Most essential wheeled mobility skills for daily life: an international survey among paralympic wheelchair athletes with spinal cord injury

Fliess-Douer O, Vanlandewijck YC, Van Der Woude LHV. Most essential wheeled mobility skills for daily life: an international survey among paralympic wheelchair athletes with spinal cord injury.ObjectivesTo create a hierarchical list of the most essential wheeled mobility (WM) skills for everyday life of wheelchair users with a spinal cord injury (SCI), and to compare perceptions of WM gained during and after clinical rehabilitation.DesignCross-sectional study using survey questionnaires.SettingThe Beijing Paralympic games, at the international zone of the Olympic village and in different sports venues.ParticipantsA sample of men (N=49) and women (N=30) elite manual wheelchair user athletes with SCI (paraplegia, n=64; tetraplegia, n=15).InterventionsNot applicable.Main Outcome MeasureA survey with 24 predefined skills was distributed during the Beijing Paralympic games. Respondents were asked to rate the essentiality of each skill (1, not essential; 5, extremely essential); to state where, when, and with whom they have learned to perform each skill; and to mark the level of WM, which they gained during and after clinical rehabilitation, on 3 different WM visual analog scales (scores 1–10).ResultsRated as the most essential skill was transfer into and out of a car (mean ± SD, 4.7±0.7). Rated as the least essential skill was the 1-handed wheelie (mean ± SD, 1.9±1.3). Of the respondents, 57% have learned the most essential skills in clinical rehabilitation, while 40% claimed to have learned those skills afterward in a community setting. Three percent have never learned to perform the most essential skills. Of the very essential skills, 40% were self-taught. Mean score ± SD for the extent to which WM skills were gained in rehabilitation was 5.4±2.5.ConclusionsThe main survey outcome is a sorted list of WM skills according to their essentiality for daily life of hand-rim wheelchair users with SCI. It is recommended to incorporate the skills that were graded as very essential and extremely essential during inpatient rehabilitation and in postrehabilitation WM workshops.     

Evaluation of yield,quality and antioxidant activity of essential oil of in vitro propagated Kaempferia galanga Linn.

ObjectiveTo determine chemical constituents and antioxidant properties of essential oil from rhizome of the medicinal plant, Kaempferia galanga (K. galanga) Linn. (Zingiberaceae) in conventionally propagated (CP) and in vitro propagated (IVP) plants.MethodsIn vitro (micro) propagation of K. galanga was done by inoculating explants on to Murashige and Skoog agar medium, supplemented with suitable combinations of phytohormones; the regenerants were transferred to soil for further growth. Essential oil preparations of both CP and IVP rhizomes grown in soil, obtained by the hydro-distillation method were analyzed by gas chromatography-mass spectrometry. Antioxidant activities of essential oil samples were monitored.ResultsMaximum numbers of regenerated shoots were found in the medium supplemented with 1 mg/L benzyl adenine and 0.5 mg/L indole-3-acetic acid. A total of 6 compounds were identified from rhizomes from CP and IVP plants that yielded 96.9% and 97.81% of the total oil contents, respectively. The major compound of rhizome oil identified from CP and IVP rhizomes was ethyl p-methoxy cinnamate in quantities, 82.01% and 71.77%, respectively, without any compositional variation. Antioxidant properties of essential oil preparations were assessed by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and hydrogen peroxide radical scavenging assays. Moreover, antioxidant activities of rhizome-oil from IVP plants were better than that of CP oil samples.ConclusionsAs IVP rhizomes had better oil yield, those could be used for a large scale commercial propagation for sustainable use of essential oil. The principal chemical in the essential oil, ethyl p-methoxy cinnamate could help apothecary, for several ailments.     

