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Global Health, Epidemiology and Genomics 2023Pediatric burns are a significant medical issue that can have long-term effects on various aspects of a child's health and well-being. Pain management in pediatric burns... (Review)
Review
Pediatric burns are a significant medical issue that can have long-term effects on various aspects of a child's health and well-being. Pain management in pediatric burns is a crucial aspect of treatment to ensure the comfort and well-being of young patients. The causes and risk factors for pediatric burns vary depending on various factors, such as geographical location, socioeconomic status, and cultural practices. Assessing pain in pediatric patients, especially during burn injury treatment, poses several challenges. These challenges stem from various factors, including the age and developmental stage of the child, the nature of burn injuries, and the limitations of pain assessment tools. In pediatric pain management, various pain assessment tools and scales are used to evaluate and measure pain in children. These tools are designed to account for the unique challenges of assessing pain in pediatric patients, including their age, developmental stage, and ability to communicate effectively. Pain can have significant physical, emotional, and psychological consequences for pediatric patients. It can interfere with their ability to engage in daily activities, disrupt sleep patterns, and negatively affect their mood and behavior. Untreated pain can also lead to increased stress, anxiety, and fear, which can further exacerbate the pain experience. Acute pain, which is short-term and typically associated with injury or illness, can disrupt a child's ability to engage in physical activities and impede their overall recovery process. On the other hand, chronic pain, which persists for an extended period, can have long-lasting effects on physical functioning and quality of life in children. The psychological consequences of burns can persist long after the physical wounds have healed, leading to ongoing emotional distress and impaired functioning. Multimodal pain management, which involves the use of multiple interventions or medications targeting different aspects of the pain pathway, has gained recognition as an effective approach for managing pain in both children and adults. However, it is important to consider the specific needs and considerations of pediatric patients when developing evidence-based guidelines for multimodal pain management in this population. Over the years, there have been significant advances in pediatric pain research and technology, leading to a better understanding of pain mechanisms and the development of innovative approaches to assess and treat pain in children. Overall, pain management in pediatric burns requires a multidisciplinary approach that combines pharmacologic and nonpharmacologic interventions.
Topics: Adult; Humans; Child; Pain Management; Quality of Life; Burns; Acute Pain; Chronic Pain
PubMed: 37745034
DOI: 10.1155/2023/9950870 -
Minerva Anestesiologica Nov 2023Accidental or surgically induced thoracic trauma is responsible for significant pain that can impact patient outcomes. One of the main objectives of its pain management... (Review)
Review
Accidental or surgically induced thoracic trauma is responsible for significant pain that can impact patient outcomes. One of the main objectives of its pain management is to promote effective coughing and early mobilization to reduce atelectasis and ventilation disorders induced by pulmonary contusion. The incidence of chronic pain can affect more than 35% of patients after both thoracotomy and thoracoscopy as well as after chest trauma. As the severity of acute pain is associated with the incidence of chronic pain, early and effective pain management is very important. In this narrative review, we propose to detail systemic and regional analgesia techniques to minimize postoperative pain, while reducing transitional pain, surgical stress response and opioid side effects. We provide the reader with practical recommendations based on both literature and clinical practice experience in a referral level III thoracic trauma center.
Topics: Humans; Pain Management; Thoracic Surgery; Chronic Pain; Thoracic Surgical Procedures; Thoracoscopy; Pain, Postoperative; Thoracotomy
PubMed: 37671536
DOI: 10.23736/S0375-9393.23.17291-9 -
International Journal of Occupational... Sep 2023The aim of this research is to present the search for psychosocial predictors explaining the strength of perceived stress in psychiatrists and the search for...
OBJECTIVES
The aim of this research is to present the search for psychosocial predictors explaining the strength of perceived stress in psychiatrists and the search for associations between stress and occupational burnout in psychiatrists. The authors also searched for associations between organizational, workload, family and non-professional - social factors and the intensity of occupational stress.
MATERIAL AND METHODS
The group of 131 doctors - specialists in psychiatry, aged 27-86 years - took part in the study. The participants completed 3 questionnaires, i.e., the , the (LBQ) and the (PSS-10).
RESULTS
The results indicated that significant predictors of the development of occupational stress for psychiatrists were psychophysical exhaustion and lack of a sense of professional efficacy. Taking holidays (several times a year, pursuing the passions and interests), and having a stable family relationship (marriage or civil partnership) were also prominent among the predictors of stress.
CONCLUSIONS
Occupational stress and burnout in the work of the surveyed psychiatrists appeared to be a high intensity phenomenon. These results indicate the need to spread preventive health care also in the work of psychiatrists. Mainly in terms of maintaining the right balance between work and rest, which can help to reduce stress levels and protect against further development of burnout syndrome. Family resources such as a stable marriage or partnership may also be a protective factor against the build-up of stress and burnout in psychiatrists (mainly female). In addition, professional resources (work experience measured by number of years of work) is also important in explaining stress levels in psychiatrists. Int J Occup Med Environ Health. 2023;36(3):379-95.
