Lucia di Lammermoor

De cada obra s'ha digitalitzat un programa sencer. De la resta s'han digitalitzat les parts que són diferents.Direcció: Gianfranco Rivoli ; Direcció d'escena: Frans BoerlageEmpresa: Juan A. PamiasÒpera en quatre acte de Gaetano Donizetti, amb llitret de Salvatore Cammarano. Dirigida per Gianfranco Rivol

The Rotterdam Elderly Pain Observation Scale (REPOS) is reliable and valid for non-communicative end-of-life patients

__Background:__ In palliative care, administration of opioids is often indispensable for pain treatment. Pain assessment may help recognize pain and guide treatment in non-communicative patients. In the Netherlands the Rotterdam Elderly Pain Observation Scale (REPOS) is recommended to this aim, but not yet validated. Therefore the objective of this study was to validate the REPOS in non-communicative or unconscious end-of-life patients. __Methods:__ In this observational study, the primary researcher applied the REPOS, while both the researcher and a nurse applied the Numeric Rating Scale (NRS). If possible, the patient in question applied the NRS as well. The NRS scores were compared with the REPOS scores to determine concurrent validity. REPOS scores obtained before and after a pain-reducing intervention were analysed to establish the scale's sensitivity to change. __Results:__ A total of 183 REPOS observations in 100 patients were analysed. Almost 90% of patients had an advanced malignancy; observations were done a median of 3 days (IQR 1 to 13) before death. Internal consistency of the REPOS was 0.73. The Pearson product moment correlation coefficient ranged from 0.64 to 0.80 between REPOS and NRS scores. REPOS scores declined with median 2 points (IQR 1 to 4) after a pain-reducing intervention (p < 0.001). Optimal sensitivity (0.81) and specificity (0.62) were found at cut-off score 3. __Conclusions:__ This study demonstrates that the REPOS has promising psychometric properties for pain assessment in non-communicative end-of-life patients. Its application may be of additional value to relieve suffering, including pain, in palliative care

Madama Butterfly

De cada obra s'ha digitalitzat un programa sencer. De la resta s'han digitalitzat les parts que són diferents.Direcció: Franco Ferraris ; Direcció escènica: Frans BoerlageEmpresa: Juan A. PamiasÒpera de Giacomo Puccini amb llibret de Giuseppe Giacosa i Luigi Illic

Werther

Direcció: Jesus Etcheverry ; Direcció escènica: Frans BoerlageEmpresa: Juan A. PamiasDe cada obra s'ha digitalitzat un programa sencer. De la resta s'han digitalitzat les parts que són diferents

Orfeo

Direcció: Leo Driehuys ; Direcció d'escena: Frans BoerlageEmpresa: Juan A. PamiasDe cada obra s'ha digitalitzat un programa sencer. De la resta s'han digitalitzat les parts que són diferents

Werther

De cada obra s'ha digitalitzat un programa sencer. De la resta s'han digitalitzat les parts que són diferents.Direcció: Antonio de Almeida ; Direcció d'escena: Frans BoerlageEmpresa: Juan A. Pamia

Pain Management in Dutch Nursing Homes Leaves Much to Be Desired

This cross-sectional multicenter study describes several aspects of pain, pain intensity, and pain treatment in a Dutch nursing home population. A standardized pain questionnaire, including the Numeric Rating Scale (NRS), was used to measure aspects of pain and intensity of present pain, pain experienced in the previous week, and tolerable pain. The eligible sample comprised 320 residents (median age 79 years), of whom 233 residents completed the questionnaire. Sixty-six percent (n = 153) experienced (mostly chronic) pain, either in the previous week (median NRS 6) or at present (median NRS 5). Intolerable pain was recorded in 41% of 100 residents. The higher the pain scores, the more interference with activities of daily living was reported Of the 153 residents with pain, about one-fourth did not receive any pain medication, and 65 (43%) received step 1, 13 (9%) step 2, and 16 (11%) step 3 analgesics. Most residents (60%) were satisfied with pain treatment, and 21% were not. Considering the high prevalenees and intensities of pain, pain management in Dutch nursing homes leaves much to be desired. Apparently, residents do not seem to expect effective pain management. Awareness and knowledge about pain assessment and treatment however needs to,, be raised. Pain measurement tools and treatment protocols should be implemented in daily practice. (C) 2009 by the American Society for Pain Management Nursin