Core competencies for pain management: results of an interprofessional consensus summit.

ObjectiveThe objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported.MethodsAn interprofessional executive committee led a consensus-building process to develop the core competencies. An in-depth literature review was conducted followed by engagement of an interprofessional Competency Advisory Committee to critique competencies through an iterative process. A 2-day summit was held so that consensus could be reached.ResultsThe consensus-derived competencies were categorized within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These domains address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care team models. A set of values and guiding principles are embedded within each domain.ConclusionsThese competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain

Relationships between prenatal smoking cessation, gestational weight gain and maternal lifestyle characteristics

Objectives: To describe maternal characteristics and lifestyle factors associated with prenatal smoking habits and to appraise the effect of quitting smoking in early gestation on maternal weight gain during pregnancy. Methods: This is a follow-up study of 1753 women who gave birth in 1984/1985 in Stockholm, Sweden. Multivariate logistic models were used to evaluate the association between smoking cessation and weight gain above the American Institute of Medicine (IOM) recommendations, based on pre-pregnancy BMI. Results: About 22% of all participants identified themselves as current smokers and 11.6% reported smoking cessation during pregnancy. Smokers were more likely to be single mothers and reported low quality of breakfast (e.g. eating only 1 food group at breakfast). Non-smokers were older, more likely to be married and have a healthier lifestyle. Quitters also adopted healthier eating habits (e.g. improvement in their breakfast quality). Women who quit smoking gained, on average, 15.3 kg (SD 4.4) during pregnancy, non-smokers gained 14.1 kg (SD 4.0) and smokers gained 13.8 kg (SD 4.3). Quitters gained significantly more weight than both non-smokers and smokers ( p < 0.001). Smoking cessation was significantly associated with gaining weight above IOM recommendations, even after controlling for potential confounders (OR: 2.0; 95%CI: 1.4—3.0; p < 0.0001). Conclusions: In this population, smoking cessation in early pregnancy doubled the likelihood of gaining excess weight. This finding highlights the need for supportive measures to help control weight gain among women who quit smoking during pregnancy

Core competencies for pain management: results of an interprofessional consensus summit.

ObjectiveThe objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported.MethodsAn interprofessional executive committee led a consensus-building process to develop the core competencies. An in-depth literature review was conducted followed by engagement of an interprofessional Competency Advisory Committee to critique competencies through an iterative process. A 2-day summit was held so that consensus could be reached.ResultsThe consensus-derived competencies were categorized within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These domains address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care team models. A set of values and guiding principles are embedded within each domain.ConclusionsThese competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain

Core Competencies for Pain Management: Results of an Interprofessional Consensus Summit

OBJECTIVE: The objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported. METHODS: An interprofessional executive committee led a consensus-building process to develop the core competencies. An in-depth literature review was conducted followed by engagement of an interprofessional Competency Advisory Committee to critique competencies through an iterative process. A 2-day summit was held so that consensus could be reached. RESULTS: The consensus-derived competencies were categorized within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These domains address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care team models. A set of values and guiding principles are embedded within each domain. CONCLUSIONS: These competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain

A phenomenological approach to the ethics of transplantation medicine : sociality and sharing when living-with and dying-with others

Recent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, they all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Pontys philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine