Carrollmorrow2725

Median duration of VAD support was 7.5months (IQR 3-11.3months). Two patients underwent VAD explant due to recovery of LV function, one died due to cancer progression, and three underwent heart transplantation.

Durable VAD support should be considered as a therapeutic option for children who have advanced HF due to chemotherapy-induced cardiomyopathy, even within 2years of completing cancer treatment. A multi-disciplinary approach is essential for appropriate patient selection prior to implant and to ensure comprehensive care throughout the duration of VAD support.

Durable VAD support should be considered as a therapeutic option for children who have advanced HF due to chemotherapy-induced cardiomyopathy, even within 2 years of completing cancer treatment. A multi-disciplinary approach is essential for appropriate patient selection prior to implant and to ensure comprehensive care throughout the duration of VAD support.Midwives and nurses play a critical role in safeguarding the lives of women in resource-constrained African countries. Working within the context of scarce resources may undermine their moral agency and hinder their ability to care. The purpose of this paper is to understand the influence of resource scarcity on midwifery and nursing care and practice. A critical ethnography was conducted in the obstetric department of three tertiary-level facilities in Ghana. Purposive sampling was used to recruit 30 midwives and nurses and semistructured interviews, field notes and documentary materials were used to generate in-depth understanding. Ethical approval was granted from Canada and Ghana and written, and ongoing informed consent was obtained from the participants. Five conceptual themes depicting the impact of scarce resources on midwifery and nursing care were discovered compromised care, constrained care, dehumanized care, missed care and disengaged care. Improving the maternal health of women and averting avoidable maternal morbidity and mortality require governments and institutions to invest in health infrastructure that will support the delivery of ethical and safe midwifery care for women in their most vulnerable period.

Various approaches exist to treat youth with anorexia nervosa (AN). Family-based treatment (FBT) has never been compared to long inpatient, multimodal treatment (IMT) in a randomized controlled trial (RCT). The aim of this study was to compare data on body weight trajectories, change in eating disorder psychopathology, hospital days and treatment costs in RCTs delivering FBT or IMT.

Review of RCTs published between 2010 and 2020 in youth with AN, delivering FBT or IMT.

Four RCTs delivering FBT (United States, n=2; Australia, n=2), one RCT delivering Family Therapy for AN (United Kingdom) and two RCTs delivering IMT (France, n=1; Germany, n=1) were identified from previous meta-analyses. The comparison of studies was limited by (1) significant differences in patient baseline characteristics including pretreated versus non-pretreated patients, (2) use of different psychometric and weight measures and (3) different initial velocity of weight recovery. Minimal baseline and outcome reporting standards for body weight metrics andnature/dose of interventions allowing international comparison are needed and suggestions to developing these standards are presented.

An RCT should investigate, whether FBT is a viable alternative to IMT, leading to comparable weight and psychopathology improvement with less inpatient time and costs.

An RCT should investigate, whether FBT is a viable alternative to IMT, leading to comparable weight and psychopathology improvement with less inpatient time and costs.Posttraumatic stress disorder (PTSD) is a prevalent disorder worldwide and often co-occurs in dementia. Both have a major impact on disease burden and quality of life. PTSD may be difficult to recognize in dementia and a structured diagnostic method is lacking. In order to get insight into the clinical diagnostics of PTSD in dementia, this systematic literature review evaluates the clinical presentation of PTSD and other relevant symptoms in people with dementia. PubMed, PsycINFO, Embase, and CINAHL were searched for all publications through 30 December 2021. Articles were included which met the following criteria (i) description of at least one case with a current diagnosis of dementia and co-morbid PTSD; (ii) clinical presentation of symptoms being adequately described; (iii) no difference being made between chronic PTSD, PTSD with re-activation, and delayed onset PTSD. Of the 947 identified abstracts, 13 papers met the inclusion criteria and were included (describing 30 cases). Based on our rating, only one case completely fulfilled the DSM-5 criteria of PTSD. Avoidance was only described in three cases. Most commonly described symptoms were irritability and anger (E1, 9%), persistent negative emotional state (D4, 9%), and sleep disturbances (E6, 8%). In 93% of the case reports, other symptoms were also described, i.e. memory problems (58%), screaming (33.3%), and wandering (22.2%). People with dementia who have experienced a traumatic event seem to present, based on our rating method, with insufficient symptoms to meet all criteria for a PTSD DSM-5 diagnosis. The DSM-5 core symptom of avoidance was absent in most of the cases. Clinical presentation consists mainly of symptoms of irritability, anger, persistent negative emotional state, and sleep disturbances, often accompanied by other symptoms. These findings suggest that older people with dementia may have other symptom presentations than people without dementia.See related article See related article See related article See related article See related article See related article See related article.

