The effect of oral care using honey as an additional topical agent on oral health status of intubated patients in the intensive care unit

BackgroundPatients using endotracheal tubes are at high risk of oral health status dysfunction due to impaired natural airway defence, oral flora composition changes and protective substances of the teeth, medication causing xerostomia. Oral care has not been enough to manage oral mucosal dryness, so an additional topical agent is needed to protect oral mucosa to maintain oral health. Honey is one of the recommended topical agents.ObjectiveThis study aims to identify the effect of oral care with honey as topical agents on the oral health status of patients using endotracheal tube in the Intensive Care Unit.MethodsThis was an experimental study with a randomized pretest and posttest design. The sample was adult intubated patients, consisting of 36 patients. The data were analysed using the parametric test, and dependent and independent t-test.ResultsThe oral health score in the control group was found to be pre & post mean score11.94 and 13.28 (p = .004) respectively, while in the intervention group 11.89 and 8.33 (p < .001). Mean differences in both groups were 4.95 (p < .001) and the BOAS subscale differences were seen on the lips, gums & mucosa, and tongue (p < .05).ConclusionOral care with honey as a topical agent can improve the oral health status of intubated patients on the lips, gum, mucosa, and tongue subscale. Therefore, honey as an additional topical agent can be a moisturizer to maintain the oral mucosa for intubated patients in the Intensive Care Unit. Furthermore, good mucosal health will help prevent the infection and colonization of microorganisms.     

Sage tea–thyme–peppermint hydrosol oral rinse reduces chemotherapy-induced oral mucositis: A randomized controlled pilot study

ObjectiveThis pilot study aimed to investigate the preventive effect of sage tea–thyme–peppermint hydrosol oral rinse used in conjunction with basic oral care on chemotherapy-induced oral mucositis.DesignAn open-label randomized controlled study.SettingTwo oncology hospitals in Ankara, Turkey.InterventionsPatients receiving 5-fluorouracil-based chemotherapy regimens were divided into the intervention group (N = 30) and control group (N = 30). Basic oral care was prescribed to the control group, while the intervention group was prescribed sage tea–thyme–peppermint hydrosol in addition to basic oral care. All patients were called to assess their compliance with the study instructions on day 5 and 14.Main outcome measuresOral mucositis was evaluated using an inspection method or by assessing oral cavity photos based on the World Health Organization oral toxicity scale on day 5 and 14.ResultsMost of the patients in the intervention group did not develop oral mucositis on day 5. In addition, the incidence of grade 1 oral mucositis was statistically lower in the intervention group (10%) than the control group (53.3%) on day 5. By day 14, the majority of patients in both the groups had grade 0 oral mucositis.ConclusionsSage tea–thyme–peppermint hydrosol oral rinse has promising results in alleviating oral mucositis. This hydrosol can be recommended for clinical use as it is well tolerated and cost-effective. However, further randomized controlled trials are needed to support the study.     

Effects of mouthwash interventions on xerostomia and unstimulated whole saliva flow rate among hemodialysis patients: A randomized controlled study

