Management Techniques Research Articles

Variabilidade patológica e genética de isolados bacterianos causadores de podridão mole em hortaliças na região oeste do Pará, Brasil

ABSTRACT: Seventy-five pectinolytic strains collected from vegetables grown in the counties of Santarém, Belterra, and Mojuí dos Campos, located in the western region of the Pará State, Brazil, were studied according to their pathological and genetic variability. The strains were grouped in 5 clusters according to pathogenicity in potato, pepper, carrot, and onion, and 38 strains were selected for genetic analysis using rep-PCR. These strains were divided into 35 genetic groups according to rep-PCR at 70% similarity. These results indicated high pathological and genetic variability of the strains causing soft rot in vegetables in the western region of the Pará State, which will be used in etiological research and for the development and assessment of management techniques for the soft rot in vegetables in this region.

Impacts of Community Participation on Sustainability of Rural Water Supply Sytems: A Study from District Lahore, Pakistan

The availability and functionality of an improved water supply system among the population are basic human rights and imperative to prevent numerous viral/infectious diseases. The provision of safe drinking water, improved sanitation, and hygiene plays a central role in individual and communal health, but unfortunately, the situation is strikingly poor among nations, especially in developing countries like Pakistan. To understand the existing situation and the impacts of community participation on the sustainability of the water supply system, this study was conducted in the district of Lahore, Pakistan. The prime objective was to find out the participation of the community in planning, execution, operation and maintenance, evaluation process, and the management approaches and techniques with a view of seeing how best community participation level contributed to the sustainability of the water supply program. For this purpose, a simple random sampling procedure was applied to draw the sample from the population. A semi-structured questionnaire was used as a tool for data collection and validated through pilot testing. Results showed that participatory approaches in water supply program planning, execution, operation, maintenance, and evaluation led to community satisfaction and program sustainability.

Adaptive Artificial Intelligence Techniques for QoS and Congestion Management in 5G Wireless Networks: A Literature

In the rapidly evolving landscape of 5G wireless networks, ensuring Quality of Service (QoS) and managing congestion effectively are critical challenges that must be addressed to meet the stringent performance requirements of modern applications. This paper presents an in-depth study on the application of adaptive artificial intelligence (AI) techniques for QoS and congestion management in 5G wireless networks. By leveraging machine learning (ML) and deep learning (DL) algorithms, we propose an intelligent framework that dynamically adjusts network parameters in real-time to optimize performance and mitigate congestion. The proposed approach integrates reinforcement learning for adaptive decision-making, convolutional neural networks (CNNs) for traffic pattern recognition, and long short-term memory (LSTM) networks for predictive analysis of network congestion trends. Through extensive simulations and real-world testing, our framework demonstrates significant improvements in QoS metrics such as latency, throughput, and packet loss, while efficiently managing congestion across diverse network scenarios. The results indicate that adaptive AI techniques hold immense potential in enhancing the robustness and efficiency of 5G wireless networks, paving the way for more reliable and high-performance communication systems. KEYWORDS: artificial intelligence (AI), machine learning (ML), convolutional neural networks (CNNs), and long short-term memory (LSTM) networks

Assessing the Impact of Climate Change on Global Crop Yields and Farming Practices

