Cough is one of the most common symptoms prompting patients to be seen by health care providers in the United States. Persistent cough can disrupt daily activities such as conversation, eating, breathing, and sleeping, and it can become extremely debilitating both physically and mentally. Pharmacological treatments include dextramethorphan, opioid cough suppressants, benzonatate, inhaled ipratropium, and guaifenesin. Successful cough suppression has also been demonstrated in several studies with the use of nebulized lidocaine. Nebulized lidocaine also appears to be well tolerated by patients with minimal side effects including dysphonia, oropharyngeal numbness, and bitter taste. Studies conducted thus far have been small, so larger randomized control trials comparing nebulized lidocaine to placebo need to be conducted in the future.

Cough is one of the most common symptoms prompting patients to be seen by health care providers in the United States. Persistent cough can disrupt daily activities such as conversation, eating, breathing, and sleeping, and it can become extremely debilitating both physically and mentally. Pharmacological treatments include dextramethorphan, opioid cough suppressants, benzonatate, inhaled ipratropium, and guaifenesin. Successful cough suppression has also been demonstrated in several studies with the use of nebulized lidocaine. Nebulized lidocaine also appears to be well tolerated by patients with minimal side effects including dysphonia, oropharyngeal numbness, and bitter taste. Studies conducted thus far have been small, so larger randomized control trials comparing nebulized lidocaine to placebo need to be conducted in the future.

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Doctorat en sciences psychologiques / info:eu-repo/semantics/nonPublished

The study examines potential opportunities from reading fictional stories. It is focusing on different ways to use fiction as a tool when dealing with difficulties in life, such as death, bullying, injustice, racism, etc. Furthermore, the study investigates in what way the teachers consider how to process what has been read. The examination is based on qualitative interviews of six teachers, including three librarians, all with different workplaces. From the result it can be concluded that fiction is a versatile tool in many areas. Reading can be used as an aesthetic and relaxing activity, but has often a pedagogical design including an educational motive. A majority of the teachers use fiction to form pupils to good and respectful human beings. In addition, fiction is used to develop a positive approach to people’s differences and to multiculturalism. The results show that the single most important factor in reading is processing the read, and a majority of the teachers state that understanding is created when pupils discuss with others.

Suffering is a fundamental experience of the human condition. Whereas the arts and humanities have struggled to make sense of this condition, no concerted effort has taken place in nursing. Suffering is painfully absent within the cancer nursing research literature, a place where suffering should be conspicuous. The purpose of this study was to explore suffering inherent in the cancer experience. The concurrent use of Travelbee's Human-To-Human Relationship Model and narrative theory provided the conceptual underpinning for this prospective ethnography. Narratives of suffering were explored among seven patients diagnosed with cancer (breast, n = 4; brain; malignant melanoma; and ovarian cancer). Five women and two men were interviewed weekly (N = 89 interviews) for a period of up to five months. Participant observation supplemented the interview data. Seven richly textured narratives revealed the suffering endured in the living-of-cancer. The narratives also detailed the informant as person, the cancer trajectory, and explanatory models of cancer causation. A second level analysis of the narratives provided an intra-group comparison of suffering. "Cascade of losses" was the overarching theme. The undermining of personhood, and a loss of faith and trust in the medical system characterized this cascade of losses. Losses were further encountered: the dismissal of symptoms presented to physicians, the failure of treatment as cure, the death of other cancer patients, and the false reassurance that "cancer can be beaten". The remaining themes were "cancer as torture" and "the work of suffering--the beauty of cancer". The findings of this study suggest that nurses may not be capable of alleviating patient suffering. Patients' lives intersect at the suffering experience; their suffering is shaped by the past, present, and future. Nurses may influence these intersections of suffering to some extent, however, it is the individual who ultimately determines the living and outcome (if any) of their suffering. In the lives of the informants, it was the love of spouses and children, faith and trust in God, and satisfaction with life's accomplishments which permitted the endurance of suffering. Competent, comfort-care provided by compassionate nurses is needed by patients who suffer with cancer.

