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Ige K, Nguyen K, Buchbinder D, Butte M, Collins C, Cowan M, Dimitriades V, McGhee S, Shah A, Puck J, Smith H, Chen XH, Franck L, Dorsey M. Severe Combined Immunodeficiency (SCID) Patient and Families Report Significant Financial Burden. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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2
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Kwesiga D, Wanduru P, Ssegujja E, Inhensiko J, Waiswa P, Franck L. Improving Post-discharge Practice of Kangaroo Mother Care: Perspectives From Communities in East-Central Uganda. Front Pediatr 2022; 10:934944. [PMID: 35911828 PMCID: PMC9326122 DOI: 10.3389/fped.2022.934944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Kangaroo mother care (KMC) is among the most cost-effective and easily accessible solutions for improving the survival and wellbeing of small newborns. In this study, we examined the barriers and facilitators to continuity of KMC at home following hospital discharge in rural Uganda. METHODS We conducted this study in five districts in east-central Uganda, within six hospitals and at the community level. We used a qualitative approach, with two phases of data collection. Phase 1 comprised in-depth interviews with mothers who practiced KMC with their babies and caretakers who supported them and key informant interviews with health workers, district health office staff, community health workers, and traditional birth attendants. We then conducted group discussions with mothers of small newborns and their caretakers. We held 65 interviews and five group discussions with 133 respondents in total and used a thematic approach to data analysis. RESULTS In hospital, mothers were sensitized and taught KMC. They were expected to continue practicing it at home with regular returns to the hospital post-discharge. However, mothers practiced KMC for a shorter time at home than in the hospital. Reasons included being overburdened with competing domestic chores that did not allow time for KMC and a lack of community follow-up support by health workers. There were increased psycho-social challenges for mothers, alongside some dangerous practices like placing plastic cans of hot water near the baby to provide warmth. Respondents suggested various ways to improve the KMC experience at home, including the development of a peer-to-peer intervention led by mothers who had successfully done KMC and community follow-up of mothers by qualified health workers and community health workers. CONCLUSION Despite wide acceptance of KMC by health workers, challenges to effective implementation persist. Amid the global and national push to scale up KMC, potential difficulties to its adherence post-discharge in a rural, resource-limited setting remain. This study provides insights on KMC implementation and sustainability from the perspectives of key stakeholders, highlighting the need for a holistic approach to KMC that incorporates its adaptability to community settings and contexts.
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Affiliation(s)
- Doris Kwesiga
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Centre of Excellence for Maternal Newborn and Child Health Research, Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Phillip Wanduru
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.,Centre of Excellence for Maternal Newborn and Child Health Research, Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Eric Ssegujja
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Justine Inhensiko
- Centre of Excellence for Maternal Newborn and Child Health Research, Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Peter Waiswa
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.,Centre of Excellence for Maternal Newborn and Child Health Research, Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Linda Franck
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, United States
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Abstract
Mexican-born women represent a significant proportion of the obstetric patient population in California and have higher incidence of adverse obstetric outcomes than white women, including maternal postpartum hemorrhage and perinatal depression. Little is known, however, about Mexican-born women's experiences of maternity care in the United States. Qualitative methods were used to conduct a secondary analysis of interview transcripts, field notes, original photographs, and analytic memos from a study of 7 Mexican-born women's birth experiences. Participants reported social isolation influenced their expectations of maternity care. Disconnection, characterized by unmet physical and relational needs, yielded negative experiences of maternity care, while positive experiences were the result of attentive care wherein they felt providers cared about them as individuals.
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Affiliation(s)
- Lauren Trainor
- May Grant Obstetrics & Gynecology, Lancaster, PA, USA.,Department of Family Health Care Nursing, School of Nursing, UCSF, San Francisco, CA, USA
| | | | - Monica McLemore
- Department of Family Health Care Nursing, School of Nursing, UCSF, San Francisco, CA, USA
| | - Linda Franck
- Department of Family Health Care Nursing, School of Nursing, UCSF, San Francisco, CA, USA
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Abstract
PURPOSE OF THE STUDY To determine the statistical indicators aimed at identifying patients for whom ambulatory colectomy could be proposed without additional risk. PATIENTS AND METHODS The medical charts of patients who benefited from scheduled colonic or rectal resection during conventional hospitalization stays between 2018 and 2019 were reviewed. Eligibility for ambulatory colectomy was defined by hospital stay≤4 days and absence of any postoperative complication. Patient characteristics were compared, and the results were modeled in the form of a decision-making tree. The effect of an enhanced recovery after surgery (ERAS) protocol for each sub-group was calculated. RESULTS One hundred and ten (110) patients were selected (41 "eligible" and 69 "non-eligible"). Median age was 73 years (27-95). Nearly 80% of the patients were operated for cancer. In multivariate analysis, age (≥65 years, OR=3.15, CI95%=1.22-8.12), diabetes (OR=3.91, CI95%=1.03-14.8) and indication (sigmoidectomy for diverticulosis, OR=0.21, CI=95%=0.05-0.9) were the only identified independent variables. Likelihood for ambulatory eligibility was 83.3% (<65 years, sigmoidectomy pour diverticulosis, +ERAS=92%-96.9%), 58.3% (<65 years, other indication, +ERAS=63.4%-89.9%), 35.7% (≥65 years without diabetes, +ERAS=40.0%-55.9%) and 8.3% (≥65 years with diabetes, +ERAS=10.0%-20.1%). CONCLUSION Sigmoidectomy for diverticulosis in a patient under 65 years age represents the best indication for ambulatory colectomy, a procedure that must not be proposed to diabetic patients over 65 years of age. In the other cases (<65 years operated in another indication and non-diabetic≥65 years), ambulatory surgery is possible, pending satisfactory application of the ERAS protocol.
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Affiliation(s)
- S Bourgouin
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France.
| | - T Monchal
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France
| | - G Schlienger
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France
| | - L Franck
- Department of Anesthesia and Intensive Care, Sainte Anne Military Teaching Hospital, Toulon, France
| | - G Lacroix
- Department of Anesthesia and Intensive Care, Sainte Anne Military Teaching Hospital, Toulon, France
| | - P Balandraud
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France; École du Val-de-Grâce, Paris, France
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McLemore MR, Berkowitz RL, Oltman SP, Baer RJ, Franck L, Fuchs J, Karasek DA, Kuppermann M, McKenzie-Sampson S, Melbourne D, Taylor B, Williams S, Rand L, Chambers BD, Scott K, Jelliffe-Pawlowski LL. Risk and Protective Factors for Preterm Birth Among Black Women in Oakland, California. J Racial Ethn Health Disparities 2020; 8:1273-1280. [PMID: 33034878 DOI: 10.1007/s40615-020-00889-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/27/2022]
Abstract
This project examines risk and protective factors for preterm birth (PTB) among Black women in Oakland, California. Women with singleton births in 2011-2017 (n = 6199) were included. Risk and protective factors for PTB and independent risk groups were identified using logistic regression and recursive partitioning. Having less than 3 prenatal care visits was associated with highest PTB risk. Hypertension (preexisting, gestational), previous PTB, and unknown Women, Infant, Children (WIC) program participation were associated with a two-fold increased risk for PTB. Maternal birth outside of the USA and participation in WIC were protective. Broad differences in rates, risks, and protective factors for PTB were observed.