Climate change is recognized as one of the most pressing challenges of our time, with profound implications for global food security. This review article delves into the multifaceted impacts of climate change on crop yields and farming practices on a global scale. By synthesizing recent research findings, identifying key challenges and opportunities, and exploring adaptation strategies, this review provides a comprehensive analysis of the complex interplay between climate change and agriculture. The effects of climate change on agriculture are diverse and far reaching. Alterations in weather patterns, including shifts in temperature, precipitation, and frequency of extreme events, pose significant challenges to agricultural productivity and food security. These changes disrupt traditional farming practices, exacerbate water stress, soil erosion, and crop loss, and threaten the livelihoods of millions of farmers worldwide. Additionally, changes in pest and disease dynamics have further compounded the challenges faced by agricultural systems under pressure from climate variability. These challenges, there are opportunities for innovation and adaptation in the agricultural systems. This review highlights the potential of climate-smart agricultural practices such as crop diversification, conservation agriculture, and precision farming to enhance resilience and mitigate the impacts of climate change on crop yields. investments in climate-resilient crop varieties, improved water management techniques, and sustainable land management practices offer pathways for building adaptive capacities and ensuring food security in a changing climate. addressing the complex challenges of climate change adaptation in agriculture requires concerted action at multiple levels. This review emphasizes the importance of coordinated efforts among policymakers, researchers, farmers, and other stakeholders in developing and implementing effective adaptation strategies. Such strategies should be context-specific, socially equitable, and environmentally sustainable, considering the diverse needs and priorities of different regions and communities. This review underscores the urgent need for coordinated action to build resilient and sustainable food systems in the face of a changing climate. By synthesizing the latest research findings, identifying key challenges and opportunities, and exploring adaptation strategies, this review aims to inform policymakers, researchers, and practitioners about the imperative of addressing climate change’s impacts on agriculture. Only through collaborative and transformative action can we ensure food security for the present and future generations in a rapidly changing world.

Exploring tourism SMEs crisis management practices during Covid-19 at Boudha, Kathmandu

<p>The worldwide tourism industry alone expanded by 3.9% in 2018, contributing $8.8 trillion in sales and 319 million jobs to the global economy. The COVID-19 pandemic, which began to spread around the planet in 2020, had an impact on every aspect of life. Though many studies have explored COVID-19’s effects on tourism SMEs in Nepal, there’s a significant lack of research on their crisis management strategies during the pandemic. Thus, this study aims to measure the crisis management techniques used by small and medium-sized businesses (SMEs) in the Boudha Area during the COVID-19 epidemic. The study uses an explanatory research design to analyze a comprehensive understanding of how the Boudha Area’s SMEs in the tourism industry handled the crisis of SMEs in the Kathmandu Valley. Non-probability with convenient sampling is used for the study. Data is collected through 403 SMEs using a structural questionnaire, and data collection is done using Kobo Toolbox. Structural Equation Modeling (SEM) using Partial Least Squares (PLS) version 4.0 is adopted for data analysis. The result shows a significant relationship between cost control and expected assistance with crisis management, while marketing and organizational support have an insignificant relationship with crisis management. Similarly, during COVID-19, 90.82% of the businesses had closed their businesses, and 47.89% of SMEs had closed for 3 months. Additionally, 88.09% of SMEs faced losses during COVID-19, and to maintain the crisis 46.4% of SMEs used their income to handle crises during COVID-19, and 93.3% of SMEs reduced their expenses to manage the crisis.</p>

Personalism and purges: Are personalist dictators more likely to engage in elite purges?

AbstractObjectiveIn this article, we empirically examine the relationship between personalism and employing purging or cooptation as regime elite management techniques. Much of the literature suggests that there is a close relationship between personalism and the use of violence to maintain power, and thus suggests a connection between personalism and violent purges.MethodsUsing data from 109 autocracies from 1946 to 2008, we employ a seemingly unrelated negative binomial regression estimationResultsWe find that personalist regimes are not more likely to engage in purges when compared to other regimes. Further, the results suggest that personalist regimes are not more likely to rely on purges as an elite management strategy. In fact, our analysis suggests that personalism as a regime attribute (rather than as an institutional type) is associated with less (not more) use of purges and that personalism tends to be more associated with the use of cooptation than purges.ConclusionWe offer an explanation for these findings and suggest that future research should focus on the characteristics of the autocrat as a political agent when explaining the propensity to engage in different elite management techniques.

