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1.
Br J Nurs ; 33(1): 34-38, 2024 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-38194332

RESUMO

The language of nurse education in the UK has shifted from 'competency' to 'proficiency' since 2018. The shift in language has been poorly articulated leaving individual higher education institutions, practice supervisors and assessors to interpret what these terms mean in relation to assessing student nurses. There appeared to be some confusion regarding the interpretation of the term proficiency among those who engaged in an exchange on the topic via Twitter. Students may focus on the procedure-based checklists within the standards. The relationship between proficiency and implementing a person-centred approach to care remains unclear.


Assuntos
Aprendizagem , Estudantes de Enfermagem , Humanos , Instituições Acadêmicas , Lista de Checagem , Confusão
2.
J Adv Nurs ; 79(1): 48-67, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36345050

RESUMO

AIM: To explore how nurses' use of electronic health records impacts on the quality of nurse-patient interactions and communication. DESIGN: An integrative review. DATA SOURCES: MEDLINE®, CINAHL®, PscyINFO, PubMed, BNI and Cochrane Library databases were searched for papers published between January 2005 and April 2022. REVIEW METHODS: Following a comprehensive search, the studies were appraised using a tool appropriate to the study design. Data were extracted from the studies that met the inclusion criteria relating to sample characteristics, methods and the strength of evidence. Included empirical studies had to examine interactions or communication between a nurse and patient while electronic health records were being used in any healthcare setting. Findings were synthesized using a thematic approach. RESULTS: One thousand nine hundred and twenty articles were initially identified but only eight met the inclusion criteria of this review. Thematic analysis revealed four key themes, indicating that EHR: impedes on face-to-face communication, promotes task-orientated and formulaic communication and impacts on types of communication patterns. CONCLUSION: Research examining nurse-patient interactions and communication when nurses' use electronic health records is limited but evidence suggests that closed nurse-patient communications, reflecting a task-driven approach, were predominantly used when nurses used electronic health records, although some nurses were able to overcome logistical barriers and communicate more openly. Nurses' use of electronic health records impacts on the flow, nature and quality of communication between a nurse and patient. IMPACT: The move to electronic health records has taken place largely without consideration of the impact that this might have on nurse-patient interaction and communication. There is evidence of impact but also evidence of how this might be mitigated. Nurses must focus future research on examining the impact that these systems have, and to develop strategies and practice that continue to promote the importance of nurse-patient interactions and communication. PATIENT OR PUBLIC CONTRIBUTION: Studies examined within this review included patient participants that informed the analysis and interpretation of data.


Assuntos
Registros Eletrônicos de Saúde , Relações Enfermeiro-Paciente , Humanos , Comunicação
3.
J Fish Biol ; 102(2): 373-379, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36371654

RESUMO

The distribution of many fishes that occupy large rivers is poorly known, in part due to the difficulties of sampling for them. This is especially true for small-bodied or rare species, such as the snail darter Percina tanasi, 44, 469-488; 1976). This federally listed (threatened) species has a limited distribution in the Tennessee River system in Alabama and Tennessee, where it is known from a few large tributaries or small rivers. In Alabama, P. tanasi was previously known from only one locality, but has recently been found in two additional, widely separated systems. These new records raise questions regarding the accuracy of our current understanding of the range for this species. Particularly, is P. tanasi present throughout the main stem Tennessee River, and is this species dispersing into new areas from source populations in the river? To clarify the distribution of P. tanasi in Alabama, 83 unique sites were surveyed using environmental DNA analysis. This cost-effective detection tool reduces the difficulty associated with empirically sampling large rivers for small fishes. Approximately 42% of sites sampled were positive for P. tanasi DNA. This study confirmed the known localities of P. tanasi in the Bear Creek, Elk River and Paint Rock River. Several new localities were also discovered throughout the main stem Tennessee River and in Shoal Creek, near Florence, Alabama. These findings can inform biologists about where to prioritize conservation efforts and further could lead to studies assessing movement and relatedness between populations in this system.


