A number of infant pain measures have been developed over the past 15 years incorporating behavioural and physiologic indicators; however, no reliable or valid measure exists for infants who are at ...risk for neurological impairments (NI). The objective of this study was to establish consensus about which behavioural, physiologic and contextual indicators best characterize pain in infants at high, moderate and low levels of risk for NI.
A 39- item, self-administered electronic survey that included infant physiologic, behavioral and contextual pain indicators was used in a two round Delphi consensus exercise. Fourteen pediatric pain experts were polled individually and anonymously on the importance and usefulness of the pain indicators for the 3 differing levels of risk for NI.
The strength of agreement between expert raters was moderate in Round 1 and fair in Round 2. In general, pain indicators with the highest concordance for all three groups were brow bulge, facial grimace, eye squeeze, and inconsolability. Increased heart rate from baseline in the moderate and severe groups demonstrated high concordance. In the severe risk group, fluctuations in heart rate and reduced oxygen saturation were also highly rated.
These data constitute the first step in contributing to the development and validation of a pain measure for infants at risk for NI. In future research, we will integrate these findings with the opinions of (a) health care providers about the importance and usefulness of infant pain indicators and (b) the pain responses of infants at mild, moderate and high risk for NI.
Bioimpedance assessment of hypohydration O'BRIEN, C; BAKER-FULCO, C. J; YOUNG, A. J ...
Medicine and science in sports and exercise,
10/1999, Letnik:
31, Številka:
10
Journal Article
Recenzirano
Odprti dostop
This study examined the utility of bioimpedance spectroscopy (BIS) for assessing total body water (TBW) changes associated with moderate (6-7% TBW), hypertonic (HH), and isotonic (IH) hypohydration.
...The TBW of nine men was measured using BIS (TBWBIS) when euhydrated (EU) and during HH and IH. These measurements were compared with TBW measurements obtained using isotope dilution (deuterium oxide; TBWD20) during EU, and the estimated TBWD20 during hypohydration calculated from body weight change.
Body weight loss was similar (P > 0.05) for HH (3.4 +/- 0.7 kg) and IH (2.9 +/- 0.7 kg). Plasma osmolality was higher (P < 0.05) on HH (292 +/- 4 mOsmol x kg(-1)) than EU (280 +/- 4 mOsmol x kg(-1)) and IH (284 +/- 3 mOsmol x kg(-1)), and higher (P < 0.05) during IH than EU. The measurements reflected a similar decrease (P < 0.05) in TBW during HH (TBWD20: 45.4 +/- 7.3 L, TBWBIS: 42.2 +/- 5.1 L) and IH (TBWD20: 45.8 +/- 7.5 L, TBWBIS: 42.0 +/- 4.9 L), compared with EU (TBWD20: 48.8 +/- 7.5 L, TBWBIS: 44.3 +/- 5.0 L), but TBWD20 was consistently higher (3.9 +/- 4.0 L, P < 0.05) than TBWBIS during all tests. TBWD20 and TBWBIS were correlated (P < 0.05) during EU (r = 0.87), HH (r = 0.84), and IH (r = 0.84). The change in TBW from EU during HH was greater (P < 0.05) for TBWD20 (3.5 +/- 0.8 L) than TBWBIS (2.1 +/- 0.9 L), but during IH the change in TBW reflected by TBWD20 (3.0 +/- 0.6 L) and TBWBIS (2.3 +/- 0.8 L) did not differ. The change in TBWD20 and TBWBIS between EU and hypohydration was correlated for HH (r = 0.77, P < 0.05), but not IH.
These findings indicate that BIS is sufficiently sensitive to detect moderate hypohydration; however, the resolution of this technique diminished with isotonic fluid loss.
The purpose of this qualitative interview study was to illuminate mentor and intern participants' relationships in one state-mandated beginning teacher internship program. We analyzed interview data ...from 29 mentors and interns using within- and cross-case analysis and generated categories and properties with supporting interview excerpts to show how mentors and interns interpreted and adapted their roles. Findings of the study indicate that mentors and interns jointly construct their relationships; these relationships are undergirded by the respect and trust the two individuals have for each other. Furthermore, interns appear to need mentors who first, and foremost, support them as fledgling teachers. Interns also need mentors who assume flexible roles and who adapt their roles based on interns' needs.
Fascicles of the sural nerve from each of 20 diabetic patients, mostly with maturity-onset diabetes, were studied by biochemical and pathological techniques, and results were compared to values found ...in nerve specimens from 15 healthy persons. The sorbitol and fructose content was much more variable in diabetic than in healthy nerves. More than one-third of the diabetic nerves had sorbitol and fructose values above the highest levels for controls. myo-Inositol and scyllo-inositol content was not reduced in diabetic nerves. The sorbitol, fructose, and inositol concentrations could not be related to clinical, neurophysiological, or pathological severity of neuropathy. A comparison of scored symptoms and signs and clinical neurophysiological studies against morphometric and teased fiber studies of sural nerve demonstrated that the former three provide sensitive and reliable measures of severity of neuropathy that can be used for controlled clinical trials of diabetic neuropathy. The presence and type of teased fiber abnormalities could be related to the duration of diabetes and to symptoms of neuropathy. In untreated diabetics without symptoms of neuropathy, a higher than normal frequency of teased fibers showing segmental demyelination and remyelination was found. Untreated diabetics with symptomatic neuropathy showed two kinds of abnormalities: fibers with segmental demyelination and remyelination and fibers undergoing axonal degeneration. In treated diabetics, who often had longstanding neuropathy, the most common abnormalities were fibers undergoing axonal degeneration.
We developed a true-or-false questionnaire with several hundred questions about symptoms encountered in peripheral neuropathy, to be scored by optical reader and computer. Responses were grouped into ...scales called "Neuropathy," "Weakness," "Sensory," "Autonomic," and subsets of these. Profiles in health were estimated for each scale based on responses from 300 healthy subjects 15 to 65 years old. The sensitivity and specificity of the scales were tested in patients with motor neuron disease, amyloidosis, or diabetes, with or without neuropathy. The questionnaire was useful in detecting neuropathy and staging severity, and in recognizing patterns that may have diagnostic implications.
The National Strategic Framework identified "common ground" on which the Cooperative Extension System has some agreement. Future search workshops engaged staff, volunteers, and customers in ...co-creating an ideal future. A sense of shared meaning emerged from the interests, values, and visions of individual participants.
Content analytic procedures were used to examine sex representation and gender bias in hybrid introductory communication textbooks. Although findings of the study suggest that men are used more ...frequently as the focal point within the texts analyzed, no significant differences exist between the representation of women and men in the written and pictorial content of the textbook chapters. Results do indicate, however, that an unintentional form of gender bias may exist as both sexes are depicted in traditional roles in both textual examples and photographs. To address such subtle forms of gender bias, it is recommended that current standards for addressing biased symbols be revisited.
