| 1. |
- Arribas, Christina, et al.
(författare)
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Global cross-sectional survey on neonatal pharmacologic sedation and analgesia practices and pain assessment tools : impact of the sociodemographic index (SDI)
- 2024
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Ingår i: Pediatric Research. - : Nature Publishing Group. - 0031-3998 .- 1530-0447.
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is variability in the use of sedatives and analgesics in neonatal intensive care units (NICUs). We aimed to investigate the use of analgesics and sedatives and the management of neonatal pain and distress.Methods: This was a global, prospective, cross-sectional study. A survey was distributed May–November 2022. The primary outcome of this research was to compare results between countries depending on their socio-sanitary level using the sociodemographic index (SDI). We organized results based on geographical location.Results: The survey collected 1304 responses, but we analyzed 924 responses after database cleaning. Responses from 98 different countries were analyzed. More than 60% of NICUs reported having an analgosedation guideline, and one-third of respondents used neonatal pain scales in more than 80% of neonates. We found differences in the management of sedation and analgesia between NICUs on different continents, but especially between countries with different SDIs. Countries with a higher SDI had greater availability of and adherence to analgosedation guidelines, as well as higher rates of analgosedation for painful or distressing procedures. Countries with different SDIs reported differences in analgosedation for neonatal intubation, invasive ventilation, and therapeutic hypothermia, among others.Conclusions: Socio-economic status of countries impacts on neonatal analgosedation management.
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| 2. |
- Bohn, Mary Kathryn, et al.
(författare)
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Validation of Serum Calprotectin Relative to Other Biomarkers of Infection in Febrile Infants Presenting to the Emergency Department
- 2024
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Ingår i: Antibiotics. - : MDPI. - 2079-6382. ; 13:5
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Tidskriftsartikel (refereegranskat)abstract
- Antimicrobial stewardship involves a delicate balance between the risk of undertreating individuals and the potential societal burden of overprescribing antimicrobials. This balance is especially crucial in neonatal care. In this observational study, the usefulness of biomarkers of infectious diseases (calprotectin, procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) were evaluated in 141 febrile infants aged 28-90 days presenting to an emergency department. Since our focus was on the usefulness of serum calprotectin, this biomarker was not part of clinical decision-making. A significant difference was observed in the levels of all biomarkers, related to final discharge diagnosis and disposition status. The difference in levels related to antibiotic prescription was significant for all biomarkers but WBCs. The performance of calprotectin in the detection of bacterial infections (AUC (95% CI): 0.804 (0.691, 0.916)) was comparable to the performance of both PCT (0.901 (0.823, 0.980)) and CRP (0.859 (0.764, 0.953)) and superior to the WBC count (0.684 (0.544, 0.823)). Procalcitonin and CRP demonstrated a statistically significantly higher specificity relative to calprotectin. In this cohort, antibiotic use did not always correlate to a definite diagnosis of confirmed bacterial infection. The sample size was limited due to associated challenges with recruiting febrile infants. Hence, there is a need for adequate diagnostic tools to help discriminate between various kinds of infections. This study suggests serum calprotectin, procalcitonin, and CRP may serve as valuable biomarkers to differentiate between types of infection, in addition to clinical input and decision-making.
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| 3. |
- Bonnevier Wallstedt, Ida, et al.
(författare)
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Skin Anatomy, Bone Histology and Taphonomy of a Toarcian (Lower Jurassic) Ichthyosaur (Reptilia : Ichthyopterygia) from Luxembourg, with Implications for Paleobiology
- 2024
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Ingår i: Diversity. - : Multidisciplinary Digital Publishing Institute (MDPI). - 1424-2818. ; 16:8
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Tidskriftsartikel (refereegranskat)abstract
- A partial ichthyosaur skeleton from the Toarcian (Lower Jurassic) bituminous shales of the ‘Schistes Carton’ unit of southern Luxembourg is described and illustrated. In addition, associated remnant soft tissues are analyzed using a combination of imaging and molecular techniques. The fossil (MNHNL TV344) comprises scattered appendicular elements, together with a consecutive series of semi-articulated vertebrae surrounded by extensive soft-tissue remains. We conclude that TV344 represents a skeletally immature individual (possibly of the genus Stenopterygius) and that the soft parts primarily consist of fossilized skin, including the epidermis (with embedded melanophore pigment cells and melanosome organelles) and dermis. Ground sections of dorsal ribs display cortical microstructures reminiscent of lines of arrested growth (LAGs), providing an opportunity for a tentative age determination of the animal at the time of death (>3 years). It is further inferred that the exceptional preservation of TV344 was facilitated by seafloor dysoxia/anoxia with periodical intervals of oxygenation, which triggered phosphatization and the subsequent formation of a carbonate concretion.
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| 4. |
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| 5. |
- Campbell-Yeo, Marsha, et al.
(författare)
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Pain in the Neonate
- 2024. - 3
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Ingår i: Managing Pain in Children and Young People. - : John Wiley & Sons. - 9781119645641 ; , s. 220-240
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter provides an overview of the epidemiology and adverse outcomes associated with untreated pain in neonates, in addition to current best evidence regarding the assessment, prevention and management of neonatal pain. Most guidelines on neonatal pain management declare pain assessment to be essential for achieving optimal pain and stress management. Investigations into the efficacy of using machine learning automated techniques to accurately analyse signals from infants and evaluate if they indicate pain are ongoing. Facilitated tucking is a physical containment intervention that involves placing hands on the head and limbs of an infant undergoing a painful procedure to maintain them in a side-lying flexed fetal position. Paracetamol is one of the most commonly used analgesic drugs in the neonatal intensive care unit. Opioids are the mainstay for the effective treatment of moderate to severe pain across all age groups, including neonates.
