ORCID Profile
0000-0001-7549-7742
Current Organisations
University of Queensland
,
University of Melbourne
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Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.EARLHUMDEV.2010.09.373
Abstract: Various methods of pain assessment in infants have been trialled in the search for objective, specific, physiologic measures of responses to pain. Skin conductance (SC) measured in the palm of the hand or on the plantar aspect of the foot may be one such measure. SC in these sites reflects the emotional sweating due to sympathetic nerve activity. The skin conductance response (SCR), which results from filling and reabsorption of sweat in the sweat glands, has previously been suggested to be the most sensitive SC parameter of sympathetic nerve activity in response to painful stimulation. To study SCRs within and between medically stable hospitalised infants while at rest. SCRs were measured in infants during at least six periods of monitoring in a maximum 48-h period. Behavioural state was recorded throughout the data collection periods. SC recordings (n=91) from 15 infants during sleep showed that frequency of SCRs varied between 0 and 0.04 SCRs per second (SCRs/s), median 0.002 SCRs/s. 73% of the total variation was within-infant variation, with the remaining 27% of variation due to variation between the mean SCR values of different infants. This pilot study contributes to establishing baseline phasic SC activity in hospitalised infants at rest by measuring SCRs. These data can be used as a reference for future studies to determine the validity and reliability of SC measurement in infants exposed to painful or stressful interventions within a neonatal unit.
Publisher: Springer Science and Business Media LLC
Date: 26-10-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2019
DOI: 10.1097/AJP.0000000000000721
Abstract: Measuring pain in infants is important but challenging, as there is no “gold standard.” The measurement of skin conductance (SC) is considered to be a measure of stress and as a surrogate indicator of pain. The objectives of this study were to identify the extent of research conducted and to synthesize the validity evidence of SC for assessing acute pain in infants. The Arksey and O’Malley framework for scoping reviews was followed, and 9 electronic databases were searched. Data were analyzed thematically and presented descriptively including the following main categories: study information/details, s ling information, characteristics of participants and settings, SC outcome measures, and validity evidence. Twenty-eight studies with 1061 infants were included, including 23 cross-sectional observation studies and 5 interventional studies. The most studied infants were those with mild severity of illness (n=13) or healthy infants (n=12). The validity evidence of SC was tested in relation to referent pain measures (13 variables), stimuli (13 variables), age (2 variables), and other contextual variables (11 variables). SC was not significantly correlated with vital signs, except for heart rate in 2 of the 8 studies. SC was significantly correlated with the unidimensional behavioral pain assessment scales and crying time rather than with multidimensional measurements. Fourteen of 15 studies (93.3%) showed that SC increased significantly during painful procedures. Inconsistent findings on validity of SC exist. Future research should aim to identify the diagnostic test accuracy of SC compared with well-accepted referent pain measures in infants, study the validity evidence of SC in critically ill infants, and utilize rigorous research design and transparent reporting.
Publisher: SAGE Publications
Date: 08-11-2021
DOI: 10.1177/08445621211047716
Abstract: Health Quality Ontario Quality Improvement (QI) framework informed this study. A pre (T1) – post (T2) intervention assessment included chart reviews and children/caregiver surveys to ascertain pain management practices. Information on self-reported pain intensity, painful procedures, pain treatment and satisfaction were obtained from children/caregivers. Documented pain assessment, pain scores, and pharmacological/non-pharmacological pain treatments were collected by chart review. T1 data was fed back to pediatric units to inform their decisions and pain management targets. At T1, 51 (58% of eligible participants) children/caregivers participated. At T2, 86 (97%) chart reviews and 51 (54%) children/caregivers surveys were completed. Most children/caregivers at T1 (78%) and T2 (80%) reported moderate to severe pain during their hospitalization. A mean of 2.6 painful procedures were documented in the previous 24 h, with the most common being needle-related procedures at both T1 and T2. Pain management strategies were infrequently used during needle-related procedures at both time points. No improvements in pain management as measured by the T1 and T2 data occurred. Findings informed further pain management initiatives in the participating hospital.
Publisher: Elsevier BV
Date: 04-2008
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
DOI: 10.1097/ANC.0000000000000425
Abstract: Breastfeeding (BF), skin-to-skin care (SSC), and sucrose effectively reduce babies' pain during newborn blood work, but these strategies are infrequently used. Our team developed a parent-targeted video intervention showing the effectiveness of the 3 pain management strategies. To evaluate neonatal intensive care unit (NICU) parents' (1) baseline knowledge and previous use of BF, SSC, and sucrose for procedural pain management (2) intention to advocate/use BF, SSC, or sucrose for their infants' future blood work after viewing the video (3) intention to recommend the video to other parents and (4) perceptions of the video and identify areas for improvement. Cross-sectional survey of parents in an NICU. Fifty parents were enrolled: 33 mothers and 17 fathers. More than two-thirds (68%) of parents had prior knowledge of analgesic effects of sucrose knowledge of SSC and BF as pain-reduction strategies was lower: 44% and 34%, respectively. Eighty-six percent of parents felt the video was the right length 7 (14%) felt the video was too long. After viewing the video, 96% of parents intended to advocate for BF, SSC, or sucrose for pain management and 88% parents would recommend the video to other parents. The video is acceptable to parents, is feasible to deliver to parents in an NICU, and has potential to increase parents' intent to advocate for pain management strategies for their infants. Future studies are required to evaluate the effectiveness of this parent-targeted intervention on increasing actual use of pain management in clinical practice.
Publisher: Springer Science and Business Media LLC
Date: 10-11-2019
DOI: 10.1007/S10900-018-0590-1
Abstract: Immunizations are a necessary but distressing and painful procedure that most infants and children regularly undergo. Each year, a tertiary pediatric hospital in Canada holds an influenza vaccination clinic for all staff and their families. Evidence-based interventions to reduce pain and distress in babies and children are used. Despite this, infants and children continue to be distressed throughout the vaccination procedure. The objectives of this study were to: (1) measure the prevalence of distress among infants and children before, during, and after vaccine administration at the clinic, and (2) evaluate parents' perception of their child(ren)'s distress before, during, and after vaccine administration and the effectiveness of pain management interventions used during the clinic. A cross-sectional design of naturalistic observation and parent surveys was used and data was analyzed using descriptive statistics. A total of 283 children between 6 months and 18 years were vaccinated at the clinic, with 52% observed to be distressed before, during, or after the procedure. There were 115 parents of 206 children that completed the survey 47% of these parents perceived that their children were distressed before, during, or after vaccination, and 42% perceived that the pain treatments used for their child(ren) were very effective. The results of this study will continue to inform interventions for needle-related pain and distress management, as well as improvements for future public vaccination clinics.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Elsevier BV
Date: 06-2005
Publisher: CMA Impact Inc.
Date: 06-11-2018
DOI: 10.1503/CMAJ.180338
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.PEDN.2017.10.012
Abstract: The purpose of this study was to gain a beginning understanding of the contextual factors that influence the use of research for pain management in Jordanian Pediatric Intensive Care Units (PICUs). A paper or online questionnaire was used to collect data on instrumental research use (IRU) and conceptual research use (CRU) and ten contextual variables from 73 registered nurses working in four Jordanian PICUs. The Pearson product-moment correlation coefficient was used to test the relationship between continuous (demographic and contextual) factors and IRU and CRU. One way ANOVA and independent t-test were used to examine the differences between sociodemographic variables and IRU and CRU. Generalized Estimating Equations (GEE) was used to determine the demographic and contextual factors that influenced research use. We modeled the significant variables identified by bivariate correlation, t-test, and ANOVA at (p≤0.10). Nine of the contextual factors significantly and positively correlated with the IRU for pain assessment, eight with the IRU for pain treatment, and six with the CRU for pain management (including assessment and treatment). Hospital type (public) predicted the IRU for pain assessment. Social capital, structural, and electronic resources predicted the IRU for pain treatment. Social capital predicted the CRU for pain management. Context influences Jordanian PICU nurses' use of research for pain management. Concentrating on modifiable contextual factors may positively influence Jordanian PICU nurses' use of research for pain management. This influence may extend to reduce children's pain in Jordanian PICUs.
