scholarly journals Pain and Associated Neuropsychiatric Symptoms in Patients Suffering from Dementia: Challenges at Different Levels and Proposal of a Conceptual Framework

2021 ◽  
pp. 1-7
Author(s):  
Liane Kaufmann ◽  
Korbinian Moeller ◽  
Josef Marksteiner
Keyword(s):  
Chronic Pain ◽  
High Risk ◽  
Conceptual Framework ◽  
Language Comprehension ◽  
Pain Perception ◽  
Neuropsychiatric Symptoms ◽  
Future Research ◽  
Advanced Dementia ◽  
Clinical Process ◽  
Different Levels

Old age is critically associated with multi-morbidity, chronic pain, and high risk for dementia. Recognizing and treating pain is very much dependent on language comprehension and production. Both may be impaired in dementia. Moreover, neuropsychiatric symptoms may interact with pain perception. The main aims of the present article were 1) to identify key areas for future research to elucidate the relation between pain and associated neuropsychiatric symptoms in dementia, and 2) to provide a conceptual framework for ameliorating the clinical process of recognizing, assessing, and managing pain in non-communicating patients with advanced dementia.

Understanding control in nonprofit organisations: moving governance research forward?

2015 ◽  
Vol 15 (1) ◽  
pp. 134-145 ◽  
Author(s):  
Terri Byers ◽  
Christos Anagnostopoulos ◽  
Georgina Brooke-Holmes
Keyword(s):  
Conceptual Framework ◽  
Design Methodology ◽  
Levels Of Analysis ◽  
Future Research ◽  
Holistic View ◽  
Content Type ◽  
Nonprofit Organisations ◽  
Critical Realist ◽  
Time Periods ◽  
Different Levels

Purpose – The purpose of this paper is to introduce the concept of organisational control and both its importance and utility for understanding nonprofit organisations. Design/methodology/approach – This paper uses a critical realist (CR) methodology to discuss the concept of control and its utility to research on governance of nonprofit organisations. Findings – The current study offers a conceptual framework that presents a holistic view of control, relevant for analysing nonprofit organisations, and a methodological lens (CR) through which this framework can be implemented. Research limitations/implications – This paper suggests that studies of governance should consider different levels of analysis, as suggested by examining the concept of control using a CR framework. This notion has yet to be tested empirically and a framework for examining governance from a CR perspective of control is suggested. Context is highly relevant to understanding control, and thus, this model requires testing in a wide diversity of nonprofit sectors, sizes of organisations and time periods. Originality/value – The literature on organisational control provides useful insights to advance our understanding of nonprofit organisations beyond the notion of governance, and this paper proposes both conceptual and methodological underpinnings to facilitate future research.

scholarly journals Benchmarking outcomes on multiple contextual levels in lean healthcare: a systematic review, development of a conceptual framework, and a research agenda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elina Reponen ◽  
Thomas G. Rundall ◽  
Stephen M. Shortell ◽  
Janet C. Blodgett ◽  
Angelica Juarez ◽  
...  
Keyword(s):  
Conceptual Framework ◽  
System Level ◽  
Future Research ◽  
Patient Centered ◽  
Performance Benchmarking ◽  
International Benchmarking ◽  
Lean Healthcare ◽  
Meta Analyses ◽  
Different Levels ◽  
Outcome Metrics