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Affiliation(s)
- Monica R McLemore
- Department of Family Health Care Nursing, UCSF School of Nursing, 2 Koret Way, N431H, San Francisco, CA, 94134, USA.
| | - Rachel L Berkowitz
- School of Public Health, UC Berkeley, 2121 Berkeley Way, #5302, Berkeley, CA, 94704, USA
| | - Scott P Oltman
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
| | - Rebecca J Baer
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- Department of Pediatrics, UCSD, San Diego, CA, USA
| | - Linda Franck
- Department of Family Health Care Nursing, UCSF School of Nursing, 2 Koret Way, N431H, San Francisco, CA, 94134, USA
| | - Jonathan Fuchs
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- San Francisco Department of Public Health, 101 Grove Street, San Francisco, 94102, USA
| | - Deborah A Karasek
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF School of Medicine, San Francisco, CA, USA
| | - Miriam Kuppermann
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF School of Medicine, San Francisco, CA, USA
| | - Safyer McKenzie-Sampson
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, UCSF School of Medicine, San Francisco, CA, USA
| | - Daphina Melbourne
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- San Francisco Department of Public Health, 101 Grove Street, San Francisco, 94102, USA
| | - Briane Taylor
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- San Francisco Department of Public Health, 101 Grove Street, San Francisco, 94102, USA
| | - Shanell Williams
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- San Francisco Department of Public Health, 101 Grove Street, San Francisco, 94102, USA
| | - Larry Rand
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- San Francisco Department of Public Health, 101 Grove Street, San Francisco, 94102, USA
| | - Brittany D Chambers
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- San Francisco Department of Public Health, 101 Grove Street, San Francisco, 94102, USA
| | - Karen Scott
- Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF School of Medicine, San Francisco, CA, USA
| | - Laura L Jelliffe-Pawlowski
- California Preterm Birth Initiative, UCSF, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, UCSF School of Medicine, San Francisco, CA, USA
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Abstract
The study reported here compared the visibility of a cane equipped with white Scotchlite Reflecting Tape with Reflexite AP 1000M Reflecting Tape. The subjects were 33 licensed drivers, randomly assigned to groups, who were told to look for and announce the sighting of a person with a cane while they rode as passengers in cars traveling at a constant speed at night on a flat, unlit rural road. Elapsed times were recorded and distances calculated. The findings indicated that microprism reflecting tape, such as Reflexite AP 1000M, provides far greater detection distances at night on rural roads than does the standard Scotchlite currently used on long canes, and thus may be safer for blind travelers in rural areas.
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Affiliation(s)
- L. Franck
- Seeing Eye, Inc., Morristown, N.J. 07963
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Chambers BD, Baer RJ, Bandoli G, Felder J, Feuer SK, Flowers E, Franck L, Gomez AM, Karasek D, Nidey NL, Oltman SP, Rogers E, Scott K, Rand L, Ryckman KK, Jelliffe-Pawlowski LL. 855: Risk of adverse birth outcome among Black women with post-traumatic stress disorder. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.11.869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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McLemore MR, Altman MR, Cooper N, Williams S, Rand L, Franck L. Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth. Soc Sci Med 2018; 201:127-135. [PMID: 29494846 DOI: 10.1016/j.socscimed.2018.02.013] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/25/2018] [Accepted: 02/15/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth. METHODS This study was a secondary analysis of focus group data generated as part of a larger project focused on patient and community involvement in preterm birth research. English and Spanish speaking women, age 18 or greater with social and/or medical risk factors for preterm birth participated in two focus groups, six weeks apart. Data from the first focus groups are included in this analysis. RESULTS Five themes emerged from thematic analysis of the transcripts. Participants described disrespect during healthcare encounters, including experiences of racism and discrimination; stressful interactions with all levels of staff; unmet information needs; and inconsistent social support. Despite these adverse experiences, women felt confidence in parenting and newborn care. Participant recommendations for healthcare systems improvement included: greater attention to birth plans, better communication among multiple healthcare providers, more careful listening to patients during clinical encounters, increased support for social programs such as California's Black Infant Health, and less reliance on past carceral history and/or child protective services involvement. DISCUSSION The women in this study perceived their prenatal healthcare as a largely disrespectful and stressful experience. Our findings add to the growing literature that women of color experience discrimination, racism and disrespect in healthcare encounters and that they believe this affects their health and that of their infants.
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Affiliation(s)
- Monica R McLemore
- Family Health Care Nursing Department, University of California, 2 Koret Way, N431H, San Francisco, CA, 94143, United States.
| | - Molly R Altman
- UCSF Preterm Birth Initiative, 3333 California Street, Suite 285, San Francisco, CA, 94118, United States.
| | - Norlissa Cooper
- Department of Social and Behavioral Sciences, Health Policy, University of California, 3333 California Street, San Francisco, CA, 94118, United States.
| | - Shanell Williams
- UCSF Preterm Birth Initiative, 3333 California Street, Suite 285, San Francisco, CA, 94118, United States.
| | - Larry Rand
- Marc and Lynne Benioff Endowed Chair in Maternal Fetal Medicine, Director of Perinatal Services, Fetal Treatment Center, University of California, Dept. of Ob/Gyn and Surgery, Divisions of Perinatology and Pediatric Surgery, 550 16th Street, Box #0132, San Francisco, CA, 94143-0132, United States.
| | - Linda Franck
- Department of Family Health Care Nursing, Jack and Elaine Koehn Endowed Chair in Pediatric Nursing, University of California, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, United States.
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Alderdice F, Gargan P, McCall E, Franck L. Online information for parents caring for their premature baby at home: A focus group study and systematic web search. Health Expect 2018; 21:741-751. [PMID: 29380916 PMCID: PMC6117489 DOI: 10.1111/hex.12670] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 11/15/2022] Open
Abstract
Background Online resources are a source of information for parents of premature babies when their baby is discharged from hospital. Objectives To explore what topics parents deemed important after returning home from hospital with their premature baby and to evaluate the quality of existing websites that provide information for parents post‐discharge. Methods In stage 1, 23 parents living in Northern Ireland participated in three focus groups and shared their information and support needs following the discharge of their infant(s). In stage 2, a World Wide Web (WWW) search was conducted using Google, Yahoo and Bing search engines. Websites meeting pre‐specified inclusion criteria were reviewed using two website assessment tools and by calculating a readability score. Website content was compared to the topics identified by parents in the focus groups. Results Five overarching topics were identified across the three focus groups: life at home after neonatal care, taking care of our family, taking care of our premature baby, baby's growth and development and help with getting support and advice. Twenty‐nine sites were identified that met the systematic web search inclusion criteria. Fifteen (52%) covered all five topics identified by parents to some extent and 9 (31%) provided current, accurate and relevant information based on the assessment criteria. Conclusion Parents reported the need for information and support post‐discharge from hospital. This was not always available to them, and relevant online resources were of varying quality. Listening to parents needs and preferences can facilitate the development of high‐quality, evidence‐based, parent‐centred resources.
