Kristoffersenguerrero5113
A successful transition from gavage to full oral feeding is a decisive indicator for discharging premature infants from the neonatal intensive care unit. A clinically useful measure of oral feeding readiness would help nurses initiate implementation of the cue-based feeding model in Taiwan. The study aimed to assess the validity and reliability of the Traditional Chinese Preterm Oral Feeding Readiness Assessment Scale (TC-POFRAS).
81 preterm infants were enrolled and assessed by TC-POFRAS regarding their oral feeding readiness. This study included two phases. Phase 1 conducted a cross language validation procedure and item-level content validity indices (I-CVIs) for content validity were estimated. In phase 2, Cronbach's alpha for internal consistency at each category and total scale levels were estimated. A receiver operating characteristic (ROC) curve was estimated to explore the scale's performance. The optimal cut-off value of TC-POFRAS was identified by the best Youden's Index [maximum (sensitivity+specificity-1)].
All of the I-CVIs were 1.00. The whole Cronbach's alpha for internal consistency was 0.804 (95% CI=0.736-0.862), and Cronbach's alpha values were between 0.538 (95%=0.332-0.689) and 0.687 (95%CI=0.572-0.781) for categories. The area under ROC was 92.2%, and an optimal cut-off value of TC-POFRAS was 29 (sensitivity 0.938, specificity 0.941).
The TC-POFRAS has been verified to be an effective and accurate instrument to determine the initiation of oral feeding in preterm infants.
The TC-POFRAS is an appropriate and complementary assessment instrument for professionals to conveniently use in clinical practice.
The TC-POFRAS is an appropriate and complementary assessment instrument for professionals to conveniently use in clinical practice.
To identify the spiritual needs of children and adolescents with chronic illnesses and how these needs are met by health professionals during hospitalization.
A qualitative descriptive study was developed with 35 children and adolescents, between 7 and 18years old, diagnosed with cancer, cystic fibrosis, and type 1 diabetes. Interviews with photo-elicitation were conducted during the hospitalization at a Brazilian public pediatric hospital. Findings were treated using thematic analysis, and the Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed for quality reporting. This research was approved by a research committee.
Two themes emerged. The first, entitled 'Spiritual needs', encompasses five types of needs (1) need to integrate meaning and purpose in life; (2) need to sustain hope; (3) need for expression of faith and to follow religious practices; (4) need for comfort at the end of life; and (5) need to connect with family and friends. The second theme was the 'Definition of spiritual care'.
Children and adolescents with chronic illnesses have spiritual needs while in hospital. Meeting these needs is essential for finding meaning, purpose and hope in the experience of living with chronic illnesses and at the end of life, based on their faith, beliefs and interpersonal relationships. But, these needs have not been fully addressed during hospitalization.
These results emphasize the need to implement spiritual care when caring for hospitalized pediatric patients, which includes addressing spiritual needs.
These results emphasize the need to implement spiritual care when caring for hospitalized pediatric patients, which includes addressing spiritual needs.
To investigate the incidence of infection in patients with prior biliary interventions undergoing hepatic embolotherapy following extended antibiotic prophylaxis using moxifloxacin monotherapy or a multidrug regimen.
Under an Institutional Review Board-approved protocol, retrospective review of a quality assurance database identified all liver-directed therapies (LDTs) at a tertiary care center between 2010 and 2019 with biliary intervention prior to LDT Records were reviewed for infectious complications within 3 months of chemo- or radioembolization. Patients were categorized based on extended antibiotic prophylaxis regimen oral moxifloxacin monotherapy or multidrug regimen of levofloxacin and metroniodazole plus preprocedural neomycin and erythromycin. Procedures without at least 2 months of clinical follow-up, hepatic ablation, and procedures without extended antibiotic prophylaxis were excluded Regression analysis was used to analyze multivariate data to detect a difference in infection rate.
Twenty differences in the incidence of infectious complications in this population.Urea cycle disorders (UCDs), inborn errors of hepatocyte metabolism, result in the systemic accumulation of ammonia to toxic levels. Sodium 4-phenylbutyrate (NaPB), a standard therapy for UCDs for over 20 years, generates an alternative pathway of nitrogen deposition through glutamine consumption. Administration during or immediately after a meal is the accepted use of NaPB. However, this regimen is not based on clinical evidence. Here, an open-label, single-dose, five-period crossover study was conducted in healthy adults to investigate the effect of food on the pharmacokinetics of NaPB and determine any subsequent change in amino acid availability. Twenty subjects were randomized to one of four treatment groups. Following an overnight fast, NaPB was administered orally at 4.3 g/m2 (high dose, HD) or 1.4 g/m2 (low dose, LD) either 30 min before or just after breakfast. At both doses, compared with post-breakfast administration, pre-breakfast administration significantly increased systemic exposure of PB and decreased plasma glutamine availability. Pre-breakfast LD administration attenuated plasma glutamine availability to the same extent as post-breakfast HD administration. Regardless of the regimen, plasma levels of branched-chain amino acids (BCAA) were decreased below baseline in a dose-dependent manner. In conclusion, preprandial oral administration of NaPB maximized systemic exposure of the drug and thereby its potency to consume plasma glutamine. This finding may improve poor medication compliance because of the issues with odor, taste, and pill burden of NaPB and reduce the risk of BCAA deficiency in NaPB therapy.
