Preferences for oral rehydration drinks among healthy individuals in Ghana: A single-blind, cross-sectional survey to inform implementation of an enterally based resuscitation protocol for burn injury.

BACKGROUND: Enterally based resuscitation for major burn injuries has been suggested as a simple, operationally superior, and effective resuscitation strategy for use in austere contexts. However, key information to support its implementation is lacking, including palatability and acceptability of widely available rehydration drinks. METHODS: We performed a single-blinded, cross-sectional survey of 60 healthy children (5-14 years), adults (15-54 years) and older adults (≥55 years) to determine palatability and overall acceptability of five oral rehydration solutions (ORS) and a positive control drink (Sprite Zero®) in Ghana. Quantitative data were described and differences between our control drink and the others across age groups were visually examined with Likert plots. Qualitative responses were analyzed using a content analysis framework. RESULTS: Twenty participants in each age group completed the study. Participants were as young as 5 years and as old as 84 years. Nearly two thirds of the sample identified as male (n = 38, 63% of all participants). The positive control was reported to taste 'good or 'very good' by the majority of participants (89%) followed by lemon-flavored ORS (78%) and orange-flavored ORS (78%). Conversely, homemade and low-osmolarity ORS were reported to taste 'good' or 'very good' by only 20% and 15% of participants, respectively. There were no major taste differences across the age groups. However, children more frequently reported positively (i.e., tastes 'good' or 'very good') about flavored and sweet drinks than did adults and older adults. When faced with the hypothetical situation of being critically injured and needing resuscitation, participants tended to be more agreeable to consuming all the drinks, even low-osmolarity and homemade ORS. CONCLUSIONS: These findings can be used to support the development of protocols that may be more acceptable among patients undergoing enterally based resuscitation, thus improving the effectiveness of the treatment. Specifically, enterally based resuscitation should likely include citrus-flavored ORS when available, given superior palatability and the fact that different flavor additives for patients of different ages do not seem necessary.

Interventions for marital discord in military couples: strengthening the home front.

This article discusses the use of role-exit theory within military couples as they attend counseling for martial discord. The adjustment of roles by both members of the marriage during a military deployment can create tension on the soldier's return. The goal of counseling is to assist the couples in regaining a balance in their marriage through cohesion and generating comfort in the roles assumed during deployment and on the soldier's return.A need for flexibility and understanding is important for a successful marriage. This need increases in a military couple. Frequent changes due to military service do not always correlate with the marital cycle, thus creating problems specific to military couples. With the current operational tempo of today's military, couples are feeling the strain of deployment and its effects on their roles within the marriage.