Publisher: Wiley
Date: 06-05-2020
DOI: 10.1002/PNE2.12023
Abstract: The “Be sweet to babies” video is a knowledge translation tool targeted at parents on the use of analgesic strategies during painful procedures performed in neonates. This study aimed to evaluate the effectiveness of the Portuguese version of this video on maternal involvement in neonatal pain management during the newborn screening blood test. Nonrandomized, pragmatic clinical trial. The study was conducted in a rooming‐in unit. All mothers received a p hlet regarding neonatal pain management and were invited to participate in daily education sessions conducted by nurses, which included the video. The intervention group included mothers who voluntarily watched the video, while the control group was comprised of mothers who did not attend the education sessions or left the session before watching the video. Data were collected by interviews conducted by the research team. Descriptive and inferential analysis considered a confidence interval of 95%. A total of 73 mothers were included in the study. Analgesic strategies were used in 14 (40%) of the procedures in the intervention group and 9 (24%) in the control group, a clinically important difference of 16% points between groups, although no statistically significant difference was found ( P = .13). Breastfeeding was the most commonly used strategy. Watching the video increased the chance of implementing analgesic strategies by 2.1 times ( P = .19), while nurses suggesting the use of analgesia increased this chance by 5.5 times ( P = .006). Although no statistical significance was found, the results suggest the clinical significance and feasibility of the “Be sweet to babies” video as a KT tool targeted at parents on neonatal pain management during nonurgent painful procedures. In addition, maternal involvement in pain care significantly increased when pain relief strategies were recommended by nurses, which suggests that nurses have a key role in facilitating parental participation.
Publisher: Elsevier BV
Date: 04-2012
Publisher: Wiley
Date: 02-05-2020
DOI: 10.1002/PNE2.12022
Abstract: The Be Sweet to Babies video demonstrates the analgesic effects of breastfeeding, skin‐to‐skin care, and sweet‐tasting solutions as interventions to reduce pain during blood s ling in newborns. Although effective and safe, these strategies are implemented inconsistently in clinical settings. Given the increasing popularity of social media, there is a potential to disseminate and promote health information through it. The study aim was to evaluate the use of Facebook as a means of disseminating the Be Sweet to Babies video in Portuguese, and to evaluate respondents’ prior knowledge, previous use of the three pain management strategies and intent to use the strategies in the future. We conducted a cross‐sectional study, using the “virtual snowball” s ling method. A Facebook webpage was created, in which the video was posted along with a brief survey. Data analyzed included number of views and visits to the page, number of views of the video, likes, dislikes, and survey responses. One year after posting, the page had 70 753 views and 2199 accesses there were 1553 “likes”, no dislikes, and 43 positive comments. The survey was completed by 930 respondents (42% response rate based on the page access). Over two thirds of the respondents had previous knowledge about breastfeeding, skin‐to‐skin care, and sweet solutions for pain relief. After watching the video, 87% of the respondents intended to use breastfeeding or skin‐to‐skin care in the future, and 71% intended to use sweet solutions. Almost all viewers rated the video as very useful (n = 917, 99%), easy to understand (n = 926, 99%), and easy to apply in real‐life situations (n = 903, 97%). Using Facebook to deliver and evaluate an intervention is feasible, rapid in obtaining responses, low cost, and it is promising for data collection and knowledge dissemination. Further studies are warranted to evaluate the actual impact of the use of social media in practice change.
Publisher: Springer Science and Business Media LLC
Date: 23-02-2018
Publisher: SAGE Publications
Date: 15-05-2018
Abstract: This study estimates the short- and long-term impacts of climate change on electricity demand in Australia. We used an autoregressive distributed lag (ARDL) model with monthly data from 1999 to 2014 for six Australian states and one territory. The results reveal significant variations in electricity demand. We then used long-term coefficients for climatic response to simulate future electricity demand using four scenarios based on the representative concentration pathways (RCPs) of the Intergovernmental Panel on Climate Change (IPCC). Our results show a gradual increase in electricity consumption due to warmer temperatures with the possibility of peak demand in winter however, demand tends to decrease in the middle of the twenty-first century across the RCPs, while the summer peak load increases by the end of the century. Finally, we simulated the impact of policy uncertainty through sensitivity analysis and confirmed the potential benefits of climate change adaptation and mitigation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 26-08-2012
DOI: 10.14309/AJG.0000000000000358
Abstract: The objective was to evaluate diagnostic performance of multiple methods used to assess gastric tube placement verification in neonates, infants, and children. A systematic review using the methods outlined in the Cochrane Handbook for Reviews of Diagnostic Test Accuracy was conducted. Eight databases were searched. Studies on neonates, infants, and children in which researchers compared different methods for gastric tube placement verification with x-ray reference standard were eligible in the review. Eight studies involving 911 participants that evaluated 9 index tests for gastric tube placement verification were included. Most studies were of moderate methodological quality, and most index tests were assessed in small in idual studies. pH testing with cutoff values ≤ 6 for gastric tube position confirmation was the only index test subjected to meta-analysis, with the summary sensitivity and specificity being 0.77 (95% confidence interval [CI] 0.56–0.90) and 0.42 (95% CI 0.16–0.73). Other tests for gastric tube placement verification showed great variations in sensitivities and specificities. pH ≤ 6 is not sufficiently accurate to be recommended for gastric tube placement verification in neonates, infants, and children. Diagnostic performance of pH ≤ 4 or 5 and other methods cannot be determined because of the paucity of data and methodological variations in studies. Clinical practice related to the diagnostic tests used will continue to be dictated by local preferences and cost factors, until stronger evidence becomes available.
Publisher: Elsevier BV
Date: 05-2008
Publisher: Elsevier BV
Date: 08-2021
Publisher: World Scientific Pub Co Pte Lt
Date: 08-05-2017
DOI: 10.1142/S0219877017500158
Abstract: This literature review explores the factors influencing a firm’s decision to patent its innovation. From the review of the available literature, some factors were identified which are related to the degree of codification or simplicity of knowledge and characteristics of a company or firm. We discovered that patent propensity vary among firms, industry, and country. The influencing factors on a firm’s patent propensity were discovered to be both internal and external. The literature review will provide assistance to researchers in understanding the factors influencing patent propensity.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.PEDN.2016.12.015
Abstract: Synthesized evidence on the effectiveness of pain management for nasogastric tube (NGT) and orogastric tube (OGT) insertions in infants is lacking. This paper is a systematic review of the effectiveness of pain management for gastric tube (GT) insertion in infants. Randomized control trial (RCT) or quasi-experimental studies published up to April 2016, on pain management strategies during GT insertions (either NGT or OGT) in infants up to 12months of age. Databases searched included seven English databases and three Chinese databases. Six English studies out of 1236 screened met the eligibility criteria and were included in the review. Two studied OGT insertion and four studies focused on NGT insertion. All six studies evaluated oral sweet solutions (24%-30% sucrose and 25% glucose) compared to placebo (water) or no treatment and all focused on newborn infants. Data from four studies which used the Premature Infant Pain Profile (PIPP) were pooled for meta-analysis. Results showed a significant reduction in PIPP scores during or immediately after the procedure for sweet solution interventions (MD=-2.18, 95% CI (-3.86, -0.51), P=0.01), compared to no intervention or placebo. Small volumes of oral sweet solutions reduce pain during GT insertion procedure in newborn infants. Oral sweet solutions can be recommended before GT insertion for newborns in clinical practice. Further studies determining the effect of sweet solution beyond the newborn period, different concentrations of sweet solution and comparison with other pain management strategies are warranted. Systematic review registration number: CRD42016038535. www.crd.york.ac.uk rospero/.
Publisher: MDPI AG
Date: 18-07-2019
Abstract: Lack of access to modern forms of energy continues to h er socio-economic development in Nigeria, and about 94% and 39% of the Nigerian population do not have access to clean cooking equipment and electricity, respectively. The United Nations Sustainable Energy for All initiative and Sustainable Development Goal number seven seek to provide universal modern energy for all by 2030. However, the implications of these global goals on Nigeria’s energy system have not been well researched in the literature. In this study, we applied the Long-Range Energy Alternatives Planning Systems model to analyse the impacts of different energy access scenarios by 2030 on household energy consumption, CO2 emissions and local air pollutant emissions. We also analysed different scenarios for biomass renewability in order to understand its impact on household net CO2 emissions. We found that achieving a 100% modern energy access by 2030 would reduce final energy demand by around 845 PJ, which is equivalent to a 52.4% reduction when compared to the baseline scenario. A 100% modern access would also significantly reduce local air pollutants, but increase CO2 emissions significantly by 16.7 MtCO2 compared to the baseline scenario. Our analysis shows that the benefits of modern energy access have been limited in Nigeria due to poor financing and low income levels of households. Therefore, we argue that for a 100% modern energy access in Nigeria by 2030, there is a need to explore local and foreign funding sources, and a serious need to couple energy access programs in the country with income-generating activities.
