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A Grounded Theory Study o f Pain Management Behaviors in Nurses Caring for Preverbal ChildrenA qualitative study using the grounded theory method was used to explore factors that affect nurses’ pain management decision-making when caring for children between the ages o f 0 and 3 years. This study was approved by the Human Assurance Committee at Medical College o f Georgia prior to the collection of data. The sample consisted of eleven nurses who were employed at three different hospitals in the southeastern part of the United States. Theoretical sampling was the basis for the selection o f participants after the first two interviews. Interviews were transcribed verbatim and were subjected to open and axial coding. The constant comparative method was used during data analysis to identify a core category and related concepts. The basic social process that emerged is engaging in tactics o f pain management. This process contained two other processes: assessing fo r pain and managing a pain episode. Intrinsic factors that affected assessing fo r pain included knowing the territory, personal attributes o f the registered nurse (RN), being a parent, and being connected. Extrinsic factors that affected engaging in tactics o f pain management included workload and culture o f the hospital. The process of managing a pain episode included five phases: eliminating other sources o f discomfort, judging pain, comforting, medicating, and letting go.
Manual Physical Therapy for a Patient Following Total Knee Arthroplasty (TKA)A 66-year-old woman was referred to outpatient physical therapy 3 weeks following primary unilateral TKA for severe osteoarthritis. Upon initial examination, the patient had significant post-operative pain, impaired gait, and decreased range of motion (ROM),strength, and functional mobility. Additionally, the patient presented with adherent scar tissue along the length of her surgical incision and diffuse soft tissue restrictions in the quadriceps and tensor fascia latae. Treatment consisted of all the components of conventional physical therapy in addition to manual physical therapy. Components of traditional physical therapy included strengthening exercises, aerobic exercises, stretching, and training in performance of everyday activities, such as navigating stairs. Manual therapy techniques included joint mobilization, scar tissue massage, soft tissue mobilization, and therapist-assisted manual stretching. Active knee flexion ROM, the Timed Up and Go (TUG), the 6 Minute Walk Test (6MW), and the 36-Item Short Form Health Questionnaire (SF-36) were completed at initial examination and again 5 weeks later at discharge.
Type III Nrg1 Back Signaling Enhances Functional TRPV1 along Sensory Axons Contributing to Basal and Inflammatory Thermal Pain SensationType III Nrg1, a member of the Nrg1 family of signaling proteins, is expressed in sensory neurons, where it can signal in a bi-directional manner via interactions with the ErbB family of receptor tyrosine kinases (ErbB RTKs)