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critical interventions

Jim Phillips, Valerie Wright, Jim Tomlinson
Scotland's political divergence from England is a key theme in late twentieth century British history. Typically seen in terms of the post-1979 Thatcher effect, this in fact developed over a longer timeframe, rooted in industrial changes revealed by analysis of the Linwood car plant in Renfrewshire. Conservatism and Unionism was an eminent political force in Scotland in the 1940s and 1950s. But in all general elections from 1959 onwards the vote share of Conservative and Unionist candidates was lower in Scotland than in England...
March 20, 2019: Journal of Tropical Pediatrics
Estefania C Botelho, Pilar S R Mataratzis, Débora L Lino, Andreia N de Oliveira, Flávia F Bezerra, Flávia Dos Santos Barbosa Brito, Marta Citelli, Cláudia Dos S Cople-Rodrigues
Children with sickle cell anemia (SCA) often exhibit nutritional deficiencies and are at high risk of dying before the age of 5 years. Ensuring adequate nutrition is a critical part of health care for such children. This study aimed to investigate the association between nutritional status, nutrient intake, and food diversity in children with SCA. A descriptive cross-sectional study was conducted on 74 children with SCA, between 24 and 71 months of age. Anthropometric measurements, food and nutrients consumption were determined...
April 2019: Journal of Pediatric Hematology/oncology
J O Sotunsa, A A Adeniyi, J O Imaralu, B Fawole, O Adegbola, C O Aimakhu, A S Adeyemi, K Hunyinbo, O A Dada, O O Adetoro, O T Oladapo
OBJECTIVE: To investigate the burden and health service events surrounding severe maternal outcomes (SMO) related to life-threatening postpartum haemorrhage (PPH) in Nigerian public tertiary hospitals. DESIGN: Secondary analysis of a nationwide cross-sectional study. SETTING: Forty-two tertiary hospitals. POPULATION: Women admitted for pregnancy, childbirth or puerperal complications. METHODS: All cases of SMO [maternal near miss (MNM) or maternal death (MD)] due to PPH were prospectively identified using WHO criteria over a 1-year period...
March 21, 2019: BJOG: An International Journal of Obstetrics and Gynaecology
Shengnan Li, Shu Wang, Priyanka Priyanka, John A Kellum
OBJECTIVES: Acute kidney injury is a common complication of major surgery. However, acute kidney injury occurring within the first 48 hours after surgery (early acute kidney injury) and therefore likely related to the surgery itself is possibly different from acute kidney injury occurring after 48 hours (late acute kidney injury). The aim of this study was to describe the epidemiology and identify differences in risk factors and outcomes between early and late acute kidney injury following major surgery...
March 20, 2019: Critical Care Medicine
Jacqueline M Kruser, Brian T Benjamin, Elisa J Gordon, Kelly N Michelson, Richard G Wunderink, Jane L Holl, Margaret L Schwarze
OBJECTIVES: Shared decision-making is recommended for critically ill adults who face major, preference-sensitive treatment decisions. Yet, little is known about when and how patients and families are engaged in treatment decision-making over the longitudinal course of a critical illness. We sought to characterize patterns of treatment decision-making by evaluating clinician discourse in the electronic health record of critically ill adults who develop chronic critical illness or die in an ICU...
March 20, 2019: Critical Care Medicine
Alexandra Lundquist, Brent A McBride, Sharon M Donovan, Alexandra Kieffer
INTRODUCTION: The childcare setting remains largely unexplored as a potential barrier to breastfeeding continuation and, therefore, the lack of interventions targeting childcare providers may be a missed opportunity for improved breastfeeding support. This article explores the perceptions of 25 first-time breastfeeding mothers on navigating the critical transition to childcare and the role of childcare providers regarding breastfeeding support. METHODS: Mothers were selected if they indicated an intent to breastfeed on a prenatal questionnaire and had enrolled their child in childcare...
March 21, 2019: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Molly Byrne
OBJECTIVE: There is powerful evidence that changing people's health-related behavior can impact the leading causes of mortality and morbidity. However, despite the significant potential to improve health and clinical outcomes, behavior change interventions frequently fall short of expected reach or impact. METHOD: Stakeholder engagement, which refers to the active involvement of public, patients, health professionals, and other decision makers throughout the research process, has been proposed as a strategy to improve the quality, reach, and impact of research...
