Measurement of Daily Energy Expenditure in Individuals with Chronic Heart Failure

Being able to accurately monitor and quantify the amount of physical activity an individual with chronic heart failure (CHF) performs can be of assistance in developing appropriate interventions. This thesis attempted to evaluate the validity of the RT3 accelerometer (RT3) and 7-day Physical Activity Recall Questionnaire (7 day PAR) in measuring the daily activity levels of community dwelling individuals with CHF. Fifty-four individuals with CHF participated in a 7 day session to estimate their daily physical activity by using the RT3 accelerometer and 7-day PAR questionnaire. In addition, 15 of the 54 individuals participated in a second study in with the validity of RT3was compared to oxygen consumption (VO2) measured by a MedGraphics VO2000 gas analyzer during typical daily activities. Although there was no significant difference between the RT3 and VO2 on mean caloric (Kcal) expenditure (p=0.67), the accelerometer tended to underestimate the energy expenditure (EE) and its validity was affected by activity intensity, movement patterns, placement location and soft tissue adhesion. The 7-day PAR overestimated EE by 22%, when compared to the RT3. There was no significant difference in the outcomes if the 7-day PAR only focused on day time activity versus 24-hour activity which included sleep. The second study revealed that the resting metabolic rate in individuals with CHF is significantly lower than 3.5 ml/kg/min, which indicates this metabolic constant for the general population is probably not appropriate for estimating daily energy expenditure in individuals with CHF

Randomised controlled trials of mental health nurse‐delivered interventions: A systematic review

Introduction Nurses are the largest professional disciplinary group working in mental health services and have been involved in numerous trials of nursing-specific and multidisciplinary interventions. Systematic appraisal of relevant research findings is rare. Aim To review trials from the core Anglosphere (UK, US, Canada, Ireland, Australia, New Zealand) published from 2005-2020. Method A systematic review reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Comprehensive electronic database searches were conducted. Eligible studies were randomised controlled trials of mental health nurse-delivered interventions conducted in relevant countries. Risk of bias was independently assessed. Synthesis involved integration of descriptive statistics of standardised metrics and study bias. Results Outcomes from 348 between-group comparisons were extracted from K=51 studies (N=11,266 participants), Standardised effect sizes for 68 (39 very small/small, 29 moderate/large) statistically significant outcomes from 30 studies were calculable. All moderate/large effect sizes were at risk of bias. Discussion Trial evidence of effective mental health nurse-delivered interventions is limited. Many studies produced few or no measurable benefits; none demonstrated improvements related to personal recovery. Implications for practice Mental health nurses should look beyond gold standard RCT evidence, and to evidence-based interventions that have not been trialled with mental health nurse delivery

Changes in Functional Status of Home Health Cardiac Patients from Admission to Discharge

The purpose of this research is to examine the functional status (ADLs and IADLs) in patients with a primary/secondary diagnosis of cardiac disease in the home health setting. The independent variables of dyspnea and service were examined for the effect on discharge functional status while controlling for the effects of age, gender, race, admission functional status, primary and secondary diagnosis. A descriptive correlational, non-experimental study of cardiac patients in an urban home health agency from January 2003 to December 2004 was conducted using data collected through a retrospective chart review. Seventeen areas of OASIS (ADL and IADL) were assessed for changes in function in this study. The null hypothesis that Home Health Care does not effect a change in functional status for cardiac patients was not supported. A paired t-test was conducted for the total admission functional score and the total discharge functional score. The mean difference in the scores was found to be significant with a t score of -11.094 (p = 0.000), thus patient\u27s functional status improved from admission to discharge. In the standard multiple regression, (F (DF=160) = 24.271, p \u3c 0.001, R2= .645) the independent variables significantly predicts the dependent variable. A stepwise multiple regression was conducted next to determine which specific independent variables made meaningful contributions to the overall predictions. The biggest contributions to discharge functional scores was admission functional score, R2 = .64, R2adj = .619, F = 24.271, p \u3c .05. With the addition of dyspnea at admit the R2 increased to .620, R2 change = .019, F = 6.451, p \u3c .05. It is interesting to note that age, gender, ethnicity, diagnosis, or service were not significant for discharge functional status scores

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Compiles peer-reviewed research and literature reviews on issues regarding patient safety and quality of care, ranging from evidence-based practice, patient-centered care, and nurses' working conditions to critical opportunities and tools for improvement

Prevention and Treatment of Sarcopenia

Sarcopenia represents the decline in skeletal muscle mass and function with age, characterized by the muscle fiber's quality, strength, muscle endurance, and metabolic ability decreasing, as well as the fat and connective tissue growing.Reduction of muscle strength with aging leads to loss of functional capacity, causing disability, mortality, and other adverse health outcomes. Because of the increase of the proportion of elderly in the population, sarcopenia-related morbidity will become an increasing area of health care resource utilization.Diagnostic screening consists of individuation of body composition, assessed by DEXA, anthropometry, bioelectrical impedance, MRI, or CT scan. Management is possible with resistance training exercise and vibration therapy, nutritional supplements, and pharmacological treatment.The book includes articles from different nationalities, treating the experimental and medical applications of sarcopenia. The consequences of sarcopenia in frailty are treated in relation to other associated pathologies or lesions, as femoral neck fractures and hepatocellular carcinoma