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21.
Robert W. McConkey RANP RNP MSc BSc PG Dip PG Cert Therese Kelly RANP RNP MSc PG Dip PG Cert Rachael Dalton RANP RNT RNP MSc BSc PG Dip Geraldine Rooney cANP RNP BSc PG Dip PG Cert Michelle Healy cANP BSc PG Cert Louise Murphy PhD BSc PG Dip RPN RNT Maura Dowling PhD MSc RGN RNT 《International Journal of Urological Nursing》2023,17(1):78-83
Evidence based practice is essential to advanced practice nursing, enabling the delivery of quality care and improved patient outcomes. As the name suggests, it requires healthcare decisions to be based on the best available and current evidence. Advanced practice nurses need astute critical analysis skills to appraise the evolving literature, and require research skills to lead on scientific inquiry and develop the profession. Yet, advanced practice nurses may not recognize themselves as research leaders. Participation in a journal club can promote evidence-based practice, improve clinician's critical thinking skills, and expose members to different research methodologies, however, nurses continue to face barriers to participation in these clubs. Establishing a clinical-academic partnership appears to be both mutually beneficial for clinicians and academics and is a significant enabler in the sustainability and functioning of the club through sharing expertise and experience. A supportive workplace culture is favourable to research utilization and knowledge translation. This paper outlines the role, practicalities, challenges, and benefits of setting up a hybrid urology journal and research club for advanced practice nurses in a clinical-academic partnership. 相似文献
22.
Prevention and management of food allergy 总被引:1,自引:0,他引:1
The phenotypic expression and natural history of food allergy vary widely according to the patient's age, disease presentation and type of offending food. Prevention of food allergy might be achieved by altering the dietary factors responsible for the sensitization and phenotypic expression of the disease. Owing to the peculiarity of the atopic status, a minute amount of allergens can trigger both sensitization and symptoms in atopic individuals. The oral dose of β-lactoglobulin causing sensitization can be estimated to be between 1 ng and several milligrams. In food allergy, sensitization and treatment are allergen specific; therefore, for primary prevention (avoiding sensitization) and secondary prevention of food allergy (avoiding symptoms in an already sensitized subject), a product without immunogenic and allergenic epitopes should be given in each case. Babies of atopic parents are particularly prone to develop food allergy and for this reason they are called high-risk babies. Cow's milk is the most commonly offending food in both gastrointestinal and cutaneous manifestations. Cow's milk proteins are potent allergens and around 2.5% of infants experience cow's milk allergy in the first years of life. The major risk factors for cow's milk allergy are positive family history of atopy and early exposure to cow's milk proteins. Hydrolysate formulae have been developed for the purpose of reducing the allergenicity of cow's milk proteins. More recently, partially and extensively hydrolysed formulae have also been used for feeding babies with a high risk of atopy for the prevention of cow's milk allergy. However, according to the results of a recent randomized controlled study, only an extensively hydrolysated formula, and not a partially hydrolysated formula, significantly decreased the prevalence of cow's milk allergy. 相似文献
23.
KI Wheeler GM Schmölzer CJ Morley PG Davis 《Acta paediatrica (Oslo, Norway : 1992)》2011,100(1):67-70
Background: Ventilator frequency is one of the determinants of tidal volume delivery during high‐frequency ventilation. Clinicians increasingly use data on ventilator displays to inform their decisions. Aim: To measure the frequencies delivered by the Dräger Babylog 8000plus ventilator when used in high‐frequency mode. Methods: Ventilator waveforms using a test lung were recorded at the full range of settings 5–20 Hz using Spectra software at 1000 Hz. The changes in frequency produced by a 1‐ Hz change in set frequency were calculated. Actual and displayed frequencies were compared. Results: For settings up to 12 Hz, median (range) difference between set and delivered frequencies was 0 (?0.4 to +0.1) Hz. Above 12 Hz, delivered frequency varied by ?0.3 (?1.9 to +0.3) Hz. For 1‐ Hz changes in frequency settings, in the range 5–12 Hz, 1‐ Hz changes produced a change in delivered frequency of 1.0 (0.6–1.4) Hz. Above 12 Hz, the corresponding changes were 0.7 (0–2.9) Hz. The ventilator displays the set frequency during operation rather than the delivered frequency. Conclusion: At 12 Hz and below, the differences between set and delivered frequencies were relatively small compared with those at 13 Hz and higher. Above 13 Hz, the difference between set and delivered frequencies was up to 2.9 Hz. Some frequency setting changes did not result in a change in delivered frequency. 相似文献
24.