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Affiliation(s)
- Fiona Alderdice
- Queen's University Belfast, Belfast, UK.,University of Oxford, England, UK
| | | | | | - Linda Franck
- University of California San Francisco, San Francisco, CA, USA
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10
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Chambers BD, Arega H, Spellen S, Arabia SE, Stanley D, Gomez AM, Franck L, Berkowitz R, Feuer S, Jelliffe-Pawlowski L, McLemore MR. 961: Pregnant Black women's experiences of racial discrimination. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.11.448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Parkinson L, Waters DL, Franck L. Systematic review of the impact of osteoarthritis on health outcomes for comorbid disease in older people. Osteoarthritis Cartilage 2017; 25:1751-1770. [PMID: 28710026 DOI: 10.1016/j.joca.2017.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 05/28/2017] [Accepted: 07/05/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A systematic review was undertaken examining the impact of comorbid osteoarthritis on health outcomes for people aged 50 years or older with cardiovascular disease, diabetes or obesity. DESIGN The protocol is registered in PROSPERO (CRD42015023417). Relevant electronic databases and grey literature were systematically searched for studies published in English between January 2005 and December 2016. Two reviewers independently screened studies for selection using predetermined inclusion and exclusion criteria, and independently completed methodological quality review. Data was extracted at study level by one reviewer and independently checked by a second reviewer, using a standardized form. The results across studies were qualitatively synthesized with outcomes described and summarized. RESULTS Of 1456 articles, we identified 15 relevant studies, with nine good to high quality studies describing significant negative impact of osteoarthritis on outcomes for cardiovascular diseases. There were too few studies focussing on diabetes and obesity to make conclusions in regard to these diseases. CONCLUSIONS This review provides evidence that osteoarthritis should not be overlooked when impacts of chronic disease on health outcomes and related health service use are considered. There is a clear need for more studies that consider the impacts of osteoarthritis on comorbid disease, especially those that consider the impact of osteoarthritis beyond the morbidity impacts. The management of comorbid osteoarthritis should be addressed for those with cardiovascular disease, and treatment choices considered given this association.
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Affiliation(s)
- L Parkinson
- Central Queensland University, Rockhampton, Australia.
| | - D L Waters
- University of Otago, Dunedin, New Zealand
| | - L Franck
- Central Queensland University, Rockhampton, Australia
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Horvath H, Brindis CD, Reyes EM, Yamey G, Franck L. Preterm birth: the role of knowledge transfer and exchange. Health Res Policy Syst 2017; 15:78. [PMID: 28874160 PMCID: PMC5586007 DOI: 10.1186/s12961-017-0238-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 08/03/2017] [Indexed: 11/12/2022] Open
Abstract
Background Preterm birth (PTB) is the leading cause of death in children under age five. Healthcare policy and other decision-making relevant to PTB may rely on obsolete, incomplete or inapplicable research evidence, leading to worsened outcomes. Appropriate knowledge transfer and exchange (KTE) strategies are an important component of efforts to reduce the global PTB burden. We sought to develop a ‘landscape’ analysis of KTE strategies currently used in PTB and related contexts, and to make recommendations for optimising programmatic implementation and for future research. Methods In the University of California, San Francisco’s Preterm Birth Initiative, we convened a multidisciplinary working group and examined KTE frameworks. After selecting a widely-used, adaptable, theoretically-strong framework we reviewed the literature to identify evidence-based KTE strategies. We analysed KTE approaches focusing on key PTB stakeholders (individuals, families and communities, healthcare providers and policymakers). Guided by the framework, we articulated KTE approaches that would likely improve PTB outcomes. We further applied the KTE framework in developing recommendations. Results We selected the Linking Research to Action framework. Searches identified 19 systematic reviews, including two ‘reviews of reviews’. Twelve reviews provided evidence for KTE strategies in the context of maternal, neonatal and child health, though not PTB specifically; seven reviews provided ‘cross-cutting’ evidence that could likely be generalised to PTB contexts. For individuals, families and communities, potentially effective KTE strategies include community-based approaches, ‘decision aids’, regular discussions with providers and other strategies. For providers, KTE outcomes may be improved through local opinion leaders, electronic reminders, multifaceted strategies and other approaches. Policy decisions relevant to PTB may best be informed through the use of evidence briefs, deliberative dialogues, the SUPPORT tools for evidence-informed policymaking and other strategies. Our recommendations for research addressed knowledge gaps in regard to partner engagement, applicability and context, implementation strategy research, monitoring and evaluation, and infrastructure for sustainable KTE efforts. Conclusions Evidence-based KTE, using strategies appropriate to each stakeholder group, is essential to any effort to improve health at the population level. PTB stakeholders should be fully engaged in KTE and programme planning from its earliest stages, and ideally before planning begins. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0238-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hacsi Horvath
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 Sixteenth Street, third floor, San Francisco, CA, 94158, United States of America. .,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States of America. .,Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States of America.
| | - Claire D Brindis
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States of America.,Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - E Michael Reyes
- Department of Family and Community Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Gavin Yamey
- Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States of America.,Present affiliation: Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Linda Franck
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, United States of America
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Parkinson L, McAllister M, Molyneux N, Franck L, Jeffrey D. EXPLORING PROGRAMS FOR REDUCING SOCIAL ISOLATION AND DEPRESSION IN RURAL AGED CARE CLIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L. Parkinson
- CQUniversity, Rockhampton, Queensland, Australia,
| | | | - N. Molyneux
- CQUniversity, Rockhampton, Queensland, Australia,
| | - L. Franck
- CQUniversity, Rockhampton, Queensland, Australia,
| | - D. Jeffrey
- PresCare, Brisbane, Queensland, Australia
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McDonald R, Sawatzky B, Franck L. A comparison of flat and ramped, contoured cushions as adaptive seating interventions for children with neurological disorders. Health Psychol Behav Med 2015. [DOI: 10.1080/21642850.2014.981189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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15
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Harris J, Franck L, Green B, Michie S. The psychological impact of providing women with risk information for pre-eclampsia: A qualitative study. Midwifery 2014; 30:1187-95. [DOI: 10.1016/j.midw.2014.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/17/2014] [Accepted: 04/20/2014] [Indexed: 11/30/2022]
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Abstract
This pilot study compared the sleep quality and quantity of parents who slept at their hospitalized child's bedside with parents who slept at the hospital's onsite Ronald McDonald House® (RMH). Wrist actigraphy and questionnaires were used to estimate parent sleep quality and quantity. Parents who slept at their hospitalized child's bedside (n = 27) experienced more sleep disruption (wake after sleep onset) and reported poorer sleep quality and feeling less rested than parents who slept at RMH (n = 11). Bedside accommodation was associated with poorer parent sleep even when controlling for the covariates of child age and parent gender. Nearby family accommodations, such as RMH, may facilitate parent-child proximity during a child's hospitalization while also providing parents with opportunities for essential sleep.
