of MIS and traditional confessions by concluding relevant agreements.

scholarly journals Relaciones de la Administración y el sector privado en la adaptación jurídica a la gestión de los servicios públicos

2014 ◽  
pp. 641
Author(s):  
Julián Torrado Sancho
Keyword(s):  
Public Management ◽  
Legal Framework ◽  
Two Dimensions ◽  
The Rule Of Law ◽  
The Public ◽  
Organization And Management ◽  
The Social ◽  
The Subject ◽  
Important Object ◽  
The One

Se considera a la modernización administrativa un proceso histórico concreto en el que se producen transformaciones en la gestión pública de los Estados liberal-democráticos de los que España forma parte. Su principal característica procede de la modificación en las formas de prestación de los servicios públicos, que afectan a dos dimensiones respecto a sus antecedentes inmediatos, por una parte la privatización de sus relaciones con el entorno social y por otra la tecnificación de sus métodos de organización y gestión. Si bien la Administración pública es el sujeto de dichos cambios basados en políticas públicas destinadas a ella, su marco jurídico constituye el objeto más relevante para el funcionamiento del Estado de Derecho, sustrato definitorio de la eficacia y razón de ser de su organización y actividad.The administrative modernization is considered a concrete historical process in which changes occur in the public management of democratic liberal states of which Spain is a part. Its main feature is from the change in the ways of delivering public services, involving two dimensions relative to its immediate antecedents, on the one hand, privatization of its relationship with the social environment and on the other the modernization of its methods of organization and management. While public administration is the subject of such changes based on public policies aimed at her, its legal framework constitutes the most important object for the operation of the rule of law, definitor of the efficacy and rationale of its organization and activity.

scholarly journals Evolution of the Abortion Law and its Practice in Poland Against the Background of the Current Legal Framework in New Zealand

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Justyna Eska-Mikołajewska
Keyword(s):  
New Zealand ◽  
Criminal Law ◽  
Legal Framework ◽  
Historical Overview ◽  
Abortion Law ◽  
Abortion Legislation ◽  
The Social ◽  
Abortion Laws ◽  
The Subject ◽  
Contemporary Approach

The article presents a comparative study on abortion legislation in Poland and New Zealand. It includes a historical overview of the social and political influences shaping the contemporary approach to abortion in these countries. The aim of the article is to discuss the changes to the Polish and New Zealand abortion legislation and the current procedures required to access abortion. This article highlights differences in approaches to this issue in both countries where abortion laws have evolved recently in opposite directions. In New Zealand, after removing abortion from the Crimes Act 1961, abortion ceased to be the subject to criminal law, while in Poland where one of the strictest anti-abortion laws had been in force already, a ban was imposed on abortion which made it practically impossible for women to access legal abortions.

Savages, Drunks, and Lab Animals: The Researcher's Perception of Pain

1993 ◽  
Vol 1 (1) ◽  
pp. 61-81 ◽  
Author(s):  
Mary T. Phillips
Keyword(s):  
Pain Relief ◽  
Social Status ◽  
Surgical Procedures ◽  
Subjective Experience ◽  
Companion Animals ◽  
Ethnographic Study ◽  
Research Protocol ◽  
Similar Tendency ◽  
The Social ◽  
The Subject

AbstractHistorically, treatment for pain relief has varied according to the social status of the sufferer. A similar tendency to make arbitrary distinctions affecting pain relief was found in an ethnographic study of animal research laboratories. The administration of pain-relieving drugs for animals in laboratories differed from standard practice for humans and, perhaps, for companion animals. Although anesthesia was used routinely for surgical procedures, its administration was sometimes haphazard. Analgesics, however, were rarely used. Most researchers had never thought about using analgesics and did not consider the subject worthy of serious attention. Scientists interviewed for this study agreed readily that animals are capable offeeling pain, but such assertions were muted by an overriding view of lab animals as creatures existing solely for the purposes of research. As a result, it was the exceptional scientist who was able to focus on anything about the animal's subjective experience that might lie outside the boundaries of the research protocol.

Regulatory and Legal Support for Stimulation of Business Activities within the Framework of the Industrial Policy

2018 ◽  
Vol 11 (3) ◽  
pp. 89-93 ◽  
Author(s):  
N. M. Abdikeev ◽  
I. G. Tyutyunnik
Keyword(s):  
Industrial Policy ◽  
Russian Federation ◽  
Social Relations ◽  
Legal Framework ◽  
Economic Situation ◽  
Russian Economy ◽  
The Social ◽  
The Subject ◽  
The Russian Federation ◽  
Stimulation Of

The subject of the research is the social relations that develop in using legal incentives aimed at supporting business activities in the industrial policy. The purpose of the research was to identify gaps in the legislation that impede the promotion of business activities of production companies. The paper examines the main forms of the regulatory and legal support for boosting business activities in the implementation of the industrial policy in order to create conditions for further reforms, attract investment to the Russian economy and thereby improve the social and economic situation in the Russian Federation. The level of the regulatory and legal support of business activities in the industrial policy is evaluated. It is concluded that the legal framework must be improved to enhance the legal support of business stimulation.