Cognitive-behavioural therapy (CBT) delivered face-to-face and via the internet reduces bulimia nervosa (BN) symptoms. However, our empirical understanding of factors affecting patient outcomes is limited.

Using data from a randomised, controlled trial comparing internet-based (CBT4BN, n=78) with face-to-face (CBTF2F, n=71) group CBT (97% female, M=28 years), we examined general treatment (across conditions) and modality-specific predictors of end-treatment and 1-year outcomes (abstinence, binge-eating frequency, purging frequency).

Improved eating disorder-related quality of life (EDQOL) during treatment and follow-up predicted abstinence at end-treatment and 1-year assessments. Improved EDQOL, disordered eating cognitions, and anxiety symptoms predicted less frequent binge eating and purging. Previous CBT and being employed predicted more frequent binge eating and purging at both assessments. Higher self-transcendence and self-directedness predicted less frequent binge eating. More severe binge eating and purging at baseline and end-treatment predicted more frequent binge eating and purging at subsequent assessments. Improved EDQOL was more strongly associated with positive outcome in CBT4BN; improved depressive symptoms and health-related QOL predicted positive outcome in CBT4BN but not CBTF2F.

Symptom improvement and certain character traits predicted positive outcome, whereas more severe presentation and prior CBT experience predicted poorer outcome. Consideration of intreatment symptom improvement may facilitate care recommendations, particularly for internet-based modalities.

Symptom improvement and certain character traits predicted positive outcome, whereas more severe presentation and prior CBT experience predicted poorer outcome. Consideration of intreatment symptom improvement may facilitate care recommendations, particularly for internet-based modalities.To present a physiological algorithmic approach to weaning of invasive ventilation in the neonatal intensive care, focusing mainly on the preterm infant. Review of literature, consensus guidelines, expert commentaries and practice guidelines from individual units. Weaning of ventilation for extubation in the neonatal population must follow certain criteria but needs individualising based on disease process, timeline and physiology. Algorithms based on scenarios and modes of ventilation used might aid the clinician on the floor for decision-making process.Climate change predicts the increased frequency, duration, and intensity of inclement weather periods such as unseasonably low temperatures (i.e., cold snaps) and prolonged precipitation. Many migratory species have advanced the phenology of important life history stages and, as a result, are likely to be exposed to these periods of inclement spring weather more often, therefore risking reduced fitness and population growth. For declining avian species, including aerial insectivores, anthropogenic landscape changes such as agricultural intensification are another driver of population declines. These landscape changes may affect the foraging ability of food provisioning parents and reduce the survival of nestlings exposed to inclement weather through, for example, pesticide exposure impairing thermoregulation and punctual anorexia. Breeding in agro-intensive landscapes may therefore exacerbate the negative effects of inclement weather under climate change. We observed that a significant reduction in the availadeclines in certain landscape contexts.

Identify and examine drivers of nurse manager competency and high-quality practice environments.

Nurse managers are a key predictor of positive professional practice environments, which are, in turn, associated with nurse, patient, and organisational outcomes. selleck chemicals llc However, little work has examined the factors that contribute to nurse manager competency.

Nurse managers completed online surveys, which were matched to unit-level aggregate data of their subordinate direct care nurses' responses on the National Database of Nursing Quality Indicators. This resulted in a final sample of 541 nurse managers across 47 U.S. hospitals. Multilevel path analysis was utilized to assess a model of the antecedents and consequences of nurse manager competency.

Nurse manager competency and practice environments were predictive of missed nursing care and nurse-reported quality of care. Nurse manager experience was found to have twice the effect on competency as advanced education.

Nurse manager competency and its downstream effects are achieved through nurse manager experience and advanced education.

Nurse manager competency yields better practice environments and nursing care. Considering the influence of experience, careful attention should be paid to the competency development process of more novice nurse managers.

Nurse manager competency yields better practice environments and nursing care. Considering the influence of experience, careful attention should be paid to the competency development process of more novice nurse managers.Links between the regulation of growth and energy balance are clear; to fuel growth, there must be consumption of energy. Therefore, it is perhaps intuitive that interactions between the hypothalamic - pituitary - growth hormone axis (growth axis) and pathways that drive metabolic processes exist. Overproduction of growth hormone has been associated with diabetes and metabolic disease for decades and the opposing effects of growth hormone and insulin have been studied since early experiments almost a century ago. The relationship between neuroendocrine axes can be complex and the growth axis is no exception, interacting with energy balance in several organ systems, both in the periphery and centrally in hypothalamic nuclei. Much is known about peripheral interactions between growth axis hormones and processes such as glucose homeostasis and adipogenesis. More is still being learned about the molecular actions of growth axis hormones in adipose and other metabolically active tissues, and recent findings are discussed in this perspective.