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Affiliation(s)
- Linda Franck
- a Department of Family Health Care Nursing University of California , San Francisco
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17
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Wray J, Edwards V, Wyatt K, Maddick A, Logan S, Franck L. Parents' attitudes toward the use of complementary therapy by their children with moderate or severe cerebral palsy. J Altern Complement Med 2013; 20:130-5. [PMID: 24205786 DOI: 10.1089/acm.2012.0973] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To describe the use of, and attitudes toward, complementary therapy (CT) by parents of children with moderate to severe cerebral palsy. METHODS Parents of 32 children with cerebral palsy (age 5-12 years) enrolled in a randomized trial of cranial osteopathy prospectively participated in semi-structured interviews in the home to explore the use of CT and views regarding access to and expectations of these therapies. Interview transcripts were analyzed thematically, and content analysis was used to determine the frequency of use of different therapies. RESULTS Sixteen children (50%) had received one or more types of CT, although only three were currently receiving any CT. The primary reasons for trying CT were to reduce children's pain and improve physical function. Parents had limited knowledge of the range of, and possible indications for, CT and expressed concerns about CT safety and effectiveness. Practical considerations of time and cost were also identified. Some parents had strong beliefs about the benefits, and, overall, parents indicated a high level of commitment to finding any treatments, conventional or CT, to help their children. CONCLUSION Parents of children with cerebral palsy want to help their child, but they need information, guidance, and practical support to facilitate their decision-making regarding the use of CT. A clearer understanding of factors predictive of optimal outcomes will enable resources to be targeted effectively.
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Affiliation(s)
- Jo Wray
- 1 Centre for Nursing and Allied Health Research, Great Ormond Street Hospital for Children , NHS Trust, London, United Kingdom
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Vico S, Franck L, Bensalah M, Gil C, De Rudnicki S. [Diagnostic difficulty for an acute hydrocephalus]. ACTA ACUST UNITED AC 2013; 32:618-20. [PMID: 23948022 DOI: 10.1016/j.annfar.2013.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
Abstract
Tuberculosis disease, in its extra pulmonary form, remains a difficult diagnosis because of its atypical symptoms and evolution. We have observed a case of acute tuberculosis neuromeningitis, without being able to make a definite diagnosis prior to the patient's death because of the negativity of the initial bacteriological samples. We started the most probable appropriate treatment but in vain. This case allows us to challenge diagnostic methods and resulting treatments in emergency cases where tuberculosis is suspected. Moreover, it seems essential to do everything possible to find the bacterium when confronted with a patient with risk factors and clinical and radiological symptoms compatible with tubercular disease, before the disease becomes acute.
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Affiliation(s)
- S Vico
- Service d'anesthésie-réanimation, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
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Franck L, Maesani M, Birenbaum A, Delerme S, Riou B, Langeron O, Le Saché F. Étude de faisabilité pour la mise en place d’une filière de chirurgie ambulatoire en urgence. ACTA ACUST UNITED AC 2013; 32:392-6. [DOI: 10.1016/j.annfar.2013.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 03/11/2013] [Indexed: 10/26/2022]
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May L, Hayward R, Chakraborty A, Franck L, Manzotti G, Wray J, Thompson D. Lack of uniformity in the clinical assessment of children with lipomyelomeningocele: a review of the literature and recommendations for the future. Childs Nerv Syst 2013; 29:961-70. [PMID: 23512293 DOI: 10.1007/s00381-013-2063-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 02/25/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE An objective clinical assessment tool whose accuracy and reproducibility can be validated is essential for the initial evaluation, selection for surgery and surveillance of children with lipomyelomeningocele (LMMC). The aim of this study was to analyse the large number of such tools presently in use and recommend an alternative that could lead to greater uniformity between different series and greater consistency in the assessment of individual patients. METHODS A systematic review of the literature between January 1980 and December 2010 was undertaken and details of how the children in each series were assessed and the degree to which age was taken into account recorded. RESULTS Thirty-six different assessment tools were used in 40 different publications. None was validated in all aspects. Objective measures were used most in urological assessments but rarely in other domains. Age-specific assessments were used in only 10 % of publications. CONCLUSION This study confirmed that the assessment tools for evaluation of children with LMMC are inconsistent, often vague and poorly validated. This compromises the ability of clinicians who care for them to compare studies across centres for both treated and untreated children. We have sought to highlight those criteria which are relevant, measurable and reproducible and which might be combined into an easily applied assessment.
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Affiliation(s)
- Lindy May
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children, NHS Foundation Trust, Great Ormond Street, London, UK.
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Paradis E, Reeves S, Leslie M, Aboumatar H, Chesluk B, Clark P, Courtenay M, Franck L, Lamb G, Lyndon A, Mesman J, Puntillo K, Schmitt M, van Soeren M, Wachter B, Zwarenstein M, Gropper M, Kitto S. Exploring the nature of interprofessional collaboration and family member involvement in an intensive care context. J Interprof Care 2013; 28:74-5. [DOI: 10.3109/13561820.2013.781141] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Franck L, de Rudnicki S, Libert N. Thrombus formation in a patent foramen ovale. Ann Fr Anesth Reanim 2013; 32:e79-e80. [PMID: 23528287 DOI: 10.1016/j.annfar.2013.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 02/26/2013] [Indexed: 06/02/2023]
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Taddio A, Shah V, Leung E, Wang J, Parikh C, Smart S, Hetherington R, Ipp M, Riddell RP, Sgro M, Jovicic A, Franck L. Knowledge translation of the HELPinKIDS clinical practice guideline for managing childhood vaccination pain: usability and knowledge uptake of educational materials directed to new parents. BMC Pediatr 2013; 13:23. [PMID: 23394070 PMCID: PMC3585914 DOI: 10.1186/1471-2431-13-23] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 01/14/2013] [Indexed: 11/21/2022] Open
Abstract
Background Although numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video) for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants. Methods Mixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video. Results Three overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents’ performance on the knowledge test improved (p≤0.001) from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video. Conclusions Using a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational pamphlet and video about management of vaccination pain. Future studies are planned to determine the impact of these educational tools when introduced in clinical settings on parent behaviors during infant vaccinations.
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Affiliation(s)
- Anna Taddio
- Clinical Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario M5S 3M2, Canada.
