Developing annotated bibliographies for pain management – A tool for education, collaboration and research development

The purpose of this paper is to present the process of developing an annotated bibliography as a tool for education and research. The authors of the paper will describe the process and demonstrate the findings from two recently completed bibliographies around pain in the older adult and pain in the terminal stages of palliative care. The benefits of this type of project will be discussed. Both bibliographies have been developed by a team of researchers within the University of Sheffield and are available for students to access as an educational tool. From the work collated within the bibliographies, the research team have been able to identify two research proposals that have been submitted for funding.     

Children at Risk from Domestic Violence and their Educational Attainment: Perspectives of Education Welfare Officers, Social Workers and Teachers

Children who witness domestic violence may have impaired educational attainment as well as facing other challenges such as struggles with self-esteem and forming relationships. This qualitative study set in Northern Ireland explored the perceptions of Education Welfare Officers, child protection social workers and teachers in post-primary schools regarding the impact of domestic violence on schooling and educational attainment, and of service responses to this. The survey used semi-structured interviews with four professionals in each of the above categories. Findings confirmed the major effect that domestic violence can have on children's schooling and relationships. Two typical types of responses by children were identified: those who became quiet and withdrawn, and those who became loud and aggressive. There seemed to have been progress in terms of professional understanding and service responses regarding domestic violence, but there seemed to be limited structured cooperation between the professional groups in addressing the effects of domestic violence on children. Sharing of information is hindered by confidentiality issues, some of which might be addressed by integrated teams of appropriate professionals. Greater investment in inter-agency training and development of the preventive role of the Education Welfare Service are recommended.     

New scans from old: digital reformatting knee MRI

Purpose: To determine the accuracy of cartilage volume and bone areas measured from a 3D knee MRI sequence reformatted in different planes.Methods: MRI of 16 adult subjects (9 females, 7 males, age range 45–68 years) were acquired in the sagittal plane using a 3D T1-weighted fat suppressed spoiled gradient echo sequence. Medial and lateral tibial cartilage volumes were determined by processing images acquired in the sagittal plane and from the same image data reformatted in the coronal plane. Tibial plateau areas were determined by processing images acquired in the sagittal plane and reformatted in the axial plane.Results: Cartilage volumes calculated from the original sagittal acquisition and data reformatted into the coronal plane were similar. The average over- or under-estimation of the lateral and medial cartilage volume from the reformatted coronal scans compared to the sagittal sequences was 4.6% and 9.8% respectively. Similar medial and lateral tibial plateau areas were obtained when the sagittal data was reformatted in the axial plane. The average over- and under-estimate of lateral and medial tibial plateau areas from the reformatted axial scans compared to the originally acquired sagittal sequences was 6.5% and 6.8% respectively.Conclusion: Knee data acquired via MRI in one plane can be reformatted into different planes, providing comparable cartilage volumes and bone areas. As different planes through the knee may provide better visualization of different joint structures, this method may be useful clinically and as a research tool, while avoiding the cost associated with the prolonged scanning times associated with acquiring multiple planes.     

Fitting dietary advice for oral health into the roles of food for elderly, mentally ill people

Aim: To identify the roles of food in a day-centre for elderly, mentally ill people, so that dietary recommendations for optimal oral health are made within the overall philosophies of the day-centre. Method: A qualitative approach was adopted. It comprised an observational study of the daily routine and a semistructured interview to examine the attitudes, beliefs and knowledge of the care-staff related to diet, general health and oral health. Results: The use of food was pivotal to the functioning of the centre. Food was used for nutrition, as a focus for communal activities, to express love and caring, and to maintain cognitive, daily living and social skills. All staff considered oral health important and appreciated the link between oral health, general health and diet (primarily sugar consumption). Despite this, one-third of carers considered tooth loss an inevitable consequence of ageing. Sugar was generally regarded as detrimental to general health, but attitudes towards use of sweeteners as an alternative were mixed. However, it was believed that elderly people can adapt to dietary changes. Conclusion: Dietary advice for oral health would be acceptable if put in the context of general health and the changes take account of the overall philosophies of the centre. To this end a ‘Healthy Eating Resource Pack’ was produced for use in the centre.     

Corrigendum to "The clinical applications of contrast echocardiography" [Eur J Echocardiogr 2007;8:S13-S23]

The authors     

氟美松对急性肝损伤大鼠肝细胞Fas/Fas配体表达和细胞凋亡的影响

目的 :观察内毒素急性肝损伤后肝细胞凋亡和Fas/Fas配体 (FasL)表达的变化 ,以及氟美松对其影响 ,探讨急性肝损伤早期作用机制 .方法 :采用免疫组化和原位杂交技术检测各时相点肝细胞Fas/FasL蛋白和mRNA的表达 ;应用原位末端标记技术对各时相点肝细胞凋亡进行检测 .结果 :内毒素急性肝损伤各时相点大鼠肝细胞Fas/FasL蛋白和mR NA的表达较对照组明显上调 (P <0 .0 5 ) ,且与肝细胞凋亡的增加相一致 ;氟美松可明显减轻炎症反应 ,抑制脂多糖 (LPS)诱导的肝细胞凋亡 ,并使肝细胞Fas/FasL蛋白和mRNA的表达明显下调 (P <0 .0 5 ) .结论 :肝细胞凋亡和Fas/FasL系统活化可能参与内毒素急性肝损伤早期的发病机制 ,而且加重早期肝损伤 ;氟美松可抑制Fas/FasL系统活化 ,阻断和调控凋亡 ,从而减轻肝组织损伤     

Application of a customised birthweight standard in the assessment of perinatal outcome in a high risk population

Objective Physiological as well as pathological variables influence birthweight. The aim of the present study was to examine perinatal outcome in relation to birthweight centiles applying a customised birthweight standard.
Methods Two hundred and seventeen babies from high risk pregnancies were evaluated and classified as small or not small for gestational age according to two standards: 1. conventional Dutch birthweight centiles and 2. customised centiles which adjust individually for physiological variables like maternal booking weight, height and ethnic origin.
Results Customisation of the weight standards resulted in identification of an additional group of infants who were small for gestational age, but not by the Dutch standards. These babies were associated with significantly more adverse perinatal events than those who were not small for gestational age as defined by a customised standard.
Conclusions Adjustment of birthweight centiles for physiological variables significantly improves the identification of infants who have failed to reach the expected birthweight and who are at increased risk for adverse perinatal events.