二维应变成像评价原发性高血压患者左心室整体收缩功能

目的 应用二维应变成像技术评价原发性高血压患者左心室整体收缩功能。方法 收集69例原发性高血压患者,其中左心室正常构型(LVN)亚组33例,左心室重构(LVR)亚组36例,另外选取同期30名健康志愿者作为对照组;应用二维应变成像技术测量长轴方向左心室整体收缩峰值应变(GLPSS)和圆周方向左心室整体收缩峰值应变(GCPSS),分析GLPSS、GCPSS与左心室质量指数(LVMI)之间的相关性。结果 与对照组相比,LVN亚组及LVR亚组GLPSS均减低(P均<0.05),且LVR亚组低于LVN亚组(P<0.05)。LVN亚组GCPSS与对照组的差异无统计学意义(P>0.05),LVR亚组GCPSS较LVN亚组及对照组均减低(P均<0.05)。原发性高血压患者GLPSS与LVMI呈正相关(r=0.68,P<0.01)。结论 二维应变成像技术能够客观评价原发性高血压患者左心室整体收缩功能,具有重要临床应用价值。     

Communication between residential aged care facilities and the emergency department: A review of the literature

BackgroundWestern countries have encountered an increase in elderly patients transferred from residential aged care facilities to emergency departments. This patient cohort frequently experiences impaired physical and cognitive function. Emergency department staff require important clinical and personal patient information to provide quality care. International studies show that documentation and handover deficiencies are common.ObjectiveThe purpose of this literature review was to explore transitional communication practices, and to consider the specific patient information deemed essential for the management of residents in the emergency department.MethodsA literature review was conducted to examine the studies exploring the documentation accompanying elderly people who were transferred from residential aged care facilities to emergency departments. Scopus, OVID Medline and Cinahl Plus data bases were searched using combinations of the following key words: ‘nursing home’, ‘long-term care’, ‘skilled nursing facility’, ‘aged care facility’, ‘communication’, ‘documentation’, ‘emergency department’, ‘emergency room’, ‘hospital’, ‘acute’, ‘transfer’, and ‘transition’. Additional data was located with the use of Google Scholar. Review of titles and exclusion of duplicates identified 69 relevant studies. These 69 papers were independently reviewed by three members of the research team for eligibility for inclusion in the review, and seven papers were retained.ResultsThere is currently no consensus regarding what information is essential when residents are transferred from aged care facilities to emergency departments, and practices vary. Key information which should accompany the resident has been reported by various authors and include the reason for transfer, past medical history, current medications, cognitive function and advance directives. Some authors also suggest that facility contact details are essential. Without agreement by key stakeholders as to what constitutes ‘essential transfer information’, clinical practices will continue to vary and resident care will be affected.ConclusionThis paper identifies frequent communication deficits in the information provided to the emergency department from aged care facilities. There is an imperative to identify suitable items of information which health care professionals agree are essential. Future research should focus on methods to improve the transfer of information between facilities, including consensus regarding what information is essential transfer data.     

Family participation in essential care activities: Needs,perceptions, preferences,and capacities of intensive care unit patients,relatives, and healthcare providers—An integrative review

BackgroundFamily participation in essential care activities may benefit both patients and relatives.ObjectivesIn this integrative review, we aimed to identify needs, perceptions, preferences, and capacities regarding family participation in essential care in intensive care units (ICUs) from the patient's, relatives', and ICU healthcare providers' perspective.Review method usedAn integrative review method was used.Data sourcesPubMed, CINAHL, EMBASE, MEDLINE, Cochrane, Web of Science, and reference lists of included articles were searched, from inception to January 25, 2021.Review methodsWe included studies on family participation in essential care activities during ICU stay which reported associated needs, perceptions, preferences and capacities. Quality assessment was performed with the Kmet Standard Quality Assessment Criteria developed for evaluating primary research papers in a variety of fields, and an extensive qualitative thematic analysis was performed on the results.ResultsTwenty-seven studies were included. Quality scores varied from 0.45 to 0.95 (range: 0–1). Patients’ needs, perceptions, preferences, and capacities are largely unknown. Identified themes on needs and perceptions were relatives' desire to help the patient, a mostly positive attitude among all involved, stress regarding patient safety, perceived beneficial effects, relatives feeling in control—ICU healthcare providers' concerns about loss of control. Preferences for potential essential care activities vary. Relatives want an invitation and support from ICU healthcare providers. Themes regarding capacities were knowledge, skills, education and training, and organisational conditions.ConclusionsImplementation of family participation in essential care requires education and training of relatives and ICU healthcare providers to address safety and quality of care concerns, though most studies lack further specification.     

