Journal of evaluation in clinical practice
-
Responses to experimental pain have suggested central and peripheral sensitisation in adult patients with sickle cell disease (SCD). Recent studies have proposed an algometry-derived dynamic measure of pain sensitisation, slowly repeated evoked pain (SREP), which is useful in the discrimination of painful conditions related to central sensitisation. Pain and fatigue are two symptoms that affect the general functioning of patients with SCD most significantly, however, research about experimental dynamic pain measures and their relation to the main symptoms of SCD (pain and fatigue) is still scarce. ⋯ Pain threshold and tolerance did not discriminate between patients and healthy individuals, but were useful for predicting fatigue severity in SCD. The SREP protocol provides a useful dynamic measure of pain for the discrimination and detection of enhanced pain sensitisation in patients with SCD, which could contribute to more personalised pain evaluations and treatment for these patients.
-
Premenstrual syndrome is a women's health problem affecting women of reproductive age. Early traumas may have negative effects on women's health. Childhood traumas are thought to be an important risk factor for the emergence of premenstrual syndrome. The aim of this study was to investigate the relationship between premenstrual syndrome and childhood traumas in women. ⋯ Childhood traumas were found to be an important factor affecting the occurrence of premenstrual syndrome and exacerbating its symptoms. Early detection of childhood traumas may prevent long-term problems that may occur in individuals.
-
The threat of the H5N1-influenza virus prompts reflection on COVID-19 pandemic experiences. This paper integrates insights from a first responder using the Cynefin framework to advocate for an adaptive strategic approach to future pandemics. Balancing individual freedoms with containment measures serves to leverage the human capital needed for rapid learning and resource distribution. ⋯ Both operate within scale free human systems which must adapt to existential challenges such as pandemics. Experience leading to knowledge and understanding occurs simultaneously at all dimensions of human existence. Ultimately, adaptive leadership and decentralized decision-making, supported by the best available knowledge, enable effective pandemic management and restoration of normal societal functions.
-
This study aims to evaluate the workload of clinical nurses by measuring the work relative value (work RVU) of common nursing items based on the resource-based relative value scale in China. ⋯ We have adhered to relevant EQUATOR guidelines and named the reporting method.
-
The Drug Burden Index (DBI) measures exposure to anticholinergic and sedative drugs, which are associated with harm in older adults. To facilitate deprescribing in older Australian inpatients, we piloted an intervention bundle integrating the DBI in Electronic Medical Records, clinician deprescribing guides, consumer information leaflets and a stewardship pharmacist. ⋯ The intervention was well accepted by hospital clinicians. The bundle requires further integration into workflows for sustainability and assessment of generalisability in other health services. Given patients, carers and GPs reported poor medication-related communication, future interventions may target this.