“So we started talking about a beach in Barbados”: Visualization practices and needle phobia

The effects of Valsalva maneuver on pain intensity and hemodynamic status during short peripheral cannula insertion in adults: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to summarize the randomized clinical trial studies regarding the effects of Valsalva maneuver on the severity of short peripheral cannula insertion pain and hemodynamic status in adults. A systematic search was conducted on PubMed, Web of Science, Scopus databases, Cochrane, ClinicalTrials.gov, and Google Scholar Search Engine using keywords extracted from Medical Subject Headings, such as "Valsalva Maneuver," "Valsalva's Maneuver," "Forced Expiratory," "Balloon Inflation," "Pain," "Ache," "Cannulation," "Peripheral Intravenous Cannulation," "Peripheral Catheterization," "Vascular Access," "Venous Cannulation," "Venous Catheterization," and "Catheterization," from the inception to January 1, 2022. Finally, 12 and 11 articles were included in the qualitative and quantitative analysis of this systematic review and meta-analysis, respectively. Overall, pain intensity based on both the Numeric Rating Scale and Visual Analog Scale resulted in a large clinical effect (Effect Size: -1.20, 95% Confidence Interval: -1.69 to -0.71, p < 0.001). A large clinical effect was observed in a separate study of both scales because clinical effect has been determined in studies based on the Numeric Rating Scale (Effect Size: -1.26, 95% Confidence Interval: -1.90 to -0.62, p < 0.001 (and Visual Analog Scale (Effect Size: -1.09, 95% Confidence Interval: -1.98 to -0.20, p = 0.016). Valsalva maneuver significantly increased the mean heart rate (Weighted Mean Difference: 1.90, 95% Confidence Interval: 1.56-2.24, p < 0.001), decreased the mean arterial pressure (Weighted Mean Difference: 0.73, 95% Confidence Interval: -0.13 to 1.60, p = 0.096), and caused a non-significant decrease in anxiety (Weighted Mean Difference: -1.95, 95% Confidence Interval: -5.24 to 1.34, p = 0.25). The results showed that Valsalva maneuver significantly reduced pain intensity. Therefore, it is recommended that nurses use it as a convenient and low-cost non-pharmacological intervention to alleviate the severity of pain in non-cardiac patients. Also, it is suggested to conduct the studies with a strong methodological design and consider its effects on hemodynamic parameters in future investigations.

'Whole onflow', the productive event: an articulation through health

In this paper we develop an understanding of 'whole onflow'. Extending philosopher Ralph Pred's original descriptions in materialist directions consistent with posthumanist and non-representational theory, we treat whole onflow as the progressing moment ever-materializing; as a never-ending more-than-human event happening everywhere that is existed in, registered, malleable and productive. In particular, using examples in health, we describe whole onflow's core qualities that lend it, as a vital forceful becoming, its productive capacities. We argue that whole onflow offers compelling ways of understanding the processual origins of health and many productions besides in all their diversity. Moreover, we argue that it offers ways of understanding how humans figure as part of the Universe's becoming.

Local anesthesia and anxiolytic techniques for oculoplastic surgery

This study discusses local anesthetic agents, administration techniques, ancillary considerations, and safety precautions for oculoplastic surgery including eyelid, lacrimal, orbital, and temporal artery biopsy procedures. Methods for reducing patient apprehension and discomfort including systemic premedication, topical pre-anesthetic, visual, auditory and tactile distraction techniques, regional blocks, small gauge needles, warmed lidocaine, and buffered lidocaine are discussed.