Publisher: Informa UK Limited
Date: 23-05-2019
Publisher: Springer Science and Business Media LLC
Date: 29-05-2014
Publisher: FapUNIFESP (SciELO)
Date: 2020
DOI: 10.1590/0034-7167-2019-0179
Abstract: ABSTRACT Objectives: to present the concept of Knowledge Translation and Exchange as it has been used in the international literature and in Canada, particularly. Next, to describe a renowned conceptual model to guide its implementation, entitled Knowledge-to-Action Cycle. Results: we described the use of the model in the context of the municipal primary health care system in southern Brazil for the implementation of pain management strategies during vaccination. Conclusions: in this theoretical reflection, we argue that in order to promote health equity and quality of care in the Unified Health System (Brazilian SUS) it is important to translate scientific knowledge to various practice settings and create opportunities for exchange with users of this knowledge, such as health professionals, managers, policy makers, patients, family members and other stakeholders.
Publisher: Elsevier BV
Date: 08-2019
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1016/J.EARLHUMDEV.2010.11.008
Abstract: A sub-analysis was conducted of data from a study of prolonged use of sucrose for hospitalized infants (N=50 infants) during heel lancing. Results showed that pain responses differed when opioid analgesics were administered concomitantly with sucrose (n=79 pain assessments), than when sucrose was administered alone (n=364 pain assessments).
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.PEDN.2018.02.005
Abstract: Clinicians and researchers require a valid way to assess procedural pain experienced by infants and children. The Modified Behavioral Pain Scale (MBPS) has been used to assess immunisation pain. However, it is unknown whether it is valid for this purpose and whether use can be extended to other procedures. The aim of this study was to rigorously assess evidence addressing the psychometric properties of this scale and to provide recommendations for its use. Psychometric evaluation studies reporting feasibility, reliability, validity, or utility data for the MBPS applied to children (birth to 18years) and randomised controlled trials (RCT) using the MBPS were included. Twenty-eight studies (8 psychometric and 20 RCTs) were included. Studies were of varying quality. Sufficient data was available to cautiously accept the MBPS as valid for assessing immunisation related pain in infants aged 2 to 22months. There was insufficient data to support the psychometrics in other age groups or in circumstances other than immunisation. There is no data addressing the clinical utility of the MBPS. It is not possible at this time to confidently accept the MBPS as suitable for assessing all procedural pain in young children. Studies to evaluate the capacity of the MBPS to assess pain in a range of procedures and to distinguish between pain and non-pain related distress are needed if it is to be recommended.
Publisher: IEEE
Date: 04-2018
Publisher: Elsevier BV
Date: 09-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Publisher: Elsevier BV
Date: 12-2022
Publisher: Wiley
Date: 2006
DOI: 10.1111/J.1440-1754.2006.00781.X
Abstract: Objective: To identify current pain assessment and procedural pain management practices in neonatal units in Australia. Methods: Postal survey conducted during December 2003 and January 2004. The survey comprised questions relating to pain assessment scores, pain reduction strategies for minor painful procedures and the use of articulated policies relating to procedural pain management. Participants were the Nurse Unit Managers or their nominees of neonatal intensive care units, special care units and newborn emergency transport services in Australia. Results: Surveys were sent to 181 eligible organizations, and 105 of these were returned (58%). Six units (6%) used pain assessment scores on a regular basis, and 16 units (15%) had an articulated policy directing pain management practices during painful procedures. Non‐nutritive sucking and various nursing comfort measures were the pain reduction strategies most frequently used during minor painful procedures. Twenty‐four units (23%) used sucrose or other sweet‐tasting solutions during procedures however, the reported frequency of their usage was low. Breast‐feeding during venepuncture, heel lance and intramuscular or subcutaneous injection was infrequently practised and topical anaesthetic agents were rarely used. Conclusion: This survey demonstrates that the majority of Australian neonatal units have no articulated policy to guide pain management during painful procedures and do not regularly undertake pain assessments. Current evidence‐based strategies to reduce procedural pain in hospitalized infants are used infrequently.
Publisher: BMJ
Date: 12-05-2010
Abstract: To compare the efficacy of oral sweet solutions to water or no treatment in infants aged 1-12 months during immunisation. Randomised controlled trials (RCTs) were retrieved through internet searches or manual searches of reference lists. Search terms included newborn, infant, pain, sucrose and alternative names for sweet solutions. Summary estimates with 95% CIs were calculated and included relative risk (RR), risk difference (RD) and number needed to treat to benefit (NNTB) for dichotomous outcomes, and weighted mean differences (WMD) for continuous outcomes. Where pooling of results was not possible, a narrative summary of study results is presented. Of the 695 studies identified, 14 RCTs with 1674 injections met the inclusion criteria. Sucrose or glucose, compared to water or no treatment decreased crying during or following immunisation in 13 of the 14 studies. Infants receiving 30% glucose (three trials, 243 infants) had a decreased RR in crying incidence following immunisation (typical RR 0.80, 95% CI 0.69 to 0.93 RD -0.17, 95% CI -0.29 to -0.05 NNTB 6, 95% CI 3 to 20). With sucrose or glucose, there was a 10% WMD reduction in proportion of crying time (95% CI -18 to -2) and a 12 s reduction in crying duration (95% CI -23 to -0.7 s). An optimal dose of sucrose or glucose could not be ascertained due to the varied volumes and concentrations used. Infants aged 1-12 months administered sucrose or glucose before immunisation had moderately reduced incidence and duration of crying. Healthcare professionals should consider using sucrose or glucose before and during immunisation.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.ICCN.2017.09.002
Abstract: The purpose of this research was to seek to understand the lived experience of intensive care nurses caring for patients with delirium. The objectives of this inquiry were: 1) To examine intensive care nurses' experiences of caring for adult patients with delirium 2) To identify factors that facilitate or hinder intensive care nurses caring for these patients. This study utilised an interpretive phenomenological approach as described by van Manen. In idual conversational interviews were conducted with eight intensive care nurses working in a tertiary level, university-affiliated hospital in Canada. The essence of the experience of nurses caring for patients with delirium in intensive care was revealed to be finding a way to help them come through it. Six main themes emerged: It's Exhausting Making a Picture of the Patient's Mental Status Keeping Patients Safe: It's aReally Big Job Everyone Is Unique Riding It Out With Families and Taking Every Experience With You. The findings contribute to an understanding of how intensive care nurses help patients and their families through this complex and distressing experience.
Publisher: Informa UK Limited
Date: 06-2019
DOI: 10.2147/JPR.S203526
Publisher: Universidade Federal de Pelotas
Date: 23-03-2020
DOI: 10.15210/JONAH.V10I1.18337
Abstract: -
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2013
Publisher: Wiley
Date: 22-12-2004
DOI: 10.1046/J.1365-2702.2003.00827.X
Abstract: The importance of interdisciplinary collaboration has been attested to by a number of authors. Some have suggested that Nurse Practitioners (NPs) may be able to improve collaboration between doctors and nurses, but this assertion does not appear to have been researched. To investigate doctors' and nurses' perceptions of interdisciplinary collaboration in two neonatal intensive care units, and to assess the impact of a Neonatal Nurse Practitioner (NNP) practice model on these perceptions. The study was conducted as part of a larger project to develop a NNP model of practice. Survey, pre- and post-intervention. Medical and nursing staff in both units were surveyed before and after introduction of the NP model of practice. The instrument consisted of 25 statements relating to nurse-doctor interactions, with which respondents indicated their level of agreement on a five-point Likert scale. The Mann-Whitney U-test was used to compare scores for in idual items and for overall collaboration between various groups of staff, and between the first and second surveys. Significant differences between the responses of nurses and doctors were found on both surveys. Areas of disagreement chiefly concerned doctors' behaviour and their attitudes towards nurses, rather than nurses' behaviour or environmental factors. Doctors consistently reported a higher degree of collaboration than did nurses. Few differences were found between first and second surveys. Results suggest that problems in nurse-physician interactions exist in both units. No impact of the NNP role, as established in this project, on interdisciplinary collaboration could be demonstrated. Further research in this area is warranted.
Publisher: Wiley
Date: 09-2020
DOI: 10.1002/PNE2.12039
Publisher: American Academy of Pediatrics (AAP)
Date: 2017
Abstract: Abundant evidence of sweet taste analgesia in neonates exists, yet placebo-controlled trials continue to be conducted. To review all trials evaluating sweet solutions for analgesia in neonates and to conduct cumulative meta-analyses (CMAs) on behavioral pain outcomes. (1) Data from 2 systematic reviews of sweet solutions for newborns (2) searches ending 2015 of CINAHL, Medline, Embase, and psychINFO. Two authors screened studies for inclusion, conducted risk-of-bias ratings, and extracted behavioral outcome data for CMAs. CMA was performed using random effects meta-analysis. One hundred and sixty-eight studies were included 148 (88%) included placebo/no-treatment arms. CMA for crying time included 29 trials (1175 infants). From the fifth trial in 2002, there was a statistically significant reduction in mean cry time for sweet solutions compared with placebo (−27 seconds, 95% confidence interval [CI] −51 to −4). By the final trial, CMA was −23 seconds in favor of sweet solutions (95% CI −29 to −18). CMA for pain scores included 50 trials (3341 infants). Results were in favor of sweet solutions from the second trial (0.5, 95% CI −1 to −0.1). Final results showed a standardized mean difference of −0.9 (95% CI −1.1 to −0.7). We were unable to use or obtain data from many studies to include in the CMA. Evidence of sweet taste analgesia in neonates has existed since the first published trials, yet placebo/no-treatment, controlled trials have continued to be conducted. Future neonatal pain studies need to select more ethically responsible control groups.