Abstract Background Reliable benchmarking in Lean healthcare requires widely relevant and applicable domains for outcome metrics and careful attention to contextual levels. These levels have been poorly defined and no framework to facilitate performance benchmarking exists. Methods We systematically searched the Pubmed, Scopus, and Web of Science databases to identify original articles reporting benchmarking on different contextual levels in Lean healthcare and critically appraised the articles. Scarcity and heterogeneity of articles prevented quantitative meta-analyses. We developed a new, widely applicable conceptual framework for benchmarking drawing on the principles of ten commonly used healthcare quality frameworks and four value statements, and suggest an agenda for future research on benchmarking in Lean healthcare. Results We identified 22 articles on benchmarking in Lean healthcare on 4 contextual levels: intra-organizational (6 articles), regional (4), national (10), and international (2). We further categorized the articles by the domains in the proposed conceptual framework: patients (6), employed and affiliated staff (2), costs (2), and service provision (16). After critical appraisal, only one fifth of the articles were categorized as high quality. Conclusions When making evidence-informed decisions based on current scarce literature on benchmarking in healthcare, leaders and managers should carefully consider the influence of context. The proposed conceptual framework may facilitate performance benchmarking and spreading best practices in Lean healthcare. Future research on benchmarking in Lean healthcare should include international benchmarking, defining essential factors influencing Lean initiatives on different levels of context; patient-centered benchmarking; and system-level benchmarking with a balanced set of outcomes and quality measures.

Plasticity

2018 ◽  
Author(s):  
Claire Magnussen ◽  
Alfredo Ribeiro-da-Silva
Keyword(s):  
Chronic Pain ◽  
Conceptual Framework ◽  
Neuronal Plasticity ◽  
Future Research ◽  
Nociceptive Neurons ◽  
Excellent Review ◽  
Pain Research ◽  
Review Articles ◽  
Plastic Changes ◽  
Highly Cited

This chapter discusses the landmark paper ‘Neuronal plasticity: increasing the gain in pain’, published by Woolf and Salter in 2000. Excellent review articles not only give a concise overview of a topic but also provide a framework for future research. In 2000, Clifford Woolf and Michael Salter joined forces to write one of the most highly cited review articles in the field of pain research and thus provided a conceptual framework for the plastic changes that occur in nociceptive neurons in response to chronic pain. With over 2,700 citations, this review is one of those rare articles that is still appreciated by pain researchers across domains.

The Emergence and Maintenance of Ethical Leadership in Organizations

2012 ◽  
Vol 11 (1) ◽  
pp. 7-19 ◽  
Author(s):  
Silke Astrid Eisenbeiß ◽  
Steffen R. Giessner
Keyword(s):  
Cultural Values ◽  
Ethical Leadership ◽  
Leadership Behavior ◽  
Peer Group ◽  
Organizational Characteristics ◽  
Future Research ◽  
Environmental Complexity ◽  
Group Influence ◽  
Analysis Society ◽  
Different Levels

The present paper gives a review of empirical research on ethical leadership and shows that still little is known known about the contextual antecedents of ethical leadership. To address this important issue, a conceptual framework is developed that analyzes the embeddedness of organizational ethical leadership. This framework identifies manifest and latent contextual factors on three different levels of analysis – society, industry, and organization – which can affect the development and maintenance of ethical leadership. In particular, propositions are offered about how (1) societal characteristics, notably the implementation and the spirit of human rights in a society and societal cultural values of responsibility, justice, humanity, and transparency; (2) industry characteristics such as environmental complexity, the content of the organizational mandate, and the interests of stakeholder networks; and (3) intra-organizational characteristics, including the organizational ethical infrastructure and the ethical leadership behavior of a leader’s peer group, influence the development and maintenance of ethical leadership in organizations. This list of factors is not exhaustive, but illustrates how the three levels may impact ethical leadership. Implications for managerial practice and future research are discussed.

Role of Ethnicity on Pain Perception, Fatigue, and Quality of Life in a Pediatric Chronic Pain Population

2007 ◽  
Author(s):  
Jeffrey I. Gold ◽  
Trina Haselrig ◽  
D. Colette Nicolaou ◽  
Katharine A. Belmont
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Perception ◽  
Pediatric Chronic Pain

scholarly journals Protocol for a systematic review on the experience of informal caregivers for people with a moderate to advanced dementia within a domestic home setting

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Charles James ◽  
Catherine Walshe ◽  
Katherine Froggatt
Keyword(s):  
Systematic Review ◽  
Negative Impact ◽  
Current Knowledge ◽  
Informal Caregivers ◽  
Informal Caregiving ◽  
Bibliographic Databases ◽  
Future Research ◽  
Advanced Dementia ◽  
Home Setting ◽  
Search Terms

