Oral application of L-menthol in the heat: From pleasure to performance

When menthol is applied to the oral cavity it presents with a familiar refreshing sensation and cooling mint flavour. This may be deemed hedonic in some individuals, but may cause irritation in others. This variation in response is likely dependent upon trigeminal sensitivity toward cold stimuli, suggesting a need for a menthol solution that can be easily personalised. Menthol’s characteristics can also be enhanced by matching colour to qualitative outcomes; a factor which can easily be manipulated by practitioners working in athletic or occupational settings to potentially enhance intervention efficacy. This presentation will outline the efficacy of oral menthol application for improving time trial performance to date, either via swilling or via co-ingestion with other cooling strategies, with an emphasis upon how menthol can be applied in ecologically valid scenarios. Situations in which performance is not expected to be enhanced will also be discussed. An updated model by which menthol may prove hedonic, satiate thirst and affect ventilation will also be presented, with the potential performance implications of these findings discussed and modelled. Qualitative reflections from athletes that have implemented menthol mouth swilling in competition, training and maximal exercise will also be included

Improving Skin Tears Healing Time is Demonstrated by the Staff RN who Performs Early Initiation Treatment of the Skin Tear Protocol

Skin tears create numerous challenges for managing skin integrity for our aging population. Skin tears result from trauma, such as a patient bumping into a doorknob or rubbing against the wheelchair; they also occur because the epidermis and dermis lose elasticity and rub against each other, causing a shearing process that separates the outer skin layers from their protective under layers. Skin tears not only look terrible but can be painful and lead to infection if treatment is not initiated early by the nurse. Purpose: The Chief Nursing Officer chose to focus on skin tear treatment at a southeast urban hospital since data existed that the current protocol was confusing, and the staff needed education on the new protocol and the importance of addressing skincare quickly. Informal discussions with the primary nurses found that nurses were not using a standard approach and often waited on the wound care team to handle skin tears. This delayed treatment and increased the patient\u27s potential for infection. A standardized Skin Tear Protocol was needed to ensure the rapid assessment and treatment of skin tears. Design Methods: This DNP project implements an evidence-based practice project with a quality improvement intervention that involves developing a standardized Skin Tear Protocol to assist the primary nurse in identifying skin tears and improving treatment initiation time for skin tears. A pretest and posttest were administered during the education course to each participant to assess their understanding of skin tears. Thirty-six randomly selected participants agreed to participate in the project. Implications for Nursing: A statistician performed the data analysis and used the paired t-test and the two independent sample tests, which showed there was not a significant difference between the two groups. By utilizing the standardized Skin Tear Protocol, the DNP student and the primary nurses can contain cost and decrease patient pain levels by implementing treatment while reducing the infection rate. By understanding and using the standardized Skin Tear Protocol, the primary nurse is ready to teach everybody about skin tears and skin tear care treatment. Education is the key to preventing skin tears

Pressure ulcer stages among bed-ridden patients in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria- Nigeria

This study was carried out to assesspressure ulcer stages among bed-ridden patients in Medical, Neurosurgical and Orthopaedic wards inAhmadu Bello University Teaching Hospital (ABUTH) Shika-Zaria. The main aim of this study is to determine the prevalence as well as the stages of pressure ulcers among bed-ridden patients and to assess the Nurses’ awareness and application of the awareness in the stage-based treatment of pressure ulcer in ABUTH. The descriptive survey design was adopted and data was collected with the help of questionnaire and observation checklist. A convenient sampling method was used among the bed-ridden patients and a single-stage cluster method was used among the nurses in the three wards. The study sample consisted of 51 Nurses whom answered a pre-established Questionnaire and 129 bed-ridden patients whom were observed using Observational Checklist. The Major Findings were as follows: the cumulative point prevalence of Pressure ulcer was noted to be 18.6% which is significantly high; Pressure ulcer stages were observed to be highest for Stages III (37.5%), and Stage IV (33.3%) which are the advanced stages, and then low in Stage II (20.8%) and Stage I (8.3%). Furthermore, 96% of Nurses were observed to be aware of pressure ulcer stages and 82% apply their awareness in the stage-based treatment of pressure ulcer. In conclusion, there was a high prevalence of pressure ulcer among bed-ridden patients majority of which were the advanced stage of the condition. Therefore it is recommended that, use of a risk assessment tool such as theBraden Scale on admission will identify if the client has pressure ulcer or not, and if they do, at which stage, health care professionals should be more informed about secondary conditions that may occur in the course of patient’s stay in the hospital rather than emphasis only on primary condition that warranted admission, and patient’s relatives should be informed about the risk factors for the development of pressure ulcers since they are also fully involved in the care

How does VTE risk for the patch and vaginal ring compare with oral contraceptives?