Publisher: John Wiley & Sons, Ltd
Date: 11-08-2014
Publisher: Wiley
Date: 26-11-2020
DOI: 10.1002/PNE2.12040
Publisher: Public Library of Science (PLoS)
Date: 03-10-2016
Publisher: IEEE
Date: 04-2018
Publisher: Elsevier BV
Date: 2011
Publisher: Elsevier BV
Date: 02-2017
Publisher: Elsevier BV
Date: 09-2002
DOI: 10.1111/J.1552-6909.2002.TB00080.X
Abstract: To evaluate a method of pain assessment to be used for hospitalized infants requiring blood test by a heel lance procedure. Observational study evaluating pain measurement and interrater reliability of pain measurement in hospitalized infants. A Level III neonatal unit and a cardiac surgical unit at a major pediatric teaching hospital. 20 infants whose gestational age ranged from 28 weeks to full-term. Observations included behavioral measurements (facial expressions, body movements, and crying characteristics) and the physiologic measure of heart rate. Interrater reliability and the feasibility of using the procedural pain assessment method at the bedside were considered. The three behavioral measurements and heart rate were responsive to the heel lance. Interrater reliability was high for facial expressions and crying scores but was low for body movements. Modifications have been made to the method of procedural pain assessment to be used in a subsequent study. The modified method is expected to be a reliable measure of procedural pain caused by a heel lance and can easily be used at the bedside during the course of further research.
Publisher: Springer International Publishing
Date: 12-2019
Publisher: Elsevier BV
Date: 12-2018
Publisher: Elsevier BV
Date: 09-2006
DOI: 10.1016/J.EARLHUMDEV.2005.12.008
Abstract: Reliable and valid methods of measuring pain responses in infants continue to be sought as a means of evaluating the effectiveness of pain reduction strategies. Skin conductance has recently been shown to be a promising physiological indicator of pain and stress in premature and term infants. To evaluate changes in skin conductance in hospitalised infants under different environmental conditions and during both painful and non-painful procedures. Measurements of skin conductance activity were made in infants under three different environmental temperature conditions (open cot, incubator and overhead radiant heater), during the routine non-painful nursing procedure of either nappy change or oral feeding, and whilst undergoing the painful procedure of heel lancing for blood s ling. Skin conductance activity in 21 infants was studied on 43 separate occasions. Skin conductance activity was highly variable between infants but did not differ significantly under the three environmental conditions. Routine nursing care did not result in a significant increase in skin conductance activity above baseline however, on cessation of care there was a significant reduction to levels below baseline (p < 0.05). Conversely, during the heel lance procedure, skin conductance activity significantly increased upon lance (p < 0.05) and remained elevated following completion of the procedure. There were no statistically significant differences between skin conductance activity changes from baseline as a result of routine nursing care compared to that of the heel lance procedure. Due to large variability in skin conductance activity further studies are needed before this technology can be recommended as a clinically useful indicator of pain and stress in neonates.
Publisher: Informa UK Limited
Date: 12-2002
DOI: 10.5172/CONU.14.1.9
Abstract: The Nurse Practitioner role is currently being implemented in most Australian states. This model of practice has existed overseas, predominantly in North America,for many years. The experiences of those countries can help inform the implementation of the role in Australia. This paper reviews the overseas literature concerning one practice context, that of the Neonatal Nurse Practitioner. The scope of the role, issues surrounding educational preparation, impact of the role on health outcomes, and factors identified as facilitating and constraining the role, are all discussed. The implications for the Australian context are highlighted.
Publisher: PeerJ
Date: 12-09-2013
DOI: 10.7717/PEERJ.147
Publisher: American Academy of Pediatrics (AAP)
Date: 11-2010
Abstract: The goal was to review published studies of analgesic effects of sweet solutions, to ascertain areas with sufficient evidence of effectiveness and areas of uncertainty. Databases searched included Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature database, and PsycINFO, using the terms pain*, infant*, neonat*, newborn*, sucrose, glucose, and alternative sugars. Publications were sorted according to type, year, painful procedure studied, placebo/no-treatment groups, population studied, and country of publication. A total of 298 relevant unique publications involving human infants were identified 125 (42%) were primary research studies, of which 116 (93%) were randomized controlled trials. Healthy preterm or term newborns were included in 82 studies (65%), and sick or very low birth weight infants were included in 22 (18%). Most studies included single episodes of painful procedures, with only 3 (2%) conducted over long periods. Procedures investigated most frequently were heel lance (49%), venipuncture (14%), and intramuscular injection (14%). Placebo or no-treatment groups were included in 111 studies (89%) in 103 (93%) of those studies, sweet solutions reduced behavioral responses, compared with placebo/ no treatment. Clinical equipoise relating to analgesic effects of sweet solutions no longer exists for single episodes of procedures for healthy preterm and term newborn infants. Uncertainties include outcomes after prolonged use of sweet solutions, concomitant use of other analgesics, and effectiveness beyond the newborn period. Future research should focus on addressing these knowledge and research gaps.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 05-2019
Publisher: Elsevier BV
Date: 02-2019
Publisher: FapUNIFESP (SciELO)
Date: 25-06-2018
DOI: 10.1590/S1980-220X2017033903313
Abstract: RESUMO Objetivo: Descrever o perfil de enfermeiros atuantes em unidades que assistem o recém-nascido, verificar seu conhecimento prévio sobre amamentação, contato pele a pele e soluções adocicadas no alívio da dor procedural neonatal, e avaliar sua percepção sobre a viabilidade, a aceitabilidade e a utilidade do vídeo “Seja Doce com os Bebês”. Método: Estudo transversal, realizado em quatro unidades de um hospital universitário de São Paulo. Foram incluídos 45 enfermeiros, que responderam ao questionário de caracterização e assistiram ao vídeo. Posteriormente, 38 avaliaram o vídeo. Estatística descritiva foi utilizada para análise das variáveis, além da análise de conteúdo na questão aberta. Resultados: Participaram do estudo 45 enfermeiros. 97,4% conheciam as estratégias analgésicas e, após assistirem ao vídeo, afirmaram pretender utilizá-las ou incentivar seu uso durante procedimentos dolorosos. Todos recomendariam o vídeo para outros profissionais, sendo o recurso avaliado como útil, fácil de entender e de aplicar em situações reais. Conclusão: Os enfermeiros conhecem as estratégias analgésicas, consideram o vídeo viável, aceitável e útil como ferramenta de tradução do conhecimento para profissionais da saúde, o que também pode favorecer o envolvimento dos pais no manejo da dor de seus filhos.
Publisher: Elsevier BV
Date: 06-2019
Publisher: American Medical Association (AMA)
Date: 05-2001
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2009
Publisher: Elsevier BV
Date: 12-2021
Publisher: Elsevier BV
Date: 12-2021
Publisher: Informa UK Limited
Date: 2019
Publisher: MDPI AG
Date: 29-09-2022
DOI: 10.3390/CLI10100142
Abstract: The global energy system is highly vulnerable to climate variability and change. This results in a vast range of impacts on the energy demand sector and production and supply channels. This article aims to estimate the impacts of variables such as heating and cooling temperatures, income, population, and price on residential electricity demand in G7 countries. Methodologically, this study uses the second-generation panel unit root and cointegration approaches (which are robust in the presence of cross-sectional dependence), a panel fixed effects model with Driscoll–Kraay standard errors, and a novel method of moments quantile regression (MM-QR) to determine long-run elasticities. The results suggest that the residential electricity demand of G7 countries is statistically and positively responsive to cold days rather than hot days. This study also presents some policy-relevant issues based on the results.