BackgroundDry mouth (xerostomia) is a common symptom in hemodialysis patients, which is associated with a reduced salivary flow. Xerostomia affects patients’ oral health and quality of life.ObjectivesThe aim of this study was to investigate using a mouthwash as a means to reduce xerostomia and improve saliva flow rates in hemodialysis patients.DesignA randomized controlled trial.Settings and methodsThree dialysis centers in Northern Taiwan served as the study sites. Patients were purposively sampled from three hemodialysis centers in Taiwan and randomly assigned to one of three groups: pure water mouthwash; n = 41, licorice mouthwash; n = 44, or no mouthwash (control); n = 37. The Summated Xerostomia Inventory, and unstimulated whole salivary flow rate measured dry mouth and salivary flow, respectively. Data was collected at baseline, dialysis Day 5 and Day 10.ResultsOne hundred twenty-two patients participated in this study. Baselines were adjusted for any imbalances in variables and generalized estimating equations analysed the data. Compared to control, a pure water mouthwash resulted in an increase in the unstimulated salivary flow rate of 25.85 × 10⁻³ mL/min and 25.78 × 10⁻³ mL/min (p < 0.05) at Day 5 and Day 10, respectively. The estimated effect size was 1.38. However, there was no significant decrease in Summated Xerostomia Inventory scores. The licorice mouthwash also significantly improved the unstimulated salivary flow rates to 114.92 × 10⁻³ mL/min, and 131.61 × 10⁻³ mL/min at Day 5 and Day 10, respectively (p < 0.001). However, in contrast to the pure water mouthwash, the licorice mouthwash resulted in a significant improvement in the scores for the Summated Xerostomia Inventory (p < 0.001).ConclusionAlthough a pure water or a licorice mouthwash and improved the objective measure of salivary flow rate, only the licorice mouthwash provided subjective relief of xerostomia. This suggests the use of a licorice mouthwash may effectively relieve feelings of dry mouth in hemodialysis patients.     

Development of an oral assessment tool to evaluate appetite in patients with head and neck cancer receiving radiotherapy

PurposeThe objective of this study was to develop an oral assessment tool for evaluating the appetite of patients with head and neck cancer receiving radiotherapy, who had dysgeusia, xerostomia, and oral mucositis, as well as to verify its validity and reliability.Methods and sampleA draft oral assessment tool, which included a 5-point scale and 19 items, was prepared based on an interview survey of 30 patients. The resultant questionnaire survey was provided to 209 subjects.ResultsOn the basis of factor analysis of construct validity, 3 factors (dysgeusia and loss of favors), (salivation abnormality and loss of moisture in the oral cavity), and (pain in the oral cavity and lack of motivation) comprising 14 items were adopted for the final survey. During a review of criteria validity, a correlation was found between the scores of the three factors and overall oral assessment tool, and the scores of taste sensitivity, xerostomia, oral mucositis, and appetite with a correlation coefficient of r = 0.41–0.89 (p < 0.01). With regard to reliability, stability was determined as 0.87 (p < 0.01) according to test–retest study results. Internal consistency was confirmed by a Cronbach's alpha coefficient of 0.83 (p < 0.01) and an interclass correlation coefficient of 0.80 (p < 0.01).ConclusionsOn the basis of the validity and reliability of the oral assessment tool developed, it has been found to be practical for use in the assessment of appetite of patients with head and neck cancer.     

The nitric oxide synthase 3 gene polymorphisms and their association with deep vein thrombosis in Asian Indian patients

BackgroundEndothelium derived nitric oxide is formed from l-arginine by endothelial nitric oxide synthase encoded by the nitric oxide synthase 3 (NOS3) gene. Nitric oxide possesses a variety of protective effects on endothelial cells and therefore NOS3 is a logical candidate gene to be investigated for the susceptibility of deep vein thrombosis (DVT).MethodsOne hundred consecutive patients (M: F = 56:44) with idiopathic deep vein thrombosis and an equal number of age and sex matched healthy controls were the study subjects. All study subjects were typed for five NOS3 polymorphisms (? 786C/T, ? 922A/G, 894G/T, Intron 4 VNTR, and Intron 23 G10T).ResultsTwo polymorphisms (? 922A/G and 894G/T) are showing their association with DVT. ? 922A/G shows both genotypic (P = 0.0218; χ² = 5.25; O.R = 1.94) as well as allelic association (P = 0.0014; χ² = 10.19; O.R = 2.0) while 894G/T shows only allelic (P = 0.04; χ² = 3.93; O.R = 3.93) association with DVT.ConclusionSusceptibility to DVT in North Indian Asian patients may be associated with some variants of NOS3 gene.     