Protocol for the development of a tool to map systemic sclerosis pain sources, patterns, and management experiences: a Scleroderma Patient-centered Intervention Network patient-researcher partnership

IntroductionSystemic sclerosis (SSc) is a rare, complex autoimmune rheumatic disease with multiple factors that contribute to pain. People with SSc emphasize the effect pain has on their quality of life, but no studies have systematically examined the frequency and relative importance of different SSc pain sources, patterns of pain from different sources, and pain management experiences. Our objectives are to (1) develop a tool, jointly with researchers, health care providers, and patients, to map sources of pain in SSc, determine patterns of pain from different sources, and understand pain management experiences; and (2) administer the final tool version to participants in the large multinational Scleroderma Patient-centered Intervention Network (SPIN) Cohort.MethodsFirst, we will use validated pain assessment tools as templates to develop an initial version of our pain assessment tool, and we will obtain input from patient advisors to adapt it for SSc. The tool will include questions on pain sources, pain patterns, pain intensity, pain management techniques, and barriers to pain management in SSc. Second, we will conduct nominal group technique sessions with people living with SSc and health care providers who care for people with SSc to further refine the tool. Third, we will conduct individual usability testing sessions with SPIN Cohort participants. Once the tool has been finalized, we will administer it to individuals in the multinational SPIN Cohort, which currently includes over 1,300 active participants from 54 sites in 7 countries. We will perform unsupervised clustering using the KAy-Means for MIxed LArge data (KAMILA) method to identify participant subgroups with similar profiles of pain sources (present or absent) and to evaluate predictors of subgroup membership. We will use latent profile analysis to identify subgroups of participants with similar profiles based on pain intensity scores for each pain source and evaluate predictors.DiscussionOnce completed, our pain assessment tool will allow our team and other researchers to map sources of pain in SSc and to understand pain management experiences of people living with SSc. This knowledge will provide avenues for studies on the pathophysiology of pain in SSc and studies of interventions to improve pain management.

Frequency-Dependent Neural Modulation of Dorsal Horn Neurons by Kilohertz Spinal Cord Stimulation in Rats.

Kilohertz high-frequency spinal cord stimulation (kHF-SCS) is a rapidly advancing neuromodulatory technique in the clinical management of chronic pain. However, the precise cellular mechanisms underlying kHF-SCS-induced paresthesia-free pain relief, as well as the neural responses within spinal pain circuits, remain largely unexplored. In this study, using a novel preparation, we investigated the impact of varying kilohertz frequency SCS on dorsal horn neuron activation. Employing calcium imaging on isolated spinal cord slices, we found that extracellular electric fields at kilohertz frequencies (1, 3, 5, 8, and 10 kHz) induce distinct patterns of activation in dorsal horn neurons. Notably, as the frequency of extracellular electric fields increased, there was a clear and significant monotonic escalation in neuronal activity. This phenomenon was observed not only in superficial dorsal horn neurons, but also in those located deeper within the dorsal horn. Our study demonstrates the unique patterns of dorsal horn neuron activation in response to varying kilohertz frequencies of extracellular electric fields, and we contribute to a deeper understanding of how kHF-SCS induces paresthesia-free pain relief. Furthermore, our study highlights the potential for kHF-SCS to modulate sensory information processing within spinal pain circuits. These insights pave the way for future research aimed at optimizing kHF-SCS parameters and refining its therapeutic applications in the clinical management of chronic pain.

(044) AN INNOVATIVE AND NON-INVASIVE METHOD OF REDUCING PAIN UTILIZING VIBRATION DURING IUD INSERTION: PATIENT REACTIONS AND ONE PROVIDER’S APPROACH

