Cesarean Section Surgical Site Infection Prevention Evidence-Based Practices and Implementation Plan

The Cesarean section (C-section) surgical site infection prevention implementation plan has been designed as a quality improvement project. The project included a microsystem assessment, identifying the problem, literature review, application of a nursing theory and conceptual model, and development of an implementation plan. The microsystem assessment involved a Labor and Delivery Unit who had initiated a new surgical site infection (SSI) prevention bundle developed by an interprofessional team utilizing evidence-based practices and other hospitals protocols. The problem defined was the elevated rates of SSIs due to gaps in the SSI bundle risking the sustainability of the bundle. A literature review was performed by searching CINAHL with the search terms: surgical site infection, cesarean section, and obstetrical surgery. The time frame chosen for the literature review was 2011-2016. The Nursing Role Effectiveness Model was utilized to assess the current unit structure and processes to evaluate related outcomes. Furthermore, the implementation plan was formulated with the idea of rapid cycle change utilizing the Plan-Do-Study-Act (PDSA) cycle. Collaboration with interprofessional teams and key stakeholders is essential for the success and sustainability of this project

Modeling Two-Phase Flow and Vapor Cycles Using the Generalized Fluid System Simulation Program

This work presents three new applications for the general purpose fluid network solver code GFSSP developed at NASA's Marshall Space Flight Center: (1) cooling tower, (2) vapor-compression refrigeration system, and (3) vapor-expansion power generation system. These systems are widely used across engineering disciplines in a variety of energy systems, and these models expand the capabilities and the use of GFSSP to include fluids and features that are not part of its present set of provided examples. GFSSP provides pressure, temperature, and species concentrations at designated locations, or nodes, within a fluid network based on a finite volume formulation of thermodynamics and conservation laws. This paper describes the theoretical basis for the construction of the models, their implementation in the current GFSSP modeling system, and a brief evaluation of the usefulness of the model results, as well as their applicability toward a broader spectrum of analytical problems in both university teaching and engineering research

The role of sensory sensitivity in predicting food selectivity and food preferences in children with Tourette syndrome

Tourette syndrome (TS) is a neurodevelopmental disorder characterised by involuntary, repetitive and non-rhythmic motor and vocal tics. Despite suggestion that diet may affect tics, and the substantial research into children's diet, eating behaviours and sensory processing in comorbid disorders (e.g. ASD), research in TS is lacking. The present study examined differences between children with and without TS in parental reports of child selective eating, food preferences and sensitivity, and aimed to examine sensory sensitivity as a predictor of food selectivity outcomes in children with and without TS. Thirty caregivers of children with TS (M = 10 years 8 months [SD = 2.40]) and the caregivers of 30 age- and sex-matched typically developing (TD) children (M = 9 years 9 months [SD = 2.50]) completed the following measures online: Short Sensory Profile, Food Preference Questionnaire for Children, Child Eating Behaviour Questionnaire. Children with TS were reported to have significantly higher levels of food selectivity and sensory sensitivity, and less preference for fruit and vegetables than TD children. Importantly, while higher levels of overall sensory sensitivity predicted eating outcomes in the TS group, only sensitivity to taste/smell was found to be a predictor of food selectivity and preference for vegetables for both groups of children. The findings suggest that efforts to address food selectivity in children with TS may be enhanced by including strategies that address atypical sensory processing

Supporting the learning of deaf students in higher education: a case study at Sheffield Hallam University

This article is an examination of the issues surrounding support for the learning of deaf students in higher education (HE). There are an increasing number of deaf students attending HE institutes, and as such provision of support mechanisms for these students is not only necessary but essential. Deaf students are similar to their hearing peers, in that they will approach their learning and require differing levels of support dependant upon the individual. They will, however, require a different kind of support, which can be technical or human resource based. This article examines the issues that surround supporting deaf students in HE with use of a case study of provision at Sheffield Hallam University (SHU), during the academic year 1994-95. It is evident that by considering the needs of deaf students and making changes to our teaching practices that all students can benefit

Antioxidative Properties of Bitter Gourd (Momordica charantia) and Zucchini (Cucurbita pepo)