Assuntos
DNA Ambiental , Percas , Animais , Rios , Tennessee , Percas/genética , Caramujos/genética
4.
Int J Aging Hum Dev ; 97(3): 354-373, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36464642

RESUMO

Sport participation can play a key role in older adults' successful aging as it provides an enjoyable opportunity for leisure-time physical activity. Research focusing on the benefits of sport participation in later life and facilitators for involvement has been increasing in the past several years. Drawing on the socioecological model, this study investigated select socioecological factors that predict older adults' sport participation from a holistic perspective. An online survey provided quantitative data from 1203 adults aged 50 and older across the United States. Results from logistic regression analyses showed that personal characteristics, individual behavior, environment/policy, and life course effects were significant predictors of sport participation in later life. The findings in this study enhance our understanding of factors related to older adults' sport participation and are also of value to practitioners seeking to promote sport participation among older adults.


Assuntos
Esportes , Humanos , Pessoa de Meia-Idade , Idoso , Envelhecimento , Inquéritos e Questionários
5.
J Nutr ; 152(10): 2218-2226, 2022 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-36084236

RESUMO

BACKGROUND: Inflammation is at the core of many chronic conditions and exacerbates infectious conditions, including the severity of coronavirus disease 2019 (COVID-19) infections. OBJECTIVES: This study aimed to examine the effects of a novel food supplement, palmitoylethanolamide (PEA), specifically Levagen+, as compared with a placebo on proinflammatory biomarkers in adults recently diagnosed with COVID-19 who were unvaccinated and nonhospitalized. METHODS: This study was a double-blind randomized placebo-controlled trial conducted October 2020-March 2021 (clinicaltrials.gov: NCT04912921). Participants aged 19-53 y were unvaccinated and recently infected with COVID-19 as indicated by a positive test result per RT-PCR or antigen test, and they reported to the test site following diagnosis as allowed by the CDC's return-to-work policy. Participants were stratified by age, sex, and BMI and randomly assigned by coin toss to receive 600 mg Levagen+ twice daily (LEV) or placebo tablets twice daily (CON) for 4 wk. At baseline and week 4, participants completed health histories, 24-h dietary recalls, anthropometrics, and nonfasting blood sampling. The primary outcomes were the 4-wk change between groups for IL-6, C-reactive protein, ferritin, intercellular adhesion molecule 1, soluble P-selectin (sP-selectin), and neutrophil/lymphocyte ratio. Multiple linear regression models were utilized to assess treatment effects on outcomes, adjusting for covariates. RESULTS: A total of 60 participants completed the study (LEV: n = 30; CON: n = 30). After 4 wk of supplementation, sP-selectin (ß = -11.5; 95% CI: -19.8, -3.15; P = 0.0078), IL-1ß (ß = -22.9; 95% CI: -42.4, -3.40; P = 0.0222), and IL-2 (ß = -1.73; 95% CI: -3.45, -0.065; P = 0.0492) concentrations were significantly reduced in the LEV group compared with the CON group. CONCLUSIONS: Inflammatory mechanisms are crucial to optimal resolution of infectious conditions, yet unchecked secretion of inflammatory mediators can promote the dysregulated immune response implicated in COVID-19 complications. Overall, PEA supplementation produced anti-inflammatory effects in individuals recently diagnosed with COVID-19 who were nonhospitalized.


Assuntos
COVID-19 , Adulto , Amidas , Anti-Inflamatórios , Biomarcadores , Proteína C-Reativa , Método Duplo-Cego , Etanolaminas , Ferritinas , Humanos , Mediadores da Inflamação , Molécula 1 de Adesão Intercelular , Interleucina-2 , Interleucina-6 , Selectina-P , Ácidos Palmíticos , SARS-CoV-2 , Resultado do Tratamento
6.
J Am Pharm Assoc (2003) ; 62(4): 1329-1337, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35365407