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Forsans E, Franck L, Leclerc T, Bensalah M, Tourtier J, Auroy Y, Bourrilhon C. Performances of ventilator at simulated altitude. Crit Care 2012. [PMCID: PMC3363894 DOI: 10.1186/cc11083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Harris JM, Franck L, Michie S. Assessing the psychological effects of prenatal screening tests for maternal and foetal conditions: a systematic review. J Reprod Infant Psychol 2012. [DOI: 10.1080/02646838.2012.710834] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- James Matthew Harris
- a Department of Clinical, Educational and Health Psychology , University College London , London , UK
| | - Linda Franck
- b University of California–San Francisco, Family Health Care Nursing , San Francisco , CA , USA
| | - Susan Michie
- a Department of Clinical, Educational and Health Psychology , University College London , London , UK
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Stevens B, McGrath P, Ballantyne M, Yamada J, Dupuis A, Gibbins S, Franck L, Finley GA, Howlett A, Johnston C, O'Brien K, Ohlsson A. Influence of risk of neurological impairment and procedure invasiveness on health professionals’ management of procedural pain in neonates. Eur J Pain 2012; 14:735-41. [DOI: 10.1016/j.ejpain.2009.11.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Revised: 11/26/2009] [Accepted: 11/27/2009] [Indexed: 11/26/2022]
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Schmelzle-Lubiecki BM, Campbell KAA, Howard RH, Franck L, Fitzgerald M. Long-term consequences of early infant injury and trauma upon somatosensory processing. Eur J Pain 2012; 11:799-809. [PMID: 17320438 DOI: 10.1016/j.ejpain.2006.12.009] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2006] [Revised: 12/15/2006] [Accepted: 12/22/2006] [Indexed: 10/23/2022]
Abstract
Long-term consequences of early infant injury upon somatosensory processing were tested in school aged children. The aim was to test whether the long-term changes in sensitivity reported in animal models, in regions both local to and distant from the injury site, could be observed in humans. To do this we used quantitative sensory testing (QST) in children aged 9-12 years who had undergone cardiac surgery in infancy. Cutaneous mechanical and thermal thresholds were measured at the thoracic scar region and at control contralateral thoracic and reference thenar areas in this early surgery group (n=9), and compared with thresholds at the same regions in age and gender-matched controls (n=9). The results showed that the cardiac surgery group was significantly less sensitive to von Frey hair tactile stimulation in the non-injured thenar area than the control group; mean threshold 5.02, SD+/-1.59 compared to 2.76, SD+/-0.79 (von Frey hair number, p=0.04). In addition, their lateral thoracotomy scar areas were significantly less sensitive to von Frey hair stimulation (mean=9.82, SD+/-1.97, p<0.001) and to cooling and warming than any other site tested. Eight of the nine children in the early surgery group did not perceive warmth on their scars and were only able to detect uncomfortable heat as the temperature was raised. Three of these children felt a paradoxical cold prior to the hot sensation and all reported subtle abnormalities in everyday sensations. Questionnaires revealed perceived differences in pain perception, individual aberrant sensations and pain interfering with daily life that warrant further study. We conclude that tissue injured in early infancy remains measurably altered to mechanical and thermal stimulation in later life. These findings are consistent with the results of animal studies that early infant injury has not only local, but also global long-term consequences upon sensory processing.
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Affiliation(s)
- B M Schmelzle-Lubiecki
- UCL, Department of Anatomy and Developmental Biology, University College London, London, UK
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Abstract
OBJECTIVE To determine the effects of acetaminophen and axillary temperature responses on infant sleep duration after immunization. METHODS We conducted a prospective, randomized controlled trial to compare the sleep of 70 infants monitored by using ankle actigraphy for 24 hours before and after their first immunization series at ∼2 months of age. Mothers of infants in the control group received standard care instructions from their infants' health care provider, and mothers of infants in the intervention group were provided with predosed acetaminophen and instructed to administer a dose 30 minutes before the scheduled immunization and every 4 hours thereafter, for a total of 5 doses. Infant age and birth weight and immunization factors, such as acetaminophen use and timing of administration, were evaluated for changes in infant sleep times after immunization. RESULTS Sleep duration in the first 24 hours after immunization was increased, particularly for infants who received their immunizations after 1:30 pm and for those who experienced elevated temperatures in response to the vaccines. Infants who received acetaminophen at or after immunization had smaller increases in sleep duration than did infants who did not. However, acetaminophen use was not a significant predictor of sleep duration when other factors were controlled. CONCLUSIONS If further research confirms the relationship between time of day of vaccine administration, increased sleep duration after immunization, and antibody responses, then our findings suggest that afternoon immunizations should be recommended to facilitate increased sleep in the 24 hours after immunization, regardless of acetaminophen administration.
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Affiliation(s)
- Linda Franck
- Department of Family Health Care Nursing, University of California, San Francisco, CA 94143-0606, USA.
| | - Caryl L. Gay
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California
| | - Mary Lynch
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California
| | - Kathryn A. Lee
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California
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Abstract
The aims of this pilot study were to assess anxiety and stress in parents of children admitted to hospital and identify influencing factors, and assess the feasibility and acceptability of the methodology to parents and hospital staff. Parents of 28 children hospitalised for at least 3 days completed questionnaires assessing psychological functioning after admission, 16 and 13 of whom completed questionnaires at discharge and 3 months after discharge, respectively. Almost two-thirds of parents scored in the borderline/clinical range for anxiety at baseline and discharge. Higher anxiety scores were associated with the use of self-blame, lower optimism scores, higher levels of illness-related uncertainty and a greater number of previous hospital stays. Three months after discharge, 38% had borderline/clinical levels of anxiety, with scores significantly correlated with those at baseline and discharge. Although parents were willing to participate, and the questionnaires were acceptable, this pilot study identified some practical and logistical difficulties that will be addressed in the next phase of the study. Parents experience substantial stress and anxiety when their child is hospitalised. Screening for those at high risk for anxiety and implementing interventions to reduce uncertainty and maladaptive coping strategies may be beneficial.
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Affiliation(s)
- Jo Wray
- UCL Institute of Child Health, UK.