Abstract Introduction Pain is commonly experienced during Intrauterine device (IUD) insertion and a possible barrier to this form of contraception. Pharmacological methods and non-pharmacological techniques are available to reduce pain during this procedure, but the efficacy varies on a case-by-case basis and data is conflicting regarding doses. Additional techniques are needed to increase the likelihood of a more patient centered approach to address pain experienced during IUD placement. Objective The purpose of the current project is to describe exploratory use of vibration and propose it as an innovative pain management technique during IUD insertion. Methods Recognizing that the umbilicus and the distal third of the vagina are embryologically connected, the current clinician hypothesized that external vibration applied to the umbilicus by a patient during IUD placement may reduce pain. Starting in 2017 external umbilical vibration was added to a previously established list of pain reduction options available during IUD placement at one clinical practice. Patients were consulted prior to IUD insertion and the list of multiple options discussed as part of regular practice. Patients and the provider determined the methods of pain reduction that best fit the individual patient’s needs based on their previous experiences, apprehension, and other concerns related to the procedure. Clinician observation and recall of response and reactions following the use of vibration will be shared. Results A detailed description of the umbilical vibration technique will be provided. Provider recall and summary of anonymous patient responses will be discussed, as well as the possible implications for gynecological care. Verbal and non-verbal responses from patients who elected to use umbilical vibration, or a combination of umbilical vibration and other techniques, to reduce pain have been overwhelmingly positive. No negative experiences with this non-invasive technique have occurred. Conclusions Umbilical vibration may serve as an effective, low-cost option to reduce pain during IUD placement. Providers considering this technique should be comfortable discussing vibration and open to this type of patient centered care. Umbilical vibration as a pain reduction technique for IUD insertion could be utilized in a trauma informed practice. A more in-depth study to further explore the intricacies of this technique is in preparation. Disclosure No.

Long-Term Effectiveness of Vestibulectomy for the Treatment of Vulvodynia: A Retrospective Cohort Study.

To evaluate the effectiveness and complication rate of vestibulectomy for vulvodynia. A retrospective cohort study in a teaching and university hospital analyzing patients with vulvodynia with insufficient response to conservative treatment who underwent a vestibulectomy. Data from 114 consecutive vestibulectomy procedures done between September 2009 and October 2018 were retrospectively analyzed. All procedures were performed by the same surgeon.The primary outcome was difference in pain scale (6-point Q-tip test, Nociceptive Rating Scale) between preoperative consultation, postoperative visit, and last follow-up consultation. The secondary outcome was surgical complications, such as wound dehiscence and hematoma. Complete data were available for 80 patients. There was a significant reduction in median pain scores of between 65% and 80% on all 6 evaluated vestibular points during Q-tip tests. The median follow-up was 21 months, ranging from 1 to 92 months (interquartile range [IQR]). Overall, 75% of patients needed no further treatment at the end of the follow-up period. In 22.6% (18/80), a limited wound dehiscence was noted. No other complications were reported nor were there any cases of worsening of the complaints. In this retrospective cohort study, a significant pain reduction occurred after vestibulectomy in patients who were not responding to conservative treatment. The complication rate of this surgical procedure is low. Vestibulectomy seems to be an effective technique for management of vulvodynia.

Unveiling the Ocean's Arsenal: Successful Integration of Marine Metabolites into Disease Management

The growing problem of antibiotic resistance calls for a paradigm shift in medication discovery. Fortunately, the enormous oceans, home to an incredible diversity of life, provide a viable solution: marine metabolites. These unusual chemicals have enormous potential for treating a wide range of diseases. This present study investigates the great potential for using these marine-derived gems in disease management techniques. Despite the difficulty of procuring and isolating marine organisms, discovering the most effective metabolites, and traversing lengthy research pipelines, the potential rewards are apparent. To demonstrate the power of these marine resources, the paper examines successful case studies. Each case study delves deeply into a single marine metabolite, including its source organism, the disease it targets, and the precise mechanism by which the metabolite disrupts the disease process. We'll look at the results of clinical trials that examined the efficacy and safety of these marine-derived medications, eventually exposing the real-world influence on patient outcomes after incorporating them into treatment plans. Examining these successful cases provides useful insights into the enormous potential of marine resources for producing novel and effective medications, opening the path for further discovery and innovation in the battle against a wide range of diseases.