Publisher: Elsevier BV
Date: 11-2015
Publisher: BMJ
Date: 09-2017
DOI: 10.1136/BMJOPEN-2017-016225
Abstract: Infants and children are frequently exposed to painful medical procedures such as immunisation, blood s ling and intravenous access. Over 40 scales for pain assessment are available, many designed for neonatal or postoperative pain. What is not well understood is how well these scales perform when used to assess procedural pain in infants and children. The aim of this study was to test the psychometric and practical properties of the Face, Legs, Activity, Cry and Consolability (FLACC) scale, the Modified Behavioural Pain Scale (MBPS) and the Visual Analogue Scale (VAS) observer pain scale to quantify procedural pain intensity in infants and children aged from 6–42 months to determine their suitability for clinical and research purposes. A prospective observational non-interventional study conducted at a single centre. The psychometric and practical performance of the FLACC scale, MBPS and the VAS observer pain scale and VAS observer distress scale used to assess children experiencing procedural pain will be assessed. Infants and young children aged 6–42 months undergoing one of four painful and/or distressing procedures were recruited and the procedure digitally video recorded. Clinicians and psychologists will be recruited to independently apply the scales to these video recordings to establish intrarater and inter-rater reliability, convergent validity responsiveness and specificity. Pain score distributions will be presented descriptively reliability will be assessed using the intraclass correlation coefficient and Bland-Altman plots. Spearman correlations will be used to assess convergence and linear mixed modelling to explore the responsiveness of the scales to pain and their capacity to distinguish between pain and distress. Ethical approval was provided by the Royal Children’s Hospital Human Research Ethics Committee, approval number 35220B. The findings of this study will be disseminated via peer-reviewed journals and presented at international conferences.
Publisher: SAGE Publications
Date: 22-11-2019
Abstract: High-quality synthesized evidence of sweet taste analgesia in neonates exists. However, Chinese databases have never been included in previous systematic reviews of sweet solutions for procedural pain. To conduct a systematic review of Chinese literature evaluating analgesic effects of sweet solutions for neonates. Data sources: Wang Fang, China National Knowledge Infrastructure and Chinese Biomedical Literature Database. Data extraction and analysis: Two authors screened studies for inclusion and conducted risk of bias ratings and data extraction. A third author resolved any conflicts. Meta-analyses were performed using RevMan 5.2 software, on mean differences in pain outcomes using random effects models. Thirty-one trials (4999 neonates) were included 26 trials used glucose, 4 used sucrose, and 1 trial evaluated both solutions. Sweet solutions reduced standardized mean pain scores (n = 21 studies −1.68, 95% confidence interval −2.08, −1.27) and cry duration (n = 6 studies −25.60, 95% confidence interval −36.47, −14.72 s) but not heart rate change (n = 7 studies −17.64, 95% confidence interval −52.71, 17.43). No included studies cited the previously published systematic reviews of sweet solutions. This systematic review of Chinese databases showed the same results as previously published systematic reviews. No trials included in this review cited the English systematic reviews, highlighting a parallel research agenda.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.JPAIN.2018.01.012
Abstract: The Modified Behavioral Pain Scale (MBPS) was designed to assess procedural pain in infants and is considered valid for assessing immunization pain. The aim of this study was to assess the practical and psychometric properties of the MBPS when applied to other commonly performed procedures. Twenty-six clinicians independently applied the MBPS scale to segments of video collected from 100 infants and children aged 6 to 42 months undergoing 1 of 4 procedures in the emergency department. Positive correlation between MBPS and Visual Analogue Scale observer applied (VASobs) pain (r = .74) was shown and inter- and intrarater reliability coefficients were high (.87 and .89, respectively). Construct validity was shown by scale responsiveness to painful stimuli (4.6 times increase in scores across phases) and the capacity of the scale to distinguish between painful versus nonpainful procedures (P 3, which was much lower than for children with scores <3 (P = .0001). Finally, 28% of scores changed after the second viewing of a video segment. The MBPS appears reliable and sensitive to procedural pain when applied by clinicians. Results question the capacity of the scale to differentiate between pain- and nonpain-related distress, the feasibility of this scale, and the appropriateness of item descriptors for medical procedures. This article presents the psychometric and practical properties of the MBPS applied to assess procedural pain. Identification of a suitable scale for this purpose will support improved pain management in infants and young children who undergo painful procedures.
Publisher: MDPI AG
Date: 09-06-2015
DOI: 10.4081/NURSREP.2015.5218
Abstract: Sweet solutions reduce procedural pain in infants but there is uncertainty about effectiveness beyond infancy. A blinded pilot randomized controlled trial (RCT) was conducted to inform a full-scale RCT. Hospitalized children aged 12- 36 months were randomized to 24% sucrose or water prior to and during venipuncture. Primary outcomes were crying time and FLACC (Face, Legs, Activity, Cry, Consolability) scores. Secondary outcomes parental report of child’s pain, parental perception of effectiveness and nurse’s score of child’s compliance with study solution. Twenty-one children were studied. There were no differences in pain outcomes between groups. Median FLACC scores at time of needle insertion were high (8/10), and mean crying time during procedure was 61%. Most parents (n=17) would use the same treatment next time and most (n=17) toddlers were compliant with receiving the solutions. The pilot RCT informed the conduct of a future full scale RCT in terms of feasibility, acceptability, data collection, data analysis and s le size estimation.
Publisher: Wiley
Date: 21-12-2013
DOI: 10.1111/JPC.12064
Abstract: The study aims to determine whether there has been improved uptake of the evidence for the management of procedural pain in neonates throughout Australia. An Australian-wide survey was undertaken to determine the use of breastfeeding and sucrose and whether a clinical practice guideline (CPG) or pain assessment tool was used. Data were available from 196 (91%) of the 215 eligible hospitals. A CPG informed the management of neonatal pain in 76 (39%) of the hospitals. There was wide variation in their use between the states, and a significantly higher use of a CPG in higher-level care units. A pain assessment tool was only used in 21 (11%) of the units with greater use in the higher level care neonatal intensive care units (50%) and surgical neonatal intensive care units (80%). Awareness of breastfeeding for procedural pain was reported by 90% of the 196 respondents while 78% reported that it was actually used. Awareness of sucrose for procedural pain was lower than breastfeeding at 79%, with 53% reporting that they used sucrose in their unit. Overall, 89% of the respondents reported that either breastfeeding or sucrose was used for the management of procedural pain in their units. There has been an increase in awareness and use of sucrose and breastfeeding for procedural pain in Australia since previous surveys were undertaken in 2004. Continued resources, local pain ch ions and a national interest group to promote the use of pain management for procedural pain in neonates are needed for continued uptake of the evidence.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Springer Science and Business Media LLC
Date: 23-04-2014
Publisher: Informa UK Limited
Date: 12-08-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-02-2023
Publisher: Elsevier BV
Date: 06-2023
Publisher: Springer Science and Business Media LLC
Date: 07-02-2015
Publisher: Wiley
Date: 05-05-2015
Publisher: American Academy of Pediatrics (AAP)
Date: 11-2012
Abstract: The use of oral sucrose has been the most extensively studied pain intervention in newborn care to date. More than 150 published studies relating to sweet-taste-induced calming and analgesia in human infants have been identified, of which 100 (65%) include sucrose. With only a few exceptions, sucrose, glucose, or other sweet solutions reduced pain responses during commonly performed painful procedures in erse populations of infants up to 12 months of age. Sucrose has been widely recommended for routine use during painful procedures in newborn and young infants, yet these recommendations have not been translated into consistent use in clinical practice. One reason may be related to important knowledge and research gaps concerning analgesic effects of sucrose. Notably, the mechanism of sweet-taste-induced analgesia is still not precisely understood, which has implications for using research evidence in practice. The aim of this article is to review what is known about the mechanisms of sucrose-induced analgesia highlight existing evidence, knowledge gaps, and current controversies and provide directions for future research and practice.
Publisher: Elsevier BV
Date: 05-2009
DOI: 10.1016/J.IJNURSTU.2008.11.001
Abstract: Describe the utilization of analgesic and sedative medications and documentation of pain scores in a cohort of critically ill infants in a neonatal intensive care unit. A prospective, longitudinal, cohort study of infants with a predicted length of stay > or =28 days. Dosages and routes of administration of analgesic and sedative medications and documentation of pain scores were collected on a daily basis. 55 infants were enrolled into the study. Oral sucrose was administered to all 55 infants, 51 infants (93%) were administered enteral acetaminophen and 50 (91%) infants were administered morphine during their hospitalization. Sedatives were administered to 42 infants (76%) 36 (65%) were administered chloral hydrate and 32 (58%) were administered intravenous midazolam. With the exception of the first week of admission, when there was highest utilization of opioids and lower use of sucrose, acetaminophen and sedatives, the pattern of administration of analgesic and sedative agents remained relatively constant throughout the hospitalization. Pain scores were documented for 36 (65%) infants during their hospitalisation, however for these 36 infants, pain scores were infrequently recorded. There was substantial and varied analgesic and sedative use in this cohort of infants, yet infrequent documentation of pain assessment scores. These practices highlight important clinical implications for sick infants requiring careful consideration of pain and distress management.
