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OBJECTIVE To revise the "Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult" published in Critical Care Medicine in 2002. METHODS The American College of Critical Care Medicine assembled a 20-person, multidisciplinary, multi-institutional task force with expertise in guideline development, pain,(More)
BACKGROUND Little research has been conducted to validate pain assessment tools in critical care, especially for patients who cannot communicate verbally. OBJECTIVE To validate the Critical-Care Pain Observation Tool. METHODS A total of 105 cardiac surgery patients in the intensive care unit, recruited in a cardiology health center in Quebec, Canada,(More)
Bcl-2-family proteins are key regulators of the apoptotic response. Here, we demonstrate that the pro-survival Bcl-2 homolog Bfl-1/A1 is a direct transcriptional target of NF-kappaB. We show that bfl-1 gene expression is dependent on NF-kappaB activity and that it can substitute for NF-kappaB to suppress TNFalpha-induced apoptosis. bfl-1 promoter analysis(More)
The nuclear factor-kappaB (NF-kappaB) transcription factors have emerged as major regulators of programmed cell death (PCD) whether via apoptosis or necrosis. In this context, NF-kappaB's activity has important ramifications for normal tissue development, homoeostasis and the physiological functions of various cell systems including the immune, hepatic,(More)
BACKGROUND Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally. OBJECTIVES To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain(More)
This study described the pain experience of cardiac surgery ICU patients. After their transfer to the surgical unit, 93 patients were interviewed using a questionnaire about their pain experience while they were in the ICU. Sixty-one patients (65.6%) recalled being ventilated and 72 patients (77.4%) recalled having pain. Turning was the most frequent source(More)
PURPOSE To examine dimensions of the psychosocial work environment that influence the psychological health of new-generation nurses. BACKGROUND While much work has been done concerning the health of nurses in general, research on the relationship between the nursing work environment and the psychological well-being of new-generation nurses at the start of(More)
BACKGROUND The Critical-Care Pain Observation Tool (CPOT) is one of the few behavioural pain scales which have been developed and validated for the purpose of detecting pain in nonverbal critically ill adults. OBJECTIVES This study aimed to complete a pre and post evaluation of the implementation of the CPOT on pain assessment/management nursing practices(More)
PURPOSE The purpose of this study was to describe behavioral and physiologic indicators to a nociceptive procedure in conscious and unconscious mechanically ventilated adults and to examine their association with the patients' self-reports of pain. MATERIALS AND METHODS A total of 257 intensive care unit patients (144 conscious and 113 unconscious) from 4(More)