It is believed by many researchers that little attention has been given to patients' perceptions of the impact of chronic pain on their lives. In recognition of this need, G. Frank Lawlis, C. Edward McCoy, and David K. Selby developed the Dallas Pain Questionnaire (DPQ) to assess the amount of chronic pain that affects four aspects (daily activities, work-leisure activities, anxiety-depression, and social interest) of the patients' lives. The present study, conducted to validate the DPQ's statistical properties, first reviews the literature addressing the various theories and varieties of pain, its opiates, and the two current approaches to quantify pain. This study included a total of 143 subjects. Clinical subjects were 104 inpatients in the Spinal and Chronic Pain Center at Medical Arts Hospital and 15 chronic pain outpatients released to work. Normal subjects consisted of staffing personnel (n = 13) and flight assistance employees (U = 11)- Both clinical and normal groups completed the DPQ. The Minnesota Multiphasic Personality Inventory (MMPI) was administered only to the clinical population. Results suggest that the DPQ is both externally reliable (stability reliability coefficient of .970) as well as an internally consistent instrument. Two factors emerged from factor structure analysis. Factor one (63.2% of variance) represents functional activities. Factor two (8.3% of variance) represents emotional capacities. A correlation analysis suggests the concurrent validity of the psychological and functional factors of the DPQ. A t-test demonstrated that chronic pain patients have significantly higher DPQ's scores than normals. Because these findings support its psychometric properties, the DPQ appears to have utility for clinical and research purposes. The findings, limitations, and implications of this study are detailed, as are suggestions for future research.

The purpose of the present study was to investigate cognitive functioning in a group of 30 chronic pain patients (CPG) as compared to a group of 39 acute pain patients (APG). In order to assess cognitive performance, certain subtests were selected from the McCarron-Dial System (MDS) of Neuropsychological Evaluation. Specifically, a measure of haptic discrimination was used along with the Bender Visual Motor Gestalt Test. As such, completion of these subtests required a cortically mediated, central nervous system processing of sensory information. This particular method of assessment was chosen because it provided a nonverbal measure of higher-order cognitive performance. Additionally, the haptic measure provided separate scores for right and left hemispheric functioning. Data analysis revealed significantly poorer Bender performance among CPG members (t(69) = -5.09, E - •0004, two tailed). Further data analysis revealed that the CPG performed significantly poorer on certain of the haptic discrimination subtests. Specifically, both texture and configuration scores for the right hemisphere were significantly lower among CPG members (texture, p = -042 and configuration, p = .002). Subsequent analyses were conducted to determine predictive relationships between important variables. These data are discussed in terms of their clinical significance and importance for future research.

Identity serves two functions: it orders our environment, and it gives us a sense of certainty. The role played by identity in the intractability of conflict has recently sparked a new line of research. Drawing on insights from social psychological research, I argue that intractable conflict circumstances bolster social identities and create rigid group norms, which affect the vulnerability of peace movement organizations that operate in this context. I hypothesize that peace organizations that disregard prominent group beliefs regarding the conflict, are more likely to be severely criticized at the collective level. For the empirical analysis, I turn to the Israeli-Palestinian conflict, a typical case of on-going intractable conflict. I compare the results of a qualitative content analysis of expressions of in-group criticism towards local Israeli peace organisations in local media reporting, within the framework of group beliefs (2005-2018). The results indicate an overall trend of in-group criticism towards peace organisations in Israel, based on which suggestions for advances to the theory are made.

