214 results on '"Denise Harrison"'
Search Results
2. Cumulative sucrose exposure for repeated procedural pain in preterm neonates and neurodevelopment at 18 months of corrected age: a prospective observational longitudinal study
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Marsha Campbell-Yeo, Janet Squires, Carole Estabrooks, Denise Harrison, Janet Yamada, Mariana Bueno, Anna Taddio, Bonnie Stevens, Anne R Synnes, Sharyn Gibbins, Marilyn Ballantyne, Carol McNair, Shirine Riahi, and Charles Victor
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Pediatrics ,RJ1-570 - Abstract
Introduction Oral sucrose is repeatedly administered to neonates in the neonatal intensive care unit (NICU) to treat pain from commonly performed procedures; however, there is limited evidence on its long-term cumulative effect on neurodevelopment. We examined the association between total sucrose volumes administered to preterm neonates for pain mitigation in the NICU and their neurodevelopment at 18 months of corrected age (CA).Methods A prospective longitudinal single-arm observational study that enrolled hospitalised preterm neonates
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- 2024
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3. Contracting retail pharmacies as a source of essential medicines for public sector clients in low- and middle-income countries: a scoping review of key considerations, challenges, and opportunities
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Warren A. Kaplan, Carlotta M. Cellini, Kwesi Eghan, Kevin Pilz, Denise Harrison, and Veronika J. Wirtz
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Public–private contracting ,Retail pharmacies ,Essential medicines ,Health system strengthening ,Health system administration ,Low- and middle-income countries ,Therapeutics. Pharmacology ,RM1-950 ,Pharmacy and materia medica ,RS1-441 - Abstract
Abstract Background Insurances in high-income countries (HIC) often contract with private community pharmacies to dispense medicines to outpatients. In contrast, dispensing of medicines in low- and middle-income countries (LMICs) often lacks such contractual arrangements. Furthermore, many LMICs lack sufficient investment in supply chains and financial and human resources to guarantee stock levels and services at public medicine-dispensing institutions. Countries striving to achieve universal health coverage (UHC) can, in principle, incorporate retail pharmacies into their supply chains to expand access to essential medicines (EMs). The objectives of this paper are (a) to identify and analyze key considerations, opportunities and challenges for public payers when contracting out the supply and dispensing of medicines to retail pharmacies and (b) to provide examples of strategies and policies to address these challenges. Methods A targeted literature strategy was used to conduct this scoping review. We created an analytical framework of key dimensions: (1) governance (including medicine and pharmacy regulation); (2) contracting (3) reimbursement; (4) medicine affordability (5) equitable access; and (6) quality of care (including ‘patient-centered’ pharmaceutical care). Using this framework, we selected a mix of three HIC and four LMIC case studies and analyzed the opportunities and challenges encountered when contracting retail pharmacies. Results From this analysis, we identified a set of opportunities and challenges that should be considered by public payers considering public–private contracting: (1) balancing business viability with medicine affordability; (2) incentivizing equitable access to medicines; (3) ensuring quality of care and delivery of services; (4) ensuring product quality; (5) task-sharing from primary care providers to pharmacies and (6) securing human resources and related capacity constraints to ensure sustainability of the contract. Conclusion Public–private partnerships offer opportunities to improve access to EMs. Nonetheless, managing these agreements is complex and is influenced by a variety of factors. For effective contractual partnerships, a systems approach is needed in which business, industry and regulatory contexts are considered in tandem with the health system. Special attention should be devoted to rapidly changing health contexts and systems, such as changes in patient preferences and market developments brought about by the COVID-19 pandemic.
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- 2023
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4. Translating evidence: pain treatment in newborns, infants, and toddlers during needle-related procedures
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Denise Harrison and Mariana Bueno
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Anesthesiology ,RD78.3-87.3 - Abstract
Abstract. Introduction:. Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented. Objectives:. To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice. Methods:. This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented. Results:. Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needle-related procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist. Conclusion:. There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.
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- 2023
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5. The effectiveness of repeated sucrose for procedural pain in neonates in a longitudinal observational study
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Mariana Bueno, Marilyn Ballantyne, Marsha Campbell-Yeo, Carole A. Estabrooks, Sharyn Gibbins, Denise Harrison, Carol McNair, Shirine Riahi, Janet Squires, Anne Synnes, Anna Taddio, Charles Victor, Janet Yamada, and Bonnie Stevens
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neonate ,pain ,procedural pain ,pain assessment ,sucrose ,effectiveness ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
GoalTo determine the analgesic effectiveness of repeated sucrose administration for skin-breaking (SB) procedures over the Neonatal Intensive Care Unit (NICU) hospitalization of preterm infants.MethodsLongitudinal observational study, conducted in four level III Canadian NICUs. Eligible infants were
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- 2023
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6. Validating the Implementation Leadership Scale in Chinese nursing context: A cross‐sectional study
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Jiale Hu, Wendy Gifford, Hong Ruan, Denise Harrison, Qingge Li, Mark G. Ehrhart, Mary‐Ann Harrison, Nick Barrowman, and Gregory A. Aarons
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China ,evidence‐based practice ,health services research ,leadership ,nursing ,psychometrics ,Nursing ,RT1-120 - Abstract
Abstract Aim This study aimed to evaluate the validity, reliability and acceptability of the Implementation Leadership Scale in the Chinese nursing context. Design This study utilized a cross‐sectional design. Methods This study was conducted in one general tertiary hospital with 234 nurses (85.3% response rate) from 35 clinical units in China. Content validity, structural validity, convergent validity, reliability (internal consistency), agreement indices and acceptability were evaluated. The data collection was from December 1st, 2017 to June 30th, 2018. Results Confirmatory factor analysis demonstrated a good model fit to the four‐factor implementation leadership model. The psychometric testing also indicated good convergent validity, high internal consistency and acceptable aggregation. Most participants completed the scale in two minutes or less and agreed or strongly agreed that the questions were relevant to implementation leadership, clear and easy to answer. Conclusions This study demonstrated that the Chinese Implementation Leadership Scale is a valid, reliable and pragmatic tool for measuring strategic leadership for implementing evidence‐based practices.
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- 2021
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7. Therapeutic hypothermia for neonatal encephalopathy with sepsis: a retrospective cohort study
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Kei Lui, Victor Samuel Rajadurai, Malcolm Battin, lex Doyle, Leah Hickey, Srinivas Bolisetty, Peter Schmidt, Andy Gill, Jane Pillow, Jacqueline Stack, Pita Birch, Dan Casalaz, Jim Holberton, Alice Stewart, Lucy Cooke, Lyn Downe, Michael Stewart, Andrew Berry, Rod Hunt, Tony De Paoli, Mary Paradisis, Pieter Koorts, Carl Kuschel, Andrew Numa, Hazel Carlisle, Nadia Badawi, Guan Koh, Jonathan Davis, Melissa Luig, Chad Andersen, Brian Darlow, Liza Edmonds, Mariam Buksh, Georgina Chambers, Clare Collins, David Barker, Denise Harrison, Steven Resnick, Jutta van den Boom, Peter Morris, Rebecca Thomas, Mary Sharp, Naomi Spotswood, M Battin, Scott Morris, Nicola Austin, Michael Stark, Anjali Dhawan, Larissa Korostenski, Karen Nothdurft, Mark Greenhalgh, John Craven, Himanshu Popat, Bevan Headley, Barbara Hammond, Kristina Sibbin, Tara M Crawford, Guy Bloomfield, Callum Gately, and Natalie Merida
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Pediatrics ,RJ1-570 - Abstract
Objective Neonatal encephalopathy remains a major cause of infant mortality and neurodevelopmental impairment. Infection may exacerbate brain injury and mitigate the effect of therapeutic hypothermia (TH). Additionally, infants with sepsis treated with TH may be at increased risk of adverse effects. This study aimed to review the clinical characteristics and outcomes for infants with sepsis treated with TH.Design and setting Retrospective cohort study of infants treated with TH within Australia and New Zealand.Patients 1522 infants treated with TH, including 38 with culture-positive sepsis from 2014 to 2018.Intervention Anonymised retrospective review of data from Australian and New Zealand Neonatal Network. Infants with culture-positive sepsis within 48 hours were compared with those without sepsis.Main outcome measures Key outcomes include in-hospital mortality, intensive care support requirements and length of stay.Results Overall the rate of mortality was similar between the groups (13% vs 13%). Infants with sepsis received a higher rate of mechanical ventilation (89% vs 70%, p=0.01), high-frequency oscillatory ventilation (32% vs 13%, p=0.003) and inhaled nitric oxide for persistent pulmonary hypertension (38% vs 16%, p
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- 2022
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8. 'Be sweet to babies': Use of Facebook as a method of knowledge dissemination and data collection in the reduction of neonatal pain
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Ana Claudia G. Vieira, Mariana Bueno, and Denise Harrison
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breastfeeding ,newborn ,pain management ,skin‐to‐skin contact ,social media ,sweet solutions ,Pediatrics ,RJ1-570 - Abstract
Abstract The Be Sweet to Babies video demonstrates the analgesic effects of breastfeeding, skin‐to‐skin care, and sweet‐tasting solutions as interventions to reduce pain during blood sampling in newborns. Although effective and safe, these strategies are implemented inconsistently in clinical settings. Given the increasing popularity of social media, there is a potential to disseminate and promote health information through it. The study aim was to evaluate the use of Facebook as a means of disseminating the Be Sweet to Babies video in Portuguese, and to evaluate respondents’ prior knowledge, previous use of the three pain management strategies and intent to use the strategies in the future. We conducted a cross‐sectional study, using the “virtual snowball” sampling method. A Facebook webpage was created, in which the video was posted along with a brief survey. Data analyzed included number of views and visits to the page, number of views of the video, likes, dislikes, and survey responses. One year after posting, the page had 70 753 views and 2199 accesses; there were 1553 “likes”, no dislikes, and 43 positive comments. The survey was completed by 930 respondents (42% response rate based on the page access). Over two thirds of the respondents had previous knowledge about breastfeeding, skin‐to‐skin care, and sweet solutions for pain relief. After watching the video, 87% of the respondents intended to use breastfeeding or skin‐to‐skin care in the future, and 71% intended to use sweet solutions. Almost all viewers rated the video as very useful (n = 917, 99%), easy to understand (n = 926, 99%), and easy to apply in real‐life situations (n = 903, 97%). Using Facebook to deliver and evaluate an intervention is feasible, rapid in obtaining responses, low cost, and it is promising for data collection and knowledge dissemination. Further studies are warranted to evaluate the actual impact of the use of social media in practice change.