The enzymatic and non-enzymatic antioxidative capacities of bitter gourd (Momordica charantia) and zucchini (Cucurbita pepo) were investigated in water extracts and chemical buffer extracts. Bitter gourd and zucchini fruits were purchased from a farmer’s market and homogenized separately in water and in a native enzyme extraction buffer. Total phenolic compounds, free radical DPPH scavenging activity, SOD activity and β- glucosidase activity were assayed in the extracts. The average total phenolic compounds recorded in bitter gourd were 13.28 GAE/g fresh weights while in zucchini, the average was 8.67GAE/g fresh weight. This study also found that bitter gourd was 82.05% as effective as ascorbic acid in inhibiting the free radical DPPH while zucchini was 12.19% as effective. The results indicated that bitter gourd was significantly higher in antioxidant content and in β-glucosidase activities than zucchini (P\u3c0.05). On the other hand, significantly higher SOD activities were recorded in zucchini than in bitter gourd extracts

Investigation of ward fidelity to a multicomponent delirium prevention intervention during a multicentre, pragmatic, cluster randomised, controlled feasibility trial

Background delirium is a frequent complication of hospital admission for older people and can be reduced by multicomponent interventions, but implementation and delivery of such interventions is challenging. Objective to investigate fidelity to the prevention of delirium system of care within a multicentre, pragmatic, cluster randomised, controlled feasibility trial. Setting five care of older people and three orthopaedic trauma wards in eight hospitals in England and Wales. Data collection research nurse observations of ward practice; case note reviews and examination of documentation. Assessment 10 health care professionals with experience in older people’s care assessed the fidelity to 21 essential implementation components within four domains: intervention installation (five items; maximum score = 5); intervention delivery (12 items; maximum score = 48); intervention coverage (three items; maximum score = 16); and duration of delivery (one item; maximum score = 1). Results the mean score (range) for each domain was: installation 4.5 (3.5–5); delivery 32.6 (range 27.3–38.3); coverage 7.9 (range 4.2–10.1); and duration 0.38 (0–1). Of the 10 delirium risk factors, infection, nutrition, hypoxia and pain were the most and cognitive impairment, sensory impairment and multiple medications the least consistently addressed. Overall fidelity to the intervention was assessed as high (≥80%) in two wards, medium (51–79%) in five wards and low (≤50%) in one ward. Conclusion the trial was designed as a pragmatic evaluation, and the findings of medium intervention fidelity are likely to be generalisable to delirium prevention in routine care and provide an important context to interpret the trial outcomes

Challenges of Integrating an Evidence-based Intervention in Health Departments to Prevent Excessive Gestational Weight Gain among Low-income Women

To examine health departments’ (HD) capacity to adapt and implement an intervention to prevent excessive gestational weight gain

Prader-Willi Syndrome Is Associated with Activation of the Innate Immune System Independently of Central Adiposity and Insulin Resistance

Background: Subjects with Prader-Willi syndrome (PWS) have a reduced life expectancy due to cardiovascular disease. Increased systemic low-grade inflammation is postulated as a contributor, despite reported lower visceral fat mass and increased insulin sensitivity. Objectives: Our aim was to compare inflammatory markers and arterial stiffness in PWS and adiposity-matched obese control subjects. Design: We conducted a cross-sectional cohort study comparing 12 PWS subjects, 12 obese subjects matched for percentage body fat and central abdominal fat mass, and 10 healthy normal-weight subjects. Main Outcome Measures: Dual-energy x-ray absorptiometry was used to assess body composition, flow cytometry to quantify activation markers on immune cells, and ELISA for measurement of C-reactive protein, adiponectin, and IL-6. Insulin resistance was estimated by homeostasis model assessment and arterial stiffness by applanation tonometry. Results: PWS and obese subjects had similarly increased homeostasis model assessment and arterial stiffness. Nevertheless, PWS subjects showed significantly higher IL-6 (4.9 ± 1.0 vs. 2.5 ± 0.4 pg/ml; P = 0.02) and nonsignificantly higher C-reactive protein (10.5 ± 3.2 vs. 4.0 ± 1.0 ng/ml; P = 0.08). Neutrophil activation markers CD66b and CD11b were higher in PWS compared to obese subjects (P < 0.01), reflecting an activated innate immune system. These markers were positively related to central adiposity in lean and obese subjects (r = 0.49; P < 0.05), but not in PWS subjects. Conclusions: PWS subjects compared to adiposity-matched obese subjects demonstrate similar insulin resistance but increased low-grade inflammation. The dissociation of inflammation and central adiposity suggests that activation of innate immunity may be either a specific genetic feature of PWS or linked to the commonly associated obstructive sleep apnea syndrome, and might offer a treatment target to reduce cardiovascular disease