Topics: Female; Humans; Male; Burnout, Professional; Workload; Burnout, Psychological; Occupational Stress; Psychiatry
PubMed: 37681426
DOI: 10.13075/ijomeh.1896.02147 -
PloS One 2023With the advance of data technologies, gig platforms have applied data and algorithms to their management and put more stringent requirements on gig workers through...
With the advance of data technologies, gig platforms have applied data and algorithms to their management and put more stringent requirements on gig workers through algorithmic management. Gig workers might perform destructive deviant behavior when coping with algorithmic management. It is meaningful to examine how the algorithmic management applied to gig platforms could lead to gig workers' destructive deviant behavior. Based on the challenge-hindrance framework, we developed a research model and validated it with survey data collected from 423 food delivery riders. We employed multi-level linear regression analysis in data analysis and found that perceived algorithmic management was appraised as both a hindrance and a challenge. As a hindrance, it elicits working/family deviant behavior; as a challenge, it helps reduce working/family deviant behavior. Regulatory focus (a prevention focus vs. a promotion focus) moderates the effect of perceived algorithmic management on stress appraisals (hindrance appraisals vs. challenge appraisals). This study explains algorithmic management's impact on gig workers' destructive deviant behavior through the appraisal of algorithmic management as both a challenge and a hindrance. It also provides practical advice to gig platforms, gig workers and policymakers on how to balance the challenge and hindrance roles of algorithmic management in gig work.
Topics: Humans; Adaptation, Psychological; Surveys and Questionnaires; Algorithms
PubMed: 37939104
DOI: 10.1371/journal.pone.0294074 -
Heliyon Aug 2023The COVID-19 pandemic has directly affected specially nurses, not only those on the front lines but also nurse managers.
BACKGROUND
The COVID-19 pandemic has directly affected specially nurses, not only those on the front lines but also nurse managers.
AIMS
To assess and compare stress levels of nurse managers before and during the pandemic, and to identify predictive factors.
METHOD
Cross-sectional studies were carried out in two moments, before and during pandemic. 102 manager nurses were recruited before the sanitary crisis (2018) and 87 during the health crisis (2020). Perceived stress was measured with the Perceived Stress Scale-14 and quality of professional life, job demands, motivation and managerial support were assessed with the Professional Quality of Life Questionnaire. Socio-demographic and job-related variables were also analysed. Statistical analysis was performed using student's t-test, correlations and multiple regression analysis.
RESULTS
The majority of nurse managers were women, married, who worked the morning shift. 78.2% managed nursing personnel who worked with COVID patients. They suffered a significant increase in both job demands and perceived stress level in the pandemic. Job demands, working in shifts morning, being young and being unmotivated were predictors of perceived stress level according to multiple linear regression analysis.
CONCLUSION
Perceived stress was greatest during the COVID-19 pandemic. Both, before and during the pandemic, job demands are central predictors of nurse managers' general perceived stress. It is necessary to adapt the workplace to personal characteristics of the nurse manager and increase actions to enhance their motivation and reduce their job demands to prevent stress.
PubMed: 37664725
DOI: 10.1016/j.heliyon.2023.e19209 -
Cureus Nov 2023Peri-implant disease, encompassing peri-implant mucositis and peri-implantitis, presents a growing challenge in implant dentistry. This comprehensive review explores the... (Review)
Review
Peri-implant disease, encompassing peri-implant mucositis and peri-implantitis, presents a growing challenge in implant dentistry. This comprehensive review explores the intricate interplay between prosthetic design factors and the development of peri-implant disease. By analyzing the impact of prosthetic components on microbial colonization, mechanical stress, and soft tissue health, the review highlights their crucial role in disease prevention and management. Additionally, it emphasizes the significance of maintenance protocols, prosthetic adjustments, and patient education in ensuring favorable long-term outcomes. The review underscores the potential for future advancements in prosthetic design, including innovative materials and digital technologies, and stresses the importance of interdisciplinary collaboration in optimizing patient care. Overall, the review underscores the critical role of prosthetic design in addressing the complexities of peri-implant disease, offering insights for clinicians and researchers to enhance the success and longevity of implant-supported restorations.
PubMed: 38699657
DOI: 10.7759/cureus.48737 -
BMJ Open Aug 2023To elicit and value patient preferences for the processes and outcomes of surgical management of stress urinary incontinence in women. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To elicit and value patient preferences for the processes and outcomes of surgical management of stress urinary incontinence in women.
DESIGN
A discrete choice experiment survey to elicit preferences for type of anaesthesia, postoperative recovery time, treatment success, adverse events, impact on daily activities and cost. An experimental design generated 40 choice tasks, and each respondent completed 1 block of 10 and 2 validity tests. Analysis was by multinomial logistical regression.
SETTING
N=21 UK hospitals.
PARTICIPANTS
N=325 adult women who were a subsample of those randomised to the single-incision mini-slings clinical trial.
