Objective: to map the use of massage to relieve neonatal pain during procedures performed in Intensive Care Units. Methods: a scoping review conducted in 11 data sources, following the Joanna Briggs Institute recommendations. The question was: what is the knowledge about the use of massage to relieve pain in newborns during painful procedures in a neonatal intensive care unit? 12 studies were selected for the results. Results: therapeutic massage in newborns is positive in reducing the score on pain scales, decreasing heart and respiratory rates, increasing oxygen saturation, improvements in behavioral status, weight gain, neurological development, shorter crying time and performing the painful procedure. Conclusion: massage/reflexotherapy is effective in reducing neonatal pain in intensive care units, being performed on lower limbs, heel, back or at the procedure site, with light to moderate pressure and an average duration of five minutes.
Background
The multidisciplinary perioperative and anaesthetic management of patients undergoing pelvic exenteration is essential for good surgical outcomes. No clear guidelines have been established, and there is wide variation in clinical practice internationally. This consensus statement consolidates clinical experience and best practice collectively, and systematically addresses key domains in the perioperative and anaesthetic management.
Methods
The modified Delphi methodology was used to achieve consensus from the PelvEx Collaborative. The process included one round of online questionnaire involving controlled feedback and structured participant response, two rounds of editing, and one round of web-based voting. It was held from December 2019 to February 2020. Consensus was defined as more than 80 per cent agreement, whereas less than 80 per cent agreement indicated low consensus.
Results
The final consensus document contained 47 voted statements, across six key domains of perioperative and anaesthetic management in pelvic exenteration, comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management. Consensus recommendations were developed, based on consensus agreement achieved on 34 statements.
Conclusion
The perioperative and anaesthetic management of patients undergoing pelvic exenteration is best accomplished by a dedicated multidisciplinary team with relevant domain expertise in the setting of a specialized tertiary unit. This consensus statement has addressed key domains within the framework of current perioperative and anaesthetic management among patients undergoing pelvic exenteration, with an international perspective, to guide clinical practice, and has outlined areas for future clinical research.
This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.
Traditional explicit authentication mechanisms, in which the device remains unlocked after the introduction of some kind of password, are slowly being complemented with the so-called implicit or continuous authentication mechanisms. In the latter, the user is constantly monitored in one or more ways, in search for signs of unauthorized access, which may happen if a third party has access to the phone after it has been unlocked. There are some different forms of continuous authentication, some of which based on Machine Learning. These are generally black box models, that provide a decision but not an explanation. In this paper we propose an approach for continuous authentication based on behavioral biometrics, machine learning, and that includes domain-dependent aspects for the user to interpret the actions and decisions of the system. It is non-intrusive, does not require any additional hardware, and can be used continuously to monitor user identity.
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