Abstract Background The knowledge about the experience of informal caregivers who provide care to people with moderate to advanced dementia in a domestic home setting is limited. A consequence of long hours of caregiving in addition to dealing with normal challenges of daily living is their experience of a poor quality of life. Some of their experiences may be described in terms of a feeling of powerlessness to make changes during care provision. This feeling may also suggest an experience of moral distress. The aim of this systematic review is to synthesise qualitative evidence relating to these experiences. Methods This review adopts a narrative synthesis approach. A search will be conducted for studies written in the English language in the bibliographic databases MEDLINE Complete, CINAHL, EMBASE, PsycINFO, Web of Science and Academic Search Complete covering periods from 1984 to present. Included studies will be qualitative or mixed-methods designs. The search terms will be related to dementia and caregivers, and the process will be focused on dementia at the moderate to the advanced stages within the domestic home setting. Reference lists of included papers will also be searched for additional relevant citations. Search terms and strategies will be checked by two independent reviewers. The identification of abstracts and full texts of studies will be done by the author, while the quality and the risk of bias will also be checked by the two independent reviewers. Discussion Psychological distress is cited as an experience reported within informal caregiving. For the caregiver, it is associated with a negative impact on general health. To date, no synthesis exists on the specific experience of informal caregiving for people with moderate to advanced dementia within the domestic home setting. This review considers that variation of accounts contributes to how the informal caregivers’ general experience is explored in future research. This may enable gaps in current knowledge to be highlighted within the wider context of caregiving in the domestic home setting. Systematic review registration This review is registered with PROSPERO (CRD42020183649).

scholarly journals Evaluating the Relationship Between Initial Injury, Referral to A Pain Clinic, and Medical Retirement from the Army: A Retrospective Analysis

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 502-505
Author(s):  
Justin J Stewart ◽  
Diane Flynn ◽  
Alana D Steffen ◽  
Dale Langford ◽  
Honor McQuinn ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Retrospective Analysis ◽  
Extended Period ◽  
Pain Clinic ◽  
Outcome Variable ◽  
Future Research ◽  
Curvilinear Relationship ◽  
The Impact ◽  
Pain Care ◽  
The Relationship

ABSTRACT Introduction Soldiers are expected to deploy worldwide and must be medically ready in order to accomplish their mission. Soldiers unable to deploy for an extended period of time because of chronic pain or other conditions undergo an evaluation for medical retirement. A retrospective analysis of existing longitudinal data from an Interdisciplinary Pain Management Center (IPMC) was used to evaluate the temporal relationship between the time of initial duty restriction and referral for comprehensive pain care to being evaluated for medical retirement. Methods Patients were adults (>18 years old) and were cared for in an IPMC at least once between May 1, 2014 and February 28, 2018. A total of 1,764 patients were included in the final analysis. Logistic regression was used to evaluate the impact of duration between date of first duty restriction documentation and IPMC referral to the outcome variable of establishment of a permanent 3 (P3) profile. Results The duration between date of first duty restriction and IPMC referral showed a curvilinear relationship to probability of a P3 profile. According to our model, a longer duration before referral is associated with an increased probability of a subsequent P3 profile with the highest probability peaking at 19 months. The probability of P3 declines gradually for those who were referred later. Discussion This is the first time the relationship between time of initial duty restriction, referral to an IPMC, and subsequent P3 or higher profile has been tested. Future research is needed to examine medical conditions listed on the profile to see how they might contribute to the cause of referral to the IPMC. Conclusion A longer duration between initial duty restriction and referral to IPMC was associated with higher odds of subsequent P3 status for up to 19 months. Referral to an IPMC for comprehensive pain care early in the course of chronic pain conditions may reduce the likelihood of P3 profile and eventual medical retirement of soldiers.