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- 2020
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9. Effectiveness of a parent‐targeted video on neonatal pain management: Nonrandomized pragmatic trial
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Ligyana Korki de Candido, Denise Harrison, Maria de La Ó Ramallo Veríssimo, and Mariana Bueno
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educational technology ,infant ,neonatal nursing ,newborn ,pain ,parents ,Pediatrics ,RJ1-570 - Abstract
Abstract The “Be sweet to babies” video is a knowledge translation tool targeted at parents on the use of analgesic strategies during painful procedures performed in neonates. This study aimed to evaluate the effectiveness of the Portuguese version of this video on maternal involvement in neonatal pain management during the newborn screening blood test. Nonrandomized, pragmatic clinical trial. The study was conducted in a rooming‐in unit. All mothers received a pamphlet regarding neonatal pain management and were invited to participate in daily education sessions conducted by nurses, which included the video. The intervention group included mothers who voluntarily watched the video, while the control group was comprised of mothers who did not attend the education sessions or left the session before watching the video. Data were collected by interviews conducted by the research team. Descriptive and inferential analysis considered a confidence interval of 95%. A total of 73 mothers were included in the study. Analgesic strategies were used in 14 (40%) of the procedures in the intervention group and 9 (24%) in the control group, a clinically important difference of 16% points between groups, although no statistically significant difference was found (P = .13). Breastfeeding was the most commonly used strategy. Watching the video increased the chance of implementing analgesic strategies by 2.1 times (P = .19), while nurses suggesting the use of analgesia increased this chance by 5.5 times (P = .006). Although no statistical significance was found, the results suggest the clinical significance and feasibility of the “Be sweet to babies” video as a KT tool targeted at parents on neonatal pain management during nonurgent painful procedures. In addition, maternal involvement in pain care significantly increased when pain relief strategies were recommended by nurses, which suggests that nurses have a key role in facilitating parental participation.
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- 2020
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10. A cluster randomized clinical trial to evaluate the effectiveness of the Implementation of Infant Pain Practice Change (ImPaC) Resource to improve pain practices in hospitalized infants: a study protocol
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Mariana Bueno, Bonnie Stevens, Melanie A. Barwick, Shirine Riahi, Shelly-Anne Li, Alexa Lanese, Andrew R. Willan, Anne Synnes, Carole A. Estabrooks, Christine T. Chambers, Denise Harrison, Janet Yamada, Jennifer Stinson, Marsha Campbell-Yeo, Melanie Noel, Sharyn Gibbins, Sylvie LeMay, and Wanrudee Isaranuwatchai
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Pain ,Procedural ,Infants ,Assessment ,Management ,Implementation ,Medicine (General) ,R5-920 - Abstract
Abstract Background Hospitalized infants undergo multiple painful procedures daily. Despite the significant evidence, procedural pain assessment and management continues to be suboptimal. Repetitive and untreated pain at this vital developmental juncture is associated with negative behavioral and neurodevelopmental consequences. To address this knowledge to practice gap, we developed the web-based Implementation of Infant Pain Practice Change (ImPaC) Resource to guide change in healthcare professionals’ pain practice behaviors. This protocol describes the evaluation of the intervention effectiveness and implementation of the Resource and how organizational context influences outcomes. Methods An effectiveness-implementation hybrid type 1 design, blending a cluster randomized clinical trial and a mixed-methods implementation study will be used. Eighteen Neonatal Intensive Care Units (NICUs) across Canada will be randomized to intervention (INT) or standard practice (SP) groups. NICUs in the INT group will receive the Resource for six months; those in the SP group will continue with practice as usual and will be offered the Resource after a six-month waiting period. Data analysts will be blinded to group allocation. To address the intervention effectiveness, the INT and SP groups will be compared on clinical outcomes including the proportion of infants who have procedural pain assessed and managed, and the frequency and nature of painful procedures. Data will be collected at baseline (before randomization) and at completion of the intervention (six months). Implementation outcomes (feasibility, fidelity, implementation cost, and reach) will be measured at completion of the intervention. Sustainability will be assessed at six and 12 months following the intervention. Organizational context will be assessed to examine its influence on intervention and implementation outcomes. Discussion This mixed-methods study aims to determine the effectiveness and the implementation of a multifaceted online strategy for changing healthcare professionals’ pain practices for hospitalized infants. Implementation strategies that are easily and effectively implemented are important for sustained change. The results will inform healthcare professionals and decision-makers on how to address the challenges of implementing the Resource within various organizational contexts. Trial registration ClinicalTrials.gov, NCT03825822. Registered 31 January 2019.
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- 2020
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11. Moving on: Transition experiences of young adults with chronic pain
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Andrea Higginson, Paula Forgeron, Denise Harrison, G. Allen Finley, and Bruce D. Dick
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transition ,chronic pain ,young adults ,adolescents ,young people ,Medicine (General) ,R5-920 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Purpose The purpose of this study was to explore the transition experience of young adults with chronic pain in Canada from the pediatric health care setting to the adult health care setting. Materials and Methods A qualitative descriptive approach using semistructured interviews was used to capture the transition experiences of young people with chronic pain who have recently transferred from the pediatric setting to the adult health care setting. Participants were recruited from west, central, and the east coast of Canada to situate the findings within the context of Canada. Interviews were transcribed and analyzed using qualitative inductive content analysis. Results Nine participants were interviewed, three from each part of Canada (west, central, and east). Five common categories were determined to describe the transition experience of young adults with chronic pain which include (1) independence (I can do it, maybe?), (2) pain trajectory (stress and pain along for the ride), (3) social support networks (need a shoulder to lean on), (4) parental support (obviously they are there), and (5) collaborative systems (the bridge). Conclusion Young people with chronic pain experience unique challenges when faced with transitioning to the adult health care setting. Supporting the young person and his or her family in preparation and readiness and collaboration between the pediatric and adult health care settings are essential to ensure a smooth transition and avoid negative transition outcomes. Further research is needed to determine the best ways to prepare young people for transition and the care activities required in both pediatric and adult health care settings to improve pain-related outcomes posttransition.
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- 2019
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12. Retrospective Assessment of Risk Factors for Head and Neck Cancer Among World Trade Center General Responders
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Michelle T. Bover Manderski, Kathleen Black, Iris G. Udasin, Taylor M. Black, Michael B. Steinberg, Anna R. Giuliano, Benjamin J. Luft, Denise Harrison, Michael A. Crane, Jacqueline Moline, Marian R. Passannante, Pamela Ohman Strickland, Christopher R. Dasaro, Roberto G. Lucchini, Andrew C. Todd, and Judith M. Graber
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behavioral risk factors ,cancer ,questionnaire ,reliability ,World Trade Center (WTC) ,Public aspects of medicine ,RA1-1270 - Abstract
Objective: To assess the reliability of a questionnaire designed to reconstruct risk factors for head and neck cancer relative to the 9/11 World Trade Center (WTC) response and over the lifetime.Methods: As part of a nested case-control study, 200 WTC Health Program (WTCHP) General Responder Cohort (GRC) members completed a newly-developed study questionnaire via telephone (with a trained interviewer) or online (self-administered). We assessed agreement between measures of tobacco and alcohol use in our questionnaire results and data collected previously during WTCHP-GRC monitoring visits using Cohens Kappa (κ) and intraclass correlation coefficient (ICC) for categorical and continuous measures, respectively. We compared agreement by disease status, survey mode, and year of WTCHP enrollment.Results: We observed high agreement between measures of lifetime, pre-WTC, and post-WTC smoking prevalence (all κ > 0.85) and smoking duration (all ICC > 0.84). There was moderate agreement between measures of smoking frequency (ICC: 0.61–0.73). Agreement between measures of smoking frequency, but not duration, differed by disease status, and agreement between smoking measures was higher for participants who completed our survey by phone than by web. Among cases, there were no differences based on enrollment in the WTCHP before or after diagnosis.Conclusion: Agreement between measures was generally high, although potential reporting bias and a mode effect that should be considered when interpreting analyses of self-reported data in this population; however differential misclassification appears to be minimal. Our questionnaire may be useful for future studies examining similar behavioral risk factors among disaster-exposed populations.