Publisher: Elsevier BV
Date: 06-2019
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.SCITOTENV.2019.04.294
Abstract: The energy system is a vital infrastructure which can be vulnerable to climate variability and change (CV&C) impacts. Understanding the impacts can prevent disruption and inform policy decision making. This study applied a scoping review in a systematic manner following the Joanna Briggs Institute guidelines to identify consistent patterns of CV&C impacts on the energy system, map and locate research gaps in the literature. A total of 176 studies were identified as eligible for inclusion in the review. This study found evidence of consistent increase in energy demand for Africa, the Americas and Asian continent. Consistent decrease was found in Northern and Eastern Europe, while increase in residential demand was projected in Oceania. There was evidence of consistent decrease in thermal power plant output globally. Solar photovoltaic showed a robust consistent pattern of increase in the Caribbean and Central America, Northern and Southern Africa and Oceania. As the global climate is changing in a future that is highly uncertain, the energy system should also evolve in order to adapt to the changing climate. Future impact assessment must integrate the impact of CV&C on power demand and supply while consider socioeconomic dynamics, cross-sectoral linkages and back-loops in a complete energy system model.
Publisher: Wiley
Date: 21-10-2003
DOI: 10.1046/J.1440-1754.2003.00242.X
Abstract: To determine the efficacy of 25% oral sucrose in the reduction of pain during a heel lance procedure in sick hospitalized infants. In a blinded randomized- controlled trial, hospitalized infants were given either 1 mL 25% sucrose or 1 mL water 2 min prior to a heel lance procedure. Pain assessment comprised a four-point facial expression score, incidence and duration of crying, heart rate and oxygen saturation changes. A total of 128 infants were included. Facial scores immediately upon heel lance, and at 1 and 2 min in the recovery period were reduced in the treatment (sucrose) group compared to the placebo (water) group (P < 0.05). At other observation points, the differences in facial scores between the two groups of infants did not reach statistical significance. Neither incidence nor duration of crying whilst the blood collection was in progress was significantly reduced by sucrose. In the 3-min recovery period following completion of the blood collection, incidence and duration of crying were significantly less in the treatment group of infants (P < 0.05). Physiological responses of heart rate and oxygen saturation were not attenuated by sucrose at any time point during or following the blood collection. Oral sucrose was effective in reducing behavioural responses to pain upon heel lance and in the period following completion of a heel lance procedure in this group of sick hospitalized infants. This simple strategy can be promoted in institutions caring for sick babies, as a method of reducing behavioural responses to procedural pain.
Publisher: Wiley
Date: 09-2005
Publisher: Informa UK Limited
Date: 23-09-2016
Publisher: FapUNIFESP (SciELO)
Date: 2017
DOI: 10.1590/S1980-220X2016034403210
Abstract: Abstract OBJECTIVE To analyze nurses' knowledge and practices regarding pain management of newborns admitted to Neonatal Intensive Care Units. METHOD A descriptive and cross-sectional study. Data were collected from 51 nurses based on an adapted questionnaire aimed at evaluating knowledge and practices regarding the management of neonatal pain in six hospitals in Curitiba and its Metropolitan Region. RESULTS For most nurses (86.0%), neonates feel pain. A total of 34.7% of the nurses reported never using pain assessment scales. Pain management was recorded by 84.3% of the nurses. Administered pharmacological measures were Paracetamol and Fentanyl (47.1%) and Morphine (17.6%) while non-pharmacological measures adopted were sweetened solution (68.6%), non-nutritive sucking (58.8%) and positioning (56.9%). CONCLUSION Nurses considered neonatal pain a real event however, they do not perform pain assessment or treatment of newborns in a systematized way.It is necessary to implement knowledge translation strategiesin order to improve pain management in newborns.
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/956549
Abstract: BACKGROUND: Sucrose has been demonstrated to provide analgesia for minor painful procedures in infants. However, results of trials investigating other sweet solutions for neonatal pain relief have not yet been synthesized. OBJECTIVE: To establish the efficacy of nonsucrose sweet-tasting solutions for pain relief during painful procedures in neonates. METHOD: The present article is a systematic review and meta-analyses of the literature. Standard methods of the Cochrane Neonatal Collaborative Review Group were used. Literature searches were reviewed for randomized controlled trials investigating the use of sweet solutions, except sucrose, for procedural pain management in neonates. Outcomes assessed included validated pain measures and behavioural and physiological indicators. RESULTS: Thirty-eight studies (3785 neonates) were included, 35 of which investigated glucose. Heel lancing was performed in 21/38 studies and venipuncture in 11/38 studies. A 3.6-point reduction in Premature Infant Pain Profile scores during heel lances was observed in studies comparing 20% to 30% glucose with no intervention (two studies, 124 neonates mean difference −3.6 [95% CI −4.6 to −2.6] P .001 I 2 =54%). A significant reduction in the incidence of cry after venipuncture for infants receiving 25% to 30% glucose versus water or no intervention was observed (three studies, 130 infants risk difference −0.18 [95% CI −0.31 to −0.05] P=0.008, number needed to treat = 6 [95% CI 3 to 20] I 2 =63%). CONCLUSIONS: The present systematic review and meta-analyses demonstrate that glucose reduces pain scores and crying during single heel lances and venipunctures. Results indicate that 20% to 30% glucose solutions have analgesic effects and can be recommended as an alternative to sucrose for procedural pain reduction in healthy term and preterm neonates.
Publisher: Elsevier BV
Date: 11-2022
Publisher: Hindawi Limited
Date: 21-04-2019
DOI: 10.1111/JONM.12768
Abstract: To translate the Implementation Leadership Scale (ILS) into Chinese and evaluate how Chinese nursing staff and leaders understood and responded to the Chinese ILS. Leadership is a critical factor for implementing evidence-based practice. The ILS is a valid and reliable instrument to understand leadership for evidence-based practice however, this scale or the other similar instrument does not exist in Chinese. We followed the translation and cross-cultural validation guideline developed by Sousa and Rojjanasrirat. Translation included two forward and blind backward translations, and their comparisons. Two rounds of cognitive interview were used to evaluate the linguistic validity. The translation process took 12 months. In the forward and backward translations, 24 translation issues were identified, of which semantic equivalence issues were most frequent. Ten nurses participated in each round of cognitive interviews and 33 linguistic issues were found. The final Chinese ILS had seven significant adaptations to the original instrument. This study provided a deep understanding of using the ILS in the local context and laid the foundation for future psychometric statistical testing. Implementation leadership scale could support organisational leadership development programmes and strategies to facilitate and support EBP implementation and sustainability.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
Publisher: BMJ
Date: 06-02-2007
Publisher: Informa UK Limited
Date: 03-2021
DOI: 10.2147/JPR.S267839
Publisher: Elsevier BV
Date: 07-2019
Publisher: Wiley
Date: 28-10-2016
Publisher: Wiley
Date: 14-03-2013
DOI: 10.1111/JPC.12161
Abstract: The study aims to identify pain management practices used during scheduled childhood immunisation. A survey of members of the Australian Nurses Federation (Victorian Branch) Immunisation Nurses Special Interest Group. Questions included frequency of use of pain reduction strategies during immunisations for infants, toddlers and children, injection techniques and existence of an articulated pain management policy. The survey was emailed to 274 Immunisation Nurses Special Interest Group members with registered email addresses, and 125 (46%) completed the survey. Nineteen respondents (15.2%) stated their main place of employment had a pain management policy during immunisations and 20 (16.0%) respondents were not sure. Distraction strategies were frequently used during immunisation for all age groups, with 95 (76.0%) replying that distraction was used often or always. Breastfeeding during immunisation for infants younger than 6 months was used occasionally (n = 54, 44.6%), often (n = 11, 9.1%) or never (n = 55, 45.5%) and was used even less frequently for infants aged 6-12 months. Sucrose or other sweet solutions were almost never used for infants prior to, or during, immunisation. As a reward, lollies were frequently given to children after immunisations. Topical anaesthetics were almost never used in any age groups. Over half the respondents used a rapid injection technique 55 (44.7%) used a slow technique and four respondents aspirated the needle before injections. Many distraction strategies were used during and following immunisation but sweet solutions, breastfeeding or topical anaesthetics were rarely used. Use of these strategies where feasible, should be facilitated in erse settings where immunisations take place.
