Acute Pain Assessment in Prematurely Born Infants Below 29 Weeks A Long Way to Go

Objectives: Neonates born extremely prematurely are at high risk of acute and prolonged pain. Effective treatment requires reliable pain assessment, which is currently missing. Our study explored whether existing pain assessment tools and physiological indicators measure pain and comfort accurately in this population. Materials and Methods: We prospectively collected data in 16 neonates born at less than 29 weeks’ gestational age during 3 conditions: skin-to-skin care, rest, and heelstick procedure for capillary blood sampling in the incubator. The neonates were video recorded in these situations, and recordings were coded using 5 observational pain assessment tools and numeric rating scales for pain and distress. We simultaneously collected heart rate, respiratory rate, arterial oxygen saturation, regional cerebral oxygenation, and the number of skin conductance peaks. All measures across the 3 conditions were compared using general linear modeling. Results: The median gestational age was 27.1 weeks (range: 24.1 to 28.7). Forty measurement periods across the 3 conditions were analyzed. Heart rate was significantly higher during heelstick procedures compared with during rest, with a mean difference of 10.7 beats/min (95% confidence interval [CI]: 2.7-18.6). Oxygen saturation was significantly higher during skin-to-skin care compared with during heelstick procedures with a mean difference of 5.5% (95% CI: 0.2-10.8). The Premature Infant Pain Profile-revised (PIPP-R) score was significantly higher during heelstick procedures compared with skin-to-skin care with a mean difference of 3.2 points (95% CI: 1.6-5.0). Discussion: Pain measurement in clinical practice in prematurely born infants below 29 weeks remains challenging. The included behavioral and physiological indicators did not adequately distinguish between a painful situation, rest, and skin-to-skin care in premature neonates

How are UK churches using social media to engage with their congregations?

Churches are important non-profit organisations that are increasingly adopting social media. In order to contribute to understanding of the value of social media as a communications channel for non-profit organisations, this article examines, and develops a typology of, the uses of social media by two global churches with a strong presence in the UK, Hillsong, a megachurch, and the Church of England. Informed by previous typologies of the use of social media in both commercial and non-profit contexts, content analysis was conducted of Hillsong's and the Church of England’s social media platforms on Facebook, Twitter, Instagram and YouTube. This analysis provided the basis for the formulation of a typology of uses, the main categories of which are: building a brand, building the church community, outreach, and developing spiritual mission. Differences between the approaches adopted by the Church of England and Hillsong are outlined. Suggestions are offered for future practice and further research

Why is there no queer international theory?

Over the last decade, Queer Studies have become Global Queer Studies, generating significant insights into key international political processes. Yet, the transformation from Queer to Global Queer has left the discipline of International Relations largely unaffected, which begs the question: if Queer Studies has gone global, why has the discipline of International Relations not gone somewhat queer? Or, to put it in Martin Wight’s provocative terms, why is there no Queer International Theory? This article claims that the presumed non-existence of Queer International Theory is an effect of how the discipline of International Relations combines homologization, figuration, and gentrification to code various types of theory as failures in order to manage the conduct of international theorizing in all its forms. This means there are generalizable lessons to be drawn from how the discipline categorizes Queer International Theory out of existence to bring a specific understanding of International Relations into existence

A 27-year review of mergers and acquisitions research in 27 leading management journals

This study contributes to the existing body of knowledge on mergers and acquisitions (M&As) by providing a systematic review of over 500 academic articles across 27 management journals over a 27-year time frame. There appears to be a mixture of empirical and conceptual articles, with a larger proportion being empirical but an increasing number leaning towards a conceptual nature. Our findings show that most studies follow a quantitative approach and use large samples, mostly originating from existing databases. There is an emergence of thematic areas related to the strategic factors influencing M&As, but with the human dimension, gaining increasing attention over time.authorsversionpublishe

Gender, age and the MBA: An analysis of extrinsic and intrinsic career benefits

Against the background of an earlier UK study, this paper presents the findings of a Canadian based survey of career benefits from the MBA. Results indicate firstly that gender and age interact to influence perceptions of career outcomes (young men gain most in terms of extrinsic benefits of career change and pay), and secondly that both men and women gain intrinsic benefits from the MBA. However, intrinsic benefits vary by gender: men in the study were more likely to say they gained confidence from having a fuller skill set while women were more likely to say they gained confidence from feelings of self worth; men emphasised how they had learned to give up control while women argued that they had gained a ‘voice’ in the organization. The role of the MBA in career self- management and the acquisition of key skills are examined as well as the implications for the design of programmes in meeting the varied need of men and women in different age groups

“Hit me up and we can get down” U.S. youths’ risk behaviors and sexual self-disclosure in MySpace profiles

Young people’s sexual self-disclosures in social media profiles can be problematic for those who produce them and for those who consume them. This study merged a content analysis with survey data to identify the characteristics of youth who engaged in online sexual self-disclosure. MySpace profiles belonging to 560 National Study of Youth and Religion respondents in the United States (18 to 23 years old) were analyzed (56,462 content units). A third of the profiles contained at least one sexual self-disclosure; their average incidence was less than one per profile. Online sexual self-disclosure was associated with offline sexual risk behaviors (e.g., sex with casual partners), and with increased frequency of alcohol consumption. Among sexually active females, it was associated with early sexual debut. In light of problem behavior theory, these findings suggest that online sexual self-disclosure may be considered a sexual risk behavior

How to Compute Worst-Case Execution Time by Optimization Modulo Theory and a Clever Encoding of Program Semantics

International audienceIn systems with hard real-time constraints, it is necessary to compute upper bounds on the worst-case execution time (WCET) of programs; the closer the bound to the real WCET, the better. This is especially the case of synchronous reactive control loops with a fixed clock; the WCET of the loop body must not exceed the clock period. We compute the WCET (or at least a close upper bound thereof) as the solution of an optimization modulo theory problem that takes into account the semantics of the program, in contrast to other methods that compute the longest path whether or not it is feasible according to these semantics. Optimization modulo theory extends satisfiability modulo theory (SMT) to maximization problems. Immediate encodings of WCET problems into SMT yield formulas intractable for all current production-grade solvers; this is inherent to the DPLL(T) approach to SMT implemented in these solvers. By conjoining some appropriate "cuts" to these formulas, we considerably reduce the computation time of the SMT-solver. We experimented our approach on a variety of control programs, using the OTAWA analyzer both as baseline and as underlying microarchitectural analysis for our analysis, and show notable improvement on the WCET bound on a variety of benchmarks and control programs