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- 2020
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13. How to translate scientific knowledge into practice? Concepts, models and application
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Ana Cláudia Garcia Vieira, Denise Gastaldo, and Denise Harrison
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Knowledge Translation ,Translation ,Information Dissemination ,Diffusion ,Clinical competence ,Nursing ,RT1-120 - Abstract
ABSTRACT Objectives: to present the concept of Knowledge Translation and Exchange as it has been used in the international literature and in Canada, particularly. Next, to describe a renowned conceptual model to guide its implementation, entitled Knowledge-to-Action Cycle. Results: we described the use of the model in the context of the municipal primary health care system in southern Brazil for the implementation of pain management strategies during vaccination. Conclusions: in this theoretical reflection, we argue that in order to promote health equity and quality of care in the Unified Health System (Brazilian SUS) it is important to translate scientific knowledge to various practice settings and create opportunities for exchange with users of this knowledge, such as health professionals, managers, policy makers, patients, family members and other stakeholders.
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- 2020
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14. The minimally effective dose of sucrose for procedural pain relief in neonates: a randomized controlled trial
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Bonnie Stevens, Janet Yamada, Marsha Campbell-Yeo, Sharyn Gibbins, Denise Harrison, Kimberley Dionne, Anna Taddio, Carol McNair, Andrew Willan, Marilyn Ballantyne, Kimberley Widger, Souraya Sidani, Carole Estabrooks, Anne Synnes, Janet Squires, Charles Victor, and Shirine Riahi
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Adverse event ,Analgesia ,Heel lance ,Neonates ,NICU ,Pain ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Orally administered sucrose is effective and safe in reducing pain intensity during single, tissue-damaging procedures in neonates, and is commonly recommended in neonatal pain guidelines. However, there is wide variability in sucrose doses examined in research, and more than a 20-fold variation across neonatal care settings. The aim of this study was to determine the minimally effective dose of 24% sucrose for reducing pain in hospitalized neonates undergoing a single skin-breaking heel lance procedure. Methods A total of 245 neonates from 4 Canadian tertiary neonatal intensive care units (NICUs), born between 24 and 42 weeks gestational age (GA), were prospectively randomized to receive one of three doses of 24% sucrose, plus non-nutritive sucking/pacifier, 2 min before a routine heel lance: 0.1 ml (Group 1; n = 81), 0.5 ml (Group 2; n = 81), or 1.0 ml (Group 3; n = 83). The primary outcome was pain intensity measured at 30 and 60 s following the heel lance, using the Premature Infant Pain Profile-Revised (PIPP-R). The secondary outcome was the incidence of adverse events. Analysis of covariance models, adjusting for GA and study site examined between group differences in pain intensity across intervention groups. Results There was no difference in mean pain intensity PIPP-R scores between treatment groups at 30 s (P = .97) and 60 s (P = .93); however, pain was not fully eliminated during the heel lance procedure. There were 5 reported adverse events among 5/245 (2.0%) neonates, with no significant differences in the proportion of events by sucrose dose (P = .62). All events resolved spontaneously without medical intervention. Conclusions The minimally effective dose of 24% sucrose required to treat pain associated with a single heel lance in neonates was 0.1 ml. Further evaluation regarding the sustained effectiveness of this dose in reducing pain intensity in neonates for repeated painful procedures is warranted. Trial registration ClinicalTrials.gov: NCT02134873. Date: May 5, 2014 (retrospectively registered).
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- 2018
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15. Special issue on knowledge mobilization: Pediatric pain
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Kathryn A. Birnie and Denise Harrison
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Pediatrics ,RJ1-570 - Published
- 2020
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16. Special issue on knowledge mobilization: Neonatal pain
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Denise Harrison and Kathryn Birnie
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Pediatrics ,RJ1-570 - Published
- 2020
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17. Seja Doce com os Bebês: avaliação de vídeo instrucional sobre manejo da dor neonatal por enfermeiros
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Hellen Caroline Carneiro de Almeida, Ligyana Korki de Candido, Denise Harrison, and Mariana Bueno
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Pain ,Infant, Newborn ,Neonatal Nursing ,Education, Nursing ,Evidence-Based Nursing ,Audiovisual Resources ,Public aspects of medicine ,RA1-1270 ,Nursing ,RT1-120 ,Mental healing ,RZ400-408 ,Education (General) ,L7-991 - Abstract
RESUMO Objetivo: Descrever o perfil de enfermeiros atuantes em unidades que assistem o recém-nascido, verificar seu conhecimento prévio sobre amamentação, contato pele a pele e soluções adocicadas no alívio da dor procedural neonatal, e avaliar sua percepção sobre a viabilidade, a aceitabilidade e a utilidade do vídeo “Seja Doce com os Bebês”. Método: Estudo transversal, realizado em quatro unidades de um hospital universitário de São Paulo. Foram incluídos 45 enfermeiros, que responderam ao questionário de caracterização e assistiram ao vídeo. Posteriormente, 38 avaliaram o vídeo. Estatística descritiva foi utilizada para análise das variáveis, além da análise de conteúdo na questão aberta. Resultados: Participaram do estudo 45 enfermeiros. 97,4% conheciam as estratégias analgésicas e, após assistirem ao vídeo, afirmaram pretender utilizá-las ou incentivar seu uso durante procedimentos dolorosos. Todos recomendariam o vídeo para outros profissionais, sendo o recurso avaliado como útil, fácil de entender e de aplicar em situações reais. Conclusão: Os enfermeiros conhecem as estratégias analgésicas, consideram o vídeo viável, aceitável e útil como ferramenta de tradução do conhecimento para profissionais da saúde, o que também pode favorecer o envolvimento dos pais no manejo da dor de seus filhos.
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- 2018
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18. A Systematic Review and Meta-Analyses of Nonsucrose Sweet Solutions for Pain Relief in Neonates
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Mariana Bueno, Janet Yamada, Denise Harrison, Sobia Khan, Arne Ohlsson, Thomasin Adams-Webber, Joseph Beyene, and Bonnie Stevens
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Medicine (General) ,R5-920 - Abstract
BACKGROUND: Sucrose has been demonstrated to provide analgesia for minor painful procedures in infants. However, results of trials investigating other sweet solutions for neonatal pain relief have not yet been synthesized.
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- 2013
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19. Using YouTube to Disseminate Effective Vaccination Pain Treatment for Babies.
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Denise Harrison, Jodi Wilding, Amanda Bowman, Ann Fuller, Stuart G Nicholls, Catherine M Pound, Jessica Reszel, and Margaret Sampson
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Medicine ,Science - Abstract
BACKGROUND:Infant vaccinations are necessary for public health, but are painful, causing distress to the infant and caregivers. Breastfeeding and sucrose effectively reduce infants' pain during vaccinations, and these strategies are recommended in health care provider (HCP)-targeted education and vaccination pain guidelines. However studies show these strategies are infrequently used. YouTube is a popular medium to publicly share and watch videos, and many consumer posted YouTube videos show distressed infants being vaccinated with no pain treatment. The aims of this study were to evaluate the reach and impact of a consumer-targeted YouTube video demonstrating use of effective pain reduction strategies during infant vaccinations. METHODS:A brief consumer-targeted video showing two infants being vaccinated was posted onto YouTube on October 2013. One infant was breastfed and another infant received sucrose by mouth before and during the injection. A link to a viewer survey was visible on a banner near the end of the video. An intensive strategically planned knowledge dissemination strategy using the media, social media and messages to professional organizations took place to promote the video. Data analysis of the viewer survey, YouTube analytics of the reach of the video in terms of number of views, country of viewers, and comments relating to the video took place 12 months after the video was posted. RESULTS:Twelve months after posting, the video had 65,478views, 68 comments, 245 likes, 17 dislikes, and 90 shares. Average duration of viewer time was 65% of the video. The viewer survey was completed by 156 (0.24%) viewers; 90 (58%) answered as HCPs and 66 (42%) as parents. Survey results showed that the video was persuasive; intent to use or support breastfeeding or sucrose was high in both parents and HCPs after viewing the video. Comments posted were often emotional in nature, and were related to anti-vaccination (n = 26, 38%); effectiveness or positive personal experiences (n = 21, 32%); research team comments or promotion (n = 12, 18%); pro-vaccination (n = 6, 8%) and barriers to using breastfeeding or sucrose during vaccinations (n = 3, 4%). CONCLUSION:The video posted onto YouTube demonstrating effective pain treatment during infant vaccinations was viewed by large numbers of people around the world, however the response rate to the linked survey was extremely low. Using YouTube videos for knowledge dissemination has an extensive reach, however it is difficult to evaluate impact on behaviours and practices.
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- 2016
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20. Be sweet to toddlers during needles: pilot randomized controlled trial of sucrose compared to placebo
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Denise Harrison, Jessica Reszel, Nick Barrowman, Brenda Martelli, Diane Sharp, and Regis Vailancourt
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Pain ,painful ,children ,sucrose ,venipuncture. ,Nursing ,RT1-120 - Abstract
Sweet solutions reduce procedural pain in infants but there is uncertainty about effectiveness beyond infancy. A blinded pilot randomized controlled trial (RCT) was conducted to inform a full-scale RCT. Hospitalized children aged 12- 36 months were randomized to 24% sucrose or water prior to and during venipuncture. Primary outcomes were crying time and FLACC (Face, Legs, Activity, Cry, Consolability) scores. Secondary outcomes parental report of child’s pain, parental perception of effectiveness and nurse’s score of child’s compliance with study solution. Twenty-one children were studied. There were no differences in pain outcomes between groups. Median FLACC scores at time of needle insertion were high (8/10), and mean crying time during procedure was 61%. Most parents (n=17) would use the same treatment next time and most (n=17) toddlers were compliant with receiving the solutions. The pilot RCT informed the conduct of a future full scale RCT in terms of feasibility, acceptability, data collection, data analysis and sample size estimation.
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- 2015
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21. Pain Prevalence in a Pediatric Hospital: Raising Awareness during Pain Awareness Week
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Denise Harrison, Cynthia Joly, Christine Chretien, Sarah Cochrane, Jacqueline Ellis, Christine Lamontagne, and Vaillancourt Regis
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Medicine (General) ,R5-920 - Abstract
BACKGROUND: Despite the evidence and availability of numerous validated pain assessment tools and pain management strategies for infants and children, their use remains inconsistent in clinical practice.
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- 2014
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22. A systematic review of methods for studying consumer health YouTube videos, with implications for systematic reviews
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Margaret Sampson, Jordi Cumber, Claudia Li, Catherine M. Pound, Ann Fuller, and Denise Harrison
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Social media ,YouTube ,Consumer health ,Research methods ,Systematic review ,Medicine ,Biology (General) ,QH301-705.5 - Abstract
Background. YouTube is an increasingly important medium for consumer health information – with content provided by healthcare professionals, government and non-government organizations, industry, and consumers themselves. It is a rapidly developing area of study for healthcare researchers. We examine the methods used in reviews of YouTube consumer health videos to identify trends and best practices.Methods and Materials. Published reviews of consumer-oriented health-related YouTube videos were identified through PubMed. Data extracted from these studies included type of journal, topic, characteristics of the search, methods of review including number of reviewers and method to achieve consensus between reviewers, inclusion and exclusion criteria, characteristics of the videos reported, ethical oversight, and follow-up.Results. Thirty-three studies were identified. Most were recent and published in specialty journals. Typically, these included more than 100 videos, and were examined by multiple reviewers. Most studies described characteristics of the videos, number of views, and sometime characteristics of the viewers. Accuracy of portrayal of the health issue under consideration was a common focus.Conclusion. Optimal transparency and reproducibility of studies of YouTube health-related videos can be achieved by following guidance designed for systematic review reporting, with attention to several elements specific to the video medium. Particularly when seeking to replicate consumer viewing behavior, investigators should consider the method used to select search terms, and use a snowballing rather than a sequential screening approach. Discontinuation protocols for online screening of relevance ranked search results is an area identified for further development.
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- 2013
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23. Health Care Professionals’ Pain Narratives in Hospitalized Children’S Medical Records. Part 2: Structure and Content
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Judy Rashotte, Denise Harrison, Geraldine Coburn, Janet Yamada, Bonnie J Stevens, and the CIHR Team in Children’s Pain
- Subjects
Medicine (General) ,R5-920 - Abstract
BACKGROUND: Although clinical narratives – described as free-text notations – have been noted to be a source of patient information, no studies have examined the composition of pain narratives in hospitalized children’s medical records.
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- 2013
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24. Establishing Intra- and Inter-Rater Agreement of the Face, Legs, Activity, Cry, Consolability Scale for Evaluating Pain in Toddlers During Immunization
- Author
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Rebecca J Gomez, Nick Barrowman, Sonja Elia, Elizabeth Manias, Jenny Royle, and Denise Harrison
- Subjects
Medicine (General) ,R5-920 - Abstract
BACKGROUND: The Face, Legs, Activity, Cry, Consolability (FLACC) scale is a five-item tool that was developed to assess postoperative pain in young children. The tool is frequently used as an outcome measure in studies investigating acute procedural pain in young children; however, there are limited published psychometric data in this context.
- Published
- 2013
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- View/download PDF
25. Health Care Professionals’ Pain Narratives in Hospitalized Children’s Medical Records. Part 1: Pain Descriptors
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Judy Rashotte, Geraldine Coburn, Denise Harrison, Bonnie J Stevens, Janet Yamada, Laura K Abbott, and the CIHR Team in Children’s Pain
- Subjects
Medicine (General) ,R5-920 - Abstract
BACKGROUND: Although documentation of children’s pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children.
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- 2013
- Full Text
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26. Nurses' knowledge and practices regarding pain management in newborns
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Taine Costa, Lisabelle Mariano Rossato, Mariana Bueno, Izabela Linha Secco, Natália Pinheiro Braga Sposito, Denise Harrison, and Júnia Selma de Freitas
- Subjects
Dolor ,Manejo del Dolor ,Recién Nacido ,Enfermería Neonatal ,Unidades de Cuidado Intensivo Neonatal. ,Public aspects of medicine ,RA1-1270 ,Nursing ,RT1-120 ,Mental healing ,RZ400-408 ,Education (General) ,L7-991 - Abstract
Abstract OBJECTIVE To analyze nurses' knowledge and practices regarding pain management of newborns admitted to Neonatal Intensive Care Units. METHOD A descriptive and cross-sectional study. Data were collected from 51 nurses based on an adapted questionnaire aimed at evaluating knowledge and practices regarding the management of neonatal pain in six hospitals in Curitiba and its Metropolitan Region. RESULTS For most nurses (86.0%), neonates feel pain. A total of 34.7% of the nurses reported never using pain assessment scales. Pain management was recorded by 84.3% of the nurses. Administered pharmacological measures were Paracetamol and Fentanyl (47.1%) and Morphine (17.6%); while non-pharmacological measures adopted were sweetened solution (68.6%), non-nutritive sucking (58.8%) and positioning (56.9%). CONCLUSION Nurses considered neonatal pain a real event; however, they do not perform pain assessment or treatment of newborns in a systematized way.It is necessary to implement knowledge translation strategiesin order to improve pain management in newborns.
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27. World Trade Center-related asthma: clinical care essentials
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Denise Harrison and Joan Reibman
- Subjects
Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Toxicology ,General Environmental Science - Published
- 2023
28. Be Sweet to Babies
- Author
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Helena, Bujalka, Melinda, Cruz, Vivien, Ingate, Jeanie, Cheong, Natalie, Duffy, Abbey, Eeles, Kaye, Spence, Alicia, Spittle, Linda, Sweet, Amy Tagliante, Saracino, and Denise, Harrison
- Subjects
Pediatrics, Perinatology and Child Health ,General Medicine - Abstract
Evidence for analgesic effects of parent-led pain management strategies during painful procedures in newborn infants exists; however, such strategies are inconsistently used in practice. A publicly available parent-targeted video demonstrates breastfeeding, skin-to-skin care, and sucrose during painful procedures. Australian parents' use and knowledge of this video and these strategies was unknown.To determine parents' use of pain management strategies, and perceived acceptability and usefulness of the parent-targeted video.A cross-sectional, online, anonymous survey with embedded video. Participants were recruited via social media channels of the Miracle Babies Foundation, an Australian parent support network. Target participants were parents or family members of infants currently or previously hospitalized in neonatal special and/or intensive care nurseries, or high dependency units.A total of 162 of 189 respondents provided sufficient data for analysis; all identified as mothers. Only 6 (4%) had previously seen the video; however, nearly all rated it as potentially useful and helpful (n = 124, 82%). Although most reported that sucrose had been used (n = 112, 84%), fewer reported having used skin-to-skin care (n = 50, 37%), or breastfeeding (n = 33, 25%). Most intended to advocate for skin-to-skin care (n = 108, 88%) or breastfeeding (n = 100, 81%) in future procedures. Perceived barriers to utilizing strategies included lack of information-sharing and organizational practices that excluded parent involvement.The video may be valuable in supporting mothers to advocate for their involvement during painful procedures in preterm and sick hospitalized infants. Further research is recommended to explore coordinated strategies targeting parents and healthcare professionals to overcome barriers to implementing parent-led infant pain management strategies.