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.VACCINE.2019.09.075
Abstract: Early childhood vaccination is one of the most important public health interventions. However, the injections are usually painful. Clinical practice guidelines recommend using pain management strategies for infants during vaccination. Public access to online health information has increased due to the advent of internet. Parents are likely to find thousands of websites, and online video platforms of variable quality. This study aims to identify and critically appraise the quality of online parent-targeted resources concerning early childhood vaccination and determine inclusion of recommended infant pain management strategies. An environmental scan of two main internet sources was conducted: (a) Google, (b) Social Media networks. Resources including information relating to infant vaccination and available to Canadians were included. Characteristics of resources were collected. Resource quality was evaluated using the CDC Clear Communication Index. A CDC index score of 90% and above indicates the resource is as an acceptable public communication material. Means and standard deviations were used for normally distributed data median and interquartile range (IQR) or numbers and proportions were used for data not normally distributed or presented in categorical format. We found 55 online resources in website format and 10 resources in video format. Overall, the mean score for the quality of resources was 60% ± 0.19. Most resources were scored as moderate to low quality (33-87%). Only 5% of material scored as acceptable quality. In terms of content, 30 (46%) resources presented information about pain management strategies during vaccination, including breastfeeding (24, 37%), holding (27, 42%), and sweet solutions (22, 34%). The remaining 35 (54%) resources made no clear statement regarding any pain management strategies during vaccination. Most publicly accessible online parent-targeted vaccination resources were of poor quality and did not contain information related to the use of recommended pain management strategies during vaccination.
Publisher: World Scientific Pub Co Pte Ltd
Date: 09-11-2017
DOI: 10.1142/S0219877017500407
Abstract: This study investigates the factors influencing the Chinese manufacturing industry’s innovation and industrial performance utilizing a panel data approach on a s le of Chinese manufacturing enterprises over the period of 2008–2013. The industries were grouped according to related sectors into five groups, a general group was also created which included the whole data s le. The study found that research and development (R& D) expenditure positively influenced the growth of product innovation and industrial performance, but not necessarily knowledge innovation and export performance. Also, expenditure on new product development had a positive impact on both innovation and industrial performance. The growth of patent application was discovered to be influenced by an R& D project and foreign patent license. Finally, the number of enterprises and firm size (i.e. number of employees) contributed positively to the industrial output performance. The findings suggest that industrial R& D and new product development influences the success of product innovation and sales performance. The study recommends that the government should set up policies that will stimulate industrial R& D, while supporting technology transfers from foreign partners. Most importantly, government policies on the development of the industry should be addressed on a sectorial level and not a “one-size-fit-all” type of policy.
Publisher: Wiley
Date: 15-01-2018
DOI: 10.1111/JOCN.14147
Abstract: To assess parents' knowledge on breastfeeding, skin to skin care and sweet solutions as neonatal analgesic strategies, and to evaluate parents' perception on the feasibility, acceptability and usefulness of the Portuguese version of the "Be Sweet to Babies" video. Neonatal pain management during blood s ling is suboptimal, and knowledge translation strategies are needed to improve clinical practices. The "Be Sweet to Babies" video is a parent-targeted knowledge translation tool that shows the effectiveness of breastfeeding, skin to skin contact and sweet solutions for procedural pain relief. Cross-sectional study. Parents of infants hospitalised in an intensive care unit watched the video during their infants' hospitalisation and then answered a survey. Descriptive analyses of the data were performed. Hundred parents were included. The majority did not know about the analgesic effects of breastfeeding (80%), skin to skin contact (69%) and sweet solutions (93%), and a limited number of parents stated their infants had received the strategies during painful procedures (7%, 11%, 2%, respectively). After watching the video, all (100%) parents intended to use or to advocate for one of the strategies most (90%) of the parents would use any of the methods. All parents (100%) would recommend the video and considered the video useful, easy to understand, easy to apply in real scenarios. Length of the video was considered as ideal by 92%. The Portuguese version of the "Be Sweet to Babies" video is feasible, acceptable and useful for parental education and is a persuasive knowledge translation tool. Further studies are needed to evaluate the effects of this parent-targeted intervention on the implementation of the analgesic strategies during clinical care. This article highlights the importance of exploring evidence-based knowledge translation tools for improving neonatal care and outcomes.
Publisher: Springer Science and Business Media LLC
Date: 05-02-2010
DOI: 10.1007/S11916-009-0091-0
Abstract: Health care professionals caring for neonates (birth to 28 days of life) and infants up to 1 year of age have a professional and ethical responsibility to provide safe and effective pain management during painful procedures. Despite 14 years of research reports highlighting that sick infants are exposed to large numbers of painful procedures with minimal or no provision of pain management strategies, and generation of abundant evidence to support effectiveness of pain reduction strategies, insufficient practice changes have been made. As untreated pain in infancy has both immediate and longer-term negative consequences, such as increased sensitivity and responses to subsequent pain, it is imperative that widespread sustained practice changes are made to reduce the burden of pain. This review highlights recent advances within the past 2 to 3 years in pain management of acute procedural pain for neonates and infants, proposes recommendations for future research, and addresses practical implications and challenges for implementing best pain management practices.
Publisher: Elsevier BV
Date: 12-2021
Publisher: Springer Science and Business Media LLC
Date: 06-01-2020
DOI: 10.1186/S13063-019-3782-9
Abstract: Hospitalized infants undergo multiple painful procedures daily. Despite the significant evidence, procedural pain assessment and management continues to be suboptimal. Repetitive and untreated pain at this vital developmental juncture is associated with negative behavioral and neurodevelopmental consequences. To address this knowledge to practice gap, we developed the web-based Implementation of Infant Pain Practice Change (ImPaC) Resource to guide change in healthcare professionals’ pain practice behaviors. This protocol describes the evaluation of the intervention effectiveness and implementation of the Resource and how organizational context influences outcomes. An effectiveness-implementation hybrid type 1 design, blending a cluster randomized clinical trial and a mixed-methods implementation study will be used. Eighteen Neonatal Intensive Care Units (NICUs) across Canada will be randomized to intervention (INT) or standard practice (SP) groups. NICUs in the INT group will receive the Resource for six months those in the SP group will continue with practice as usual and will be offered the Resource after a six-month waiting period. Data analysts will be blinded to group allocation. To address the intervention effectiveness, the INT and SP groups will be compared on clinical outcomes including the proportion of infants who have procedural pain assessed and managed, and the frequency and nature of painful procedures. Data will be collected at baseline (before randomization) and at completion of the intervention (six months). Implementation outcomes (feasibility, fidelity, implementation cost, and reach) will be measured at completion of the intervention. Sustainability will be assessed at six and 12 months following the intervention. Organizational context will be assessed to examine its influence on intervention and implementation outcomes. This mixed-methods study aims to determine the effectiveness and the implementation of a multifaceted online strategy for changing healthcare professionals’ pain practices for hospitalized infants. Implementation strategies that are easily and effectively implemented are important for sustained change. The results will inform healthcare professionals and decision-makers on how to address the challenges of implementing the Resource within various organizational contexts. ClinicalTrials.gov, NCT03825822 . Registered 31 January 2019.
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.ICCN.2019.05.002
Abstract: To map research based pain management interventions used in the paediatric intensive care unit. A scoping review of research literature has been conducted. Five databases were searched from their inception to end 2015 (CINAHL, EMBASE, MEDLINE, PsychINFO, and ProQuest Dissertations & Theses Global). Reference lists from the screened full text articles were reviewed. 7046 articles were identified, 100 underwent full text screening and 27 were included in the scoping review. Seventeen (63%) were non-experimental, and 10 (37%) were experimental, of which 8 (30%) were randomised controlled trials. The majority of the articles focused on pharmacological interventions (n = 21, 78%), one on physical, and one on psychological interventions. Four studies included more than one category of interventions. The majority of the studies focused on post-operative pain management (n = 18, 67%), three (11%) on analgesia and sedation management and six (22%) on other pain management for different conditions. Most studies included in this scoping review focused on medications and post-operative pain management and most were non clinical trials. More research, including clinical trials, is warranted to determine the effectiveness of pharmacological and non-pharmacological interventions for pain management in the paediatric intensive care unit.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.APNR.2018.06.009
Abstract: Hospitalized children continue to experience inadequate pain management. Children in the rural hospital setting may be at risk due to unique challenges experienced by Registered Nurses (RNs) in this context. To understand the experience of pain care from RNs who work in rural hospitals with inpatient pediatric patients. Qualitative description that used semi-structured interviews to explore RNs' inpatient pediatric pain care experiences. RNs who: 1) worked directly with pediatric in-patients 2) spoke English 3) and who worked in rural Northern Ontario. Hospital sites were selected based on population density, from one province in Canada. To reduce heterogeneity, only sites with dedicated pediatric beds were eligible (n = 9). This qualitative descriptive study used semi-structured interviews over Skype and telephone. Data were analyzed using inductive content analysis. Ten participants were recruited from seven sites. Five main categories were identified, with one category that influenced all other categories. Rural RNs needed to practice as generalists as they care for many types of patients. Resource challenges included a lack of specialist expertise and educational opportunities. Pediatric pain was not perceived as a priority within their organizations. Most participants perceived there were no explicit standards for pain care. Moving forward the adoption of built in assessments in electronic documentation was suggested as a solution to standard pain care. Opportunity exists to improve pediatric pain management, however, without a systematic approach that considers the rural context, pain care for children will continue to be based on in idual's beliefs and knowledge.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Wiley
Date: 08-10-2012
DOI: 10.1111/J.1440-1754.2012.02586.X
Abstract: Chloral hydrate is generally considered a safe and effective single dosing procedural sedative for neonates in the clinical setting. However, its safety profile as a repetitive dosing maintenance sedative is largely unknown. This study aimed to document current administration practices of chloral hydrate in the Neonatal Unit, Royal Children's Hospital, Melbourne, Australia, over a 6-month period. Patients who had been prescribed chloral hydrate during the specified audit period were recruited into the study and prospectively followed for a period of 28 days, or until they were discharged from the unit. Demographic data were collected on recruitment, and daily documentation of chloral hydrate administration was recorded. A total of 238 doses of chloral hydrate were administered to a cohort of 32 patients during the study period. The majority of the audited doses (84%) were ordered as repeating doses. Doses were more likely to be given at night than during the day, and the median dosage for repetitive dosing was found to be above the study site's recommended dosing range. Pre-dose and/or post-dose assessment of distress/agitation accompanied dosage approximately half of the time. The audit did not reveal any recognisable pattern of sedation maintenance or weaning process for patients who received multiple doses. Health-care professionals caring for hospitalised infants should be made aware of the potential risks of chloral hydrate as a repetitive dosing sedative, and of the importance of systematically evaluating the appropriateness and effectiveness of utilising such pharmacological intervention for managing and treating distress.
