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- Bueno, Mariana, et al.
(författare)
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Neonatal and infant pain assessment
- 2021. - 2
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Ingår i: Oxford Textbook of Pediatric Pain. - : Oxford University Press. - 9780198818762
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Pain assessment is an essential foundation to mitigate pain and its consequences in the developing child. However, pain assessment in neonates and infants is challenging and, to date, there is no “gold standard” infant pain indicator, measure, or approach. This chapter encompasses (1) a comprehensive evaluation of the most current and well validated neonatal/infant pain assessment measures; (2) an overview on biomarkers and cortical indicators on neonatal/infant pain; (3) the integration of recommendations on pain-assessment measures and practices within clinical practice guidelines, policies, and procedures; and (4) challenges associated with neonatal and infant pain assessment in terms of research, clinical, and knowledge translation issues.
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| 3. |
- Ilhan, Emre, et al.
(författare)
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What is the definition of acute episodic and chronic pain in critically ill neonates and infants? A global, four-stage consensus and validation study
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To define and validate types of pain in critically ill neonates and infants by researchers and clinicians working in the neonatal intensive care unit (NICU) and high dependency unit (HDU).Design: A qualitative descriptive mixed-methods design.Procedure/s: Each stage of the study was built on and confirmed the previous stages. Stage 1 was an expert panel to develop definitions; stage 2 was a different expert panel made up of neonatal clinicians to propose clinical characteristics associated with the definitions from stage 1; stage 3 was a focus group of neonatal clinicians to provide clinical case scenarios associated with each definition and clinical characteristics; and stage 4 was a survey administered to neonatal clinicians internationally to test the validity of the definitions using the clinical case scenarios.Results: In stage 1, the panel (n=10) developed consensus definitions for acute episodic pain and chronic pain in neonates and infants. In stage 2, a panel (n=8) established clinical characteristics that may be associated with each definition. In stage 3, a focus group (n=11) created clinical case scenarios of neonates and infants with acute episodic pain, chronic pain and no pain using the definitions and clinical characteristics. In stage 4, the survey (n=182) revealed that the definitions allowed an excellent level of discrimination between case scenarios that described neonates and infants with acute episodic pain and chronic pain (area under the receiver operating characteristic=0.87 and 0.89, respectively).Conclusions: This four-stage study enabled the development of consensus-based and clinically valid definitions of acute episodic pain and chronic pain. There is a need to define and validate other pain types to inform a taxonomy of pain experienced by neonates and infants in the NICU and HDU.
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| 6. |
- Olsson, Emma, 1980-, et al.
(författare)
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Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)
- 2018
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Ingår i: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Preterm infants are especially vulnerable to pain. The intensive treatment often necessary for their survival unfortunately includes many painful interventions and procedures. Untreated pain can lead to both short- and long-term negative effects. The challenge of accurately detecting pain has been cited as a major reason for lack of pain management in these non-verbal patients. The Premature Infant Pain Profile (PIPP) is one of the most extensively validated measures for assessing procedural pain in premature infants. A revised version, PIPP-R, was recently published and is reported to be more user-friendly and precise than the original version. The aims of the study were to develop translated versions of the PIPP-R in Finnish, Icelandic, Norwegian, and Swedish languages, and to establish their content validity through a cultural adaptation process using cognitive interviews.Methods: PIPP-R was translated using the recommendations from the International Society for Pharmacoeconomics and Outcomes Research and enhanced with cognitive interviews. The respondent nurse was given a copy of the translated, national version of the measure and used this together with a text describing the infant in the film to assess the pain of an infant in a short film. During the assessment the nurse was asked to verbalize her thought process (thinking aloud) and upon completion the interviewer administered probing questions (verbal probing) from a structured interview guide. The interviews were recorded, transcribed, and analyzed using a structured matrix approach.Results: The systematic approach resulted in translated and culturally adapted versions of PIPP-R in the Finnish, Icelandic, Norwegian and Swedish languages. During the cultural adaptation process several problems were discovered regarding how the respondent understood and utilized the measure. The problems were either measure problems or other problems. Measure problems were solved by a change in the translated versions of the measure, while for other problems different solutions such as education or training were suggested.Conclusions: This study have resulted in translations of the PIPP-R that have content validity, high degree of clinical utility and displayed beginning equivalence with each other and the original version of the measure.
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| 7. |
- Olsson, Emma, 1980-, et al.
(författare)
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Translation, cultural adaptation and validation of the revised version of the Premature Infant Pain Profile : An effort to improve pain assessment in infants in the Nordic countries
- 2015
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Konferensbidrag (refereegranskat)abstract
- Background: In order to effectively treat pain in the neonatal period and diminish its negative effects, pain must be recognized and properly assessed. Objective: a) Translate the revised version of Premature Infant Pain Profile (PIPP-R) (1, 2) scale into Finnish, Icelandic, Norwegian and Swedish languages. b) Test the content validity of each of the translated versions. Design: a) translation and cultural adaption following the ISPOR recommendations (3) and b) testing of content validity using cognitive interviews. Setting: Finland, Iceland, Norway and Sweden, with cognitive debriefing and interviews at selected neonatal units (NU). Participants: In each country 5-10 nurses working in the NU will be included through purposeful sampling. Procedures: Phase a): The following steps of the ISPOR protocol will be followed: 1)Preparation, 2) Forward translation, 3) Reconciliation, 4) Back translation, 5) Back translation review, 6) Harmonization, 7) Cognitive debriefing, 8) Review of cognitive debriefing results and finalization, 9) Proofreading, 10) Final report. Phase b): Interviews to gain an understanding concerning the respondents’ understanding of PIPP-R will be performed. Respondents’ first perform a pain assessment with the preliminary version of the scale while verbalizing their thought processes (Think Aloud) followed by an interview based on a semi-structured interview guide (Verbal Probing). Measures: National data will be analyzed in accordance with a predefined problems matrix (4). Results: None obtained yet. However; members of our research group have previous experience with the original PIPP scale from both research and clinical practice and have tested out the proposed translation methodology in a previous validation study (4).Conclusions: Having well validated pain assessment measures available, is a necessary first step for efficient treatment of pain in vulnerable preterm infants. This collaboration among the Nordic countries will help to standardize and develop our pain management practices and contribute to further building the PEARL research network.
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| 8. |
- Onengut-Gumuscu, Suna, et al.
(författare)
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Fine mapping of type 1 diabetes susceptibility loci and evidence for colocalization of causal variants with lymphoid gene enhancers.
- 2015
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 47:4, s. 381-386
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Tidskriftsartikel (refereegranskat)abstract
- Genetic studies of type 1 diabetes (T1D) have identified 50 susceptibility regions, finding major pathways contributing to risk, with some loci shared across immune disorders. To make genetic comparisons across autoimmune disorders as informative as possible, a dense genotyping array, the Immunochip, was developed, from which we identified four new T1D-associated regions (P < 5 × 10(-8)). A comparative analysis with 15 immune diseases showed that T1D is more similar genetically to other autoantibody-positive diseases, significantly most similar to juvenile idiopathic arthritis and significantly least similar to ulcerative colitis, and provided support for three additional new T1D risk loci. Using a Bayesian approach, we defined credible sets for the T1D-associated SNPs. The associated SNPs localized to enhancer sequences active in thymus, T and B cells, and CD34(+) stem cells. Enhancer-promoter interactions can now be analyzed in these cell types to identify which particular genes and regulatory sequences are causal.
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