Adverse effects and appetite suppression associated with particle beam therapy in patients with head and neck cancer

Aim: This purpose of this study was to investigate the relationship between the appetite and various factors that are associated with particle beam therapy, including the adverse effects of radiation, dry‐mouth period, analgesic medication use, frequency of oral care, and participants' characteristics, in 121 patients with head and neck cancer. Methods: A path analysis was used to evaluate the causal relationship of the factors that affected the participants' appetite. Results: At a cumulative dose of 40 GyE, the factors that impacted the participants' appetite included xerostomia, oral mucositis, age, frequency of oral care, and analgesic medication use. At a cumulative dose of 50 GyE, the factors that affected the participants' appetite were xerostomia, sensitivity to taste, oral mucositis, dry‐mouth period (in the morning), frequency of oral care, number of artificial teeth, and analgesic medication use. The results indicate that interventions to avoid appetite suppression during particle beam therapy will differ according to a radiation schedule of 40 GyE, compared to 50 GyE. Conclusions: These results are important to consider when deciding how best to maintain the dietary intake of patients who are receiving particle beam therapy.     

FTO and MC4R gene variants determine BMI changes in children after intensive lifestyle intervention

ObjectivesThis study aimed to determine whether there is a relationship between common FTO (rs17817449) and MC4R (rs17782313) gene variants and body mass reduction or weight loss after a one-month lifestyle intervention in overweight/obese children.Design and methodsWe genotyped 357 unrelated non-diabetic Czech children (age 13.7 ± 4.9 years, average BMI at baseline 30.8 ± 4.6 kg/m²). Biochemical and anthropometrical measurements were performed before and after 4 weeks of lifestyle interventions (comprising a reduction in energy intake to the age-matched optimum and a supervised exercise program consisting of 5 exercise units per day, 50 min each).ResultsThe mean weight loss achieved was 6.2 ± 2.1 kg (P < 0.001). Significant associations were found between a BMI decrease and the FTO and MC4R variants. Carriers of the FTO GG genotype and/or MC4R CC genotype lost significantly more body weight compared to noncarriers (P < 0.0009 for BMI and P < 0.002 for body weight). These differences remained significant following adjustment for sex, age and baseline values (P = 0.004 for BMI and P = 0.01 for body weight).ConclusionsFTO and MC4R gene variants modify the impact of an intensive lifestyle intervention on BMI decrease in overweight/obese children. Carriers of the FTO GG genotype and MC4R CC genotype benefit significantly more from the lifestyle intervention.     

Use of error grid analysis to evaluate acceptability of a point of care prothrombin time meter

BackgroundStatistical methods (linear regression, correlation analysis, etc.) are frequently employed in comparing methods in the central laboratory (CL). Assessing acceptability of point of care testing (POCT) equipment, however, is more difficult because statistically significant biases may not have an impact on clinical care. We showed how error grid (EG) analysis can be used to evaluate POCT PT INR with the CL.Materials and methodsWe compared results from 103 patients seen in an anti-coagulation clinic that were on Coumadin maintenance therapy using fingerstick samples for POCT (Roche CoaguChek XS and S) and citrated venous blood samples for CL (Stago STAR). To compare clinical acceptability of results we developed an EG with zones A, B, C and D.ResultsUsing 2nd order polynomial equation analysis, POCT results highly correlate with the CL for CoaguChek XS (R² = 0. 955) and CoaguChek S (R² = 0. 93), respectively but does not indicate if POCT results are clinically interchangeable with the CL. Using EG it is readily apparent which levels can be considered clinically identical to the CL despite analytical bias.ConclusionWe have demonstrated the usefulness of EG in determining acceptability of POCT PT INR testing and how it can be used to determine cut-offs where differences in POCT results may impact clinical care.     