Determining the outcomes for clinicians completing a postgraduate diploma in transfusion medicine

BackgroundMuch is known about outcomes and content of training programs in blood banking, but only a limited amount of formal research has been done on the outcomes required for a postgraduate training program aimed at medical doctors working in clinical practice.Study design and methodsA formal qualitative and semi-quantitative research approach was followed to determine and test the factors considered important in determining the outcomes for clinicians completing a postgraduate diploma in transfusion medicine, and consisted of a literature survey, followed by semi-structured interviews and a Delphi survey.ResultsAfter a series of semi-structured interviews, based on an extensive literature survey, 42 factors were identified. These factors were categorized into eight groups and tested in a Delphi survey to determine which of these would be essential outcomes of a postgraduate training program in transfusion medicine. After three rounds of the Delphi survey, consensus was reached on 27 factors and stability on 14 factors. On one factor, neither consensus nor stability could be reached. Twenty-six factors were identified as essential outcomes.ConclusionThis research provides support for the essential outcomes to be considered in any postgraduate training program in transfusion medicine aimed at clinicians.     

Managing Cancer Pain in Patients with Opioid and Substance Use Disorders

ObjectiveTo discuss the assessment and management of pain in patients with substance use disorders.Data SourcesPeer-reviewed articles, book chapters, internet sources.ConclusionPatients should be routinely assessed for SUDs. Pain management should be stratified according to patient risk. An interdisciplinary approach is essential.Implications for Nursing PracticeOncology nurses should be aware of assessment approaches to screen and monitor patients with SUDs. Oncology nurses are an essential part of the interdisciplinary team when monitoring patients with SUDs.     

Increased serum S-100B and neuron specific enolase - Potential markers of early nervous system involvement in essential hypertension

ObjectivesTo investigate the occurrence of subclinical neurologic involvement in patients with essential hypertension employing serum biochemical markers.Design and methodsFifty patients with essential hypertension and 42 controls with no clinical evidence of neurological disease were recruited. Serum S100B protein and neuron specific enolase (NSE) were determined by employing immunoassay kits from CanAg Diagnostics AB (Sweden). Brain MRI and fundoscopic exploration were conducted.ResultsS-100B and NSE levels were significantly higher in hypertensive patients than in controls. In hypertensive patients, multivariate analysis revealed that NSE was independently associated with two variables expressing severity of hypertension: diastolic blood pressure and grade of retinopathy. Brain MRI studies demonstrated higher NSE levels in patients with more severe white matter lesions.ConclusionsRaised NSE levels are associated with a higher severity of hypertension and of white matter lesions, providing preliminary evidence that suggests the presence of silent brain damage in a subset of hypertensive patients.     

A randomized placebo-controlled study of aromatherapy for the treatment of postoperative nausea and vomiting

