The influence of adolescent postpartum women’s psychosocial condition on mother-infant bonding

Objective

To identify the correlation between the psychosocial condition of adolescent women in the postpartum period and mother-infant bonding.

The influence of common free radicals and antioxidants on development of Alzheimer’s Disease

Alzheimer’s Disease (AD) is one of the most important neurodegenerative disorders in the 21st century for the continually aging population. Despite an increasing number of patients, there are only few drugs to treat the disease. Numerous studies have shown several causes of the disorder, one of the most important being oxidative stress. Oxidative stress is connected with a disturbance between the levels of free radicals and antioxidants in organisms. Solutions to this problem are antioxidants, which counteract the negative impact of the reactive molecules. Unfortunately, the currently available drugs against AD do not exhibit activity toward these structures. Due to the fact that natural substances are extremely significant in new drug development, numerous studies are focused on substances which exhibit a few activities including antioxidants and other anti-AD behaviors. This review article presents the most important studies connected with the influence of free radicals on development of AD and antioxidants as potential drugs toward AD.     

Psychometric evaluation of the Persian version of the Templer’s Death Anxiety Scale in cancer patients

In this study, 398 Iranian cancer patients completed the 15-item Templer's Death Anxiety Scale (TDAS). Tests of internal consistency, principal components analysis, and confirmatory factor analysis were conducted to assess the internal consistency and factorial validity of the Persian TDAS. The construct reliability statistic and average variance extracted were also calculated to measure construct reliability, convergent validity, and discriminant validity. Principal components analysis indicated a 3-component solution, which was generally supported in the confirmatory analysis. However, acceptable cutoffs for construct reliability, convergent validity, and discriminant validity were not fulfilled for the three subscales that were derived from the principal component analysis. This study demonstrated both the advantages and potential limitations of using the TDAS with Persian-speaking cancer patients.     

Update on the therapy of highly aggressive non-Hodgkin’s lymphoma

This review focuses on the current understanding of the biology of highly aggressive non-Hodgkin’s lymphomas, such as Burkitt’s lymphoma, lymphoblastic lymphoma and adult T cell lymphoma/leukaemia. Specifically, this review will examine how our increased understanding of the pathophysiology of these diseases can be used to develop new therapies.     

“He’s on his dying bed”: Next-of-kin’s experiences of the dying body

For family members of dying patients who have grown accustomed to providing daily body care, the transition from home to hospital is stressful. The authors used the experiences surrounding death for 78 U.S. veterans who died in a Veterans Affairs hospital. The research is based on interviews conducted with the decedent’s next-of-kin. Secondary qualitative analysis of previously-coded transcribed interviews was used. Themes of social disorganization and a loss of control over the body emerged. Next-of-kin experienced the physical and functional breakdown of their loved one’s body. Understanding the nature of the loss of control may help alleviate the loss of control may help alleviate the strain on families.     

Georgia’s healthcare system and integration of complementary medicine

BackgroundAn increasing number of people in the Republic of Georgia use complementary and alternative medicine (CAM). CAM has long been practiced in the country, but is not currently part of the formal medical system. The aim of this study was to explore patients’ CAM use and their perspectives of CAM complementation of existing services in Georgia’s health care system.MethodologyWe conducted a qualitative study exploring patient needs and wants by performing in-depth, contextual interviews with patients using CAM. We recruited participants at CAM clinics and collected data until we reached saturation. A thematic analysis involving line by line coding explored perspectives and allowed us to formulate recommendations of CAM integration in Georgia.ResultsStudy participants voiced that they pursued cure beyond symptom relief; their disappointment in that regard with conventional medicine in Georgia directed them towards CAM as a safe and effective care setting. Most sought natural approaches as a sustained approach to their health and perceived CAM as empathetic therapeutic and preventive space. Participants were in favor of integration of CAM with conventional health services through government support and regulation. They saw coverage of payments for CAM visits and treatments as important aspect for an effective and sustainable integration.ConclusionPatients favor an integration of CAM into Georgia’s current healthcare systems to ensure CAM’s broad availability as well as effective regulation and financing, including coverage by health insurance.     