A infusão intratecal de fármacos analgésicos é método considerado útil no tratamento da dor decorrente do câncer. Entretanto, estudos sobre eficácia no tratamento prolongado da dor crônica não decorrente de câncer são escassos. Este trabalho objetivou analisar prospectivamente o resultado do tratamento de 80 doentes com dor crônica não decorrente de câncer com infusão intratecal de morfina. Os resultados foram avaliados quanto à intensidade, características e etiologias da dor, qualidade de vida e complicações dos procedimentos; 42 doentes eram do sexo masculino, a média das idades foi de 48,4 anos e a duração média da condição álgica foi de 53 meses. A dor decorreu de mielopatia em 26,3% dos doentes, de síndrome dolorosa miofascial em 6,3%, de síndrome dolorosa pós-laminectomia em 23,8%, de síndrome complexa de dor regional em 8,8%, de síndrome fibromiálgica em 13,8% e de neuralgia pós herpética em 5,0%. Apresentavam dor neuropática 49 (61,2%), nociceptiva 19 (23,8%) e mista 12 (15%) pacientes. Foram implantadas 62 bombas de acionamento digital para infusão em bolo e 18 bombas de infusão contínua (gás) ou programável. As médias das intensidades da dor reduziram-se de 9,5 para 4,6 segundo a escala visual analógica (EVA) ao final do acompanhamento que variou de 18 a 98 meses (média = 46,7 meses); houve melhora significativa da dor nos doentes com dor neuropática (p < 0,001), nociceptiva (p < 0,001) ou mista (p = 0,005). Apesar da melhora da qualidade de vida de acordo com SF-36 (30,8 para 49,6) e nas dimensões do Questionário \"Treatment of Pain Survey\" (TOPS), não houve alteração na capacidade objetiva para o trabalho. Não houve diferença significativa entre infusão contínua e em bolo quanto à melhora da dor (p = 0,597). O consumo de morfina estabilizou-se após o sexto mês de tratamento na maioria dos casos. Não houve diferença significativa quanto à melhora em relação à localização da extremidade do cateter subaracnóideo (p = 0,227). Ocorreu agravamento da dor de 4,9 para 8,9 (p < 0,001) durante o período de uso de medicação placebo. Alguns efeitos adversos ocorreram inicialmente e geralmente foram toleráveis. Conclui-se que a infusão intratecal de opióides é método adequado e seguro para o tratamento da dor crônica rebelde não decorrente do câncer. / Implantable pumps for intrathecal delivery of opiates are efficient for treatment of cancer pain. However, studies of nonmalignant pain with long term follow-up are few. The present study use prospective analysis of the result of the long term treatment of 80 patients presenting nonmalignant pain with intrathecal infusion of morphine. The nature and etiology of the pain, quantitative and qualitative expressions of pain and the quality of the life before and at the end of the treatment and complications of procedures were evaluated; were male 42 (52%) patients, the average of the ages was 48.4 years and the mean duration of previous pain, 53 months. Pain was due to mielopathy in 26.3% of the cases, myofascial pain syndrome in 6.3%, failed back pain in 23.8%, complex regional pain syndrome in 8.8%, fibromyalgia in 13.8% and post-herpetic neuralgia in 5.0%. Presented as neuropathic pain 49 (61.2%) patients, as nociceptive pain 19 (23.8%) patients and as mixed pain 12 (15%) patients. In 62 patients pumps for self-administration bolus of morphine was implanted and in 18 constant-flow(gas) or programable pumps. The mean intensity of pain according the visual analogical scale (VAS) reduced from 9.5 to 4.6 at the end of 46.7 months (18 to 98 months) mean follow-up; there was significant improvement of the results in neuropathic(p < 0.001), nociceptive(p < 0.001) and mixed pain(p = 0.005). There was improvement of the quality of life measured by SF-36(30.8 to 49.6) and in all dimensions of the Questionnaire \"Treatment of Pain Survey\" (TOPS), except in working capacity. There was no significant difference of the results for patients treated with bolus or constant flow pumps (p = 0.597). The daily dose of morphine became constant after six month of treatment in the majority of the cases. The position of the tip of the cateter did not influenced improvement in pain intensity (p = 0.277). Patients treated with placebo had increasing of pain intensity from 4.9 to 8.9 according the VAS (p < 0,001). Side effects were more frequent at the beginning of the treatment and few were intolerable. Concluded that intrathecal infusion of morphine is a suitable and safe method for treatment of chronic nonmalignant pain.