Performance evaluation of Siemens ADVIA Centaur and Roche MODULAR Analytics E170 Total 25-OH Vitamin D assays

ObjectivesTo evaluate the newly developed Roche MODULAR Analytics E170 Total Vitamin D and the Siemens ADVIA Centaur® Vitamin D Total assays.Materials and MethodsAssays were evaluated using the Clinical and Laboratory Standards Institute protocols. Split patient samples were compared with LC-MS/MS and DiaSorin LIAISON assays (n = 79 including 15 specimens with detectable endogenous 25-OH vitamin D₂). Assay accuracy was also evaluated using the Vitamin D External Quality Assessment Scheme (DEQAS) samples.ResultsThe ADVIA Centaur and E170 assays demonstrated maximum total CVs of 14.1% and 5.9%, respectively. Both showed excellent linearity (R² > 0.99). The ADVIA Centaur assay demonstrated interference with bilirubin at 800 μmol/L, hemolysis at 1.25 g/L, and triglycerides at 2.8 mmol/L. Compared to LC-MS/MS, the ADVIA Centaur assay demonstrated a R² value of 0.893, average bias of ? 8.8%; the E170 assay an R² value of 0.872, average bias of 14.3% with underestimation of 25-OH vitamin D₂. Compared to the LIAISON assay, the ADVIA Centaur assay demonstrated an R² value of 0.781, average bias of ? 17.3%; the E170 assay an R² value of 0.823, average bias of 11.4%. The ADVIA Centaur and E170 assays demonstrated a biases of < 20% in 10/10 and 8/10 DEQAS samples, respectively.ConclusionsThe ADVIA Centaur and E170 vitamin D assays demonstrated acceptable linearity, imprecision, and accuracy. The E170 assay demonstrated consistent underestimation of 25-OH vitamin D₂ levels. Compared with LC-MS/MS, the ADVIA Centaur assay demonstrated a higher R² value and a smaller average bias than the E170 assay.     

Association of R230C ABCA1 gene variant with low HDL-C levels and abnormal HDL subclass distribution in Mexican school-aged children

BackgroundThe effect of ABCA1 genetic variation on HDL-C levels has been widely documented, although studies in children are scarce. We recently found a frequent non-synonymous ABCA1 variant (R230C) exclusive to populations with Native American ancestry, associated with low HDL-C levels and other metabolic traits in adults.MethodsWe genotyped R230C variant in 1253 healthy unrelated Mexican school-aged children aged 6–15 years (595 boys and 658 girls) to seek associations with HDL-C levels and other metabolic traits. HDL subclass distribution was analyzed in a subgroup of 81 age, gender and BMI-matched children.ResultsIndividuals carrying the C230 allele showed a significantly lower HDL-C levels (P = 2.9 × 10^? 8), and higher TC/HDL-C ratio, BMI, BMI z-score and percent fat mass (P = 0.001, 0.049, 0.032 and 0.039, respectively). HDL size was smaller in R230C heterozygotes as compared to R230R homozygotes (P < 0.05). Moreover, the proportion of HDL_2b was lower, while the proportion of HDL_3a and HDL_3b particles was higher in R230C heterozygous and/or C230C homozygous individuals as compared to R230R homozygotes (P < 0.05).ConclusionsOur data suggest that the R230C ABCA1 gene variant plays an important role in HDL-C level regulation and HDL subclass distribution in healthy Mexican school-aged children.     

A preliminary evaluation of attenuated total reflection Fourier transform infrared spectroscopy for the hematological analysis of thalassemias

ObjectivesThe effectiveness of attenuated total reflection Fourier transform infrared spectroscopy for the hematological analysis of thalassemias was evaluated.Design and methodsThe correlations of hemoglobin, mean corpuscular volume and mean corpuscular hemoglobin between routine method and attenuated total reflection Fourier transform infrared spectroscopy were analyzed using linear regression analysis. Appropriate cut-off values of predicted mean corpuscular volume and predicted mean corpuscular hemoglobin in screening of thalassemias were derived from the receiver operator characteristic curve conducted on 103 subjects.ResultsObvious positive correlations of hemoglobin (beta = 0.876, R² = 0.791, P < 0.001), mean corpuscular volume (beta = 0.656, R² = 0.516, P < 0.001) and mean corpuscular hemoglobin (beta = 0.674, R² = 0.583, P < 0.001) were observed between routine method and attenuated total reflection Fourier transform infrared spectroscopy. Based on the receiver operator characteristic curve analysis, the best cut off value of predicted mean corpuscular volume for the phenotype-positive subjects was found to be 79.9 fl with a sensitivity of 100.0% and a specificity of 97.8%, and the proposed cut off value of predicted mean corpuscular hemoglobin was 27.3 pg with a sensitivity of 100.0% and a specificity of 96.8%. The area under curve was 0.996 for predicted mean corpuscular volume and 0.992 for predicted mean corpuscular hemoglobin, respectively.ConclusionsThe established method could be an additional potentially promising tool for the preliminary screening of thalassemias in population prevention and control program. The main advantage of this method is no unwanted chemical regents compared with conventional method. Strategy for the development of this method could be of use for the other important parameters of thalassemias.     

Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis

ObjectiveTo systematically review the effects of static stretching with positioning orthoses or simple positioning combined or not with other therapies on upper-limb spasticity and mobility in adults after stroke.MethodsThis meta-analysis was conducted according to PRISMA guidelines and registered at PROSPERO. MEDLINE (Pubmed), Embase, Cochrane CENTRAL, Scopus and PEDro databases were searched from inception to January 2018 for articles. Two independent researchers extracted data, assessed the methodological quality and rated the quality of evidence of studies.ResultsThree studies (57 participants) were included in the spasticity meta-analysis and 7 (210 participants) in the mobility meta-analysis. Static stretching with positioning orthoses reduced wrist-flexor spasticity as compared with no therapy (mean difference [MD] = −1.89, 95% confidence interval [CI] −2.44 to −1.34; I² 79%, P < 0.001). No data were available concerning the spasticity of other muscles. Static stretching with simple positioning, combined or not with other therapies, was not better than conventional physiotherapy in preventing loss of mobility of shoulder external rotation (MD = 3.50, 95% CI −3.45 to 10.45; I² 54.7%, P = 0.32), shoulder flexion (MD = −1.20, 95% CI −8.95 to 6.55; I² 0%, P = 0.76) or wrist extension (MD = −0.32, 95% CI −6.98 to 5.75; I² 38.5%, P = 0.92). No data were available concerning the mobility of other joints.ConclusionThis meta-analysis revealed very low-quality evidence that static stretching with positioning orthoses reduces wrist flexion spasticity after stroke as compared with no therapy. Furthermore, we found low-quality evidence that static stretching by simple positioning is not better than conventional physiotherapy for preventing loss of mobility in the shoulder and wrist. Considering the limited number of studies devoted to this issue in post-stroke survivors, further randomized clinical trials are still needed.Clinical Trial RegistrationPROSPERO (CRD42017078784).     

Rehabilitation of 190 non-ambulatory children with cerebral palsy in structures of care or in liberal sector

AimsTo describe the rehabilitation of non-ambulatory children with cerebral palsy and to explore adjustability on their individual needs.Material and methodData described are extracted from an on-going national cohort study, following during 10 years 385 children with cerebral palsy, aged from 4 to 10, Gross Motor Function Classification System IV and V. We analysed data from the first 190 patients (mean age 6 years 10 months (SD 2.0), 111 boys), focusing on physiotherapy, ergotherapy, psychomotility and speech therapy in medico-social and liberal sectors.ResultsIn medico-social sector, duration of paramedical care is significantly more important than in liberal sector (structure of care: median = 4.25 h/week, liberal sector: median = 2.00 h/week) (P < 0.0001). More than 4 different types of care per week are given in medico-social sector, while in liberal sector children benefit from only 2 different types of care a week. In investigators opinion, rehabilitation in structures of care is 71.65% adapted as opposed to 18.75% in the liberal sector (P < 0.001). Children level V have less time of rehabilitation than the others (P = 0.0424).InterpretationRehabilitation of children with cerebral palsy who are not able to walk, with an objective to improve quality of life, is truly multidisciplinary and suitable in medico-social sector.     

