3,925 research outputs found

    Cortical pain responses in human infants

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    Despite the recent increase in our understanding of the development of pain processing, it is still not known whether premature infants are capable of processing pain at a cortical level. In this study, changes in cerebral oxygenation over the somatosensory cortex were measured in response to noxious stimulation using real-time near-infrared spectroscopy in 18 infants aged between 25 and 45 weeks postmenstrual age. The noxious stimuli were heel lances performed for routine blood sampling; no blood tests were performed solely for the purpose of the study. Noxious stimulation produced a clear cortical response, measured as an increase in total hemoglobin concentration [HbT] in the contralateral somatosensory cortex, from 25 weeks (mean Delta[HbT] = 7.74 mu mol/L; SE, 1.10). Cortical responses were significantly greater in awake compared with sleeping infants, with a mean difference of 6.63 mu mol/L [95% confidence interval (CI) limits: 2.35, 10.91 mu mol/L; mean age, 35.2 weeks]. In awake infants, the response in the contralateral somatosensory cortex increased with age ( regression coefficient, 0.698 mu mol/L/week; 95% CI limits: 0.132, 1.265 mu mol/L/week) and the latency decreased with age (regression coefficient, -0.9861 mu mol/L/week; 95% CI limits: -1.5361, -0.4361 mu mol/L/week; age range, 25-38 weeks). The response was modality specific because no response was detected after non-noxious stimulation of the heel, even when accompanied by reflex withdrawal of the foot. We conclude that noxious information is transmitted to the preterm infant cortex from 25 weeks, highlighting the potential for both higher-level pain processing and pain-induced plasticity in the human brain from a very early age

    Cortical activity evoked by inoculation needle prick in infants up to one-year old

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    Inoculation is one of the first and most common experiences of procedural pain in infancy. However, little is known about how needle puncture pain is processed by the central nervous system in children. In this study, we describe for the first time the event-related activity in the infant brain during routine inoculation using electroencephalography. Fifteen healthy term-born infants aged 1 to 2 months (n = 12) or 12 months (n = 5) were studied in an outpatient clinic. Pain behavior was scored using the Modified Behavioral Pain Scale. A distinct inoculation event-related vertex potential, consisting of 2 late negative-positive complexes, was observable in single trials after needle contact with the skin. The amplitude of both negative-positive components was significantly greater in the 12-month group. Both inoculation event-related potential amplitude and behavioral pain scores increased with age but the 2 measures were not correlated with each other. These components are the first recordings of brain activity in response to real-life needle pain in infants up to a year old. They provide new evidence of postnatal nociceptive processing and, combined with more traditional behavioral pain scores, offer a potentially more sensitive measure for testing the efficacy of analgesic protocols in this age group

    Direct to consumer advertising via the Internet, a study of hip resurfacing

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    With increased use of the internet for health information and direct to consumer advertising from medical companies, there is a concern about the quality of the information available for patients. The aim of this study was to examine the quality of health information on the internet for hip resurfacing. An assessment tool was designed to measure quality of information. Websites were measured on credibility of source; usability; currentness of the information; content relevance; content accuracy/completeness and disclosure/bias. Each website assessed was given a total score, based on number of scores achieved from the above categories websites were further analysed on author, geographical origin and possession of an independent credibility check. There was positive correlation between the overall score for the website and the score of each website in each assessment category. Websites by implant companies, doctors and hospitals scored poorly. Websites with an independent credibility check such as Health on the Net (HoN) scored twice the total scores of websites without. Like other internet health websites, the quality of information on hip resurfacing websites is variable. This study highlights methods by which to assess the quality of health information on the internet and advocates that patients should look for a statement of an "independent credibility check" when searching for information on hip resurfacing

    Strengthening Indigenous Social Work in the Academy

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    This paper provides an account of the development of an Indigenous Social Work program in Sudbury, Ontario and how it was conceived, developed and implemented. It describes the transformational approaches that Aboriginal faculty, communities and academic allies engaged in to create a rightful space for Indigenous social work in mainstream academia. In its 25th year, this program has provided many transformational opportunities for students, faculty and Aboriginal communities. Incorporating resistance and proactive momentum, the program has become pivotal in expanding the visibility and legitimacy for Indigenous social work in practice, theory, research and pedagogies. This program is an example of how community-faculty collaborations can sustain a robust Indigenous social work program
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