- Published
- 2022
29. Évaluation de la version française d’une formation en ligne sur l’appropriation d’une échelle d’évaluation de la douleur pédiatrique
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Julie Chartrand, Juliana Choueiry, Élyse Patry, Jemila S. Hamid, Jodi Wilding, Jessica Reszel, Nicholas Mitsakakis, and Denise Harrison
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General Medicine - Published
- 2022
30. There are already enough studies on sweet solutions for neonatal procedural pain and more would be unethical and unnecessary
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Tian Lin, Hao‐fei Qiu, Rui‐rui Huang, Tao Zhang, and Denise Harrison
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Pediatrics, Perinatology and Child Health ,General Medicine - Published
- 2023
31. Elevated Sound Levels in the Neonatal Intensive Care Unit
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Kelli J, Mayhew, Sarah L, Lawrence, Janet E, Squires, and Denise, Harrison
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Sound ,Intensive Care Units, Neonatal ,Pediatrics, Perinatology and Child Health ,Infant, Newborn ,Infant ,Humans ,General Medicine ,Child ,Noise ,United States - Abstract
Premature and sick neonates may require weeks of hospitalization in a noisy neonatal intensive care unit (NICU) environment with sound levels that may reach 120 decibels. The American Academy of Pediatrics recommends a maximum sound level of 45 decibels.To measure sound levels in a level III NICU and to describe contributing environmental factors.Descriptive quantitative study. Sound levels were measured using a portable sound meter in an open-bay level III NICU. Contributing environmental factors were recorded and analyzed.Mean sound levels for day, evening, and night shifts were 83.5, 83, and 80.9 decibels, respectively. Each period of time exceeded the recommended guidelines 90% of the time and was almost double the American Academy of Pediatrics' recommendation. Multiple linear regression findings demonstrated significant factors associated with elevated sound levels including number of neonates, number of people, number of alarms, acuity level, and shift type. Observational data explain 14.5% of elevated sound levels.An understanding of baseline sound levels and contributing environmental factors is the first step in developing strategies to mitigate excessive noise in the NICU.Research should focus on effective and sustainable ways to reduce sound levels in the NICU, including inside the isolette, in order to provide an environment that is conducive to optimal growth and neurodevelopment for preterm and sick infants.
- Published
- 2022
32. Be sweet to babies during painful procedures: Evaluation of a parent-targeted and mediated video in Farsi
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Denise Harrison, Jessica Reszel, Jiale Hu, Catherine Larocque, and Shokoufeh Modanloo
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medicine.medical_specialty ,Newborn screening ,Venipuncture ,business.industry ,Breastfeeding ,Early detection ,Pain management ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,Analytics ,030225 pediatrics ,Knowledge translation ,Release date ,Physical therapy ,medicine ,030212 general & internal medicine ,business - Abstract
Newborn screening is necessary for early detection of rare diseases, however, venipuncture and heel lance are painful for newborn infants. There are however effective evidence-based pain management strategies include breastfeeding or skin-to-skin care or giving a small volume of sweet solution. These strategies are demonstrated in a parent-targeted publicly accessible video titled Be Sweet to Babies, which has been produced and disseminated in multiple languages, including Farsi. We aimed to evaluate (1) the dissemination and reach of the Farsi video (using video analytics); and (2) viewers’ i) baseline knowledge and previous use of these pain management strategies; ii) intention to advocate for/recommend these strategies (using an online survey accessed from the video). Eight months after the release date, the video had 618,685 views and 202 viewers completed the survey. Almost half the participants knew about or used breastfeeding (n = 81, 40%), skin-to-skin care (n = 106, 53%) or sucrose (82, 41%) before viewing the video. After viewing the video, almost all participants (n = 195, 96%) intended to advocate for use or recommend these strategies to others. This study showed the acceptability, reach, and feasibility of the “Be Sweet to Babies” video, translated and voiced over in Farsi, as a parent-targeted and mediated knowledge translation tool.
- Published
- 2021
33. Family-centred care in the Neonatal Intensive Care Unit: A concept analysis and literature review
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Denise Harrison, Janet E. Squires, Catherine Larocque, Kelli Mayhew, Wendy E. Peterson, and Martha Mason-Ward
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Neonatal intensive care unit ,MEDLINE ,PsycINFO ,CINAHL ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,030225 pediatrics ,Formal concept analysis ,Family centred ,Neonatal nursing ,030212 general & internal medicine ,Psychology ,Meaning (linguistics) - Abstract
Purpose Family-centred care (FCC) in the Neonatal Intensive Care Unit (NICU) is an aspect of high-quality neonatal nursing. The aim of this manuscript is to clarify the meaning of FCC in the NICU to inform future research. Methods Rodger's evolutionary concept analysis. Three databases were searched, each representing a different discipline: CINAHL, Medline, and PsycINFo. Results A total of 188 full-text papers were included. The concept of FCC in the NICU was defined according to its surrogate and related terms, antecedents, attributes, and consequences. Discussion Although interdisciplinary in nature, academic literature about FCC in the NICU is dominated by a biomedical perspective. Important conceptual departures, namely developmental care and family-integrated care are discussed. Conclusion Considering FCC as a model of care may be too reductionist; it should be regarded as a philosophy. Further work should explore the delivery of FCC for increasingly specialized NICU populations, such as perioperative infants.
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- 2021
34. Nurses' perspectives on pain management practices during newborn blood sampling in China
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Wendy Gifford, Denise Harrison, Qing Zhang, Jiale Hu, and Yiyan Zhou
- Subjects
medicine.medical_specialty ,business.industry ,Breastfeeding ,Pain management ,Pediatrics ,Mandarin Chinese ,language.human_language ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Family medicine ,language ,Medicine ,030212 general & internal medicine ,China ,business ,Blood sampling - Abstract
Introduction Nurses' use of evidence-based pain treatments for newborns during needle-related procedures in China was unknown. This study aimed to ascertain knowledge and use of pain management strategies and usefulness of a publicly accessible 'BSweet2Babies' video, produced in Mandarin, demonstrating the use of breastfeeding, skin-to-skin care (SSC), and sweet solutions during painful procedures. Methods An online survey was conducted during six nursing conferences in China ascertaining nurses' previous viewing of the video and knowledge and use of the demonstrated strategies. Results 221 nurses participated. Only 25 (11.3%) had previously seen the video. Over half knew that breastfeeding (n = 138, 62.4%) and SSC (n = 173, 78.3%) reduced pain, and 89 (40.3%) knew that sucrose reduced pain, but these strategies were infrequently used. Most intended to use the strategies in the future. Discussion A knowledge-to-action gap for newborn pain management was identified. Future research is needed to improve the implementation of effective pain treatment for newborns.
- Published
- 2021
35. Autoimmune conditions in the World Trade Center general responder cohort: A nested case‐control and standardized incidence ratio analysis
- Author
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Robert Hirten, Margaret Smirnoff, Richard S. Haber, Iris Udasin, Michael L. Cooney, Michael Crane, Benjamin L Cohen, Christopher J Hahn, Andrew C. Todd, Denise Harrison, Cynthia S. Crowson, Henry S. Sacks, David M. Simpson, Deborah Carson, Moshe Shapiro, Benjamin J. Luft, Nancy L Sloan, Jacqueline Moline, Ioannis Tassiulas, Christopher R. Dasaro, Terry F. Davies, and Susan L. Teitelbaum
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Incidence ,Incidence (epidemiology) ,Emergency Responders ,Public Health, Environmental and Occupational Health ,Environmental exposure ,Odds ratio ,Article ,Confidence interval ,Autoimmune Diseases ,Rochester Epidemiology Project ,Standardized mortality ratio ,Case-Control Studies ,Occupational Exposure ,Internal medicine ,Cohort ,Nested case-control study ,Humans ,Medicine ,Female ,New York City ,September 11 Terrorist Attacks ,business - Abstract
Background The World Trade Center (WTC) general responder cohort (GRC) was exposed to environmental toxins possibly associated with increased risk of developing autoimmune conditions. Objectives Two study designs were used to assess incidence and risks of autoimmune conditions in the GRC. Methods Three clinically trained professionals established the status of possible GRC cases of autoimmune disorders adhering to diagnostic criteria, supplemented, as needed, by specialists' review of consenting responders' medical records. Nested case-control analyses using conditional logistic regression estimated the risk associated with high WTC exposure (being in the 9/11/2001 dust cloud or ≥median days' response worked) compared with low WTC exposure (all other GRC members'). Four controls were matched to each case on age at case diagnosis (±2 years), sex, race/ethnicity, and year of program enrollment. Sex-specific and sensitivity analyses were performed. GRC age- and sex-adjusted standardized incidence ratios (SIRs) were compared with the Rochester Epidemiology Project (REP). Complete REP inpatient and outpatient medical records were reviewed by specialists. Conditions meeting standardized criteria on ≥2 visits were classified as REP confirmed cases. Results Six hundred and twenty-eight responders were diagnosed with autoimmune conditions between 2002 and 2017. In the nested case-control analyses, high WTC exposure was not associated with autoimmune domains and conditions (rheumatologic domain odds ratio [OR] = 1.03, 95% confidence interval [CI] = 0.77, 1.37; rheumatoid arthritis OR = 1.12, 95% CI = 0.70, 1.77). GRC members had lower SIR than REP. Women's risks were generally greater than men's. Conclusions The study found no statistically significant increased risk of autoimmune conditions with WTC exposures.
