Metabolic impact of infant formulas in young infants. An outlook from the urine metabolome.

Introduction: Although breast milk is the ideal food source for newborns during the first six months of life, a high percentage of children receive infant formulas. There is evidence that specific diet habits may influence individual metabolic profile. Therefore, in newborns, such profile can be influenced by the use of infantile formulas given the composition differences that display compared to human milk. Up to now, there are no reports in the literature that address this issue. Objectives: this work aims to compare the metabolic profile of full-term newborns that were feed with either breast milk (n = 32) or infantile formulas (n = 21). Methods: Metabolic profile was established based on urine analysis through gas chromatography-mass spectrometry (GC-MS) and nuclear magnetic resonance (H-NMR). Results: our results evidenced a more gluconeogenic profile in breast-fed infants characterized by elevation of Kreb's cycle intermediaries like fumaric, succinic and ketoglutaric acids compared to infants receiving infant formula. In addition, infant formula fed infants presented urinary excretion of metabolites derived from specific compounds present in this type of diet that were not observed in breast-fed infants, for instance D-glucitol, and 4-deoxytetronic. Moreover, in infant formula fed infants there was excretion of basal levels of metabolites of clinical relevance like 3-hydroxy-3-methyl-glutaric, 2-methyl-3-keto-valeric and 3,4-dihydroxybutyric. Conclusion: These results show the importance of understanding the metabolic impact of diet in newborn population in normal and pathological contexts.

Reducing Employee Injury Rates with a Hospital-wide Employee Safety Program.

Introduction: Despite the well-known dangers of working in the healthcare industry, healthcare organizations have historically accepted workplace injuries as business as usual. In 2017, Children's National Hospital began our Employee and Staff Safety program to drive down the employee injury rate and address this disturbing industry trend. Methods: With guidance and support from executive leadership, we created an Employee and Staff Safety program that aligned employee safety work with existing patient safety and quality improvement efforts. Team leads collected and analyzed baseline employee injury data and identified areas of highest injuries. Dedicated subcommittees focused on five specific areas: slips, trips, and falls; sharps injuries; blood and body fluid exposures; verbal and physical violence; and overexertion injuries. Subcommittees established aims, identified key drivers, and brainstormed interventions for tests of change. Results: Because the inception of the Employee and Staff Safety program, Children's National has seen significant reductions in our Days Away Restricted or Transfer (DART) rate. The DART rate shows a sustained 37% reduction since the baseline period of FY16-FY17 (1.48 injuries/200,000 h worked to 0.93 injuries/200,000 h worked). The regression trend shows a significant decrease (38.3%) in DART injuries, from 1.544 to 0.952 over 56 months; P = 0.016. Conclusions: Active leadership support and analyzing data on specific employee harm areas coupled with targeted interventions, helped improve Children's National's DART rate. The Employee and Staff Safety program's success in utilizing patient safety and quality improvement tools creates a generalizable framework for other hospitals to advance their high-reliability journey.

Factores socioeconómicos y rendimiento académico en estudiantes de enfermería. Revisión bibliográfica integrativa / Socioeconomic factors and academic performance in nursing students. Integrative litera-ture review

La formación exitosa de profesionales de la enfermería es una necesidad para la sociedad contemporánea. Así, la investigación tuvo el objetivo de establecer las regularidades reportadas por diferentes autores acerca de la forma en que los factores socioeconómicos interactúan con el rendimiento académico en diversos contextos formativos de profesionales de la enfermería. Las autoras realizaron una revisión integrativa. La búsqueda se hizo en las bases de datos: WOS, PubMed y BVS, resultando 461 fuentes iniciales, quedando 14 seleccionas al final, de las que, la mayoría tenía enfoque cuantitativo, corte transversal, de tipo descriptivo o correlacional, publicadas entre 2016 y 2021, en su mayor parte genera-das en países africanos y latinoamericanos. El rendimiento académico en estudiantes de enfermería se está influenciado por factores socioeconómicos, tales como: etnia, tener empleo, problemas económicos, insuficiente apoyo familiar, demasiado uso de las tecnologías de la información y las comunicaciones, dificultades psicológicas y estilo de vida poco saludable