OUTCOMES
Patient preferences; valuation obtained using willingness to pay.
RESULTS
N=227 of 325 (70%) returned a questionnaire, and 94% of those completed all choice tasks. Respondents preferred general anaesthesia, shorter recovery times, improved stress urinary incontinence symptoms and avoidance of adverse events. Women were willing to pay (mean (95% CI)) £76 (£33 to £119) per day of reduction in recovery time following surgery. They valued increases in Patient Global Impression of Improvement, ranging from £8173 (£5459 to £10 887) for 'improved' to £11 706 (£8267 to £15 144) for 'very much improved' symptoms, compared with no symptom improvement. This was offset by negative values attached to the avoidance of complications ranging between £-8022 (£-10 661 to £-5383) and £-10 632 (£-14 077 to £-7187) compared to no complications. Women valued treatments that reduced the need to avoid daily activities, with willingness to pay ranging from £-967 (£-2199 to £266) for rarely avoiding activities to £-5338 (£-7258 to £-3417) for frequently avoiding daily activities compared with no avoidance.
CONCLUSION
This discrete choice experiment demonstrates that patients place considerable value on improvement in stress urinary incontinence symptoms and avoidance of treatment complications. Trade-offs between symptom improvement and adverse event risk should be considered within shared decision-making. The willingness to pay values from this study can be used in future cost-benefit analyses.
TRIAL REGISTRATION NUMBER
ISRCTN: 93264234; Post-results.
Topics: Adult; Humans; Female; Patient Preference; Urinary Incontinence, Stress; Anesthesia, General; Anesthesiology; Cost-Benefit Analysis
PubMed: 37643846
DOI: 10.1136/bmjopen-2022-066157 -
BMC Endocrine Disorders Sep 2023The effect of stress on Graves' disease (GD) is controversial. Our purpose was to quantify the impacts of stress on patients with Graves' disease. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The effect of stress on Graves' disease (GD) is controversial. Our purpose was to quantify the impacts of stress on patients with Graves' disease.
METHODS
Systematic searches of PubMed, MEDLINE, Embase, Web of Science, Scopus, Cochrane Library and PsycInfo were conducted from inception to 1 January 2023. Studies comparing the incidence of stressful life events (SLEs) that occurred before diagnosis and during drug therapy in cases diagnosed with GD and controls were included in the final analysis.
RESULTS
Nine case-control studies and four cohort studies enrolling 2892 participants (1685 [58%] patients) were included. Meta-analysis revealed a high and significant effect-size index in a random effect model (d = 1.81, P = 0.01), indicating that stress is an important factor in the onset of GD. The relationship between SLEs and GD was stronger in studies with higher proportions of female patients (β = 0.22, P < 0.01) and weaker in studies with older patients with GD (β =-0.62, P < 0.01). However, stress did not significantly affect the outcome of antithyroid drug therapy for GD (d = 0.32, P = 0.09).
CONCLUSIONS
The results of this meta-analysis suggest that stress is one of the environmental triggers for the onset of GD. Therefore, we recommend stress management assistance for individuals genetically susceptible to GD, especially for young females.
Topics: Humans; Female; Graves Disease; Antithyroid Agents; Case-Control Studies; Genetic Predisposition to Disease
PubMed: 37700292
DOI: 10.1186/s12902-023-01450-y -
Journal of Mother and Child Jun 2023High workplace/ambient temperatures have been associated with Adverse Pregnancy Outcomes (APO). Millions of women working in developing nations suffer due to the rising... (Review)
Review
INTRODUCTION
High workplace/ambient temperatures have been associated with Adverse Pregnancy Outcomes (APO). Millions of women working in developing nations suffer due to the rising temperatures caused by climate change. There are few pieces of research linking occupational heat stress to APO, and fresh evidence is required.
METHODOLOGY
We used databases including PubMed, Google Scholar, and Science Direct to search for research on high ambient/workplace temperatures and their effects. Original articles, newsletters, and book chapters were examined. The literature we analysed was categorised as follows: Heat, strain, and physical activity harming both mother and fetus. After categorising the literature, it was examined to identify the major results.
RESULTS
We found a definite association between heat stress and APOs such as miscarriages, premature birth, stillbirth, low birthweight, and congenital abnormalities in 23 research articles. Our work provides important information for future research into the biological mechanisms that create APOs and various prevention measures.
CONCLUSION
Our data suggest that temperature has long-term and short-term effects on maternal and fetal health. Though small in number, this study stressed the need for bigger cohort studies in tropical developing countries to create evidence for coordinated policies to safeguard pregnant women.
Topics: Female; Humans; Pregnancy; Abortion, Spontaneous; Pregnancy Outcome; Premature Birth; Stillbirth; Hot Temperature; Women, Working; Workplace; Occupational Exposure; Heat-Shock Response; Infant, Low Birth Weight; Infant, Newborn; Congenital Abnormalities
PubMed: 37368943
DOI: 10.34763/jmotherandchild.20232701.d-22-00051