scholarly journals Identification of novel autophagy-related lncRNAs associated with a poor prognosis of colon adenocarcinoma through bioinformatics analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dejun Wu ◽  
Zhenhua Yin ◽  
Yisheng Ji ◽  
Lin Li ◽  
Yunxin Li ◽  
...  
Keyword(s):  
High Risk ◽  
Poor Prognosis ◽  
Notch Pathway ◽  
Colon Adenocarcinoma ◽  
High Risk Group ◽  
The Cancer Genome Atlas ◽  
Future Research ◽  
Risk Patients ◽  
Cancer Genome Atlas ◽  
Immune Score

AbstractLncRNAs play a pivotal role in tumorigenesis and development. However, the potential involvement of lncRNAs in colon adenocarcinoma (COAD) needs to be further explored. All the data used in this study were obtained from The Cancer Genome Atlas database, and all analyses were conducted using R software. Basing on the seven prognosis-related lncRNAs finally selected, we developed a prognosis-predicting model with powerful effectiveness (training cohort, 1 year: AUC = 0.70, 95% Cl = 0.57–0.78; 3 years: AUC = 0.71, 95% Cl = 0.6–0.8; 5 years: AUC = 0.76, 95% Cl = 0.66–0.87; validation cohort, 1 year: AUC = 0.70, 95% Cl = 0.58–0.8; 3 years: AUC = 0.73, 95% Cl = 0.63–0.82; 5 years: AUC = 0.68, 95% Cl = 0.5–0.85). The VEGF and Notch pathway were analyzed through GSEA analysis, and low immune and stromal scores were found in high-risk patients (immune score, cor =  − 0.15, P < 0.001; stromal score, cor =  − 0.18, P < 0.001) , which may partially explain the poor prognosis of patients in the high-risk group. We screened lncRNAs that are significantly associated with the survival of patients with COAD and possibly participate in autophagy regulation. This study may provide direction for future research.

scholarly journals Vitamin D Deficiency Induces Chronic Pain and Microglial Phenotypic Changes in Mice

2021 ◽  
Vol 22 (7) ◽  
pp. 3604
Author(s):  
Nicola Alessio ◽  
Carmela Belardo ◽  
Maria Consiglia Trotta ◽  
Salvatore Paino ◽  
Serena Boccella ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vitamin D ◽  
Chronic Pain ◽  
Vitamin D Deficiency ◽  
Morphological Analysis ◽  
Pain Perception ◽  
Ex Vivo ◽  
Ros Generation ◽  
Peroxisome Proliferator ◽  
Neuroprotective Effects

The bioactive form of vitamin .D, 1,25-dihydroxyvitamin D (1,25D3), exerts immunomodulatory actions resulting in neuroprotective effects potentially useful against neurodegenerative and autoimmune diseases. In fact, vitamin D deficiency status has been correlated with painful manifestations associated with different pathological conditions. In this study, we have investigated the effects of vitamin D deficiency on microglia cells, as they represent the main immune cells responsible for early defense at central nervous system (CNS), including chronic pain states. For this purpose, we have employed a model of low vitamin D intake during gestation to evaluate possible changes in primary microglia cells obtained from postnatal day(P)2-3 pups. Afterwards, pain measurement and microglia morphological analysis in the spinal cord level and in brain regions involved in the integration of pain perception were performed in the parents subjected to vitamin D restriction. In cultured microglia, we detected a reactive—activated and proliferative—phenotype associated with intracellular reactive oxygen species (ROS) generation. Oxidative stress was closely correlated with the extent of DNA damage and increased β-galactosidase (B-gal) activity. Interestingly, the incubation with 25D3 or 1,25D3 or palmitoylethanolamide, an endogenous ligand of peroxisome proliferator-activated-receptor-alpha (PPAR-α), reduced most of these effects. Morphological analysis of ex-vivo microglia obtained from vitamin-D-deficient adult mice revealed an increased number of activated microglia in the spinal cord, while in the brain microglia appeared in a dystrophic phenotype. Remarkably, activated (spinal) or dystrophic (brain) microglia were detected in a prominent manner in females. Our data indicate that vitamin D deficiency produces profound modifications in microglia, suggesting a possible role of these cells in the sensorial dysfunctions associated with hypovitaminosis D.

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