RESUMO

BACKGROUND: Unused prescription opioids from family and friends continue to be the primary access point to prescription opioids for nonmedical use among youth. Implementation of medicine disposal boxes at pharmacies is one approach to facilitate removal of unused prescription opioids from the home to prevent diversion. OBJECTIVES: We sought to examine the implementation rates of disposal boxes at pharmacies in North Carolina from 2016 to 2021 and place-based health disparities in availability. METHODS: We identified pharmacies with a disposal box in 2016, 2018, and 2021 among licensed pharmacies in North Carolina in 2018 (N = 2587). We computed descriptive statistics to describe disposal box implementation rates over time and used geographic information systems to identify spatial trends. We used separate logistic regression models in 2018 and 2021 to assess the relationship between neighborhood characteristics and the likelihood of a pharmacy implementing a disposal box. RESULTS: We found an increase in disposal boxes over time with 43 pharmacies (1.7%) in 2016, 144 (5.6%) in 2018, and 350 (13.5%) in 2021 implementing a disposal box. In 2018, independent pharmacies were more likely than chains to have a disposal box. In 2021, medical-affiliated and pharmacies defined as "other" were less likely than chains to have a disposal box. In both 2018 and 2021, pharmacies in census tracts with a higher percentage of the population below the federal poverty line were more likely to have a disposal box. In 2021, pharmacies in tracts with a higher percentage of the population unemployed were less likely to have a disposal box. In 2018, pharmacies located in counties with a greater number of opioid overdose deaths were more likely to have a disposal box. CONCLUSION: Our findings highlight the growth of disposal boxes in North Carolina over time and the potential for continued expansion to provide opportunities to prevent prescription opioid diversion.


Assuntos
Farmácias , Adolescente , Analgésicos Opioides/efeitos adversos , Humanos , Estudos Longitudinais , North Carolina
7.
Nutr Health ; : 2601060221129159, 2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36221988

RESUMO

Background: Females are prone to urinary tract infections (UTIs) due to estrogen fluctuations affecting vaginal flora. While menstruating, increased fluid consumption to support urination frequency and void volume may be important, as the urethra and urinary tract are more predisposed to bacteria, particularly UTI pathogens. Aim: This study aimed to investigate the impact of hydration on urinary tract health during menstruation among underhydrated premenopausal women. Methods: Thirteen females participated in a 60-day 2 × 2 randomized crossover trial to evaluate the effectiveness of consuming ≥2.2 L of total beverage fluid intake, with 1.9 L being water, (intervention, INT) and maintaining habitual fluid intake (control, CON) on two subsequent menses. Participants completed fluid and urination diaries at days 2 and 5 after the onset of bleeding (day 1) to determine the fluid amount consumed and urination frequency. Urine concentration was assessed in afternoon (days 2 and 5) and uropathogenic bacterial activity in first-morning (days 3 and 6) urinations. General linear models assessed differences in bacterial and hydration outcomes. Results: The intervention led to a 62% mean total fluid increase, INT 3.0 ± 1.1 L and CON 1.9 ± 0.9 L, p < 0.001, η2 = 0.459. Urination frequency was greater and urine concentration less in the INT to CON, all ps < 0.05, η2 range = 0.023-0.019. Only four cultures detected uropathogenic bacteria, with no patterns between conditions or days, making it difficult to determine the intervention's effectiveness. Conclusion: Fluid intake increased, and hydration status improved. No differences in uropathogenic bacterial activity were seen between the hydration and control conditions.

8.
Can J Diet Pract Res ; 83(3): 133-138, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35503908

RESUMO

The purpose of this study was to evaluate nutrition knowledge and diet quality in collegiate athletes to determine if referral to a sports registered dietitian (RD) is warranted. This cross-sectional study analyzed four sections of the Nutrition for Sport Knowledge Questionnaire and the Rapid Eating Assessment for Patients Questionnaire, both validated in athletic populations. The relationship between nutrition knowledge and diet quality was evaluated. Significance was set at P ≤ 0.05. One hundred and twenty athletes reported a median nutrition score of 52 (45-61), and a dietary quality score of 53 (46-58), with a weak, positive association between both (r = 0.28 (95% CI: 0.11-0.44), P < 0.01). Fifty-four percent were categorized as needing a referral to a sports RD. Diet quality scores differed between dietitian referral group with 49 (43-54) versus 58 (52-62) for the nonreferral group, respectively (P < 0.01, V = 0.71), with no difference in nutrition knowledge observed, P = 0.73. Overall, nutrition knowledge and diet quality in our sample of collegiate athletes was poor. College athletic departments with limited access to sports RD should use these questionnaires to evaluate knowledge and the need of dietitian referral separately.


Assuntos
Nutricionistas , Atletas , Estudos Transversais , Dieta , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Encaminhamento e Consulta , Inquéritos e Questionários
9.
Br J Nurs ; 31(12): 632-638, 2022 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-35736855

RESUMO

Health and social care employers in the UK cannot afford to lose nurses given the current nursing workforce crisis. A variety of staff engagement initiatives aim to improve employee retention. This article describes how Listening to Staff (L2S) events were used as part of a service review to inform nurse retention strategies in one acute hospital trust. Over a 3-year period, 576 nurses took part in L2S events that examined nurses' perspectives of teamworking and support as well as career plans in areas with high nurse turnover rates. Comparative content analysis was used to analyse narrative data, which informed managers' retention plans. Examination of retention data before and after L2S events showed nursing turnover decreased, suggesting a variety of strategies to retain staff may have improved nurse retention. Findings imply capturing nurses' perceptions through staff engagement events may offer solutions for nurse retention.


Assuntos
Recursos Humanos de Enfermagem Hospitalar , Recursos Humanos de Enfermagem , Comunicação , Humanos , Satisfação no Emprego , Reorganização de Recursos Humanos , Confiança
10.
BMC Pregnancy Childbirth ; 21(1): 258, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33771102

RESUMO

BACKGROUND: Non-Hispanic black (NHB) pregnant women disproportionately experience adverse birth outcomes compared to Non-Hispanic white (NHW) pregnant women. The positive effects of prenatal exercise on maternal and neonatal health may mitigate these disparities. This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age (GA), birthweight (BW), and risks of preterm birth (PTB), cesarean section (CS), and low-birthweight (LBW) neonates. METHODS: This study performed a secondary data analysis using data from a 24-week, two-arm exercise intervention trial (ENHANCED by Mom). Women with singleton pregnancies (< 16 weeks), aged 18-40 years, BMI between 18.5-34.99 kg/m2, and no preexisting health conditions were eligible. The aerobic exercisers (EX) participated in 150 min of moderate-intensity weekly exercise while non-exercising controls (CON) attended low-intensity stretching/breathing sessions. Data on GA, PTB (< 37 weeks), BW, LBW (< 2.5 kg), and delivery mode were collected. Poisson, median and linear regressions were performed. RESULTS: Participants with complete data (n = 125) were eligible for analyses (EX: n = 58, CON: n = 67). NHB pregnant women delivered lighter neonates (ß = - 0.43 kg, 95% CI: - 0.68, - 0.18, p = 0.001). After adjusting for prenatal exercise, racial/ethnic disparities in BW were reduced (ß = - 0.39 kg, 95% CI: - 0.65, - 0.13, p = 0.004). Prenatal exercise reduced borderline significant racial/ethnic disparities in PTB (p = 0.053) and GA (p = 0.07) with no effects found for CS and LBW. CONCLUSIONS: The findings of this study demonstrate that prenatal exercise may attenuate the racial/ethnic disparities observed in neonatal BW, and possibly GA and PTB. Larger, diverse samples and inclusion of maternal biomarkers (e.g., cytokines) are encouraged to further evaluate these relationships.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Terapia por Exercício/métodos , Disparidades nos Níveis de Saúde , Nascimento Prematuro/epidemiologia , População Branca/estatística & dados numéricos , Adolescente , Adulto , Cesárea/estatística & dados numéricos , Feminino , Humanos , Saúde do Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Nascimento Prematuro/prevenção & controle , Resultado do Tratamento , Adulto Jovem
11.
J Med Internet Res ; 23(3): e24134, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33650977

RESUMO

BACKGROUND: A diet high in fermentable, oligo-, di-, monosaccharides and polyols (FODMAPs) has been shown to exacerbate symptoms of irritable bowel syndrome (IBS). Previous literature reports significant improvement in IBS symptoms with initiation of a low FODMAP diet (LFD) and monitored reintroduction. However, dietary adherence to the LFD is difficult, with patients stating that the information given by health care providers is often generalized and nonspecific, requiring them to search for supplementary information to fit their needs. OBJECTIVE: The aim of our study was to determine whether Heali, a novel artificial intelligence dietary mobile app can improve adherence to the LFD, IBS symptom severity, and quality of life outcomes in adults with IBS or IBS-like symptoms over a 4-week period. METHODS: Participants were randomized into 2 groups: the control group (CON), in which participants received educational materials, and the experimental group (APP), in which participants received access to the mobile app and educational materials. Over the course of this unblinded online trial, all participants completed a battery of 5 questionnaires at baseline and at the end of the trial to document IBS symptoms, quality of life, LFD knowledge, and LFD adherence. RESULTS: We enrolled 58 participants in the study (29 in each group), and 25 participants completed the study in its entirety (11 and 14 for the CON and APP groups, respectively). Final, per-protocol analyses showed greater improvement in quality of life score for the APP group compared to the CON group (31.1 and 11.8, respectively; P=.04). Reduction in total IBS symptom severity score was 24% greater for the APP group versus the CON group. Although this did not achieve significance (-170 vs -138 respectively; P=.37), the reduction in the subscore for bowel habit dissatisfaction was 2-fold greater for the APP group than for the CON group (P=.05). CONCLUSIONS: This initial study provides preliminary evidence that Heali may provide therapeutic benefit to its users, specifically improvements in quality of life and bowel habits. Although this study was underpowered, findings from this study warrant further research in a larger sample of participants to test the efficacy of Heali app use to improve outcomes for patients with IBS. TRIAL REGISTRATION: ClinicalTrials.gov NCT04256551; https://clinicaltrials.gov/ct2/show/NCT04256551.


Assuntos
Síndrome do Intestino Irritável , Aplicativos Móveis , Adulto , Inteligência Artificial , Dieta com Restrição de Carboidratos , Dissacarídeos , Fermentação , Humanos , Síndrome do Intestino Irritável/terapia , Projetos Piloto , Qualidade de Vida , Resultado do Tratamento
12.
J Strength Cond Res ; 35(5): 1279-1286, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33900261

RESUMO

ABSTRACT: Wardenaar, FC, Ortega-Santos, CP, Vento, K, Beaumont, JS, Griffin, SC, Johnston, C, and Kavouras, SA. A 5-day heat acclimation program improves heat stress indicators while maintaining exercise capacity. J Strength Cond Res 35(5): 1279-1286, 2021-This study aimed to evaluate whether a daily 60 minutes isothermic biking protocol during a 5-day period could improve physiological heat acclimation and exercise performance capacity in partially acclimated subjects. A quasi-experimental study consisted of an intervention (INT, n = 7) and control (CON, n = 7) group completing 2 12 minutes Cooper tests (pre-CT on day 1 and post-CT on day 7) and a heat stress test (HST, on day 9). INT performed additional intensive exercise 1 hour per day on days 1-5, whereas CON did not. During CTs and HST, core temperature (Tc, telemetric capsule), skin temperature (Tsk, sensors at neck, right shoulder, left hand, and right shin), and heart rate (HR, chest strap) were continuously monitored and baseline, average, peak, and increment were calculated. During the HST, the INT group showed a smaller baseline-peak Tc increment (INT 0.88 ± 0.27 vs. CON 1.64 ± 0.90° C, p = 0.02), a lower HR peak (150.2 ± 12.6 vs. 173.0 ± 16.8 b·min-1, p = 0.02), and lower Tsk peak (36.47 ± 0.62 vs. 36.54 ± 0.46° C, p = 0.04). There was a nonsignificant, but practical difference based on a moderate effect size for change in pre-CT to post-CT performance of nearly +2.7 ± 12.3% in INT and -3.0 ± 8.5% in CON (p = 0.32 and d = 0.51), and HST distance covered resulting in a nonsignificant difference of 464 ± 849 m between INT and CON (p = 0.38 and d = 0.44). In conclusion a short-term 5-day heat acclimation program including 300 minutes of extra exercise resulted in positive physiological adaptions to heat stress, as indicated by lower core temperature and HR in comparison with a control group.


Assuntos
Temperatura Corporal , Tolerância ao Exercício , Aclimatação , Frequência Cardíaca , Resposta ao Choque Térmico , Temperatura Alta , Humanos
13.
Br J Nurs ; 30(12): 747-752, 2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34170728

RESUMO

BACKGROUND: There is limited research evaluating the implementation and effectiveness of clinical nurse educator (CNE) roles in clinical practice. UK employers tend to use generic nursing job profiles, although the definition, expectations and implementation of nurse educator roles are interpreted differently between employers. AIM: This project intended to reduce variation and standardise job titles, job descriptions and job plans for CNEs ranging from band 5 to band 7 and identify the academic requirements and professional experience required of each band. METHODS: An evaluative service review of existing CNE roles was conducted across a large division of a major NHS hospital trust. Focus group interviews were conducted to identify CNEs' and matrons' perceptions of the role. FINDINGS: Themes identified from the coding of narrative data included: the importance of the role; variations in expectations of the role, job titles, job descriptions and plans; and a lack of career progression pathways. CONCLUSION: This service improvement project demonstrates that a standardised approach to the implementation of CNE roles can be achieved with the support of a unified senior nursing team. Clearer role definition and career progression pathways would improve job satisfaction and may help retain CNEs in post.


Assuntos
Docentes de Enfermagem , Satisfação no Emprego , Humanos , Descrição de Cargo
14.
Child Youth Serv Rev ; 1102020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33518859

RESUMO

BACKGROUND: Over 16 million U.S. adults report a major depressive episode each year. Hispanic females comprise the highest number of U.S. births compared to other race/ethnicities and are expected to remain as the Hispanic population grows. Research postulates that depression often co-occurs within families and is passed down to future generations but has yet to determine racial/ethnic disparities for depression and more acute forms including ideation. METHODS: Using data from the Fragile Families and Child Wellbeing Study, latent class analyses examined the association of primary caregiver's (PCG) depressive symptoms and how their child's perceived level of parent-child closeness is related to their now-adolescent's (age 15) likelihood of ideation (N = 4,898 families). RESULTS: Hispanic PCG's reported a lower rate of depressive symptoms (37%) than non-Hispanic PCG's (45%). Hispanic PCG's depressive symptoms were more likely to be chronic throughout their adolescent's lifetime (15%). Regardless of race/ethnicity, PCG's chronic depressive symptoms negatively affected parental closeness and increased suicidal risk for adolescents. These associations were found at ages 9 and 15 for non-Hispanic families, and at age 15 for Hispanic families. LIMITATIONS: While this is an important first step, parental closeness and ideation can wax and wane. Asking teens about ideation before adolescence could have strengthened our study. CONCLUSIONS: Suicide prevention must be family system focused, and not solely adolescent focused. Impressing upon individuals who serve children (i.e. teachers) and adults (i.e. physicians) to include yearly depression and suicide screens/assessments is crucial given PCG's different wave presentations and how ideation can present as early as middle school.

15.
Nutr J ; 17(1): 89, 2018 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-30266095

RESUMO

The Healthy Eating Index-2010 is a measure of diet quality as portrayed by the Dietary Guidelines for Americans; however, computing the Healthy Eating Index score is time consuming and requires trained personnel. The Rapid Eating Assessment for Participants [shortened version] is a simple measure that quickly, in less than 10 min, assesses diet quality in a clinical or research setting. This research evaluated the degree of correlation between these two methods of scoring diet quality, as well as between these methods and other indicators of diet quality, including the nutrient density of the diet, the dietary potential renal acid load, urine pH, and plasma vitamin C concentrations. The research design was a secondary data analysis, and participants were healthy adults (n = 81) self-classified as omnivorous, vegetarian, or vegan. Confounding variables were identified and controlled using partial correlations. The two methods of scoring diet quality were significantly correlated (r = 0.227, p = 0.047). Both the Healthy Eating Index and the Rapid Eating Assessment for Participants scoring methods were correlated to nutrient density of the diets (r = 0.474 and r = 0.472 respectively, p < 0.001) as well as to the dietary potential renal acid load and urinary pH (r ranging from 0.304-0.341, p ≤ 0.002). The Rapid Eating Assessment for Participants, but not the Healthy Eating Index, was significantly correlated to plasma vitamin C concentrations (r = 0.500, p < 0.001 and 0.192, p = 0.095 respectively). These results in combination with ease of use and low cost suggest that the Rapid Eating Assessment for Participants measure is a useful tool for assessing diet quality.