The successful training of nursing professionals is a necessity for contemporary society. Thus, this research aimed to establish the regularities reported by different authors about the way in which socioeconomic factors interact with academic performance in various training contexts of nursing professionals. The authors conducted an integrative review. The search was made in the databases: WOS, PubMed and VHL, resulting in 461 initial sources, getting 14 selections at the end, most of them had a quantitative approach, they were cross-sectional, descriptive, or correla-tional, and published between 2016 and 2021, mostly generated in African and Latin American countries. Academic performance in nursing students is influenced by socioeconomic factors, such as: ethnicity, having a job, economic problems, insufficient family support, excessive use of information and communication technologies, psychological difficulties, and unhealthy lifestyle

Nursing and respite care services for ventilator-assisted children.

Home care for children requiring life-sustaining technological interventions has become an increasingly common alternative to long-term hospitalization since the 1970s. The Ventilator Assisted Children's Home Program, a state-funded program in the Commonwealth of Pennsylvania, has provided services to more than 600 infants and children requiring mechanical ventilation and their families. Under this program, children have the opportunity to live at home with their families and receive quality medical care. However, over time, parents and nurses have acknowledged that this care can often be stressful and overwhelming. Nursing and respite care services in the home environment can provide these families with extremely valuable supports.

Diagnóstico de la unidad de Cuidados Intensivos del Hospital Enrique Garcés / Diagnosis of the unit of Intensive Cares of the Hospital Enrique Garcés

Fué de interés para el grupo el desarrollar el diagnóstico de la Unidad de Cuidados Intensivos por tratarse de una área nueva y de gran complejidad para nosotros. Realizamos un diagnóstico con un enfoque integral no solamente de los aspectos convencionales sino de los aspectos subjetivos los cuales determinan las actividades del personal...

Participacion de la enfermera en la orientacion y educacion especifica en salud a pacientes pre-eclampticas / Participation of the nurse in specific orientation and health education for patients with pre-eclampsy

Al realizar una observacion objetiva de los servicios de consulta externa en los hospitales Materno-Infantil, San Jose y de la Clinica San Pedro Claver pudimos detectar una falla en la educacion brindada a las pacientes pre-eclampticas; esto nos llevo a plantearnos un interrogante: "Influye la educacion en la evolucion de la paciente pre-eclamptica?". Es entonces cuando nos propusimos desarrollar nuestro trabajo tomando como base este tema. Segun el analisis obtuvimos la confirmacion de la hipotesis propuesta en el trabajo, ya que logramos determinar que la educacion si influye en la evolucion del embarazo de pacientes pre-eclampticas, razon por la cual recomendamos a las instituciones que presten asistencia en salud a estas pacientes, que elaboren y desarrollen un plan con el fin de orientar y educar a este grupo suceptible para que de esta forma se prevengan futuras complicaciones

Participacion de la enfermera en la orientacion y educacion especifica en salud a pacientes pre-eclampticas / Participation of the nurse in specific orientation and health education for patients with pre-eclampsy

Al realizar una observacion objetiva de los servicios de consulta externa en los hospitales Materno-Infantil, San Jose y de la Clinica San Pedro Claver pudimos detectar una falla en la educacion brindada a las pacientes pre-eclampticas; esto nos llevo a plantearnos un interrogante: "Influye la educacion en la evolucion de la paciente pre-eclamptica?". Es entonces cuando nos propusimos desarrollar nuestro trabajo tomando como base este tema. Segun el analisis obtuvimos la confirmacion de la hipotesis propuesta en el trabajo, ya que logramos determinar que la educacion si influye en la evolucion del embarazo de pacientes pre-eclampticas, razon por la cual recomendamos a las instituciones que presten asistencia en salud a estas pacientes, que elaboren y desarrollen un plan con el fin de orientar y educar a este grupo suceptible para que de esta forma se prevengan futuras complicaciones..