Distraction Technique for pain reduction in Peripheral Venous Catheterization: randomized, controlled trial

Background and aim of the work: Procedural pain during Peripheral Venous Catheterization (PVC) is a significant issue for patients. Reducing procedure-induced pain improves the quality of care and reduces patient discomfort. We aimed to compare a non-pharmacological technique (distraction) to anaesthetic cream (EMLA) for the reduction of procedural pain during PVC, in patients undergoing Computerized Tomography (CT) or Nuclear Magnetic Resonance (NMR) with contrast. Methods: This is a Prospective, Randomized Controlled Trial. The study was carried out during the month of October 2015. A total of 72 patients undergoing PVC were randomly assigned to the experimental group (distraction technique, n=36) or control group (EMLA, n=36). After PVC, pain was evaluated by means of the numeric pain-rating scale (NRS). Pain perception was compared by means of Mann-Whitney Test. Results: The average pain in the distraction group was 0.69 (SD±1.26), with a median value of 0. The average pain in the EMLA group was 1.86 (SD±1.73), with a median value of 2. The study showed a significant improvement from the distraction technique (U=347, p<.001, r=.42) with respect to the local anaesthetic in reducing pain perception. Conclusions/Implication for practice: Distraction is more effective than local anaesthetic in reducing of pain-perception during PVC insertion. This study is one of few comparing the distraction technique to an anaesthetic. It confirms that the practitioner-patient relationship is an important point in nursing assistance, allowing the establishment of trust with the patient and increasing compliance during the treatment process.

Geographical thinking in nursing inquiry, part two: performance, possibility, and non-representational theory

Part one in this two paper series reviewed the nature of geographical thinking in nursing research thus far. The current paper builds on it by looking forwards and providing a particular vision for future research. It argues that it is time to once again look to the parent discipline of human geography for inspiration, specifically to its turn towards non-representational theory, involving an emphasis on life that onflows prior to meaning, significance, and full cognition; on life's 'taking-place'. The paper introduces this way of viewing and animating the world. Some potential connections to nursing research and practice are suggested, as are some specific avenues for future inquiry. Explained is how, through non-representational theory, nursing might be re-imagined as something that reveals space-time.

Re-spacing and re-placing gerontology: relationality and affect

This paper describes how space and place have been understood in gerontology as phenomenon that are both physical and social in character, yet are relatively bounded and static. The argument is posed as to how, following recent developments in human geography, a relational approach might be adopted. Involving a twist in current thinking, this would instead understand space and place each as highly permeable, fluid and networked at multiple scales. Moreover, it is proposed that the concept of ‘affect’ might also be insightful, recognising space and place as being relationally configured and performed, possessing a somatically registered energy, intensity and momentum that precedes deep cognition. Three vignettes illustrate the relationalities and affects in the lives and circumstances of older people, and how focusing more explicitly on them would allow for a richer understanding of where and how they live their lives. The paper closes with some thoughts on future theoretical, methodological and disciplinary considerations.

Vasovagal reactions in whole blood donors at three REDS-II blood centers in Brazil

BACKGROUND

In Brazil little is known about adverse reactions during donation and the donor characteristics that may be associated with such events. Donors are offered snacks and fluids before donating and are required to consume a light meal after donation. For these reasons the frequency of reactions may be different than those observed in other countries.

STUDY DESIGN AND METHODS

A cross-sectional study was conducted of eligible whole blood donors at three large blood centers located in Brazil between July 2007 and December 2009. Vasovagal reactions (VVRs) along with donor demographic and biometric data were collected. Reactions were defined as any presyncopal or syncopal event during the donation process. Multivariable logistic regression was performed to identify predictors of VVRs.

RESULTS

Of 724,861 donor presentations, 16,129 (2.2%) VVRs were recorded. Rates varied substantially between the three centers: 53, 290, and 381 per 10,000 donations in Recife, São Paulo, and Belo Horizonte, respectively. Although the reaction rates varied, the donor characteristics associated with VVRs were similar (younger age [18-29 years], replacement donors, first-time donors, low estimated blood volume [EBV]). In multivariable analysis controlling for differences between the donor populations in each city younger age, first-time donor status, and lower EBV were the factors most associated with reactions.

CONCLUSION

Factors associated with VVRs in other locations are also evident in Brazil. The difference in VVR rates between the three centers might be due to different procedures for identifying and reporting the reactions. Potential interventions to reduce the risk of reactions in Brazil should be considered.