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| 6. |
- Carlsen Misic, Martina, 1986-, et al.
(författare)
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Clonidine as analgesia during retinopathy of prematurity screening in preterm infants -cloROP
- 2024
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Konferensbidrag (refereegranskat)abstract
- BackgroundPreterm infants are vulnerable and sensitive to stimuli, during their stay in neonatal intensive care they undergo frequent stressful and painful procedures. One of these painful procedures is the screening for retinopathy of prematurity, ROP. In Sweden all preterm infants born before gestation week 30 undergo ROP-screening. The screening involves regular eye examinations to detect ROP at the early stages and these examinations are both stressful and painful. Several studies have investigated different ways of pain management during eye examinations with inconsequent results. No study has investigated Clonidine as pain management during ROP-screening. AimThe aim of this clinical trial is to investigate the analgesic effect of clonidine during ROP eyeexaminations.MethodThis study is a multicenter randomized controlled clinical trial with a crossover design. Infants born before gestation week 30 and therefore undergoing ROP-screening, will be eligible for inclusion in the study. Infants will be recruited from two Swedish NICUs (neonatal intensive care units). The NICUs use different examination techniques, where NICU A uses indirect ophthalmoscopy while NICU B uses RetCam. A total of 50 infants will be recruited (25 at each NICU). During the first eye examination the infant will be randomized to either clonidine 4mcg/kg or sterile water in the equivalent dose 60 minutes before the eye examination. The order of the treatment is blinded for everyone except the nurse preparing the study solution. During the second eye examination the infant will receive the study solution, (intervention or placebo) that he/she did not receive the first time. The primary outcome of the study is pain assessment with the Premature Infant Pain Profile – Revised. The infants´ face and monitor showing oxygen saturation and heart rate will be videorecorded to be able to assess the pain afterwards. The secondary outcome is Galvanic Skin Response where three probes are attached to the infant’s foot sole to register changes in the sweat gland activity in response to stimuli such as pain or stress. The ophthalmologist performing the eye examination will also rate how easy it was to examine the infant by marking an X on a 10cm VAS scale with “very easy to examine” on one end and “very difficult to examine” on the other end. Data collection is ongoing with 19 infants included at the moment.
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| 7. |
- Carlsen Misic, Martina, 1986-, et al.
(författare)
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Parents as pain management in Swedish neonatal care – SWEpap
- 2024
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Konferensbidrag (refereegranskat)abstract
- Parents as pain management in Swedish neonatal care (SWEpap), is a new cutting-edge interdisciplinary multi-center clinical study. Using a mixed methods approach, SWEpap investigates combined parent-delivered interventions such as infant-directed lullaby singing, breastfeeding and skin-to-skin contact where parents themselves mediate pain alleviation. This approach is consistent with a modern understanding of pain and of family-integrated care. Today non-pharmacological strategies are considered the first choice in neonatal pain management, and parent-delivered interventions are valuable but often overlooked resources in the procedural pain management in newborn infants. Research shows that parents desire to be actively involved. More research on parents’ experiences of being active in pain alleviation is needed, as well as research on the effectiveness of combined parent-delivered pain management including relationship-based interventions as the parent’s musical presence. The qualitative part of the project is investigating the experiences and attitudes of parents and nurses towards combined parent-delivered pain management. The study applies a collaborative participatory action research (PAR) design with ethnographic inspired data collection in form of focus groups, video-observations, and video-stimulated recall interviews for data collection. ResultsPreparation was considered the key for combined parent-delivered pain management. Both parents and nurses emphasized the importance of allowing time for the parent-infant dyad to calm down together before the painful procedure to cope with the situation. The combined parent-delivered pain management was considered feasible by both parents and nurses. Parents expressed that the singing helped them focus on their infant instead of the procedure. The parental lullaby singing created a calm and trusting atmosphere, affecting not only the parent-infant dyad but also the nurses. After the procedure both parents and nurses felt that they have successfully supported the infant through a painful procedure. The second part of the ongoing SWEpap project is a randomized controlled trial investigating the efficacy of combined parent-delivered pain management with live parental lullaby singing, skin-to-skin contact, and breastfeeding compared with standard pain care during routine blood sampling of healthy newborn infants.
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| 10. |
- Eriksson, Mats, 1970-
(författare)
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A Multi-motive Risk Communication Model for “Making” Crisis Preparedness
- 2024. - 1
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Ingår i: Risk and Crisis Communication in Europe. - New York : Routledge. - 9781003375296 - 9781032437132 - 9781032450803
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Bokkapitel (refereegranskat)abstract
- This chapter introduces a mixed-motive model for the practice of risk communication for preparedness in a pre-crisis and pre-disaster phase. Rather than describing how research is done or presenting research results from a single study, this chapter focuses on how communication practitioners can integrate the extensive, but not always congruent, body of existing communication-related risk and preparedness research, in order to understand and reflect on their risk communication practice. The model especially aims to support practitioners in creating a holistic understanding of their own ongoing or future “communication practice” with the goal of increasing society’s level of crisis preparedness and resilience.
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