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Wyatt K, Edwards V, Franck L, Britten N, Creanor S, Maddick A, Logan S. Cranial osteopathy for children with cerebral palsy: a randomised controlled trial. Arch Dis Child 2011; 96:505-12. [PMID: 21349889 DOI: 10.1136/adc.2010.199877] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To estimate the effect of cranial osteopathy on the general health and wellbeing, including physical functioning, of children with cerebral palsy. DESIGN Pragmatic randomised controlled trial. PARTICIPANTS 142 children from Greater London and the South West of England, aged 5-12 years with cerebral palsy. INTERVENTION Participants were randomised to six sessions of cranial osteopathy with a registered osteopath or a waiting list with partial attention control (parents invited to participate in two semistructured interviews). PRIMARY OUTCOME MEASURES Blind assessment of motor function by physiotherapists using the Gross Motor Function Measure-66 (GMFM-66) and quality of life using the Child Health Questionnaire (CHQ) PF50 at 6 months. SECONDARY OUTCOME MEASURES Parents' assessment of global health and sleep at 6 months, pain and sleep diaries at 10 weeks and 6 months, CHQ PF50 at 10 weeks and quality of life of main carer (Short Form 36) at 10 weeks and 6 months. RESULTS Compared with children in the control group, children in the osteopathy group demonstrated no statistically significant differences in GMFM-66 (mean difference 4.9, 95% CI -4.4 to 14.1), CHQ Physical Summary Score (mean difference 2.2, 95% CI -3.5 to 8.0) or CHQ Psychological Summary Score (mean difference 3.4, 95% CI -0.8 to 7.7). There were no significant differences between groups with respect to pain; sleep (either 'time asleep' or 'time to sleep'); or main carer's quality of life. Compared with children in the control group, carers of children receiving cranial osteopathy were nearly twice as likely to report that their child's global health had 'improved' at 6 months rather than 'decreased' or 'remained the same' (38% vs 18%; odds ratio 2.8, 95% CI 1.1 to 6.9). CONCLUSIONS This trial found no statistically significant evidence that cranial osteopathy leads to sustained improvement in motor function, pain, sleep or quality of life in children aged 5-12 years with cerebral palsy nor in quality of life of their carers.
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Affiliation(s)
- Katrina Wyatt
- Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
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Stevens B, Riahi S, Cardoso R, Ballantyne M, Yamada J, Beyene J, Breau L, Camfield C, Finley GA, Franck L, Gibbins S, Howlett A, McGrath PJ, McKeever P, O'Brien K, Ohlsson A. The influence of context on pain practices in the NICU: perceptions of health care professionals. Qual Health Res 2011; 21:757-770. [PMID: 21357756 DOI: 10.1177/1049732311400628] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In this qualitative descriptive study, we explored health care professionals' perceptions of the influence of context (i.e., organizational culture, structure, resources, capabilities/competencies, and politics) on evidence-based pain practices. A total of 16 focus groups with 147 health care professionals were conducted in three neonatal intensive care units (NICUs) in central and eastern Canada. Three overarching themes emerged from the data, which captured influences on optimal pain practices in the NICU, including (a) a culture of collaboration and support for evidence-based practice, (b) threats to autonomous decision making, and (c) complexities in care delivery. These results were consistent with theoretical conceptualizations of how context influences practice, as well as recent empirical research findings. This study supports the importance of context in shaping evidence-based practices by health care professionals in the management of pain in the NICU.
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Baumgartner I, Patocchi A, Franck L, Kellerhals M, Broggini G. FIRE BLIGHT RESISTANCE FROM 'EVERESTE' AND MALUS SIEVERSII USED IN BREEDING FOR NEW HIGH QUALITY APPLE CULTIVARS: STRATEGIES AND RESULTS. ACTA ACUST UNITED AC 2011. [DOI: 10.17660/actahortic.2011.896.56] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Franck L, Noble G, Liossi C. Translating the tears: parents' use of behavioural cues to detect pain in normally developing young children with everyday minor illnesses or injuries. Child Care Health Dev 2010; 36:895-904. [PMID: 20637021 DOI: 10.1111/j.1365-2214.2010.01130.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The objectives of this paper were to (i) identify the behavioural cues used by parents to detect young children's transient pain from minor illnesses or injuries ('everyday pain'); and (ii) perform an initial psychometric evaluation of the Parents' Post-operative Pain Measure (PPPM) in the context of children's everyday pain. METHOD Cross-sectional Internet survey. RESULTS One thousand seven hundred sixteen parents of children (1-6 years) completed the survey. The parents reported more behaviours when children had pain from minor illnesses than from minor injuries (9.6 ± 3.9 vs. 2.5 ± 2.3, P < 0.001). Principal component analysis of the PPPM revealed a two-factor solution for illness-related pain and a three-factor solution for injury-related pain. Behavioural cues varied with characteristics of children (age, gender and prior hospital experience) and parents (gender, age and parenting experience). CONCLUSIONS The PPPM is a promising tool for parental assessment of children's pain in everyday situations. Further research is needed to determine its utility in facilitating communication between parents and healthcare professionals, and in improving the management of young children's pain.
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Affiliation(s)
- L Franck
- UCL Institute of Child Health, London, UK.
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Franck L, Noble G, Liossi C. From tears to words: the development of language to express pain in young children with everyday minor illnesses and injuries. Child Care Health Dev 2010; 36:524-33. [PMID: 20345397 DOI: 10.1111/j.1365-2214.2010.01084.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about the development of language to express pain in the young or how children and parents verbally communicate when young children have everyday minor illnesses and injuries. METHODS UK parents of children between the ages of 1 and 6 were invited to complete an Internet survey on children's pain language during everyday situations of minor illness or injury. RESULTS Of the 1716 parents completing the survey, 45% reported their child had at least one word to express pain by 17 months of age, increasing to 81% by 23 months of age. Children used different words based on their age and in the contexts of minor illnesses and injuries, with words for expressing pain related to illness emerging slightly later. Children's language was purposeful in describing causes of pain and requesting specific forms of assistance from parents even in the very youngest age groups. Parents' communicated with their children primarily to gain further information about the source and nature of pain and to direct children's behaviour. CONCLUSIONS Children rapidly develop an extensive vocabulary to describe pain between 12 and 30 months of age, with words for pain from injury emerging first and reflecting the development of normal speech acquisition. The differences in verbal expressions in the context of minor illnesses and injuries suggest that children make a cognitive distinction between the origins and sensory aspects of pain. These findings can help parents, childcare and healthcare professionals to appreciate the early communication capabilities of young children and to engage in more effective pain assessment and management for young children.
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Affiliation(s)
- L Franck
- UCL Institute of Child Health, London, UK.
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Cherrill J, Hudson H, Cocking C, Unsworth V, Franck L, Fakis A, McIntyre J, Choonara I. Clinical trials: the viewpoint of children with a chronic illness compared with healthy children. Arch Dis Child 2010; 95:229-32. [PMID: 19843506 DOI: 10.1136/adc.2009.159145] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The views of over 200 children (11-16 years old, who were either healthy or attending paediatric medical clinics with a chronic illness) on issues relating to paediatric clinical trials were determined by a questionnaire. Children with a chronic illness had a better understanding of the concept of dosing of medicines (40% vs 23%) and placebo (34% vs 20%). They were more likely to support children's involvement in clinical trials (51% vs 37%). The altruistic nature of children in both groups was similar. It was of concern, however, that 57-63% children would participate as healthy volunteers in a cancer drug trial. Both groups were able to differentiate between the different types of illnesses where it is appropriate to study medicines in children (86-89% for illness where there is no treatment; 34-40% for 'me-too' drugs). Young people should be given more opportunities to be involved in decision-making regarding clinical trials of medicines.