- Published
- 2021
36. A Quality Improvement Project on Pain Management at a Tertiary Pediatric Hospital
- Author
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Zarina Geddes, Deborah Mervitz, Nora Ullyot, Mary MacNeil, Jodi Wilding, Hailey Scott, Carolina Lavin Venegas, Victoria Suwalska, Deborah Long, Denise Harrison, Jessica Reszel, Gail Macartney, Brenda Martelli, and Carol Theoret-Douglas
- Subjects
medicine.medical_specialty ,Quality management ,business.industry ,media_common.quotation_subject ,Chronic pain ,Pain ,Audit ,Pain management ,Hospitals, Pediatric ,medicine.disease ,Quality Improvement ,Pain assessment ,Pediatric hospital ,medicine ,Physical therapy ,Humans ,Pain Management ,Quality (business) ,Child ,business ,General Nursing ,Pain Measurement ,media_common - Abstract
To assess and improve pain management practices for hospitalized children in an urban tertiary pediatric teaching hospital. Methods Health Quality Ontario Quality Improvement (QI) framework informed this study. A pre (T1) – post (T2) intervention assessment included chart reviews and children/caregiver surveys to ascertain pain management practices. Information on self-reported pain intensity, painful procedures, pain treatment and satisfaction were obtained from children/caregivers. Documented pain assessment, pain scores, and pharmacological/non-pharmacological pain treatments were collected by chart review. T1 data was fed back to pediatric units to inform their decisions and pain management targets. Results At T1, 51 (58% of eligible participants) children/caregivers participated. At T2, 86 (97%) chart reviews and 51 (54%) children/caregivers surveys were completed. Most children/caregivers at T1 (78%) and T2 (80%) reported moderate to severe pain during their hospitalization. A mean of 2.6 painful procedures were documented in the previous 24 h, with the most common being needle-related procedures at both T1 and T2. Pain management strategies were infrequently used during needle-related procedures at both time points. Conclusion No improvements in pain management as measured by the T1 and T2 data occurred. Findings informed further pain management initiatives in the participating hospital.
- Published
- 2021
37. Validating the Implementation Leadership Scale in Chinese nursing context: A cross‐sectional study
- Author
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Mary-Ann Harrison, Jiale Hu, Qingge Li, Mark G. Ehrhart, Denise Harrison, Hong Ruan, Nick Barrowman, Gregory A. Aarons, and Wendy Gifford
- Subjects
leadership ,psychometrics ,China ,Data collection ,Psychometrics ,Leadership Scale ,evidence‐based practice ,RT1-120 ,Reproducibility of Results ,Context (language use) ,health services research ,Cross-Sectional Studies ,Convergent validity ,Nursing ,Strategic leadership ,nursing ,Scale (social sciences) ,Surveys and Questionnaires ,Content validity ,Humans ,Psychology ,General Nursing ,Research Articles ,Research Article - Abstract
Author(s): Hu, Jiale; Gifford, Wendy; Ruan, Hong; Harrison, Denise; Li, Qingge; Ehrhart, Mark G; Harrison, Mary-Ann; Barrowman, Nick; Aarons, Gregory A | Abstract: AimThis study aimed to evaluate the validity, reliability and acceptability of the Implementation Leadership Scale in the Chinese nursing context.DesignThis study utilized a cross-sectional design.MethodsThis study was conducted in one general tertiary hospital with 234 nurses (85.3% response rate) from 35 clinical units in China. Content validity, structural validity, convergent validity, reliability (internal consistency), agreement indices and acceptability were evaluated. The data collection was from December 1st, 2017 to June 30th, 2018.ResultsConfirmatory factor analysis demonstrated a good model fit to the four-factor implementation leadership model. The psychometric testing also indicated good convergent validity, high internal consistency and acceptable aggregation. Most participants completed the scale in two minutes or less and agreed or strongly agreed that the questions were relevant to implementation leadership, clear and easy to answer.ConclusionsThis study demonstrated that the Chinese Implementation Leadership Scale is a valid, reliable and pragmatic tool for measuring strategic leadership for implementing evidence-based practices.
- Published
- 2021
38. Pain management for infants – Myths, misconceptions, barriers; knowledge and knowledge gaps
- Author
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Denise Harrison
- Subjects
medicine.medical_specialty ,business.industry ,Breastfeeding ,Mythology ,Pain management ,Pediatrics ,Infant newborn ,03 medical and health sciences ,0302 clinical medicine ,Systematic review ,Harm ,030225 pediatrics ,Family medicine ,Medicine ,Neonatal nursing ,Effective treatment ,030212 general & internal medicine ,business - Abstract
Twelve years ago, the paper ‘Oral sucrose for pain management in infants: Myths and misconceptions’ was published in the Journal of Neonatal Nursing. At this time, eight myths or misconceptions were addressed. Since this time there has been more than 100 studies published reporting on analgesic effects of sweet solutions in newborns, which have been synthesised and included in systematic reviews. There has also been a growth of literature to support analgesic effects of breastfeeding and skin-to-skin care as well as concerning evidence of adverse long-term neurobehavioural outcomes associated with painful procedures. Yet, ongoing studies of pain management practices continue to report inconsistent use of these strategies during painful procedures. We are therefore at a cross-roads of evidence – there is knowledge of effective treatments, knowledge of harm of untreated pain, yet sick, premature as well as healthy infants are continuing to be exposed to painful procedures with no effective treatment. There are however ongoing myths, misconceptions, and practical barriers to using the evidence as well as ongoing knowledge gaps. This paper will therefore highlight existing myths, misconceptions, barriers and current knowledge gaps to using the three key evidence-based pain management strategies of breastfeeding, skin-to-skin care and sweet solutions, in the hope that this will bring to light newborn infant pain treatment practices that can be improved.
- Published
- 2021
39. A Cross-Sectional Review of Pain Management Interventions Used for Painful Pediatric Blood Draw Procedures in Hospital
- Author
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Jennifer Revell, Susan Vasily, Denise Harrison, and Chantal Backman
- Subjects
medicine.medical_specialty ,Adolescent ,Best practice ,Psychological intervention ,Pain ,Pain, Procedural ,Topical anesthetic ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,medicine ,Humans ,Pain Management ,Blood test ,030212 general & internal medicine ,Child ,Advanced and Specialized Nursing ,030504 nursing ,Descriptive statistics ,medicine.diagnostic_test ,business.industry ,Chronic pain ,medicine.disease ,Hospitals ,Cross-Sectional Studies ,Clinical research ,Physical therapy ,0305 other medical science ,business - Abstract
Background Hospitalized children continue to experience procedural pain due to inconsistent implementation of readily available, evidence-based pain interventions. Aims To explore the prevalence of painful blood-testing procedures, pain management interventions, child-caregiver perceptions of effectiveness of, and satisfaction with, pain interventions, and adherence to best practice guidelines. Design A single-site cross-sectional study using a combination of child-caregiver interviews and chart reviews for hospitalized children, 0-18 years. Methods Interviews gathered information about the child's most recent blood test, procedural pain management intervention use, and participant perceptions of effectiveness of and satisfaction with these interventions. Concurrently, patient charts were reviewed for procedure documentation and pain management strategies used, including topical anesthetic and oral sucrose orders. Data were analyzed using descriptive statistics. Results Fifty children were included. At the time of data collection, 34 (68%) had experienced painful blood-testing procedures during their current admission. Pharmacologic pain interventions were documented for only 7 (21%) procedures and were often inconsistent with participant reports. Almost all interview respondents (n = 31, 91%) identified at least one pain intervention for the child's most recent painful blood-test. Twenty (59%) participants perceived pain interventions as effective and most were satisfied with utilized interventions (n = 27, 79%). Conclusions A multi-modal procedural pain management approach was infrequently used and documented, highlighting undertreatment based on recommended practices and guidelines. Perceived intervention effectiveness and satisfaction with pain management were however found to be relatively high.
- Published
- 2021
40. The validity of skin conductance for assessing acute pain in mechanically ventilated infants: A cross‐sectional observational study
- Author
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JoAnn Harrold, Shokoufeh Modanloo, Jiale Hu, Janet E. Squires, and Denise Harrison
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Population ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Pain assessment ,Anesthesiology ,Intensive care ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,education ,Pain Measurement ,Mechanical ventilation ,education.field_of_study ,business.industry ,Infant, Newborn ,Infant ,Acute Pain ,Respiration, Artificial ,Cross-Sectional Studies ,Anesthesiology and Pain Medicine ,Anesthesia ,Observational study ,business ,Skin conductance ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Assessing pain in mechanically ventilated infants is challenging. The assessment of skin conductance (SC) is based on the sympathetic nervous system response to stress. This study purpose was to evaluate the validity of SC for assessing pain in mechanically ventilated infants. METHODS: A prospective cross-sectional observational design was used to study SC and its relation to: the category of procedure (i.e., painful or non-painful); the phase of procedure (i.e., before, during and after), and referent pain measurements (i.e., Premature Infant Pain Profile-Revised (PIPP-R) and Neonatal Facial Coding System (NFCS)). Eligible infants were those up to 12 months of age, in intensive care units, who were mechanically ventilated, and required painful and non-painful procedures. RESULTS: From October 2017 to November 2018, 130 eligible infants were identified, and 55 infants were studied. SC (number of waves per second) during painful procedures (median 0.27, interquartile range 0.2-0.4) was statistically significantly higher than those during non-painful procedures (0, 0-0.09). SC during painful procedures was statistically significantly higher than those before (0, 0-0.07) and after painful procedures (0, 0-0.07). SC showed moderate statistically significant positive correlations with PIPP-R (Spearman's rho = 0.4-0.62) and the four-item NFCS (Spearman's rho = 0.31-0.67) before, during and after painful or non-painful procedures respectively. SC had excellent performance (area under the receiver operator curve = 0.979) with excellent sensitivity (92.31%), specificity (95.42%) and negative predictive value (99.21%) but only sufficient positive predictive value (66.67%) when used to discriminate moderate-to-severe pain. CONCLUSIONS: SC showed good validity for assessing pain in critically ill infants requiring mechanical ventilation. SIGNIFICANCE OF THE STUDY: Pain assessment in mechanically ventilated infants is challenging. In this study, the validity of skin conductance (SC) for pain assessment is evaluated in the same population of infants during painful and nonpainful procedures. SC showed good validity for assessing acute pain in relation to category of procedure, phase of procedure, and referent pain measurements. SC is a promising method, especially with other pain assessment methods and other determinants of pain, in a multimodal pain assessment approach to understand the complexity of pain in mechanically ventilated infants.
