Background: In postoperative pain treatment patients are asked to rate their pain experience on a single uni-dimensional pain scale. Such pain scores are also used as indicator to assess the quality of pain treatment. However, patients may differ in how they interpret the Numeric Rating Scale (NRS) score. Objectives: This study examines how patients assign a number to their currently experienced postoperative pain and which considerations influence this process. Methods: A qualitative approach according to grounded theory was used. Twenty-seven patients were interviewed one day after surgery. Results: Three main themes emerged that influenced the Numeric Rating Scale scores (0–10) that patients actually reported to professionals: score-related factors, intrapersonal factors, and the anticipated consequences of a given pain score. Anticipated consequences were analgesic administration—which could be desired or undesired—and possible judgements by professionals. We also propose a conceptual model for the relationship between factors that influence the pain rating process. Based on patients’ score-related and intrapersonal factors, a preliminary pain score was ‘‘internally’’ set. Before reporting the pain score to the healthcare professional, patients considered the anticipated consequences (i.e., expected judgements by professionals and anticipation of analgesic administration) of current Numeric Rating Scale scores. Conclusions: This study provides insight into the process of how patients translate their current postoperative pain into a numeric rating score. The proposed model may help professionals to understand the factors that influence a given Numeric Rating Scale score and suggest the most appropriate questions for clarification. In this way, patients and professionals may arrive at a shared understanding of the pain score, resulting in a tailored decision regarding the most appropriate treatment of current postoperative pain, particularly the dosing and timing of opioid administration.
Privacy, copyright, classified documents and state secrets, but also spontaneous network phenomena like flash mobs and hashtag revolutions, reveal one thing – we lost control over the digital world. We experience a digital tailspin, or as Michael Seemann calls it in this essay: a loss of control or Kontrollverlust. Data we never knew existed is finding paths that were not intended and reveals information that we would never have thought of on our own. Traditional institutions and concepts of freedom are threatened by this digital tailspin. But that doesn’t mean we are lost. A new game emerges, where a different set of rules applies. To take part, we need to embrace a new way of thinking and a radical new ethics – we need to search for freedom in completely different places. While the Old Game depended upon top-down hierarchies and a trust in the protective power of state justice systems, the New Game asks you to let go of all these certainties. Strategies to play the game of digital tailspin rely on flexibility, openness, transparency and what is dubbed ‘antifragility’. In Digital Tailspin: Ten Rules for the Internet After Snowden Michael Seemann examines which strategies are most appropriate in the New Game and why.
Does our knowledge about city and urban planning have solid ground? Can historical research promote creative thinking? How can we theorise about urban design and architecture in our age of the media? These questions have guided the creation of this multi-layered, richly documented and illustrated triptych, in which the Dutch architectural theorist Wim Nijenhuis pursues a creative goal: to stimulate new ways of thinking in architectural culture.Each part of the triptych treats distinctive issues with a particular style of writing:I – a treatise on urban history. Using the archaeological-genealogical toolkit Nijenhuis reveals the difference between urbanistic discourse in the modern and the classical age; the first staging the street and public space, the latter adhering to representation and mathematical order. In great detail he shows how modern urbanism did not emerge from idealistic motives and technical urgencies, but from an accidental mix of medical, engineering and aesthetical parlances, and how classical thinking on the city dissociated from Renaissance by an intertwining of military science, political science, anthropology and ethics.II – a bundle of essays about the condition of the city in our media age. In strikingly composed texts the author prophesies how rapid traffic and transmission speed of media will distort the perception of our real cities. This gradual event will profoundly influence the cultural role of architecture.III – a set of meditations about epistemological problems. Questioning the practice of critical writing, Nijenhuis proposes change of subjectivity (and thereby worldview), ethical indifference, parody, curative mythomania and hypermodern dilettantism.The book is composed as a cloud essay that serves to enrich the reader’s theoretical understanding of urban interventions. Dialoguing with philosophers like Bataille, Deleuze, Foucault, Klossowski, Sloterdijk and Virilio, Nijenhuis covers multiple disciplines such as urbanism, architecture, history, media science, philosophy and art. Stretching urbanistic thinking beyond its limits he carries the reader along into the miraculous world of the street, the engineer, the norm, the form, order, fortresses, discipline, army camps, city frontiers, the Temple of Salomon, the quest for beauty, the ‘impressiveness’ of images, speed, the tragedy of the omnipolis, solidification of time, and the liquidising potency of apocalypticism and Taoist non-action.The Riddle of the Real City testifies to four experimental exercises: transitory subjectivism to reveal hidden dimensions of the person, transhistorical verticality to communicate with singular events from the past, theory as toolkit and pursuing a personal path in reading and investigation.
