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Observational Scale (observational + scale)

Distribution by Scientific Domains

Medical Sciences	60%

Selected Abstracts

Pneumonia: The Demented Patient's Best Friend?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2002
Discomfort After Starting or Withholding Antibiotic Treatment
OBJECTIVES: To assess suffering in demented nursing home patients with pneumonia treated with antibiotics or without antibiotics. This study should provide the first empirical data on whether pneumonia is a "friend" or an "enemy" of demented patients and promote a debate on appropriate palliative care. DESIGN: Prospective cohort study. SETTING: Psychogeriatric wards of 61 nursing homes in the Netherlands. PARTICIPANTS: Six hundred sixty-two demented patients with pneumonia treated with (77%) or without (23%) antibiotics. MEASUREMENTS: Using an observational scale (Discomfort Scale,Dementia of Alzheimer Type), discomfort was assessed at the time of the pneumonia treatment decision and periodically thereafter for 3 months or until death. (Thirty-nine percent of patients treated with antibiotics and 93% of patients treated without antibiotics died within 3 months.) Physicians also offered a retrospective judgment of discomfort 2 weeks before the treatment decision. In addition, pneumonia symptoms were assessed at baseline and on follow-up. Linear regression was performed with discomfort shortly before death as an outcome. RESULTS: A peak in discomfort was observed at baseline. Compared with surviving patients treated with antibiotics, the level of discomfort was generally higher in patients in whom antibiotic treatment was withheld and in nonsurvivors. However, these same patients had more discomfort before the pneumonia. Breathing problems were most prominent. Shortly before death from pneumonia, discomfort increased. Discomfort was higher shortly before death when pneumonia was the final cause of death than with death from other causes. CONCLUSION: Irrespective of antibiotic treatment, pneumonia causes substantial suffering in demented patients. Adequate symptomatic treatment deserves priority attention. [source]

The wolves of Isle Royale display scale-invariant satiation and ratio-dependent predation on moose

JOURNAL OF ANIMAL ECOLOGY, Issue 5 2005
CHRISTIAN JOST
Summary 1The importance of two features of the predator functional response (satiation and predator dependence) is investigated in the wolf,moose interaction on Isle Royale National Park (Michigan, USA). This is done by fitting and comparing nine different functional response models to the observed kill rates. 2Three different observational scales (the whole island, the wolf packs, or a ,mixed' scale) are used to assess the sensitivity of the detected properties with respect to these spatial scales. 3Independently of the observational scale and of statistical assumptions on data structure, strong predator dependence and satiation of the wolf functional response are found. The ,mixed' scale gives the most consistent results, suggesting that predation should be measured for each pack, but that packs share all moose on the island. On this scale, the functional response is clearly ratio-dependent. [source]

Reducing distress for children during invasive procedures: randomized clinical trial of effectiveness of the PediSedate®

PEDIATRIC ANESTHESIA, Issue 8 2009
STEPHEN C. BROWN Md Frcp(C)
Summary Background:, Procedural pain control remains problematic for young children, especially during anxiety-causing procedures for which children should not be deeply sedated. The PediSedate® was designed to address this problem by delivering nitrous oxide in oxygen through a simple nosepiece, combined with an interactive video component, so that children can use attention and distraction with drug delivery. Objectives:, We conducted a randomized clinical trial to evaluate the effectiveness of the PediSedate® for reducing children's behavioral distress in comparison with standard care in the emergency department. Secondary objectives were to assess children's acceptance, cooperation, and pain. Methods:, Thirty-six children, aged 3,9 years old, who required invasive procedures associated with high levels of anxiety and low levels of pain such as sutures, IVs, and lumbar punctures were randomized to receive either the standard care or the PediSedate®. The primary outcome was children's distress (observational scale of behavioral distress) that was monitored before and during the procedure. Results:, Children randomized to the PediSedate® group had significantly less distress during invasive procedures (mean = 1.8, sd = 3.2) than children receiving standard care (mean = 9.3, sd = 5.6; anova, P < 0.0001). Also, children in the PediSedate® group were more cooperative [,2(1) = 22.05, P < 0.0001] and fewer children reported pain [,2(1) = 14.45, P < 0.001]. Conclusions:, Previous studies have demonstrated the effectiveness of nitrous oxide sedation alone for minimizing pain and distress during invasive procedures. We have found that delivering nitrous oxide sedation via a system combined with an interactive video component is also effective. Further studies should determine which factors are dominant and determine the specific failure rate for this delivery system in comparison with other systems. [source]

Assessment of pain by parents in young children following surgery

PEDIATRIC ANESTHESIA, Issue 4 2001
Joanna Morgan BMed Sci
Background:,We asked parents to assess pain in young children following surgery. Methods:,Assessments were carried out by both parents and an independent assessor using a behavioural observational scale. Results:,Forms were returned from the parents of 42 children aged 1,5 years. There were 123 joint assessments and there was a strong correlation between the scores by the observer and the parents (r2=0.84). Twenty-nine children experienced pain following discharge from hospital. Conclusions:,Our findings suggest that parents can assess pain in young children following surgery. The management of pain following discharge from hospital can be improved. [source]