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Affiliation(s)
- J Cherrill
- Academic Division of Child Health, The University of Nottingham, Derby, UK
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Tourtier J, Falzone E, Schaal J, Franck L, Nkilly GE, Chrisment A, Borne M. Acute severe asthma: performance of ventilator at simulated altitude. Crit Care 2010. [PMCID: PMC2934040 DOI: 10.1186/cc8508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Libert N, Schérier S, Dubost C, Franck L, Rouquette I, Tortosa JC, Rousseau JM. Prise en charge anesthésique d’un accouchement chez une patiente atteinte d’un déficit en inhibiteur de C1 estérase. ACTA ACUST UNITED AC 2009; 28:375-80. [DOI: 10.1016/j.annfar.2009.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 02/25/2009] [Indexed: 10/20/2022]
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Batjom E, Franck L, Dubost C, Rouquette-Vincenti I. [When an antibiotic becomes toxic]. Ann Fr Anesth Reanim 2009; 28:105-106. [PMID: 19101108 DOI: 10.1016/j.annfar.2008.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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40
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Gibbins S, Stevens B, McGrath P, Dupuis A, Yamada J, Beyene J, Breau L, Camfield C, Finley GA, Franck L, Johnston C, McKeever P, O'Brien K, Ohlsson A. Changes in physiological and behavioural pain indicators over time in preterm and term infants at risk for neurologic impairment. Early Hum Dev 2008; 84:731-8. [PMID: 18565699 DOI: 10.1016/j.earlhumdev.2008.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 04/25/2008] [Accepted: 05/08/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Approximately 10% of infants admitted to a Neonatal Intensive Care Unit (NICU) are at risk for Neurological Impairment (NI). While we have limited knowledge on the influence of NI risk on pain responses, we have no knowledge of how these responses change over time. OBJECTIVE To compare physiological and behavioural pain responses of infants at three levels of NI risk during the NICU neonatal period (Session 1) and at 6 months of age (Session 2). DESIGN/METHODS Prospective observational design with 149 preterm and term infants at high (Cohort A, n=54), moderate (Cohort B, n=45) and mild (Cohort C, n=50) risks for NI from 3 Canadian tertiary level NICUs. Infants were observed in the NICU during 3 standardized phases of a heel lance: baseline, stick and return-to-baseline. At 6 months, infants were observed during the same three phases during an intramuscular immunization injection. Physiological (heart rate, oxygen saturation) and behavioural (9 facial actions, cry) responses were continuously recorded. RESULTS A significant interaction of Phase by Session was found with less total facial activity observed during Session 2 (all p values<0.04). A significant interaction for Session by Cohort was found, showing that infants in Cohort A had significantly more change from baseline-to-stick phase for brow bulge, eye squeeze, nasolabial furrow and open lips between sessions with less facial actions demonstrated at Session 2 (all p<0.02). There were significantly lower mean and minimum heart rate (all p<0.02) and higher minimum and maximum oxygen saturation (p<0.04) at Session 2. Significantly higher mean and minimum fundamental cry frequencies (pitch) in Cohort B (p<0.04) were found in Session 1. Cohort A had significantly longer cry durations, but no significant differences in cry dysphonation. CONCLUSIONS Behavioural and physiological infant pain responses were generally diminished at 6 months of age compared to those in the neonatal period with some differences between NI risk groups in cry responses. Future exploration into the explanation for these differences between sessions and cohorts is warranted.
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Affiliation(s)
- Sharyn Gibbins
- Interdisciplinary Research, NICU, Sunnybrook Health Sciences Centre, Canada.
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Franck L, Noble G, McEvoy M. Enquiring minds want to know: topics requested by users of a children's health information website. Patient Educ Couns 2008; 72:168-171. [PMID: 18406098 DOI: 10.1016/j.pec.2008.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2007] [Revised: 02/05/2008] [Accepted: 02/16/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To investigate health information needs of users of a health information website for children and young people. METHODS A prospective analysis was conducted of unsolicited information requests to the Children First for Health (www.childrenfirst.nhs.uk) website, an NHS-run health and hospital online information resource for children, young people and families. All specific and general enquiries were recorded prospectively and coded according to health topic, age of the enquirer and web pages accessed. RESULTS There were 2865 (62%) general health information and 924 (21%) specific enquiries received over an 18-month period (6.3 enquiries per day). More general enquiries were received about adolescent (64%) than children's (36%) health issues. The most common topics were psychosocial issues, hospital and health services, and normal growth and development. Only 1% of requests for information related to smoking, alcohol and drugs. CONCLUSION Children and adolescents are active users of the Internet for health information. The results of this study highlight the health topics that are of greatest interest to children and young people. PRACTICE IMPLICATIONS The findings provide objective data on health information topics of interest to UK children and young people and can be used to guide development of health information aimed at UK youth.
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Affiliation(s)
- Linda Franck
- UCL Institute of Child Health, London, United Kingdom.
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Abstract
BACKGROUND Pain in infancy is poorly understood, and medical staff often have difficulty assessing whether an infant is in pain. Current pain assessment tools rely on behavioural and physiological measures, such as change in facial expression, which may not accurately reflect pain experience. Our ability to measure cortical pain responses in young infants gives us the first opportunity to evaluate pain assessment tools with respect to the sensory input and establish whether the resultant pain scores reflect cortical pain processing. METHODS AND FINDINGS Cortical haemodynamic activity was measured in infants, aged 25-43 wk postmenstrual, using near-infrared spectroscopy following a clinically required heel lance and compared to the magnitude of the premature infant pain profile (PIPP) score in the same infant to the same stimulus (n = 12, 33 test occasions). Overall, there was good correlation between the PIPP score and the level of cortical activity (regression coefficient = 0.72, 95% confidence interval [CI] limits 0.32-1.11, p = 0.001; correlation coefficient = 0.57). Of the different PIPP components, facial expression correlated best with cortical activity (regression coefficient = 1.26, 95% CI limits 0.84-1.67, p < 0.0001; correlation coefficient = 0.74) (n = 12, 33 test occasions). Cortical pain responses were still recorded in some infants who did not display a change in facial expression. CONCLUSIONS While painful stimulation generally evokes parallel cortical and behavioural responses in infants, pain may be processed at the cortical level without producing detectable behavioural changes. As a result, an infant with a low pain score based on behavioural assessment tools alone may not be pain free.
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Affiliation(s)
- Rebeccah Slater
- Department of Anatomy and Developmental Biology, University College London, London, United Kingdom.