April 2019: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
Christa Burke, Jennifer Currin-McCulloch
As the number of older adults and those with chronic medical conditions continues to rise, the need to train social work students in palliative and end-of-life competencies becomes critical. To address this growing need, the social work team at a large urban academic medical center in the Midwest developed an MSW concentration practicum in palliative and end-of-life care. During the practicum, students receive immersive training in palliative care social work values and the skills required for these specialized assessments, interventions, and evaluations...
March 21, 2019: Journal of Social Work in End-of-life & Palliative Care
Marylyn Morris McEwen, Alice Pasvogel, Carolyn Murdaugh
PURPOSE: The purpose of the study is to test the effects of a culturally tailored family-based self-management education and social support intervention on family social capital with Mexican American (MA) adults with type 2 diabetes (T2DM) and their family member. METHODS: Using a 2-group, experimental repeated-measures design, 157 dyads were randomly assigned to an intervention (group education and social support, home visits, and telephone calls) or a wait list control group...
March 21, 2019: Diabetes Educator
Somayeh Riahi, Fateme Goudarzi, Shirin Hasanvand, Hasan Abdollahzadeh, Farzad Ebrahimzadeh, Zahra Dadvari
Aim & Objective : Due to the importance of spiritual care as a part of holistic care, this study aimed to investigate the effect of spiritual intelligence training on the nurses' competence in spiritual care in critical care units. Methods: The study was performed on 82 nurses (40 in the experimental group and 42 in the control group). Participants were selected from critical care units of teaching hospitals affiliated to Lorestan University of Medical Sciences. The experimental group took part in eight sessions of spiritual intelligence training, held in the form of workshops...
October 2018: Journal of Medicine and Life
Greg L Stewart, Katey S S Enfield, Adam P Sage, Victor D Martinez, Brenda C Minatel, Michelle E Pewarchuk, Erin A Marshall, Wan L Lam
Transcriptome sequencing has led to the widespread identification of long non-coding RNAs (lncRNAs). Subsequently, these genes have been shown to hold functional importance in human cellular biology, which can be exploited by tumors to drive the hallmarks of cancer. Due to the complex tertiary structure and unknown binding motifs of lncRNAs, there is a growing disparity between the number of lncRNAs identified and those that have been functionally characterized. As such, lncRNAs deregulated in cancer may represent critical components of cancer pathways that could serve as novel therapeutic intervention points...
2019: Frontiers in Genetics
Natalie J Ball, Eduardo Mercado, Itzel Orduña
The beneficial effects of enriched environments have been established through a long history of research. Enrichment of the living conditions of captive animals in the form of larger cages, sensory stimulating objects, and opportunities for social interaction and physical exercise, has been shown to reduce emotional reactivity, ameliorate abnormal behaviors, and enhance cognitive functioning. Recently, environmental enrichment research has been extended to humans, in part due to growing interest in its potential therapeutic benefits for children with neurodevelopmental disorders (NDDs)...
2019: Frontiers in Psychology
Asako Ochiai, Keiji Kuroda, Rie Ozaki, Yuko Ikemoto, Keisuke Murakami, Joanne Muter, Akemi Matsumoto, Atsuo Itakura, Jan J Brosens, Satoru Takeda
Pregnancy critically depends on the transformation of the human endometrium into a decidual matrix that controls embryo implantation and placenta formation, a process driven foremost by differentiation and polarization of endometrial stromal cells into mature and senescent decidual cells. Perturbations in the decidual process underpin a spectrum of prevalent reproductive disorders, including implantation failure and early pregnancy loss, emphasizing the need for new therapeutic interventions. Resveratrol is a naturally occurring polyphenol, widely used for its antioxidant and anti-inflammatory properties...