Assuntos
Dieta Saudável/estatística & dados numéricos , Política Nutricional , Inquéritos Nutricionais/instrumentação , Inquéritos Nutricionais/métodos , Valor Nutritivo , Adulto , Arizona , Estudos Transversais , Dieta Saudável/métodos , Feminino , Humanos , Masculino , Inquéritos Nutricionais/provisão & distribuição , Vegetarianos
16.
J Clin Nurs ; 26(1-2): 115-124, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27219073

RESUMO

AIMS AND OBJECTIVES: This study designed and evaluated the use of a specific implementation strategy to deliver a nursing staff-led Intentional Rounding intervention to reduce inpatient falls. BACKGROUND: Patient falls are a common cause of harm during hospital treatment. Intentional Rounding has been proposed as a potential strategy for prevention, but has not received much objective evaluation. Previous work has suggested that logical interventions to improve patient care require an integrated implementation strategy, using teamwork training and systems improvement training, to instigate positive change and improvement. METHODS: Customised Intentional Rounding was implemented and evaluated as part of a staff-led quality improvement intervention to reduce falls on a neuroscience ward. Intentional Rounding was instigated using a prespecified implementation strategy, which comprised of: (1) engagement and communication activities, (2) teamwork and systems improvement training, (3) support and coaching and (4) iterative Plan-Do-Check-Act cycles. Process (compliance with hourly visiting to patients by staff) and outcome (incidence of falls) measures were recorded pre- and postintervention. Falls measured on the active ward were compared with incidence of falls in 50 wards across the rest of the same Trust. RESULTS: There was a 50% reduction in patient falls on the active ward vs. a minimal increase across the rest of the Trust (3·48%). Customised Intentional Rounding, designed by staff specifically for the context, appeared to be effective in reducing patient falls. CONCLUSIONS: Improvement programmes based on integrating teamwork training and staff-led systems redesign, together with a preplanned implementation strategy, can deliver effective change and improvement. RELEVANCE TO CLINICAL PRACTICE: This study demonstrates, through the implementation of a specific strategy, an effective improvement intervention to reduce patient falls. It provides insight into the effective design and practical implementation of integrated improvement programmes to reduce risk to patients at the frontline.


Assuntos
Acidentes por Quedas/prevenção & controle , Segurança do Paciente , Melhoria de Qualidade , Humanos
17.
Plant Foods Hum Nutr ; 72(3): 308-313, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28677099

RESUMO

Acidogenic diets, commonly measured by the potential renal acid load (PRAL), have been linked with metabolic diseases including insulin resistance, hepatic dysfunction, and cardiometabolic risk. Vegan diets are linked to low dietary acid loads, but the degree of adherence to a vegan diet to demonstrate this benefit is unknown. This study compared the change in PRAL and urine pH of omnivores who followed a vegan diet for either 2, 3, or 7 days over one week. Healthy adults were recruited from a campus population and randomly assigned to one of the three groups: VEG7 (vegan diet followed for seven consecutive days); VEG3 (vegan diet followed for three evenly spaced days over one week); or VEG2 (vegan diet followed for two evenly spaced days over one week). Gender, age, and body mass index did not differ between groups (overall: 21.8 ± 2.4 y and 24.4 ± 5.6 kg/m2). Following the one week intervention, outcome measures did not vary between the VEG2 and VEG3 groups, and these groups were collapsed for the final analyses. The 24-h urine pH was raised after seven consistent days of vegan diet adherence and was unchanged after 2-3 days of vegan diet adherence over the course of a week (+0.52 ± 0.69 and -0.02 ± 0.56 respectively, p = 0.048). However, dietary PRAL scores fell significantly in both dietary groups during the 7-day trial. Since low dietary PRAL scores have been related to improve metabolic parameters, adoption of a vegan diets for several days per week should be explored as a diet strategy to lower disease risk.


Assuntos
Equilíbrio Ácido-Base , Dieta Vegana , Adulto , Feminino , Humanos , Concentração de Íons de Hidrogênio , Resistência à Insulina , Masculino , Urina , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-27766381

RESUMO

Early amphibious tetrapods may have detected aquatic sound pressure using sound-induced lung vibrations, but their lack of tympanic middle ears would have restricted aerial sensitivity. Sharing these characteristics, salamanders could be models for the carryover of auditory function across an aquatic-terrestrial boundary without tympanic middle ears. We measured amphibious auditory evoked potential audiograms in five phylogenetically and ecologically distinct salamanders (Amphiuma means, Notophthalmus viridescens, Ambystoma talpoideum, Eurycea spp., and Plethodon glutinosus) and tested whether metamorphosis and terrestrial niche were linked to aerial sensitivity. Threshold differences between media varied between species. A. means' relative aerial sensitivity was greatest at 100 Hz and decreased with increasing frequency. In contrast, all other salamanders retained greater sensitivity up to 500 Hz, and in A. talpoideum and Eurycea, relative sensitivity at 500 Hz was higher than at 100 Hz. Aerial thresholds of terrestrial P. glutinosus above 200 Hz were similar to A. talpoideum and Eurycea, but lower than N. viridescens and A. means. Metamorphosis did not affect aerial sensitivity in N. viridescens or A. talpoideum. These results fail to support a hypothesis of terrestrial hearing specialization across ontogeny or phylogeny. We discuss methodological limitations to our amphibious comparisons and factors affecting variation in amphibious performance.