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Gibbins S, Stevens B, McGrath PJ, Yamada J, Beyene J, Breau L, Camfield C, Finley A, Franck L, Johnston C, Howlett A, McKeever P, O'Brien K, Ohlsson A. Comparison of pain responses in infants of different gestational ages. Neonatology 2008; 93:10-8. [PMID: 17630493 DOI: 10.1159/000105520] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2005] [Accepted: 04/02/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is a plethora of infant pain measures; however, none of them have been validated for extremely low for gestational age (ELGA) infants (<27 weeks' gestation). To date, clinicians, researchers and parents use information gleaned from more mature infants to make inferences about pain in ELGA infants. Using physiological or behavioral pain indicators derived from more mature infants may lead to inaccurate assessments and management. OBJECTIVES To compare physiological (heart rate, oxygen saturation) and behavioral (9 facial activities, cry) pain indicators of ELGA infants with infants of varying more mature gestational ages (GAs). METHODS The aim was to determine the effects of GA on pain response. GA was categorized into four mutually exclusive strata: <27 6/7 weeks, 28-31 6/7 weeks, 32-35 6/7 weeks and >36 weeks. Physiological data during four phases of a routine heel lance were collected by placing disposable ECG electrodes and pulse oximetry probes on the infant's chest. Behavioral data were collected by videotaping facial activities, and cry data were collected by audio recording. RESULTS Four facial activities (brow bulge, eye squeeze, nasolabial furrow, vertical mouth stretch) in response to acute pain were present in ELGA infants. Facial activities increased following painful procedures and the magnitude of responses was proportional to GA with the youngest infants (<27 6/7 weeks GA) showing the least amount of change. Decreased oxygen saturation and increased heart rate were associated with the most invasive phase of the heel lance; however, the differences were neither clinically or statistically significant across age groups. Cry was not a sensitive pain indicator in ELGA infants, due to the presence of endotracheal tubes in this high-risk population. DISCUSSION ELGA infants have similar pain responses to older infants, but the responses are dampened. Other factors such as severity of illness, frequency of painful procedures or medication use should be examined, as they may influence the pain responses in ELGA infants.
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Affiliation(s)
- Sharyn Gibbins
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
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Abstract
The views of 30 children (8-16 years old) attending paediatric medical clinics on paediatric clinical trials were determined by semi-structured interviews. Nineteen children recognised that there were risks involved with taking part in clinical trials. Risks concerned with being paid were recognised by all children.
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Affiliation(s)
- J Cherrill
- Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby, UK
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Liossi C, White P, Franck L, Hatira P. Parental pain expectancy as a mediator between child expected and experienced procedure-related pain intensity during painful medical procedures. Clin J Pain 2007; 23:392-9. [PMID: 17515737 DOI: 10.1097/ajp.0b013e31804ac00c] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this prospective investigation was to evaluate child and parental expectancies as a predictor of pain perception in pediatric oncology patients undergoing painful medical procedures. METHODS Forty-five children with leukemia or non-Hodgkin lymphoma and their parents rated expected and experienced pain during lumbar punctures at baseline, during intervention (ie, cognitive-behavior therapy) administered by a therapist and when children were using cognitive-behavior therapy skills independently. RESULTS Parental and child expectancies were significantly correlated. Parents consistently expected their children to experience more pain than children were expecting themselves. Parental expectancy was found to mediate the relationship between child expected and experienced pain during every phase of the study. DISCUSSION It is concluded that parental expectancies are reliable predictors of pediatric procedure-related pain and possible useful targets for psychologic interventions to manage such pain.
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Affiliation(s)
- Christina Liossi
- School of Psychology, University of Southampton, Highfield, Southampton, UK.
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Affiliation(s)
- Nina Power
- Centre for Nursing and Allied Health Professions Research, UCL Instutite of Child Health, Great Ormond Street Hospital for Children, London, UK.
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Stevens B, Franck L, Gibbins S, McGrath PJ, Dupuis A, Yamada J, Beyene J, Camfield C, Finley GA, Johnston C, O'Brien K, Ohlsson A. Determining the structure of acute pain responses in vulnerable neonates. Can J Nurs Res 2007; 39:32-47. [PMID: 17679584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
The primary purpose was to determine the underlying structure of the vulnerable infant's response to an acute painful procedure. The secondary purpose was to explore the influence of context (e.g., risk for neurological impairment [NI] and gestational age [GA]). A descriptive cohort design determined contributions of selected indicators to the structure of infant pain. The magnitude of variance for 19 pain indicators was assessed using 3 exploratory factor analyses in 149 neonates. The basic exploratory factor structure included behavioural (e.g., facial actions) and physiological (e.g., oxygen saturation, heart rate) indicators. Facial actions accounted for the greatest variance across all factor solutions (29-39%). Physiological indicators explained 8 to 26% additional variance. There were no consistent differences in the factor structures when contextual factors were explored.
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Affiliation(s)
- Bonnie Stevens
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Canada
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Abstract
Demand for complementary and alternative medicine is high despite limited evidence. Linda Franck and colleagues believe that a thorough review by NICE would benefit the NHS and patients, but David Colquhoun argues that it cannot afford to re-examine evidence that has shown little benefit
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Affiliation(s)
- Linda Franck
- University College London Institute of Child Health, London WC1N 1EH.
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Stevens B, McGrath P, Gibbins S, Beyene J, Breau L, Camfield C, Finley A, Franck L, Howlett A, Johnston C, McKeever P, O'Brien K, Ohlsson A, Yamada J. Determining behavioural and physiological responses to pain in infants at risk for neurological impairment. Pain 2006; 127:94-102. [PMID: 16997468 DOI: 10.1016/j.pain.2006.08.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Revised: 07/13/2006] [Accepted: 08/03/2006] [Indexed: 01/10/2023]
Abstract
Multiple researchers have validated indicators and measures of infant pain. However, infants at risk for neurologic impairment (NI) have been under studied. Therefore, whether their pain responses are similar to those of other infants is unknown. Pain responses to heel lance from 149 neonates (GA>25-40 weeks) from 3 Canadian Neonatal Intensive Care units at high (Cohort A, n=54), moderate (Cohort B, n=45) and low (Cohort C, n=50) risk for NI were compared in a prospective observational cohort study. A significant Cohort by Phase interaction for total facial action (F(6,409)=3.50, p=0.0022) and 4 individual facial actions existed; with Cohort C demonstrating the most facial action. A significant Phase effect existed for increased maximum Heart Rate (F(3,431)=58.1, p=0.001), minimum Heart Rate (F(3,431)=78.7, p=0.001), maximum Oxygen saturation (F(3,425)=47.6, p=0.001), and minimum oxygen saturation (F(3,425)=12.2, p=0.001) with no Cohort differences. Cohort B had significantly higher minimum (F(2,79)=3.71, p=0.029), and mean (F(2,79)=4.04, p=0.021) fundamental cry frequencies. A significant Phase effect for low/high frequency Heart Rate Variability (HRV) ratio (F(2,216)=4.97, p=0.008) was found with the greatest decrease in Cohort A. Significant Cohort by Phase interactions existed for low and high frequency HRV. All infants responded to the most painful phase of the heel lance; however, infants at moderate and highest risk for NI exhibited decreased responses in some indicators.
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Affiliation(s)
- Bonnie Stevens
- Faculty of Nursing, University of Toronto, Toronto, Ont., Canada.
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