Efficacy of a care bundle to prevent multiple infections in the intensive care unit: A quasi-experimental pretest-posttest design study

BackgroundHealthcare-associated infections extend hospitalization time, increase treatment costs and increase morbidity-mortality rates.ObjectivesTo evaluate the efficacy of a care bundle aimed at preventing three most frequent intensive care unit-acquired infections.Materials and methodThis quasi-experimental study occurred in an 18-bed tertiary care intensive care unit at a university hospital in Turkey. The sample consisted of 120 patients older than 18 years and receiving invasive mechanical ventilation therapy, or had a central venous catheter or urinary catheter. The study comprised three stages. In stage one, the intensive care unit nurses were trained in infection measures, VAP, CA-UTIs and CLABSIs sections of the care bundle. In stage two, the trained nurses applied the care bundle and received feedback on any problematic issues. In stage three, the nurses' compatibility and efficacy of the infection prevention care bundle on the infection rates of VAP, CA-UTIs and CLABSIs were evaluated over three 3-month periods.ResultsOver 1000 ventilation days, ventilator-associated pneumonia infection rates were 23.4, 12.6, and 11.5, during January – March, April – June and July – September, respectively, with January – March and April – June showing a significant decrease (χ² = 6.934, p = 0.031). The central line-associated bloodstream infection rates were 8.9, 4.2, and 9.9 per 1000 catheter days, during January – March, April – June and July – September, respectively, but were not significantly different based on pair-wise comparisons (p > 0.05). The catheter-associated urinary tract infection rates were higher during July – September (6.7/1000 catheter days) compared to January – March (5.7/1000 catheter days) and April – June (10.4/1000 catheter days) but the differences were not significant (p > 0.05).ConclusionsThe infection rates decreased with increased compatibility of the care bundle prepared from evidence-based guidelines.     

Evaluating the effect of Matricaria recutita and Mentha piperita herbal mouthwash on management of oral mucositis in patients undergoing hematopoietic stem cell transplantation: A randomized,double blind,placebo controlled clinical trial

ObjectivesTo investigate the effects of Matricaria recutita and Mentha piperita on oral mucositis (OM) in patients undergoing hematopoietic stem cell transplantation (HSCT).DesignRandomized double blind placebo controlled clinical trial.SettingFaculty of Pharmacy, Shahid Beheshti University of Medical Sciences, and Bone Marrow Transplantation Center at Taleghani Teaching Hospital, Tehran, Iran.ParticipantsSixty patients undergoing HSCT were randomly assigned to two groups: placebo (n = 33), and herbal mouthwash group (n = 27).InterventionsAll patients received the mouthwash one week before HSCT and were instructed to use it three times daily for at least 30 s.Main outcome measuresOM was graded using National Cancer Institute Common Toxicity Criteria (NCI-CTC) scale (grade 0–5). The Numerical Rating Scale (NRS: 0–10 scale) measured the severity of OM symptoms.ResultsThe duration, maximum and average daily grade of OM were significantly reduced in the treatment group (P < 0.05). The use of herbal mouthwash led to significant improvements in pain intensity (P = 0.009), dryness (P = 0.04) and dysphagia (P = 0.009). Other significant results included: reduced need for complementary medications (P = 0.03), narcotic analgesics (P = 0.047), total parenteral nutrition (TPN) (P = 0.02) and the duration of TPN (P = 0.03).ConclusionThis study shows that patients receiving the herbal mouthwash experienced less complications and symptoms associated with OM. In summary, it seems that the use of our prepared herbal mouthwash is beneficial for patients undergoing HSCT.     

Rapid and quantitative detection of CpG-methylation status using TaqMan PCR combined with methyl-binding-domain polypeptide

ObjectivesTo assess the medical applicability of CpG methylation as molecular markers for cancer diagnosis, we established a new system to determine DNA methylation based on TaqMan PCR combined with a methyl-binding-domain polypeptide 2.Design and methodsWe evaluated the diagnostic applicability of this approach by examining the methylation status of two tumor suppressor genes, RASSF1A and APC, in 10 paired hepatocellular carcinoma (HCC) and the corresponding non-tumor liver tissues.ResultsMethylation levels of total 20 clinical samples measured by the TaqMan PCR assay showed a significantly positive correlation (R = 0.814, P < 0.0005 for RASSF1A, R = 0.736, P < 0.00001 for APC) with those calculated by bisulfite sequencing. The methylated DNA amount measured by our TaqMan PCR system precisely replicated the methylation status estimated by direct sequencing.ConclusionsThis suggests our method may serve as a reliable and easy-to-use tool for cancer diagnosis using methylated genes as biomarkers.     

