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The Orb of Life

Orb of LifeDecember 1, 2009 -- Today the Democrat and Chronicle (Rochester, NY) ran a very good article by Patti Singer about the work of University of Rochester nursing scholar Martin Schiavenato to develop an "orb" that uses artificial intelligence to measure pain in premature infants. Schiavenato and his team are developing ways to measure vital signs and movements, then translate them into colors so clinicians can determine and treat the conditions of vulnerable infants, for whom pain may have life-long developmental effects. The report includes quotes from Schiavenato, who used to practice in the NICU, and from two other nursing scholars. It notes that the orb could have far-reaching implications, potentially giving us new ways to assess pain in older patients, including those with disabilities, dementia, or language barriers, and those in comas. We commend Singer and the Democrat and Chronicle for a helpful report on this vital nursing research.

Martin SchiavenatoThe article is headlined: "Device assesses infant pain: Professor's invention used to translate hurt into colors." It explains the problem Schiavenato (right) has been addressing for four years: Premature infants can't tell anyone about their pain, even though it can change how their neural pathways develop, affecting how they experience sensations and their cognitive and motor skills later in life. However, as he notes, there are "signs of distress in infants," including changes in heart rate, an "O"-shaped mouth, and splayed fingers.

Babies usually have their hands fisted. When they get overwhelmed, these infants will splay their hands, open up, almost like saying stop.

The piece describes Schiavenato's goal as "using artificial intelligence to develop objective measures of pain and translate them into colors that will light up an orb for anyone in the room to see." The report explains that he and his team will use an electrocardiograph to measure changes in heart rate, sensors to measure mouth and hand movements, and software to convert these signals into colors to signify "specific pain conditions." The piece notes that the device has been compared to a "1970's mood ring."

Unlike some pieces on nurses, this one does not waste time on marginally relevant personal background or melodrama. We simply get the (obviously relevant) information that the 41-year-old Schiavenato is a nursing professor who used to practice nursing in the neonatal intensive care unit. However, it might have been useful to mention that he has a PhD in nursing.

The article also gives a good sense of the broader context, explaining that the device might have implications for pain control for many different patients. The report explains that using "the algorithms and the orb" could remove the subjective element from the usual adult pain self-assessments. And it could "allow clinicians to assess the pain of children with developmental disabilities, people with dementia, those in a coma and [it] can knock down a language barrier." However, the piece notes, Schiavenato is especially concerned about NICU patients and the "sometimes invasive treatments" they endure:

We're not trying to torture them. But it is an intensive care unit. These little guys have come out too early. They're not ready for prime time.

The report also says that Schiavenato recently received "a three-year $350,000 Robert Wood Johnson Foundation Nurse Faculty Scholar grant," which he will use to move from the prototype stage to "a workable device that will be placed at the bedside." The piece quotes RWJF's Jacquelyn Campbell (herself a leading nursing scholar) who says that this project combined "imagination and practicality" in a way with the potential to help the "youngest and most vulnerable." And Harriet Kitzman, the associate dean for research at the University of Rochester's nursing school, echoes Schiavenato's points about the stresses on NICU patients, noting that the new device could help "clinicians who are caring for these very vulnerable infants [to] see the responses very rapidly so we can keep the stress and pain on infants as minimal as possible."

On the whole, this is a remarkable example of mainstream reporting about nursing research. Maybe it's just that orbs are so cool. But it remains relatively rare for the mainstream media to take an interest in nursing research, even when it is as potentially important as this. And this project, which focuses on caring for the whole patient rather than one isolated condition, clearly reflects the overall focus of nursing research and practice. In particular, nurses have long been at the forefront of pain research, showing just how critical it is to patients' recovery and overall well-being. Of course, nurses also play a central role in neonatal intensive care settings. And the report does not stop with a basic description of the project, but makes clear that it is a multi-year venture with far-reaching potential and the financial support of a major foundation.

We thank Singer, the Democrat and Chronicle, and everyone involved in making the article happen.

See the article by Patti Singer "Device assesses infant pain Professor's invention used to translate hurt into colors" posted on December 1, 2009.

Please thank Ms. Singer for covering this research at PSINGER@DemocratandChronicle.com. Thank you!