- Published
- 2021
41. The effectiveness of high-fidelity simulation on undergraduate nursing students' clinical reasoning-related skills: A systematic review
- Author
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Fadiyah D. Alshehri, Sophie Jones, and Denise Harrison
- Subjects
General Nursing ,Education - Abstract
High-fidelity simulation is used widely in the education of healthcare professionals; however, its effectiveness in teaching undergraduate nursing students clinical reasoning skills is not known. The objective of this systematic review is to synthesise findings from current literature about the effectiveness of high-fidelity simulation on the development of clinical reasoning-related skills in undergraduate nurses.A systematic review of the effectiveness of high-fidelity simulation was conducted, guided by the Joanna Briggs Institute methodology. Studies included were experimental and quasi-experimental study designs published in English between 2014 and 2020 that investigated clinical reasoning-related skills for undergraduate nursing students. Databases searched included Medline, CINAHL, Embase and the Joanna Briggs Institute of Evidence-based Practice database.A total of 1980 studies were identified and 15 studies met the inclusion criteria. Seven studies were randomised controlled trials, and eight studies were quasi-experimental. The 15 included studies reported 19 outcomes, as studies examined one or more outcomes of clinical reasoning-related skills. Statistically significant results favouring the simulation groups were reported in the following outcomes: clinical reasoning skills (three studies of three studies), critical thinking skills (four out of eight studies), problem-solving (two of four studies), decision-making skills (one of two studies), and clinical judgment skills (two of two studies).High-fidelity simulation was reported to be effective alone and in combination with traditional teaching or other simulation types in improving undergraduate nursing students' clinical reasoning-related skills acquisition. Limitations included cost and availability of high-fidelity simulation to large numbers of students, which have implications for practice. Further research is needed to determine the actual effect of high-fidelity simulation compared to other simulation types on undergraduate nursing students' clinical reasoning-related skills.
- Published
- 2022
42. Comparison of the Psychometric Properties of the FLACC Scale, the MBPS and the Observer Applied Visual Analogue Scale Used to Assess Procedural Pain
- Author
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Nick Santamaria, Dianne Crellin, Denise Harrison, and Franz E Babl
- Subjects
Pain score ,medicine.medical_specialty ,validity ,reliability ,Visual analogue scale ,business.industry ,infants ,Chronic pain ,Pain scale ,Emergency department ,medicine.disease ,pain measurement ,Procedural Pain ,03 medical and health sciences ,Distress ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,030202 anesthesiology ,FLACC scale ,medicine ,Physical therapy ,Journal of Pain Research ,business ,030217 neurology & neurosurgery ,Original Research - Abstract
Dianne Crellin,1– 3 Denise Harrison,1,2,4 Nick Santamaria,1 Franz E Babl2,3,5 1Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia; 2Murdoch Children’s Research Institute, Melbourne, VIC, Australia; 3Royal Children’s Hospital, Melbourne, VIC, Australia; 4Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, ON, Canada; 5Department of Paediatrics, The University of Melbourne, Melbourne, VIC, AustraliaCorrespondence: Dianne Crellinc/o Emergency Department, Royal Children’s Hospital, Flemington Road Parkville, Melbourne, VIC, 3052, AustraliaTel +61 39345 5331Fax +61 9345 5983Email dianne.crellin@rch.org.auPurpose: The purpose of this study was to compare the psychometric data and feasibility and clinical utility of the Face Legs, Activity, Cry and Consolability scale (FLACC), the Modified Behavioral Pain Scale (MBPS) and the Visual Analogue Scale for observers (VASobs) used to assess procedural pain in infants and young children.Patients and Methods: Twenty-six clinicians assessed videorecorded segments of 100 infants and young children who underwent a painful and/or distressing procedure in the emergency department using the FLACC scale, the MBPS and the VASobs pain and VASobs distress.Results: VASobs pain scores were lowest across all procedures and phases of procedures (p < 0.001). Inter-rater reliability was lowest for VASobs pain scores (ICC 0.55). Sensitivity and specificity were highest for FLACC scores (94.9% and 72.5%, respectively) at the lowest cut-off score (pain score two). Observers changed their MBPS scores more often than they changed FLACC or VASobs scores, but FLACC scores were more often incomplete. Reviewers did not consider any scale of use for procedural pain measurement.Conclusion: The reliability and sensitivity of the FLACC and MBPS were supported by study data but concerns about the capacity of these scales to distinguish between pain- and non-pain-related distress were raised. The VASobs cannot be recommended. Despite its limitations, the FLACC scale may be better suited than other scales for procedural pain measurement.Keywords: pain measurement, infants, validity, reliability
- Published
- 2021
43. What About Parental Involvement in Infants' Pain Management? A Commentary on Erkut, Mutlu, and Çakıcı (2021)
- Author
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Ligyana K. Candido, Paula Forgeron, and Denise Harrison
- Subjects
Parents ,Maternity and Midwifery ,Humans ,Infant ,Pain Management ,Parent-Child Relations ,Critical Care Nursing ,Pediatrics - Published
- 2022
44. Moving on: A survey of Canadian nurses' self-reported transition practices for young people with chronic pain
- Author
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Andrea Higginson, Bruce D. Dick, Paula Forgeron, and Denise Harrison
- Subjects
young adults ,medicine.medical_specialty ,pediatrics ,Care setting ,03 medical and health sciences ,0302 clinical medicine ,Pediatric Nurses ,Health care ,Medicine ,030212 general & internal medicine ,adolescents ,Young adult ,Adult health ,business.industry ,digestive, oral, and skin physiology ,Chronic pain ,transition ,Original Articles ,medicine.disease ,Anesthesiology and Pain Medicine ,Family medicine ,business ,chronic pain ,030217 neurology & neurosurgery ,Young person ,Research Article - Abstract
Background Practices to support the transition of a young person from the pediatric to the adult health care setting have been examined for many chronic illness populations. However, specific transition practices to support young people with chronic pain have not been examined. Aim The aim of this study was to describe the current nursing practices used in the pediatric and the adult health care to support transition of young people with chronic pain in Canada. Methods An online survey of pediatric and adult chronic pain nurses’ self-reported transition practices was conducted. Results Twenty-two nurses completed the survey, 10 (45.5%) from the pediatric chronic pain setting and 12 (54.4%) from the adult chronic pain setting. Of the pediatric nurses surveyed none reported using a psychometrically valid tool to assess a young person’s readiness of general transition skills; however, one reported using a tool to assess understanding of chronic pain. Most health care facilities in which these pediatric nurses worked offered a general transition clinic, but only one of these facilities also had a chronic pain transition clinic. Nurses in both settings perceived that young people experience increased levels of distress during transition yet most did not report using formal transition practices in their care. Conclusion Nursing practices and clinic resources to support the transition of young people with chronic pain may not meet the needs of this population. Practices may benefit from the use of psychometrically validated tools to assess general transition preparedness. Research is needed to adapt tools and determine best transition practices for the chronic pain population.