Force and depth of mechanical chest compressions and their relation to chest height and gender in an out-of-hospital setting

IntroductionThe LUCAS 2 device stores technical data that documents the chest compression process. We analyzed chest wall dimensions and mechanics stored during chest compressions on humans using data gathered with the LUCAS 2 device.MethodsData from LUCAS 2 devices used in out-of-hospital cardiac arrest were downloaded with dedicated proprietary software and matched to the corresponding patient data. Cases were included only if the suction cup was placed correctly, if it was not realigned during the first 5 min of chest compressions, and if no other anomaly in device use was noted. Trauma cases were excluded.ResultsNinety-five patients were included. All patients received manual cardiopulmonary resuscitation prior to the application of the device. The mean (SD) chest height was 232 (25) mm for males and 209 (26) mm for females (P < 0.001). The mean (min–max) compression depth in patients with chest height >185 mm was 53 (50–55) mm, corresponding with 19–28% of the chest diameter. The mean force required to achieve the compression depth of 53 mm ranged between 219 and 568 N. No correlation was found between chest height and force to reach 53 mm depth (females: R² = 0.001, males: R² = 0.007).ConclusionThere was a large variation of the required force to achieve a compression depth of 53 mm. No correlation was seen between chest height and maximum force required to compress the chest 53 mm.     

Dancer perceptions of the cognitive,social, emotional,and physical benefits of modern styles of partnered dancing

ObjectiveTo study dancers’ perceptions of the physical, cognitive, affective, and social benefits of partnered dancing.Method225 dancers (71% female) were recruited through a community ballroom dance center and completed an online survey designed to measure their perceptions of the physical, cognitive, affective, and social benefits of modern, partnered dance styles (swing, Lindy Hop, and ballroom dancing). Subgroups were formed for analyses. For one set of analyses, groups based on length of dance participation were formed: experienced (dancing for more than 2 years) or novice (dancing for less than a year) dancers. For another set of analyses, groups based on frequency of dance practice were formed: committed (dancing at least one or more times per week) or occasional (dancing two or fewer times per month).ResultsThe majority of participants reported perceived benefits in physical fitness, cognition, affect, and social functioning. Experienced dancers reported significantly greater self-perceived physical, social, and cognitive benefits than novice dancers. Committed dancers were more likely than occasional dancers to report improvements in physical fitness, U = 6942, z = 2.38, r = 0.16, p < 0.05. A Mann-Whitney test indicated that self-reported improvements in mood (i.e., feeling less depressed and more happy) were greater for women than for men, U = 3945, z = −3.07, r = 0.20, p < 0.001. Length and frequency of dance participation significantly predicted perceived physical benefits [Χ² (1,6) = 35.463, p <0.001, R² = 0.16] and social benefits [Χ² (1,6) = 15.776, p < 0.05, R² = 0.07], but not cognitive benefits.ConclusionsResults suggest that participation in partnered dance styles is associated with perceived improvements in physical fitness, cognitive functioning, social functioning, mood, and self-confidence, and that perceived benefits may increase as individuals dance more frequently and over longer periods of time.     