March 20, 2019: Cell Death & Disease
Thaís M Monteiro, Leila Katz, Silvana F Bento, Melania M Amorim, Patrícia C Moriel, Rodolfo C Pacagnella
BACKGROUND: In clinical trials, pregnant women are potentially vulnerable, and the fetus is exposed to the intervention. This study aimed to identify the reasons that led pregnant women at a high risk of premature delivery to participate in a randomized clinical trial. METHODS: The women participating in the main trial were contacted by telephone postpartum and invited to answer an open questionnaire in a cross-sectional study. Data were collected by telephone and analyzed using thematic analysis...
March 20, 2019: BMC Pregnancy and Childbirth
Onuma Chaiwat, Mellada Chanidnuan, Worapat Pancharoen, Kittiya Vijitmala, Praniti Danpornprasert, Puriwat Toadithep, Chayanan Thanakiattiwibun
BACKGROUND: A common postoperative complication found among patients who are critically ill is delirium, which has a high mortality rate. A predictive model is needed to identify high-risk patients in order to apply strategies which will prevent and/or reduce adverse outcomes. OBJECTIVES: To identify the incidence of, and the risk factors for, postoperative delirium (POD) in surgical intensive care unit (SICU) patients, and to determine predictive scores for the development of POD...
March 20, 2019: BMC Anesthesiology
W Widagdo, Syriam Sooksawasdi Na Ayudhya, Gadissa B Hundie, Bart L Haagmans
Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic pathogen that causes respiratory infection in humans, ranging from asymptomatic to severe pneumonia. In dromedary camels, the virus only causes a mild infection but it spreads efficiently between animals. Differences in the behavior of the virus observed between individuals, as well as between humans and dromedary camels, highlight the role of host factors in MERS-CoV pathogenesis and transmission. One of these host factors, the MERS-CoV receptor dipeptidyl peptidase-4 (DPP4), may be a critical determinant because it is variably expressed in MERS-CoV-susceptible species as well as in humans...
March 19, 2019: Viruses
Adam Hege, Michael K Lemke, Yorghos Apostolopoulos, Brian Whitaker, Sevil Sönmez
Work-life balance and job stress are critical to health and well-being. Long-haul truck driving (LHTD) is among the unhealthiest and most unsafe occupations in the U.S. Despite these disparities, there are no extant published studies examining the influence of work, stress and sleep outcomes on drivers' work-life balance. The current study investigated whether adverse work organization, stress, and poor sleep health among LHTDs are significantly associated with work-life conflict. Logistic regression was used to examine how work organization characteristics, job stress, and sleep influenced perceived stress and a composite measure of work-life conflict among a sample of 260 U...
March 19, 2019: International Journal of Environmental Research and Public Health
Bhagteshwar Singh, Derek Cocker, Hannah Ryan, Derek J Sloan
BACKGROUND: Linezolid was recently re-classified as a Group A drug by the World Health Organization (WHO) for treatment of multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB), suggesting that it should be included in the regimen for all patients unless contraindicated. Linezolid use carries a considerable risk of toxicity, with the optimal dose and duration remaining unclear. Current guidelines are mainly based on evidence from observational non-comparative studies...
March 20, 2019: Cochrane Database of Systematic Reviews
Kristine J Harrington, Mary Lou Affronti, Susan M Schneider, Abdul Rab Razzak, Thomas J Smith
Nurses play an integral role in high-quality patient care. Thus, their skills in providing end-of-life care should be assessed and continually enhanced. Education intended to improve end-of-life skills must address the affective/emotional component of nursing care. Evidence demonstrates that emotional engagement and resilience among health care providers are correlated with improved quality outcomes and, conversely, that burnout and stress negatively affect patient safety. Addressing the emotional needs of health care providers is critical to improving quality throughout the health care system...
March 20, 2019: Journal of Hospice and Palliative Nursing: JHPN
Steven G Schauer, Patrick C Ng, Michael D April, Guyon J Hill, Allyson A Arana, Vikhyat S Bebarta
BACKGROUND: Vascular access in critically ill pediatric patients can be challenging with delays potentially leading to worse outcomes. Intraosseous (IO) access has a low rate of complications and can be utilized to administer lifesaving medications. Combat medics are trained to treat adults but may also be required to treat children in the deployed setting. Vascular access in children can be challenging, especially in a hypovolemic state. There are limited data on prehospital lifesaving interventions in children in the combat setting...
March 19, 2019: Pediatric Emergency Care
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