- Published
- 2022
45. Identifying research priorities with children, youth, and families: A scoping review
- Author
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Shokoufeh Modanloo, Quinn Correll, Rhonda Correll, Nathalie Major, Michelle Quinlan, Jessica Reszel, Jodi Wilding, Zhi Lin Zhou, Linda S Franck, and Denise Harrison
- Subjects
Pediatrics, Perinatology and Child Health ,Pediatrics - Abstract
Increased patient advocacy has resulted in a shift toward more active patient engagement in the research. A scoping review was conducted to explore the literature on healthcare research priority settings wherein children, youths, or their families were involved in the priority-setting process. Six databases including MEDLINE, CINAHL, PsycINFO, Embase, Web of Science, and Global Health and the James Lind Alliance website were searched up until September 2019. All primary studies involving children (
- Published
- 2023
46. Commentary: Does Twitter have a role in Family Planning in Low-and-Middle-Income Countries (LMICs)?
- Author
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Kristina Brown, Saumya RamaRao, Denise Harrison, Dinesh Vijeyakumar, Stanley John Mierzwa, and James McKinnon
- Subjects
medicine.medical_specialty ,business.industry ,Public health ,Developing country ,Public relations ,Body of knowledge ,Family planning ,Global health ,medicine ,General Earth and Planetary Sciences ,The Internet ,Social media ,business ,General Environmental Science ,Reproductive health - Abstract
Stakeholders are coming together to develop a vision for increasing access to family planning (FP) by 2030. Of the 923 million women in the developing world who wish to avoid a pregnancy, 218 million women are not using a modern contraceptive (Guttmacher Institute, 2020). In 2016, over 3.4 billion people were using the internet (https://ourworldindata.org/internet 2016). Moreover, internet users in the developing world use social media more frequently than Internet users in the U.S. and Europe. Of the many proposed actions to accelerate progress in family planning, the use of Twitter should be a key component. In this commentary, we describe the use of Twitter in a select group of low-and-middle-income countries that have made commitments to the family planning 2020 initiative (FP2020 countries, and have the potential to leverage Twitter with current and potential family planning users. We examine Twitter feeds in eight key FP2020 countries, and we look at the content of Tweets issued by the ministries of health in most of these same countries. Our view is that it is feasible and easy to access Twitter feeds in low and middle income countries. We base our view on the types of reproductive health and family planning terms discussed in a public forum such as Twitter by current and potential users and their partners and ministries of health. We highlight two broad considerations that merit discussion among interested stakeholders, including policy makers, program designers, and health advocates. The first relates to the use of Twitter within family planning programs, and the second relates to themes that require more significant research. Data coupled with analytical capacity will help policy makers and program designers to effectively leverage Twitter for expanding the reach of family planning services and influencing social media policy. Our aim is to not only to contribute to the body of knowledge but also to spur greater engagement by program personnel, researchers, health advocates and contraceptive users.
- Published
- 2021
47. Commentary: Does Twitter have a role in improving Family Planning messages and services in Low-and-Middle-Income Countries (LMICs)?
- Author
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Denise, Harrison, Saumya, RamaRao, Dinesh, Vijeyakumar, James, McKinnon, Kristina, Brown, and Stanley, Mierzwa
- Subjects
Research Article - Abstract
Stakeholders are coming together to develop a vision for increasing access to family planning (FP) by 2030. Of the 923 million women in the developing world who wish to avoid a pregnancy, 218 million women are not using a modern contraceptive (Guttmacher Institute, 2020). In 2016, over 3.4 billion people were using the internet (https://ourworldindata.org/internet 2016). Moreover, internet users in the developing world use social media more frequently than Internet users in the U.S. and Europe. Of the many proposed actions to accelerate progress in family planning, the use of Twitter should be a key component. In this commentary, we describe the use of Twitter in a select group of low-and-middle-income countries that have made commitments to the family planning 2020 initiative (FP2020 countries and have the potential to leverage Twitter with current and potential family planning users. We examine Twitter feeds in eight key FP2020 countries, and we look at the content of Tweets issued by the ministries of health in most of these same countries. Our view is that it is feasible and easy to access Twitter feeds in low-and -middle income countries. We base our view on the types of reproductive health and family planning terms discussed in a public forum such as Twitter by current and potential users and their partners and ministries of health. We highlight two broad considerations that merit discussion among interested stakeholders, including policy makers, program designers, and health advocates. The first relates to the use of Twitter within family planning programs, and the second relates to themes that require more significant research. Data coupled with analytical capacity will help policy makers and program designers to effectively leverage Twitter for expanding the reach of family planning services and influencing social media policy. Our aim is to not only to contribute to the body of knowledge but also to spur greater engagement by program personnel, researchers, health advocates and contraceptive users.
- Published
- 2021
48. Sucrose and sweet taste
- Author
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Mariana Bueno, Denise Harrison, and Janet Yamada
- Subjects
chemistry.chemical_compound ,Sucrose ,chemistry ,Sweet taste ,Food science - Abstract
Abundant published evidence demonstrates the pain-reducing effects of sweet solutions in human infants and animals. Analgesic effects persist up to around 1 year of age in human infants, though there is less research to support analgesic effects in older infants and, for the existing research, effects are more moderate than seen in the neonatal period. Though the exact mechanisms are unclear, analgesic effects are believed to be due to the relationship between sweet taste and the endogenous opiate system. Based on the extensive evidence to support sweet solutions, their use can be recommended prior to commonly performed short-lasting minor painful procedures in newborn and young infants. Despite extensive research, knowledge gaps and controversies remain relating to the mechanisms of analgesia; the effectiveness and safety of sweet solutions when given over prolonged periods to preterm and sick infants; the effectiveness in sick infants receiving concomitant analgesics; and the effectiveness in children older than 12 months of age.
- Published
- 2021
49. Pain management interventions in the Paediatric Intensive Care Unit: A scoping review
- Author
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Ahmad Fauzi Ismail, Viola Polomeno, William Dagg, Denise Harrison, Huda Gharaibeh, and Paula Forgeron
- Subjects
medicine.medical_specialty ,030504 nursing ,business.industry ,Sedation ,Psychological intervention ,MEDLINE ,Pain ,030208 emergency & critical care medicine ,CINAHL ,Pain management ,Intensive Care Units, Pediatric ,Critical Care Nursing ,Clinical trial ,03 medical and health sciences ,Paediatric intensive care unit ,0302 clinical medicine ,medicine ,Physical therapy ,Humans ,Pain Management ,medicine.symptom ,0305 other medical science ,business ,Adverse effect - Abstract
Objective To map research based pain management interventions used in the paediatric intensive care unit. Methodology A scoping review of research literature has been conducted. Five databases were searched from their inception to end 2015 (CINAHL, EMBASE, MEDLINE, PsychINFO, and ProQuest Dissertations & Theses Global). Reference lists from the screened full text articles were reviewed. Results 7046 articles were identified, 100 underwent full text screening and 27 were included in the scoping review. Seventeen (63%) were non-experimental, and 10 (37%) were experimental, of which 8 (30%) were randomised controlled trials. The majority of the articles focused on pharmacological interventions (n = 21, 78%), one on physical, and one on psychological interventions. Four studies included more than one category of interventions. The majority of the studies focused on post-operative pain management (n = 18, 67%), three (11%) on analgesia and sedation management and six (22%) on other pain management for different conditions. Discussion Most studies included in this scoping review focused on medications and post-operative pain management and most were non clinical trials. More research, including clinical trials, is warranted to determine the effectiveness of pharmacological and non-pharmacological interventions for pain management in the paediatric intensive care unit.
- Published
- 2019
50. Risk factors for head and neck cancer in the World Trade Center Health Program General Responder Cohort: results from a nested case–control study
- Author
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Marian R. Passannante, Taylor M Black, Pamela Ohman Strickland, Christopher R. Dasaro, Andrew C. Todd, Kathleen Black, Jacqueline Moline, Anna R Giuliano, Benjamin J. Luft, Michelle T. Bover Manderski, Denise Harrison, Michael B. Steinberg, Iris Udasin, Michael Crane, Roberto Lucchini, and Judith M. Graber
- Subjects
Adult ,Male ,Alcohol Drinking ,Sexual Behavior ,medicine.medical_treatment ,Population ,Ethnic group ,Cigarette Smoking ,Odds ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Occupational Exposure ,Humans ,Medicine ,030212 general & internal medicine ,Risk factor ,education ,education.field_of_study ,business.industry ,Incidence ,Head and neck cancer ,Emergency Responders ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,Head and Neck Neoplasms ,Case-Control Studies ,030220 oncology & carcinogenesis ,Nested case-control study ,Cohort ,Smoking cessation ,Female ,New York City ,September 11 Terrorist Attacks ,business ,Demography - Abstract
ObjectivesHead and neck cancers (HNCs) may be among the health consequences of involvement in the World Trade Center (WTC) response on and after 11 September 2001. We conducted a nested case–control study of WTC Health Program (WTCHP) general responders to examine the effects of WTC exposures and behavioural risk factors on HNC.MethodsWe enrolled 64 cases and 136 controls, matched on age, sex and race/ethnicity within risk sets. We assessed tobacco and alcohol use, sexual activity, and occupational exposures prior to, during and after WTC exposure until case diagnosis via questionnaire. We obtained WTC exposure information (duration (first to last day), total days and location of work) from the WTCHP General Responder Data Center. We assessed associations with HNC, and interaction among exposures, using conditional logistic regression.ResultsResponders in protective services versus other occupations had increased odds (OR: 2.51, 95% CI 1.09 to 5.82) of HNC. Among those in non-protective services occupations, arriving to the WTC effort on versus after 11 September 2001 was significantly associated with HNC (OR: 3.77, 95% CI 1.00 to 14.11). Duration of work was not significantly associated with HNC. Lifetime and post-WTC years of cigarette smoking and post-WTC number of sex partners were positively and significantly associated with HNC, while alcohol consumption was not.ConclusionsThese findings suggest opportunities for HNC risk factor mitigation (eg, smoking cessation, human papillomavirus vaccination) and contribute to a risk factor profile which may assist WTCHP clinicians with identifying high-risk responders and improve detection and treatment outcomes in this population.
- Published
- 2019
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