PG Kareru JM Keriko GM Kenji GT Thiong'o AN Gachanja HN Mukiira 《African journal of traditional, complementary, and alternative medicines》2010,7(3):214-218
In this study, Tithonia diversifolia Helms. (A Gray), Aloe secundiflora (Miller) and Azadirachta indica (A. Juss) plant extracts were used to make herbal soaps while Thevetia peruviana (Schum) seed oil was used to make a herbal lotion for skincare. The soaps were tested for the growth inhibition of Escherichia coli, and Candida albicans. The lotion was evaluated against Staphylococcus aureus and E.coli. Although Tithonia diversifolia soap exhibited the highest inhibitory effect on the test bacterial strains, it had the least inhibition against C. albicans. Results from this study indicated that the ‘Tithonia diversifolia’ soap would have superior skin protection against the tested bacteria but would offer the least skin protection against C. albicans. The herbal lotion inhibited S. aureus and E. coli in a concentration dependent manner, however, the inhibitory effect was more pronounced on S. aureus. 相似文献
25.
Catt SL; Sakkas D; Bizzaro D; Bianchi PG; Maxwell WM; Evans G 《Molecular human reproduction》1997,3(9):821-825
Controlling the sex of offspring by the separation of X and Y
chromosome-bearing spermatozoa using flow cytometry has been reported as a
clinical technique aiding prevention of X-linked diseases. Although this
technique has resulted in several hundred normal births in animals and at
least one human birth, there is still concern over its genetic safety due
to the involvement of two potentially mutagenic agents: UV light and the
fluorochrome dye, Hoechst 33342 (H33342). Human spermatozoa, particularly
those considered abnormal, may be more likely to suffer DNA damage
following exposure to mutagenic agents, compared with other mammalian
species. The stability of normal fresh and decondensed human spermatozoa
were examined after exposure to a range of levels of UV and H33342
staining, using an assay that detects endogenous nicks in the DNA of
spermatozoa. The stability of abnormal and normal, fresh and frozen-thawed
human spermatozoa was examined following UV laser, H33342 staining and flow
cytometry treatments utilizing the same assay. There was an increase in the
presence of endogenous nicks when spermatozoa were decondensed compared
with fresh spermatozoa. There was no increase in the incidence of nicks in
any group of spermatozoa after UV and fluorochrome exposure compared with
controls without exposure.
相似文献
26.
Battaglia C; Artini PG; Giulini S; Salvatori M; Maxia N; Petraglia F; Volpe A 《Human reproduction (Oxford, England)》1997,12(11):2477-2482
The objective of this study was to evaluate the Doppler flow variations
which occur following the use of different protocols of ovarian stimulation
in an IVF programme, and to investigate the thromboxane production by
cultured endometrial cells and its influence on embryo implantation. A
total of 60 patients underwent three different ovarian stimulation
protocols: long gonadotrophin-releasing hormone agonist (GnRH-a), short
GnRH-a and no GnRH-a. Transvaginal ultrasonography and colour Doppler
analysis were performed before and during the treatment. On the day that
the Doppler examination took place, luteinizing hormone, follicle
stimulating hormone, plasma oestradiol and thromboxane concentrations were
assayed. On the day of oocyte retrieval, endometrial cells were collected
and cultured, and their thromboxane production evaluated. No significant
differences in hormonal, ultrasonographic or Doppler parameters were
observed between the three groups. Ten out of 56 patients who had a
successful embryo transfer became pregnant. In the group of pregnant women
the pulsatility index values of both uterine and spiral arteries was lower
than in non-pregnant patients, and was associated with significantly lower
thromboxane concentrations from cultured endometrial cells. It is concluded
that thromboxane plays a role in embryo implantation, and that Doppler flow
analysis of uterine and spiral arteries in infertile patients may be
important in the management of ovarian stimulation.
相似文献
27.
Brenda Happell RN Cert Psych Nurs BA DipEd MEd PhD FACMHN Shifra Waks BA MIHP B Int Global Stud Aine Horgan PhD MSc BNS PGCert T&L RPN Sonya Greaney DipSPH PG Cert Peer Support Fionnuala Manning John Goodwin MA PGDip Bsc BA ALCM DipMgmt RPN Julia Bocking BPhil B Soc & Comm Stud Brett Scholz BHSci PhD Elisabeth Hals MA Arild Granerud PhD Rory Doody B.Soc.Sc. Chris Platania-Phung BA PhD Martha Griffin H. Dip in Community Youth Work Siobhan Russell BSc RPN PhD Liam MacGabhann BSc MSc DrNursSci Jarmo Pulli Annaliina Vatula BA Graeme Browne RN MHN PhD FACMHN Kornelis Jan van der Vaart BN MSci Jerry Allon Einar Bjornsson Heikki Ellilä RN MNSc PhD Mari Lahti MNSc PhD Pall Biering PhD 《Perspectives in psychiatric care》2020,56(4):811-819
28.