scholarly journals Analgesia after Caesarean Delivery

2009 ◽  
Vol 37 (4) ◽  
pp. 539-551 ◽  
Author(s):  
N. J. Mcdonnell ◽  
M. L. Keating ◽  
N. A. Muchatuta ◽  
T. J. G. Pavy ◽  
M. J. Paech
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Multimodal Approach ◽  
Nerve Blocks ◽  
Resource Limitations ◽  
Is Research ◽  
New Mother ◽  
Effective Pain Relief ◽  
No Gold Standard ◽  
Developed World

As the number of women giving birth by caesarean increases throughout most of the developed world, so too is research into postoperative pain relief for these women. Like most other post-surgical populations, the new mother needs effective pain relief so that she can mobilise early but she also has the added responsibility of needing to care for her newborn baby. There is no ‘gold standard’ for post-caesarean pain management; the number of options is large and the choice of method is at least partly determined by drug availability, regional and individual preferences, resource limitations and financial considerations. Most methods rely on opioids, supplemented with anti-inflammatory analgesics, nerve blocks or other adjunctive techniques. The aim of this review is to detail commonly used opioid-based methods and to review the evidence supporting non-opioid methods, when incorporated into a multimodal approach to post-caesarean pain management. Areas of promising research are also discussed.

Fakir Baykurt’un Almanya öykülerinde Türk göçmen çocukları

2016 ◽  
Vol 3 (1) ◽  
pp. 5-28
Author(s):  
Efnan Dervişoğlu
Keyword(s):  
Social Sciences ◽  
Migrant Workers ◽  
Life Experiences ◽  
Main Theme ◽  
Social Dimensions ◽  
Home Life ◽  
Literary Forms ◽  
The Social ◽  
The Subject ◽  
Life Education

Almanya’ya işçi göçü, neden ve sonuçları, sosyal boyutlarıyla ele alınmış; göç ve devamındaki süreçte yaşanan sorunlar, konunun uzmanlarınca dile getirilmiştir. Fakir Baykurt’un Almanya öyküleri, sunduğu gerçekler açısından, sosyal bilimlerin ortaya koyduğu verilerle bağdaşan edebiyat ürünleri arasındadır. Yirmi yılını geçirdiği Almanya’da, göçmen işçilerle ve aileleriyle birlikte olup işçi çocuklarının eğitimine yönelik çalışmalarda bulunan yazarın gözlem ve deneyimlerinin ürünü olan bu öyküler, kaynağını yaşanmışlıktan alır; çalışmanın ilk kısmında, Fakir Baykurt’un yaşamına ve Almanya yıllarına dair bilgi verilmesi, bununla ilişkilidir. Öykülere yansıyan çocuk yaşamı ise çalışmanın asıl konusunu oluşturmaktadır. “Ev ve aile yaşamı”, “Eğitim yaşamı ve sorunları”, “Sosyal çevre, arkadaşlık ilişkileri ve Türk-Alman ayrılığı” ile “İki kültür arasında” alt başlıklarında, Türkiye’den göç eden işçi ailelerinde yetişen çocukların Almanya’daki yaşamları, karşılaştıkları sorunlar, öykülerin sunduğu veriler ışığında değerlendirilmiş; örneklemeye gidilmiştir. Bu öyküler, edebiyatın toplumsal gerçekleri en iyi yansıtan sanat olduğu görüşünü doğrular niteliktedir ve sosyolojik değerlendirmelere açıktır. ENGLISH ABSTRACTMigration and Children in Fakir Baykurt’s stories from GermanyThe migration of workers to Germany has been taken up with its causes, consequences and social dimensions; the migration and the problems encountered in subsequent phases have been stated by experts in the subject. Fakir Baykurt’s stories from Germany, regarding the reality they represent, are among the literary forms that coincide with the facts supplied by social sciences. These stories take their sources from true life experiences as the products of observations and experiences with migrant workers and their families in Germany where the writer has passed twenty years of his life and worked for the education of the worker’s children; therefore information related to Fakir Baykurt’s life and his years in Germany are provided in the first part of the study.  The life of children reflected in the stories constitutes the main theme of the study.  Under  the subtitles of “Family and Home Life”, “Education Life and related issues”, “Social environment, friendships and Turkish-German disparity” and “Amidst two cultures”, the lives in Germany of children who have been  raised in working class  families and  who have immigrated from Turkey are  evaluated under the light of facts provided by the stories and examples are given. These stories appear to confirm that literature is an art that reflects the social reality and is open to sociological assessments.KEYWORDS: Fakir Baykurt; Germany; labor migration; child; story

Cancer pain management

2014 ◽  
Vol 155 (3) ◽  
pp. 93-99
Author(s):  
Péter Heigl
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Pain Relief ◽  
Life Expectancy ◽  
Cancer Pain ◽  
Cancer Pain Management ◽  
Medical Activity ◽  
Short Summary ◽  
Adequate Quality

Pain is a significant and alarming symptom of cancer seriously affecting the activity and quality of life of patients. Recent research proved that inadequate analgesia shortens life expectancy. Therefore, pain relief is not only a possibility but a professional, ethical and moral commitment to relieve patients from suffering, as well as ensure their adequate quality of life and human dignity. Proper pain relief can be achieved with medical therapy in most of the cases and the pharmacological alternatives are available in Hungary. Yet medical activity regarding pain relief is far from the desired. This paper gives a short summary of the guidelines on medical pain management focusing particularly on the use of opioids. Orv. Hetil., 2014, 155(3), 93–99.

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