ObjectiveThe purpose of this study was to compare the aromatherapy treatment effects on PONV patients using ginger, lavender and rose oils and a placebo.DesignA randomized 4-armed placebo controlled study.SettingGaziosmanpasa University, School of Medicine, Health Research and Application Center.InterventionThe total of 184 patients were randomized into 4 groups: Aromatherapy with lavender essential oil (Lavender group), with rose essential oil (Rose group), with ginger essential oil (Ginger group) or with pure water (Placebo group).Main outcome measuresPostoperative nausea (0–3 Likert type; 0=no nausea, 1=some, 2=a lot, 3=severe) and vomiting scores (0–3 Likert type; 0=no vomiting, 1 = 1 time, 2 = 2 or 3 time, 3 = 4 times and up) and antiemetic medication requirement.ResultsThe nausea scores at 15 min were statistically significantly different between the groups (p = 0.00). The postoperative nausea scores improved in 20 (43.5%) subjects in the placebo group, 38 (82.6%) subjects in the lavender group, 22 (47.8%) subjects in the rose group and 30 (65.2%) subjects in the ginger group (p = 0.00). There were statistically significant differences between the groups with regard to the vomiting and antiemetic drug requirements (p = 0.00).ConclusionThe aromatherapy can be used as an alternative or complementary method for managing PONV. Specifically, the ginger and lavender essential oils were superior to the rose oil and pure water for the aromatherapy treatments. However, further studies with larger sample sizes are necessary to confirm these results.     

How are older people’s care preferences documented towards the end of life?

BackgroundMeeting individuals’ preferences is essential to achieve quality care at the end of life. Documenting these preferences in the healthcare system is an essential step to achieve them.AimTo investigate the documentation of older people’s care preferences including end of life care preferences in health records.MethodsRetrospective audit of health records for the last six months of life of people aged over 74 years who died in hospitals, residential aged care facilities, or community palliative care.FindingsFifty records were audited, including 28 hospital, 12 residential aged care facilities, and 10 community palliative care records with overall 297 documented care preferences. 30% of preferences were recorded on institution-specific forms at admission which focussed on patients’ medical/healthcare needs and less on personal/lifestyle preferences. Documentation mainly included clinical care preferences (35%), resuscitation plans (28%), and place of care (20%). Preferred place of death was not documented in 70% of cases. Increased documentation occurred closer to death with 63% of preferences recorded in the last week of life.DiscussionThe low rates of recorded preferences, especially non-medical choices like preferred place of death, may indicate low rates of preference discussions and/or poor documentation of these conversations. The increase in documentation closer to death may be explained by increased care needs and higher rates of care place transitions towards the end of life.ConclusionDiscussion and documentation of older people’s care preferences needs to be further encouraged within the healthcare system. It is essential not to wait for a crisis at the end of life to begin these processes.     

Quality of Care and Its Impact on Quality of Life for Care-Dependent Persons With Dementia in Shared-Housing Arrangements: Results of the Berlin WGQual-Study

AimThe aim of study was to evaluate setting-specific quality indicators (QIs) for shared-housing arrangements (SHA) regarding effects of a guided quality development process on resident's quality of life (QoL).BackgroundSHA are a specific German kind of small-scale living facilities for care-dependent persons with dementia. SHA are disconnected from residential facilities and served by community care services.MethodIn a longitudinal cluster-randomised design 104 residents of 34 SHA were surveyed for 1 year; the intervention group took part in a quality development process. QIs, physical and psychological health outcomes including QoL were surveyed.ResultsDuring the 1 year follow-up, analyses show a positive trend regarding QI-outcomes in the intervention group, but no statistically significant differences could be proved regarding QoL.ConclusionsSetting-sensitive QIs are absolutely essential to measure quality of care in multi-professional settings like SHA. Further research as well as longer study intervals is essential.     

Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study

AimTo examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students.BackgroundThe competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students.DesignA quasi-experimental study.MethodsBased on Astin’s Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor’s program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students’ EBP competence, learning experience and satisfaction and score of team-based research protocol assignment.ResultsCompared with conventional teaching, the innovative teaching characterized by EBP improved students’ EBP competence in terms of attitudes and skills and enhanced student’s comprehensive ability in nursing research. Students’ learning experience and satisfaction were similarly favorable between the two groups.ConclusionsFor undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.     