Evidence is conflicting with regard to the comparative frequency of venous thrombolic events (VTE) among women using the transdermal patch when compared to an oral contraceptive (OC), even though the patch produces a relatively high serum ethinyl estradiol (EE) level (strength of recommendation [SOR]: C, conflicting cohort case-control studies). The vaginal ring has a risk of VTE comparable to that of an OC (SOR: B, 1 comparative study)

Heat-Ready: heatwave awareness, preparedness and adaptive capacity in aged care facilities

AbstractThis study identifies the current policies and strategies Australian ACFs use to keep residents well, and highlights the barriers to heatwave adaptation and maintaining wellness in the residential aged during periods of extreme heat. As the Australian population ages, planning for the health effects of extreme heat in elderly residents is critical to ensure wellness in this population group is maintained.Aims were to: 1) investigate current heat-wave planning, policies, staff knowledge and heat prevention strategies and 2) identify barriers to adaptation and successful implementation of adequate heat-wave health care in ACFs in three Australian states (NSW, Queensland and South Australia).Residential ACFs were identified across three states using Department of Health and Ageing databases, white pages and internet searching. After removal of duplicates, 1,561 facilities were invited to participate in the study. Each participating facility was asked to provide informed consent and invited to select one administrative and one clinical staff member to participate in a 15 minute Computer Assisted Telephone Interview (CATI). Participants were asked about their knowledge of the effects of heat on the elderly and to detail current plans and policies which addressed residents’ health during heat-waves, and barriers to care during periods of extreme heat. Data was entered into a purpose-built database and analysed using Statistical Package for the Social Sciences (SPSS) Version 19.Two hundred and eighty seven (287) facilities (18%) participated in the telephone interview. The ACFs enrolled represented 20,928 Australian aged care residents.  Ninety percent of facilities had a current ACF emergency plan, although only 30% included heat-wave emergency planning. Heatwave policies were not routine in all ACFs in any state. Staff used a range of strategies to keep residents cool in extreme heat, although strategies were not consistent across all states or facilities. The issues raised in relation to clinical care in this group can be synthesised into four key messages; cooling, hydration, monitoring and emergency planning, which, at a practical level are essential to maintain the health of older people in very hot weather.Please cite this report as: Black, DA, Veitch, C, Wilson, LA, Hansen, A 2013 Heat-Ready: Heatwave awareness, preparedness and adaptive capacity in aged care facilities in three Australian states: New South Wales, Queensland and South Australia, National Climate Change Adaptation Research Facility, Gold Coast, 47 pp.AbstractThis study identifies the current policies and strategies Australian ACFs use to keep residents well, and highlights the barriers to heatwave adaptation and maintaining wellness in the residential aged during periods of extreme heat. As the Australian population ages, planning for the health effects of extreme heat in elderly residents is critical to ensure wellness in this population group is maintained.Aims were to: 1) investigate current heat-wave planning, policies, staff knowledge and heat prevention strategies and 2) identify barriers to adaptation and successful implementation of adequate heat-wave health care in ACFs in three Australian states (NSW, Queensland and South Australia).Residential ACFs were identified across three states using Department of Health and Ageing databases, white pages and internet searching. After removal of duplicates, 1,561 facilities were invited to participate in the study. Each participating facility was asked to provide informed consent and invited to select one administrative and one clinical staff member to participate in a 15 minute Computer Assisted Telephone Interview (CATI). Participants were asked about their knowledge of the effects of heat on the elderly and to detail current plans and policies which addressed residents’ health during heat-waves, and barriers to care during periods of extreme heat. Data was entered into a purpose-built database and analysed using Statistical Package for the Social Sciences (SPSS) Version 19.Two hundred and eighty seven (287) facilities (18%) participated in the telephone interview. The ACFs enrolled represented 20,928 Australian aged care residents.  Ninety percent of facilities had a current ACF emergency plan, although only 30% included heat-wave emergency planning. Heatwave policies were not routine in all ACFs in any state. Staff used a range of strategies to keep residents cool in extreme heat, although strategies were not consistent across all states or facilities. The issues raised in relation to clinical care in this group can be synthesised into four key messages; cooling, hydration, monitoring and emergency planning, which, at a practical level are essential to maintain the health of older people in very hot weather.&nbsp