Publisher: MDPI AG
Date: 09-12-2020
DOI: 10.3390/SU122410280
Abstract: Climate change governance has metamorphosed from multilateral pacts such as the United Nations Framework Convention on Climate Change and the Paris Agreement to the enactment of country-specific dedicated legislation for mitigation and adaptation. A common feature of this phenomenon is the establishment of an expert committee on climate change, or simply, a climate change commission (CCC). For effective climate change governance, a multidisciplinary CCC will play a key role. The objective of this study is to inquire into the multidisciplinary requirements of a CCC and how multidisciplinarity can influence the efficacy of climate governance measures. Accordingly, it inquires into transnational circumstances on the disciplinary/multidisciplinary composition of CCCs and s les the perspectives of over 120 climate policy experts—through a structured survey—to draw insights into how countries could establish a suitable multidisciplinary CCC in legislative and policy processes. Key results from transnational circumstances and expert perspectives reveal the propriety of establishing CCCs to drive robust mitigation and adaptation policies. As the study shows, multiple countries have already incorporated erse domains and backgrounds of expertise in the composition of their CCCs. Furthermore, our experts’ survey reveals overwhelming support among respondents (98%) for CCCs, and all those who support these commissions believe they should be, to some degree, independent and multidisciplinary. Experts’ perspectives reveal a spectrum of specific desirable multidisciplinary categories—legal, physical science, biosciences, energy and engineering, economics, planning, social sciences, ethics, governance, health, and communication. We also highlight some caveats regarding multidisciplinarity and reflect on the existence of quasi-institutions across countries without dedicated CCCs.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.PMN.2017.07.004
Abstract: Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines. All units had written pain management guidelines that included pain assessment, documentation, and management. All four units used one or more pain assessment tools. In three units, pain management was considered multidisciplinary and routinely discussed on unit rounds. In two units, continuous infusion of intravenous opioids was used as well as sedatives and neuromuscular blockers for most ventilated patients. In the two other units, continuous intravenous infusion of opioids was not used and only sedatives were administered for patients on mechanical ventilation. In two units, there were no specific guidelines on the use of nonopioid analgesics, patient-controlled anesthesia, or the management of postoperative pain. No unit used an opioid or sedative withdrawal assessment tool or had pain management guidelines on the use of topical anesthetic agents or sucrose. Pain management practices and guidelines varied across the four units, suggesting that there is an opportunity for improvement in pain management in pediatric intensive care units in Jordan.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
Publisher: Elsevier BV
Date: 07-2009
DOI: 10.1016/J.JPAIN.2008.12.011
Abstract: A number of evidence-based consensus statements relating to pain in infants include recommendations concerning effective pain management during painful procedures. Yet numerous studies have shown that procedural pain remains poorly managed in neonatal intensive care units. The aim of this prospective clinical audit was to ascertain analgesics administered during skin-breaking, minor painful procedures occurring over the entire course of a hospitalization in a cohort of infants with a length of stay of 28 days or more. Data were collected on aspects relating to utilization of oral sucrose specifically for minor painful procedures as well as administration of opioid analgesics or other strong analgesics on the day the procedures were performed. A total of 3605 minor painful procedures were recorded for 55 infants during the study period, a mean of 65 minor procedures per infant. The majority of procedures recorded were heel lance (71%), followed by intravenous catheter insertion or venepuncture (14%). Either oral sucrose was specifically administered or background opioid analgesics were being administered during 85% of all minor painful procedures. These results show considerably higher frequency of analgesic use during acute minor painful procedures compared with similar studies of pain management practices in neonatal intensive care units. This study ascertained analgesics administered to sick infants during minor painful procedures during a prolonged hospitalization. Oral sucrose or morphine was administered during the most painful procedures, whereas 15% of procedures were performed with no analgesics. This illustrates a vast improvement compared with similar studies.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
Publisher: Elsevier BV
Date: 2005
Abstract: The aim of this study was to validate a clinician-friendly pain assessment tool for all groups of critically ill infants cared for in the specific neonatal intensive care units (NICUs) studied. A prospective study was undertaken to test the Pain Assessment Tool (PAT). Interrater reliability of the PAT score was assessed by two nurses who simultaneously determined an infant's PAT score. The PAT was validated against the CRIES score--crying, requires increased oxygen administration, increased vital signs, expression, sleeplessness--and the mother's assessment of her infant's discomfort using the Visual Analogue Scale (VAS). The NICUs at two children's hospitals. Participants were 144 preterm and term infants. Infants on a ventilator and those who had undergone surgery were included. The interrater reliability of the PAT was .85 with a mean difference of 0.17 (standard deviation: 1.73). There was a strong correlation between the PAT and CRIES scores (r = 0.76) and a moderate correlation (.38) between the PAT score and the VAS scores of the infant's mother. The correlation coefficient between the PAT score and CRIES score was significant for all groups (p < .01). The PAT score was shown in this study to be a valid, reliable, and clinician-friendly pain assessment measurement tool for all infants nursed in the NICU.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.JPAIN.2018.02.013
Abstract: The Face, Legs, Activity, Cry, and Consolability (FLACC) scale is one of the most commonly and widely used behavioral observation pain scales. The aim of this study was to test the psychometric and practical properties of the FLACC scale to quantify procedural pain in infants and young children. Twenty-six clinicians independently applied the FLACC scale to segments of video collected from 100 children aged 6 to 42 months undergoing a procedure. Video segments were scored by 4 reviewers. Inter- and intrarater reliability coefficients were high (.92 and .87, respectively). Linear mixed modeling confirmed scale responsiveness (differences in difference between FLACC scores across phases for painful versus nonpainful procedures was 4.2, 95% confidence interval = 3.67-4.81). Sensitivity and specificity were 94.9% and 73.5%, respectively, at a cutoff of 2. However, the mean difference across phases for children with baseline scores >3 was much lower than for children with scores <3, P = .0001. Correlations between FLACC and Visual Analog Scale observer pain and distress were good (r = .74 and r = .89, respectively). This study supports the reliability and sensitivity of the FLACC scale for procedural pain assessment. However, the circumstances of procedures interfered with application of the scale and the findings question the capacity of the scale to differentiate between pain- and nonpain-related distress. This article provides evidence that the FLACC scale is reliable and sensitive to pain for procedural pain assessment. Concerns remain about specificity and scale design. Identification of a scale valid for this purpose is needed to provide a platform for improved procedural pain management in infants and young children.
Start Date: 2013
End Date: 2014
Funder: Nova Scotia Health Research Foundation
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Funder: Canadian Institutes of Health Research
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End Date: 2015
Funder: Canadian Institutes of Health Research
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End Date: 2018
Funder: Canadian Institutes of Health Research
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End Date: 2016
Funder: Canadian Institutes of Health Research
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End Date: 2023
Funder: Canadian Institutes of Health Research
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Funder: Canadian Institutes of Health Research
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End Date: 2016
Funder: Canadian Institutes of Health Research
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End Date: 2017
Funder: Canadian Institutes of Health Research
View Funded ActivityStart Date: 2008
End Date: 2009
Funder: Canadian Institutes of Health Research
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