Assuntos
Audição/fisiologia , Metamorfose Biológica/fisiologia , Urodelos/crescimento & desenvolvimento , Urodelos/fisiologia , Ar , Ambystoma/fisiologia , Animais , Audiometria , Limiar Auditivo/fisiologia , Evolução Biológica , Ecossistema , Potenciais Evocados Auditivos/fisiologia , Notophthalmus viridescens/fisiologia , Filogenia , Água
19.
Adv Exp Med Biol ; 877: 93-120, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26515312

RESUMO

Darters (Perciformes, Percidae), sculpins (Perciformes, Cottidae), and gobioids (Gobiiformes, Gobioidei) exhibit convergent life history traits, including a benthic lifestyle and a cavity nesting spawning mode. Soniferous species within these taxa produce pulsed and/or tonal sounds with peak frequencies below 200 Hz (with some exceptions), primarily in agonistic and/or reproductive contexts. The reduced or absent swim bladders found in these taxa limit or prevent both hearing enhancement via pressure sensitivity and acoustic amplification of the contracting sonic muscles, which are associated with the skull and pectoral girdle. While such anatomies constrain communication to low frequency channels, optimization of the S/N (signal-to-noise) ratio in low frequency channels is evident for some gobies, as measured by habitat soundscape frequency windows, nest cavity sound amplification, and audiograms. Similar S/N considerations are applicable to many darter and sculpin systems. This chapter reviews the currently documented diversity of sound production in darters, sculpins, and gobioids within a phylogenetic context, examines the efficacy of signal transmission from senders to receivers (sound production mechanisms, audiograms, and masking challenges), and evaluates the potential functional significance of sound attributes in relation to territorial and reproductive behaviours.


Assuntos
Comunicação Animal , Limiar Auditivo/fisiologia , Audição/fisiologia , Perciformes/fisiologia , Acústica , Sacos Aéreos/fisiologia , Animais , Evolução Biológica , Ecossistema , Perciformes/classificação , Som , Espectrografia do Som , Especificidade da Espécie
20.
Artigo em Inglês | MEDLINE | ID: mdl-26194768

RESUMO

Animals exhibit unique hearing adaptations in relation to the habitat media in which they reside. This study was a comparative analysis of auditory specialization in relation to habitat medium in Testudines, a taxon that includes both highly aquatic and fully terrestrial members. Evoked potential audiograms were collected in four species groups representing diversity along the aquatic-terrestrial spectrum: terrestrial and fossorial Gopherus polyphemus, terrestrial Terrapene carolina carolina, and aquatic Trachemys scripta and Sternotherus (S. odoratus and S. minor). Additionally, underwater sensitivity was tested in T. c. carolina, T. scripta, and Sternotherus with tympana submerged just below the water surface. In aerial audiograms, T. c. carolina were most sensitive, with thresholds 18 dB lower than Sternotherus. At 100-300 Hz, thresholds in T. c. carolina, G. polyphemus, and T. scripta were similar to each other. At 400-800 Hz, G. polyphemus thresholds were elevated to 11 dB above T. c. carolina. The underwater audiograms of T. c. carolina, T. scripta, and Sternotherus were similar. The results suggest aerial hearing adaptations in emydids and high-frequency hearing loss associated with seismic vibration detection in G. polyphemus. The underwater audiogram of T. c. carolina could reflect retention of ancestral aquatic auditory function.


Assuntos
Limiar Auditivo/fisiologia , Meio Ambiente , Potenciais Evocados Auditivos/fisiologia , Tartarugas/fisiologia , Estimulação Acústica , Análise de Variância , Animais , Audiometria , Feminino , Masculino , Psicoacústica , Especificidade da Espécie , Tartarugas/classificação , Estados Unidos , Água
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