The existence and characteristics of bone marrow T-cell progenitors have not yet been established in man. Several pieces of evidence such as the reconstitution of certain immunodeficiencies by bone marrow graft suggest that T-cell precursors are present in the bone marrow. We report the growth of T-cell colonies from bone marrow populations using PHA-stimulated lymphocyte-conditioned medium containing T-cell growth factor (TCGF). Rosetting experiments and complement-dependent cytotoxicity assays with monoclonal antibodies indicate that the bone marrow T colony-forming cells (T-CFC) are E- OKT 3- and la+, i.e., immature progenitors. The colonies derived from these cells have the phenotype of mature T cells: E + OKT 3 + la- with either helper (OKT 4+) and suppressor (OKT 8 +) antigens. These results suggest that a thymic microenvironment may not be necessary for the in vitro proliferation and differentiation of the T-cell lineage in adult humans. These methodologies may permit direct investigation of early phenomena concerning the T-cell lineage, such as the acquisition of self-tolerance, the formation of a repertoire of specificities, and the HLA restriction phenomena that we believe takes place before the thymic maturation. 相似文献
29.
Effects of monoclonal antibody therapy in patients with chronic lymphocytic leukemia 总被引:4,自引:0,他引:4
Foon KA; Schroff RW; Bunn PA; Mayer D; Abrams PG; Fer M; Ochs J; Bottino GC; Sherwin SA; Carlo DJ 《Blood》1984,64(5):1085-1093
A phase I clinical trial was initiated to treat patients with stage IV B-derived chronic lymphocytic leukemia (CLL) with the IgG2a murine monoclonal antibody T101. This antibody binds to a 65,000-mol wt (T65) antigen found on normal T lymphocytes, malignant T lymphocytes, and B- derived CLL cells. All of the patients had a histologically confirmed diagnosis of advanced B-derived CLL and were refractory to standard therapy, and more than 50% of their leukemia cells reacted with the T101 antibody in vitro. The patients received T101 antibody two times per week, over two to 50 hours by intravenous administration in 100 mL of normal saline containing 5% human albumin. Twelve patients were treated with a fixed dosage of 1, 10, 50, or 100 mg, and one patient was treated with 140 mg of antibody. It was demonstrated that patients given two-hour infusions of 50 mg developed pulmonary toxicity, with shortness of breath and chest tightness. This toxicity was eliminated when infusions of 50 or 100 mg of T101 were prolonged to 50 hours. All dose levels caused a rapid but transient decrease in circulating leukemia cell counts. In vivo binding to circulating and bone marrow leukemia cells was demonstrated at all dose levels with increased binding at higher dosages. Antimurine antibody responses were not demonstrated in any patients at any time during treatment. Circulating free murine antibody was demonstrated in the serum of only the two patients treated with 100 mg of antibody as a 50-hour infusion and the patient treated with 140 mg of antibody over 30 hours. Antigenic modulation was demonstrated in patients treated at all dose levels but was particularly apparent in patients treated with prolonged infusions of 50 and 100 mg of antibody. We were also able to demonstrate antigenic modulation in lymph node cells, which strongly suggests in vivo labeling of these cells. Overall, T101 antibody alone appears to have a very limited therapeutic value for patients with CLL. The observations of in vivo labeling of tumor cells, antigenic modulation, antibody pharmacokinetics, toxicity, and antimurine antibody formation may be used in the future for more effective therapy when drugs or toxins are conjugated to the antibody. 相似文献
30.
Ventilator-associated pneumonia (VAP) is a common cause of morbidity, antibiotic use, increased length of stay and, possibly,
increased mortality in ICU patients. Colonization of the oropharyngeal cavity with potentially pathogenic micro-organisms
is instrumental in the pathogenesis of VAP, and selective oropharyngeal decontamination (SOD) with antibiotics (AB-SOD) or
antiseptics, such as chlorhexidine gluconate (CHX-SOD), has been associated with reduced incidences of VAP. In a recent issue
of Critical Care Scannapieco and colleagues investigated differences in oropharyngeal colonization between mechanically ventilated patients
receiving oropharyngeal decontamination with 0.12% CHX-SOD either once or twice daily compared to placebo. CHX-SOD was associated
with a reduction in Staphylococcus aureus colonization, but the study was underpowered to demonstrate a reduction in VAP incidence. We urgently need well-designed
and adequately powered studies to evaluate the potential benefits of CHX-SOD on patient outcome in ICUs. 相似文献