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Hello everyone, and welcome to this presentation on thermoregulatory responses.
My focus today is on how thermoregulatory feedback systems became
a guide to intervention research in the nursing management of fever symptoms.
I'm Barbara Holtzclaw, and I'm at
the University of Oklahoma Health Sciences Center in Oklahoma City, USA.
This is where my program of research took a shift from a direction I was in,
studying responses of people losing heat to those with rising temperatures.
I'd first like to acknowledge the contributions to my work from
the Robert Wood Johnson Clinical Nurse Scholars Program who
funded my postdoctoral work.
I also would like to thank the faculty and the clinical mentors who have
informed me all these years and encouraging me throughout my career,
specifically my mentor, Dr. June Abbey,
who inspired me to answer clinical questions with research.
Finally, I'd like to acknowledge
that meaningful clinical research is seldom done in isolation.
I had nurse clinicians that often identified the symptoms most in need of management,
and I had research collaborators who helped me lead the work.
It's also important that I share that, finding solutions to this problem
didn't happen in the solitude of a library or even in an ivory tower.
It took a virtual village of curiosity and concern and
knowledge from interdisciplinary collaborators on three university campuses.
My objectives for this presentation are to share with you how my interests in
thermoregulation actually motivated me to take
a deep dive into the mechanisms that surround specific symptoms.
By doing that, I was able to more appropriately develop
interventions aimed directly at
the underlying cause to either prevent or treat the symptom.
My hope is that this talk will help you understand that the thermoregulatory mechanisms
that cause shivering when you are cold are the
same as those responsible for the shivering seen in fever.
Understanding that muscle activity in shivering produces heat during fever
helps to explain why we should avoid either cooling or stimulating that response.
We should consider fever as a whole array of responses,
with the two that are most prevalent being the acute phase response,
and this is what causes the aches and malaise during fever,
and the thermal consequences which cause chills and elevated body temperature.
Many people and some nurses are not aware that the ache and ill-feeling that accompanies
fever is related to the biochemical actions of
the acute phase response and not to the rising temperature.