Tailored educational supportive care programme on sleep quality and psychological distress in patients with heart failure: A randomised controlled trial

BackgroundUp to 74% of patients with heart failure report poor sleep in Taiwan. Poor symptom management or sleep hygiene may affect patients’ sleep quality. An effective educational programme was important to improve patients’ sleep quality and psychological distress. However, research related to sleep disturbance in patients with heart failure is limited in Taiwan.ObjectivesTo examine the effects of a tailored educational supportive care programme on sleep disturbance and psychological distress in patients with heart failure.Designrandomised controlled trial.Participants and settingEighty-four patients with heart failure were recruited from an outpatient department of a medical centre in Taipei, Taiwan. Patients were randomly assigned to the intervention group (n = 43) or the control group (n = 41).MethodsPatients in the intervention group received a 12-week tailored educational supportive care programme including individualised education on sleep hygiene, self-care, emotional support through a monthly nursing visit at home, and telephone follow-up counselling every 2 weeks. The control group received routine nursing care. Data were collected at baseline, the 4th, 8th, and 12th weeks after patients’ enrollment. Outcome measures included sleep quality, daytime sleepiness, anxiety, and depression.ResultsThe intervention group exhibited significant improvement in the level of sleep quality and daytime sleepiness after 12 weeks of the supportive nursing care programme, whereas the control group exhibited no significant differences. Anxiety and depression scores were increased significantly in the control group at the 12th week (p < .001). However, anxiety and depression scores in the intervention group remained unchanged after 12 weeks of the supportive nursing care programme (p > .05). Compared with the control group, the intervention group had significantly greater improvement in sleep quality (β = −2.22, p < .001), daytime sleepiness (β = −4.23, p < .001), anxiety (β = −1.94, p < .001), and depression (β = −3.05, p < .001) after 12 weeks of the intervention.ConclusionThis study confirmed that a supportive nursing care programme could effectively improve sleep quality and psychological distress in patients with heart failure. We suggested that this supportive nursing care programme should be applied to clinical practice in cardiovascular nursing.     

Effects of a nurse-led transitional care program on clinical outcomes,health-related knowledge,physical and mental health status among Chinese patients with coronary artery disease: A randomized controlled trial

BackgroundCoronary artery disease is a major cause of morbidity and mortality among adults worldwide, including China. After a hospital stay, transitional care could help to ensure improved patient care and outcomes, and reduce Medicare costs. Nevertheless, the results of the existing transitional care are not always satisfactory and our knowledge of how to perform effective transitional care for patients with coronary artery disease is limited in mainland China.ObjectivesTo examine the effectiveness of a nurse-led transitional care program on clinical outcomes, health-related knowledge, and physical and mental health status among Chinese patients with coronary artery disease.DesignRandomized controlled trial.MethodsThe Omaha system and Pender’s health promoting model were employed in planning and implementing this nurse-led transitional care program. The sample was comprised of 199 Chinese patients with coronary artery disease. The experimental group (n = 100) received nurse-led transitional care intervention in addition to routine care. The nurse-led transitional care intervention included a structured assessment and health education, followed by 7 months of individual teaching and coaching (home visits, telephone follow-up and group activity). The control group (n = 99) received a comparable length routine care and follow-up contacts. Evaluations were conducted at baseline and completion of the interventions using the perceived knowledge scale for coronary heart disease, the medical outcomes study 36-item short-form health survey and clinical measures (blood pressure, blood glucose, lipids, body mass index). Data were collected between March and October 2014.ResultsCompared with the control group, participants in the experimental group showed significant better clinical outcomes (systolic blood pressure, t = 5.762, P = 0.000; diastolic blood pressure, t = 4.250, P = 0.000; fasting blood glucose, t = 2.249, P = 0.027; total cholesterol, t = 4.362, P = 0.000; triglyceride, t = 3.147, P = 0.002; low density lipoprotein cholesterol, t = 2.399, P = 0.018; and body mass index, t = 3.166, P = 0.002), higher knowledge scores for coronary artery disease (total knowledge score, t = −7.099, P = 0.000), better physical health status (t = −2.503, P = 0.014) and mental health status (t = −2.950, P = 0.004).ConclusionsThis study provides evidence for the value of a nurse-led transitional care program using both the Omaha system and Pender’s health promoting model as its theoretical framework. The structured interventions in this nurse-led transitional care program facilitate the use of this program in other settings.