COVID-19 and human resource management: status, trends and research directions

PurposeThis study aims to conduct an extensive bibliometric analysis of research across COVID-19 and human resource management (HRM). It captures an exhaustive conceptual understanding of theoretical foundations, research trends, developments and research directions in the HRM domain.Design/methodology/approachA set of 505 HRM and COVID-19-specific articles collected from the Scopus database were systematically analyzed using a two-tier method. In the first tier of analysis, the evolution and current state of research are identified using citation analysis. In the second tier, network analysis and content analysis of research clusters and thematic mapping are done to identify the prominent research themes and research gaps and suggest future research directions.FindingsThe study highlights the emergence of six research clusters: SHRM and competitive advantage, employer branding and employee engagement, crisis management and resilience, challenges, career shock and job demand resources and burnout. The thematic mapping categorizes the themes into four categories: motor, basic, emerging or declining, and niche research themes published on COVID-19 and HRM. To understand the socio-cultural dynamics and cross-cultural issues during human resource management, the findings emphasized the need for the increased contribution of researchers and practitioners, especially from the developing and emerging nation’s context. Increased co-authorship among influential authors and institutions will also help formulate strategies and policies to effectively deal with similar pandemics.Originality/valueUnlike the previous literature review, the present findings provide meaningful insights for formulating people management techniques, policies, and practices in response to COVID-19 or similar pandemics.

Analyzing Quantum Error Resilience for Quantum Communication in Guided and Unguided Media

AbstractThis research examines quantum key distribution and its applications in guided and unguided quantum communication. The importance of secure communication in the quantum era requires a thorough exploration of both guided and unguided quantum communication strategies. The research aims to address the challenges posed by guided channels, such as fiber optics, and unguided channels, such as free‐space quantum communication. This study addresses existing knowledge gaps in quantum error resilience management and signal processing techniques in unguided quantum communication. Advanced quantum gate analysis, environmental noise analysis, and quantum channel modeling techniques are employed. The research presents key findings on the impact of gate imperfections on quantum error resilience in guided media, the influence of noise‐induced errors in unguided media, and a unified metric for assessing various error sources in guided channels. Additionally, the study analyses stabilizer codes and surface codes for error mitigation through quantum error correction strategies. Simulation results provide a benchmark for theoretical predictions and guide the refinement of quantum communication protocols. In this context, machine learning‐based error prediction is introduced as a cutting‐edge approach to enhance the robustness of quantum communication systems.

Cognitive reserve, cortisol, and Alzheimer's disease biomarkers: A memory clinic study.

Cognitive reserve might mitigate the risk of Alzheimer's dementia among memory clinic patients. No study has examined the potential modifying role of stress on this relation. We examined cross-sectional associations of the cognitive reserve index (CRI; education, occupational complexity, physical and leisure activities, and social health) with cognitive performance and AD-related biomarkers among 113 memory clinic patients. The longitudinal association between CRI and cognition over a 3-year follow-up was assessed. We examined whether associations were influenced by perceived stress and five measures of diurnal salivary cortisol. Higher CRI scores were associated with better cognition. Adjusting for cortisol measures reduced the beneficial association of CRI on cognition. A higher CRI score was associated with better working memory in individuals with higher (favorable) cortisol AM/PM ratio, but not among individuals with low cortisol AM/PM ratio. No association was found between CRI and AD-related biomarkers. Physiological stress reduces the neurocognitive benefits of cognitive reserve among memory clinic patients. Physiological stress may reduce the neurocognitive benefits accrued from cognitively stimulating and enriching life experiences (cognitive reserve [CR]) in memory clinic patients. Cortisol awakening response modified the relation between CR and P-tau181, a marker of Alzheimer's disease (AD). Effective stress management techniques for AD and related dementia prevention are warranted.