Exploration of the graduate nursing program in a forensic mental health setting: A qualitative enquiry

BackgroundForensic mental health nursing is a specialised practice area. Graduate programs are essential for recruitment and retention. There have, however, been very few studies exploring forensic mental health graduate programs.AimThe aim of this study was to explore the experience of graduate nurses who completed a 2-year graduate program in a forensic mental health service in the state of Victoria Australia, and the nurses who support the graduates in the program.MethodsAn exploratory study was conducted gathering data via one-to-one interviews, with purposive sample of 20 forensic mental health nurses.FindingsAnalysis resulted in the interpretation of two themes; essential ingredients and ‘hitting hurdles’.DiscussionGraduate nurses commence with limited knowledge, experience challenges, and organisational pressures.ConclusionTransition to practice was enhanced with consistent support, university education, and program structure.     

Western herbal medicines in the treatment of irritable bowel syndrome: A systematic review and meta-analysis

ObjectiveTo evaluate the efficacy of Western herbal medicines in the treatment of irritable bowel syndrome (IBS).DesignA computer-based search of MEDLINE, EMBASE, CINAHL, AMED, GreenFILE, Health Source: Nursing/Academic Edition, and the Cochrane Library was conducted. A hand-search of the bibliographies of relevant papers and previous meta-analyses and reviews was also undertaken. Trials were included in the review if they were double-blind and placebo-controlled investigating the effects of Western herbal medicines on IBS-related symptoms or quality of life. There were no language restrictions. Eligibility assessment and data extraction were performed by two independent researchers. For herbal medicines where there was more than 1 trial of similar design, data were synthesised using relative risk of symptoms improving using the random effects model.ResultsThirty-three trials were identified that met all eligibility criteria. Seventeen of these evaluated peppermint essential oil, fifteen other Western herbal medicines, and one trial evaluated peppermint oil in one arm and aniseed essential oil in the other arm. Eighteen different herbal preparations were evaluated in these trials. Data suggests that a number of Western herbal medicines may provide relief of IBS symptoms. Meta-analyses suggest that peppermint essential oil is both efficacious and well-tolerated in the short-term management of IBS. Aloe vera and asafoetida also demonstrated efficacy in reducing global IBS symptoms in meta-analyses. The herbal formulas STW 5, STW 5-II and Carmint, along with Ferula assa-foetida, Pimpenella anisum oil, the combination of Curcumin and Foeniculum vulgare oil, and the blend of Schinopsis lorentzii, Aesculus hippocastanum, and peppermint essential oil also demonstrated efficacy in rigorously-designed clinical trials.ConclusionA number of Western herbal medicines show promise in the treatment of IBS. With the exception of peppermint essential oil, Aloe vera, and asafoetida, however, none of the positive trials have been replicated. This lack of replication limits the capacity to make definitive statements of efficacy for these herbal medicines.     

As of 2012, what are the key predictive risk factors for pressure ulcers? Developing French guidelines for clinical practice

IntroductionAn evaluation of predictive risk factors for pressure ulcers is essential in development of a preventive strategy on admission to hospitals and/or nursing homes.ObjectivesIdentification of the predictive factors for pressure ulcers as of 2012.MethodSystematic review of the literature querying the databases PASCAL Biomed, Cochrane Library and PubMed from 2000 through 2010.ResultsImmobility should be considered as a predictive risk factor for pressure ulcers (grade B). Undernutrition/malnutrition may also be a predictive risk factor for pressure ulcers (grade C).DiscussionEven if the level of evidence is low, once these risk factors have been detected, management is essential. Sensitizing and mobilizing health care teams requires training in ways of tracking and screening. According to the experts, risk scales should be used. As decision aids, they should always be balanced and complemented by the clinical judgment of the treatment team.ConclusionAccording to experts, it is important to know and predictively evaluate risk of pressure ulcers at the time of hospital admission. The predictive risk factors found in this study are identical to those highlighted at the 2001 consensus conference of which was PERSE was the promoter.