Jeremiah’s Deathscapes

This chapter explores the rhetorical structures of the book of Jeremiah with regard to its message of violent destruction—a topic that the chapter defines under the heading of “deathscape.” This term is defined as having two sub-strands: embodiment and spatiality. Jeremiah contains much material relating to the experiences of the central prophetic figure, which provides a solid textual resource for examining how the human person is impacted by the task of proclaiming terror and loss. The Confessions especially display a persona traumatized by this task. At the same time, land is rendered desolate, alongside the human inhabitants. Spatiality provides a tool for reading urban destruction via the lens of a withered landscape. Reading Jeremiah as a single work employs the methodological lens of rhetorical criticism, examining the way in which violent imagery expresses the link between historical events and literary depictions of the impact of warfare. Seeking for the cause of great suffering, Jeremiah locates it in the action of divine justice, a manner of providing order for chaos that renders the deity monstrous since it is the divine sphere that contextualizes unbearable human pain. Evaluation of Jeremiah’s urban imaginary aligns not only with material events but also with responses from differing audiences and parallel subject areas, such as gender, disability, and colonialism. Ultimately, the chapter suggests, further reflection on the inanimate agency of urban environments in creating textual poetics of deathscape will be useful.

The importance of professional based questionnaire in the dog’s acute and chronic pain evaluation

The measurement of pain levels is made differently depending if acute or chronic pain is diagnosed, objective (e.g. cortisol, prolactin, serotonin, catecholamines, or the cardiac frequency and arterial pressure evaluation) or subjective methods being imagined. All subjective methods are including questionnaires and specific additional methods. The aim was the verifying the effectiveness of drug and physiotherapy combinations by using an owner based questionnaire for the chronic patients and a veterinary professional based questionnaire for the acute pain patient group. In this study a total of 20 dogs with observable pain were selected and two groups (n = 10 / group), constituted: G1 - chronic pain, and G2 - acute pain. The treatment of dogs with acute signs of pain was made oral or injectable with NSAIDs administration and for dogs with signs of chronic pain, physiotherapy treatment and drug therapy was administered. The owners of the dogs with chronic pain received the HCPI questionnaire in order to evaluate their dog’s pain level subjectively. For the dogs with acute pain the veterinarian filled out the short form of Glasgow Composite Measure Pain Scale (CMPS-SF). After initiating a Paired t-test in Excel 2010 with the scores obtained with HCPI and CMPS-SF, there was observed a significant reduction of pain after associated drug administration and physiotherapy and no significant evidence of acute pain after drug therapy. The used physiotherapy and drug combinations delivered a significant reduction of chronic pain, both clinically and visually mirrored in score reduction after treatments. The HCPI questionnaire could be considered a valuable tool for evaluating chronic pain in patients in the clinic environment. The CMPS-SF has also proven to be a very useful questionnaire in diagnose of acute pain and evaluation of the effectiveness of drug therapy used.

Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency

Aim: Hemorrhoidectomy is still the most effective surgical treatment for hemorrhoidal disease, but it is, however, associated with complications such as pain and stenosis. We proposed to break the “vicious circle” of “pain–sphincteric spasm–stenosis–pain” with the postoperative use of self-mechanical anal dilation.Methods: We retrospectively analyzed patients with hemorrhoidal disease presenting with a minimum of piles of three quadrants, treated with radiofrequency hemorrhoidectomy between January 2018 and December 2019. All the patients that at 3 weeks presented sphincteric spasms with painful defecation, were considered. Thirty-nine patients performed the cycle of self-mechanical anal dilation (Group A). This group was 1:1 matched with homogeneous patients from our historical cohort of patients (Group B). The primary endpoint was the pain evaluation, secondary endpoints: WCS, overall satisfaction of the patient, anal sphincter spasm, scarring, and the incidence of postoperative stenosis.Results: In Group A mean VAS was 3.25 after 14 days of application and 1.15 at the end of the application. In Group B mean VAS was persistently higher, with a mean VAS of 5 (p = 0.000002) and 3.38 (p = 0.0000000000009). In Group A we observed an improvement of symptoms at the end, with a good overall satisfaction (Group A 7.4 vs. Group B 5.9; p = 0.0000007) and a better mean WCS (Group A WCS 2.8 vs. Group B WCS 4.18; p = 0.0001). Stenosis was observed in 3/39 patients of Group B (7.7%).Conclusions: Self-mechanical anal dilation improves the pain in the late postoperative course, minimizing the risk of anal stenosis.

Pain Evaluation and Treatment Techniques Designed Specially for Hospital Nurses in Order to Provide High-Quality Health Care Services

The purpose of this research was to examine the pain evaluation and treatment procedures used by practicing nurses. The research is a descriptive cross-sectional research that was conducted on 146 nurses who were directly engaged in patient care, were not on leave throughout the data collecting period, and volunteered to participate in the research using the convenience sample methodology. The data collection instrument was a pretested self-structured questionnaire with a 0.9 reliability value. Sorting, coding, entering, and analyzing data were performed using the SPSS version 23.0 software program at a 5% level of significance. The majority of respondents, 136 (93.1 percent), were female, while just 10 (6.9 percent) were male. 48 (23.9 percent) of respondents were SNOs, 86 (58.9 percent) of respondents had 6–10 years of experience, 120 (82.2 percent) were married, and 140 (95.9 percent ) were Christians. Concerning respondents' degree of knowledge regarding pain assessment techniques, 28 (19.2 percent) had inadequate knowledge, 44 (30.1 percent) had acceptable knowledge, and 74 (50.7 percent) had enough information. Self-reported pain management strategies included patient positioning and movement, massage, breathing exercises, diversional therapy, the use of warm or hot compresses, encouraging rest and relaxation, the use of both weak and strong opioid analgesics, and the administration of non-opioid analgesics. Using chi-square analysis, it was shown that there is no statistically significant relationship between nurses' knowledge and use of pain assessment instruments (p-value =0.15).