Managing construction project risks in turbulent times: a stakeholders perspective

PurposeThe construction industry is unique but with uncertainties. This is because of the operating environment. This intricacy gives rise to several construction risks and is compounded in developing countries’ turbulent times. If not managed, these risks enhanced in turbulent times could negatively impact the Nigerian construction projects’ cost, time, quality, and performance. Hence, this study investigated the perceived encumbrances facing construction risk management techniques and identified measures to promote sustainable-based construction risk management in turbulent times.Design/methodology/approachThe researchers adopted a qualitative approach and achieved saturation with 28 participants. The participants were government policymakers, quantity surveyors in government ministries/agencies/departments, consultant engineers, consultant architects, consultant and contracting quantity surveyors, and construction contractors knowledgeable about construction risk management. The research employed a thematic analysis for the study’s data.FindingsFindings identified turbulent times related to the industry and major techniques for managing construction project risks in the Nigerian construction industry. It revealed lax adoption and implementation of practices. Also, the study identified major encumbrances facing construction risk and proffered initiatives that would promote sustainable-based construction risk management in turbulent times.Originality/valueThis study investigates encumbrances and suggests measures to promote construction project risk management in turbulent times in Nigeria. Also, the study contributes to the literature’s paucity, uncovering perceived encumbrances and evolving organisations’ management styles to imbed sustainable-based risk management practices by qualitative research design method.

Current and emerging feral cat management practices in Australia

Context Feral cats are responsible for the decline and extinction of species globally. Predation by feral cats is identified in Australian legislation as a key threatening process. However, clear guidance to local land managers on feral cat management techniques and their impacts, limitations and potential costs can be difficult to find. Aims In this study, feral cat management experts from around Australia identified available management techniques and their average environmental, social, and economic impact for different ecoregions and land-use types. Methods We convened a 1-day structured elicitation workshop with 19 experts and five facilitators. Experts identified the techniques used for feral cat management; the effectiveness, impact, and cost of each method; and the key knowledge gaps associated with feral cat management. Facilitators aided in the design and format of the workshop, led the discussion at each stage and collated the results. Key results Experts identified the following 10 techniques currently used in Australia: aerial baiting; ground baiting; leghold trapping; cage trapping; shooting; tracking with detector dogs; tracking by Indigenous Rangers; habitat modification; resource modification; and exclusion fencing. In general, experts highlighted that permits, legislation and scale of application constrained many of these techniques. Aerial baiting was considered the most effective technique for reducing feral cat populations in natural and production systems. Cage trapping, shooting, or tracking with detector dogs were considered more effective in residential areas. For all techniques, efficacy estimates varied according to the following three broad vegetation structural regions: (1) deserts and xeric shrublands; (2) forests and woodlands; and (3) grasslands, savannas and shrublands. Techniques considered to have the lowest social tolerance and highest impact to non-target native species included aerial baiting, ground baiting and leghold trapping. Techniques considered to have high social tolerance and low impact on non-target species included tracking by Rangers, tracking with detector dogs, and habitat and resource modification. Conclusions Estimates of management action efficacy differ among land-use types and at least three vegetation structural regions. However, social licence, logistic and legislative constraints are the key drivers of the availability of methods for these areas. Implications Feral cat management programs should consider how program strategy can be prioritised on the basis of technique availability, region of use and expected impact.

Deep Q‐network learning‐based active speed management under autonomous driving environments

AbstractEfficient traffic safety management necessitates real‐time crash risk prediction using expressway characteristics. With the emergence of autonomous vehicles (AVs), the development and evaluation of variable speed limit (VSL) strategies, a key active traffic management technique, become crucial for enhancing safety and mobility in mixed traffic flows. This underscores the need for optimized VSL strategies to accommodate both conventional and AVs. This paper presents a study on the development of VSL control algorithms using deep reinforcement learning in a microscopic traffic simulation. As the rewards function, time‐to‐collision and speed were considered. To enhance traffic safety, VSL strategies were refined across various market penetration of connected AVs. Analysis revealed that safety and traffic density are improved by 53% and 59%, respectively, in market penetration rate (MPR) 50, marking significant safety improvements in congested and low MPR scenarios. These findings present the importance of developing and evaluating VSL strategies for mixed traffic flow, particularly in the context of increasing the prevalence of connected and AVs.

The technology of "Debate" in history lessons: the conditions of occurrence, the technique of conducting, educational opportunities.