The purpose of this study was to examine nurses' use and knowledge of caffeine and high energy drinks (HED) in three countries.
Nurses in each country completed a survey on caffeine and HED use and knowledge.
In a sample of 182 nurses, caffeine use was high with 92% of nurses in Korea, 90.8% in Italy and 88.1% in the United States (US) having at least one cup of coffee a day while 64% of Koreans and 11.9% of those in the US had at least one HED per day. In Korea 68% of nurses (Italy 63.1% and 35.8% US) had at least one cup of caffeinated tea per day. Most agreed there is a need to educate nurses about HED, which contain high amounts of caffeine. Over half of nurses in Korea (58%) and the US (56.7%) said their colleagues consume HED at work.
Findings of this study indicate many nurses are consuming caffeine at work and there is a need for education. It is unclear how caffeine affects nurses' clinical performance, which raises the issue of patient safety. Further research is needed regarding safe amounts of caffeine while nurses are on the job as well as an understanding of how HED additives may affect the well-being and clinical care of nurses.
Findings of this study indicate many nurses are consuming caffeine at work and there is a need for education. It is unclear how caffeine affects nurses' clinical performance, which raises the issue of patient safety. Further research is needed regarding safe amounts of caffeine while nurses are on the job as well as an understanding of how HED additives may affect the well-being and clinical care of nurses.Depression and anxiety are highly prevalent and have major adverse effects on function and quality of life in Parkinson's disease (PD). Optimal management requires that motor symptoms and psychiatric symptoms be simultaneously addressed. While there is fairly robust evidence for the treatment of motor symptoms, there are no completed randomized controlled trials to guide pharmacological treatment of anxiety in PD and no nonpharmacologic interventions have proven efficacious. Several high-quality trials for depression in PD suggest a number of antidepressants and cognitive behavioral therapy may help, but there is no data on rates of recurrence, comparative efficacy, or augmentation strategies. In order to address the gaps in knowledge, the authors provide a summary of the current evidence for treating depression and anxiety in PD and offer an algorithm that extends beyond the current literature based on clinical experience working in a multidisciplinary specialty center.
Detrusor contractility (DC) can have a considerable impact on the management oflower urinary tract symptoms (LUTS). However, it is currently impossible to predict, based on clinical data alone, which woman has an impaired DC. Our aim was to determine if DC, assessed by projected isovolumetric pressure-1 (PIP1) and VBN contractility parameter k, was associated with age, main complaint, and urodynamic diagnosis in a population of older women.
Pressure-flow studies of non-neurologic post menopausal women over 65 referred for investigation of LUTS were retrospectively analyzed. Associations between DC indices PIP1 and k, and age, main complaint and urodynamic diagnosis were assessed in univariate analysis.
One hundred and ninety women were included (mean age 74.5 years). There was no significant association between detrusor contractility indices and age considered as a continuous or a categorical variable. Urge urinary incontinence was significantly associated with greater detrusor contractility regardless of age. Regarding urodynamic diagnoses, DC was greater when bladder outlet obstruction and detrusor overactivity were diagnoses vs. Bcr-Abl inhibitor detrusor underactivity alone or associated with detrusor overactivity, regardless of age.
PIP1 and k indices allow an easy evaluation of detrusor contractility. In that population of older, post menopausal women, no significant change in the value of the indices is observed with aging whatever the complaint or the urodynamic diagnosis. None of these indices has predominance.
4.
4.Most of the people experience digestive problems like constipation, diarrhoea, acid eructations, loss of appetite etc. at some stage of life. These are the acute conditions that appear due to Agnimandya (reduced power of digestion, assimilation and metabolism). Conditions that may cause Agnimandya includes changes in diet and lifestyle and chronic diseased conditions. When the Agnimandya or the conditions that may cause Agnimandya persist for longer duration it turns into a life threatening disease. When Doshas (body humours) get aggravated, they affect the Agni (Power of digestion, assimilation and metabolism) and thus the food taken is not digested properly forming the Ama (morbid material). Ama when formed is accumulated in the body over the period of time, forming roots of many diseases. In the present case study the patient has Agnimandya, because of the chronic metabolic conditions. The Agnimandya and consequent nutritional deficiencies are addressed, while preparing the treatment protocol. The central focus of Ayurvedic treatment is the management of Agni and the Ama.