Effect of the Patient’s Knowledge on Peritonitis Rates in Peritoneal Dialysis

♦ Introduction: After a training period, patients maintained on continuous ambulatory peritoneal dialysis (CAPD) assume responsibility for their own treatment. With the aid of appropriate tools, home visits help with ongoing evaluation and training for these patients.♦ Methods: We conducted a home visit survey of 50 patients maintained on CAPD in Sudan between April 2009 and June 2010. Housing conditions, home environment, and patient’s or caregiver’s knowledge about peritoneal dialysis and the exchange procedure were evaluated using structured data collection sheets. Scores were compared with infection rates in the patients before the home visit.♦ Results: Patients were maintained on CAPD for a median duration of 11 months. Their mean age was 42 ± 23 years; 70% were male; and 14% had diabetes. Only 34% of patients had suitable housing conditions, and 56% required assisted PD. Of the autonomous patients and assisting family members, 11.6% were illiterate. The median achieved knowledge score was 11.5 of 35 points. The median achieved exchange score was 15 of 20 points. Knowledge and exchange scores were positively and significantly correlated (R = 0.5, p = 0.00). More patients in the upper quartile than in the middle and lower quartiles of knowledge scores were adherent to daily exit-site care (33.3% vs 5.3%, p = 0.02). Compared with patients in the middle and lower quartiles of knowledge score, patients in the upper quartile had lower rates of peritonitis, exit-site infection, and hospitalization.♦ Conclusions: The proposed evaluation form is a valid and reliable assessment tool for the follow-up of CAPD patients. Patients in the upper quartile of knowledge score demonstrated better adherence to the recommended treatment protocols and lower infection rates.Key words: Adherence, housing conditions, knowledge, peritonitisAfter a training period, patients maintained on con tinuous ambulatory peritoneal dialysis (CAPD) assume responsibility for their own treatment. The need for a home visiting service to manage this program of self-care is widely acknowledged (1-5). The provision of specialist community care for CAPD patients was reported to be associated with significant reductions in infections and hospital admissions (1). The development of home visit protocols has also been reported to be a valuable addition to continuous quality improvement projects in established PD centers (6).Sudan currently has 7 active peritoneal dialysis (PD) units: 6 in Khartoum state and 1 in Al-Gezira state. The most recent unit was established in December 2008 as part of the adult nephrology service at Soba University Hospital in Khartoum. In that unit, strong emphasis is placed on application of the principles of the adult learning theory in patient education. Patients are evaluated in their own homes at the end of training and at regular intervals afterwards. For that purpose, we designed a concise evaluation form that focuses on practical aspects of PD-related knowledge in compliance with the International Society for Peritoneal Dialysis recommendations (7). We also designed comprehensive checklists for the evaluation of PD-related procedures and the home environment. To ensure construct validity, those tools were reviewed and refined by a group of doctors and nurses with working experience in PD, and they were piloted in a small group of patients.In the present study, we used those same tools to evaluate a group of prevalent PD patients who had been maintained on CAPD for variable durations in Sudan. The patients received conventional training upon initiation of dialysis in the other 6 PD units and were never visited in their homes by the PD team. We also evaluated the association between scores on the evaluation tools and infection rates before the home visit.     

Effect of transcatheter aortic valve implantation on the ascending aorta’s elasticity

Background

The elastic properties of the ascending aorta were studied before and 1?week after transcatheter aortic valve implantation (TAVI). Previous studies have shown that the distensibility of the ascending aorta was decreased in the early post-operative period after aortic valve replacement. Aortic stiffness is a major moderator of arterio-ventricular coupling and an independent predictor of cardiovascular risk and mortality. We evaluated the effect of TAVI on the elastic properties of the ascending aorta in the early post-operative period.

Methods

Aortic distensibility (AD) and Aortic Stiffness Index (ASI) were evaluated using echocardiographic techniques and brachial artery pressure obtained by sphygmomanometry 2–3?days before and 7–8?days after TAVI.

Results

A total of 30 patients (14 males) were studied with a mean age of 79.9?±?4.7?years and aortic valve area before TAVI of 0.61?±?0.16?cm². Mean arterial pressure decreased significantly after TAVI (from 89.6?±?8.9?mmHg to 83.3?±?10.9?mmHg, p?=?0.004). AD did not change significantly after TAVI (pre: 1.89?±?1.11?cm²/(dynes?×?10⁶), post: 2.05?±?1.50?cm²/(dynes?×?10⁶); p?=?0.813). ASI also remained unchanged (pre: 11.4?±?6.5, post: 15.6?±?14.9; p?=?0.349).

Conclusions

The elastic properties of the ascending aorta did not change significantly in the early post-procedural period after TAVI. This may in part be attributable to the less invasive procedure (compared to aortic valve replacement) which has no effect on vasa vasorum flow.     

Potential influence of nurses’ implicit racial bias on maternal mortality

Stark disparities persist in maternal mortality and perinatal outcomes for Black and other birthing people of color, such as Native Americans, and their newborns compared to White people in the United States. An increasing body of research describes the phenomenon of implicit racial bias among providers and how it may affect communication, treatment decisions, the patient care experience, and health outcomes. This synthesis of literature reviews and distills current research on the presence and influence of implicit racial bias among nurses as it may relate to maternal and pregnancy-related care and outcomes. In this paper, we also summarize what is known about implicit racial bias among other types of healthcare providers and interventions that can mitigate its effects, identify a gap in research, and recommend next steps for nurses and nurse researchers.     

Does calcium cause the different effects of Gelofusine and Haemaccel on coagulation?

Background

Gelofusine (which does not contain calcium) has a greater effect on coagulation than Haemaccel (which contains 6.25 mmol/l of calcium). This in vitro study was performed to assess whether calcium might be the cause of the different effects on coagulation.

Methods

Three solutions were compared; (a) Gelofusine, (b) Gelofusine with calcium added to 6.25 mmol/l, and (c) Haemaccel. Thromboelastography (Sonoclot) was used to examine whole blood coagulation, with time to peak clot weight as the primary outcome measure.

Results

There was no significant difference between the Gelofusine containing solutions. Both Gelofusine solutions gave a greater impairment of coagulation than the Haemaccel solution.

Conclusions

The different effect of Gelofusine on coagulation compared with Haemaccel does not seem to be related to the different calcium contents of the solutions.