The integration of debate as a pedagogical technology in educational settings has gained significant attention for its potential to enhance critical thinking, communication skills, and student engagement. This paper examines the historical development of the "Debate" methodology in classroom settings, focusing on the conditions that facilitated its emergence and the management techniques required for its successful implementation. It explores the educational opportunities provided by debate, including fostering a deeper understanding of subject matter, promoting active learning, and encouraging diverse perspectives. Through a comprehensive analysis of case studies and existing literature, this study identifies best practices for managing debate technology in lessons and highlights the impact of debate on student learning outcomes. The findings underscore the importance of structured debate formats, teacher facilitation, and supportive classroom environments in maximizing the educational benefits of this interactive teaching approach.

Biological potential of plant pathogenic fungi on weeds: A mini-review essay

The invasion of weeds into productive areas has substantial negative effects on native ecosystems as well as agricultural production systems globally. Consequently, the task of maintaining or restoring these systems will become increasingly challenging without consistent, ongoing management efforts. The intensifying emergence of herbicide resistance in numerous weed species, coupled with the unintended pollution caused by synthetic herbicides, underscores the growing necessity for alternative, environmentally friendly, and sustainable management techniques, such as the utilisation of bioherbicides. Plant pathogenic microbes play an important role in biologically management of weeds, with the utilization of plant pathogenic fungi emerging as a promising area of study for novel research trends aimed at weed management without reliance of herbicides and to mitigate environmental pollution. A potential solution to decreasing pesticide usage involves the development of bioherbicides containing fungal active ingredients. Among the most commonly utilised fungi in bioherbicides are genera like Alternaria, Colletotrichum, Cercospora, Fusarium, Phomopsis, Phytophthora, Phoma, and Puccinia. Increased weed resistance to herbicides has influenced new strategies for weed management, with some fungi from genera such as Colletotrichum and Phoma already employed for weed control. Nonetheless, it is evident from reviews that further research is imperative in this domain, with particular emphasis on analysing the efficacy of each plant pathogenic fungi.

Arnica D30 – an alternative for managing procedural pain in full-term neonates

Background: Despite scientific advances, the management of procedural pain in neonates remains suboptimal. Applying adequate therapy to control pain during the neonatal period is a moral and ethical act. In recent decades, ample evidence has accumulated regarding the risks, associated with both untreated pain and the use of more aggressive analgesic therapy. Thus, the emphasis in neonatal clinical practice is on non-aggressive pain management techniques, including non-pharmacological methods, such as glucose and homeopathic agents. The efficacy and safety of homeopathic agents for reducing procedural pain in neonates is the subject of the present study. Materials and methods: Healthy full-term newborn babies with an average age of 72–84 hours were included. They were divided into three study groups: group (A) – without analgesia, (n = 67), group (B) – analgesic with Arnica D30 (n = 57) and group (C) – analgesic with Sol.Glucose 25% (n = 40). The severity of the pain was assessed using the multimodal - Neonatal Infant Pain Scale (NIPS) and the unimodal - Neonatal Facial Coding System (NFCS) scale. Assessments were done 30s before, 30 seconds after, and 5 minutes after the painful stimulus caused by the heel prick. Heart rate, transcutaneous oxygen saturation, respiratory rate and blood pressure were examined at the same intervals. The results obtained were processed statistically by descriptive analysis and ANOVA at a significance level of p < 0.05. Results: Five minutes after heel prick both scales showed a score near 3, i.e. no significant pain, and statistically significant lower score in those given Arnica D30, compared to those who received Sol.Glucose 25% (p < 0.05). When monitoring the physiological indicators, we found a significant increase in the heart rate 30 seconds after the procedure between group B and C. Five minutes after the heel prick we recorded significantly values of respiratory rate and systolic blood pressure in all three groups compared to accounted for pre-procedural values. Conclusion: Arnica D30 has better analgesic effects compared to Sol.Glucose 25% for newborn babies after heel prick tests.