What information-related activities do people with ESKD use?

Background Information practice is an emerging area of research that seeks to reveal how people learn to connect with the complex multimodal information landscapes that informs their ability to make decisions. Previous research has identified that people with end stage kidney disease (ESKD) tend to adopt a ‘received’ or ‘engaged’ view of information but little is known about the activities of information practice. Objectives This research project sought to identify the: i) information-related activities; and ii) how information is used. Methods Using a constructivist qualitative methodology, ten people with ESKD living in a large metropolitan city were purposively selected and interviewed. Data was subject to thematic analysis by researchers from nursing and information science. Saturation of themes was achieved. Results Participants were between 38 and 72 years, had been receiving kidney replacement therapy from 2 weeks to 31 years. Eight participants reported having access to the internet but none participated in chat rooms. The activities were conceptualized into themes as listening, seeking, searching, sharing and observing. These activities enabled people to create, reflect on and evaluate the information needed to inform their decision-making Conclusion/Application to Clinical Practice The information practice research approach will enable a better understanding of the underlying relationship between information, knowledge and experience to be better understood. For renal nurses who are involved in patient education being able to recognise the way people use information will assist in individualizing educational sessions and tailoring teaching strategies to make it more meaningful

Observations on the composition of the blood in the neonatal period

It has been realised for many years that the infants of diabetic mothers have notably high foetal and neonatal mortality rates, the reasons for which remain obscure. These infants tend to be large, puffy and hyperkinetic. If they are delivered at term, the mortality rate is very high. Even if pregnancy is terminated two or three weeks earlier, the incidence of respiratory distress and of pulmonary hyaline membrane syndrome is high.Typertrophy of the pancreatic islet cells in such infants has been established (Driscoll, Benirschke and Curtis, 1960). Pederson (1952) considers that this is a result of stimulation of the foetus by maternal hyperglycaemia. There is evidence that these infants become hypoglycaemic immediately after birth (Komrower, 1954; Farquhar, 1961). Some evidence of adrenocortical disturbance is present (Farquhar, 1958). There are also some indications of acidosis (Ibid).This study was begun to investigate the possibility that there might be a disturbance in lipid and lipoprotein metabolism in these infants, since it is already known that such a disturbance exists in the mothers (Albrink and Nan, 1958).Information about normal serum lipid concentrations in blood, at birth and in the neonatal period, is limited so that any study of the infants of diabetic mothers necessitates a parallel study of infants of normal mothers. In the course of obtaining blood specimens from so called "normal infants ", a considerable number of samples were obtained from infants whose mothers had various ante- ï_atal complications. These were notably toxaemia and abortive tendencies. The investigation has therefore been extended to cover these groups.Obtainiir_ blood specimens was naturally a rather erratic process, dependin_ entirely on the availability of hospital staff. In order that the intervening periods might be occupied constructively, certain subsidiary investigations were begun.To supplement the earlier work in the Department of Child Life and Health in this University by Dr. J. W. Farquhar on adrenocortical disturbances in the infants of diabetic mothers, a very limited investigation of the urinary excretion of 17- ketosteroids and l7ketogenic steroids has been made in newborn infants. Difficulties in obtaining complete twenty -four hour urine collections are considerable. The amount of blood necessary for studying serum cortico steroid concentrations is prohibitive in infants. Therefore only a small number of urinary steroid estimations were made.Finally some information has been collected on the amino -acid content of urine and serum in the neonatal period in both normal and abnormal infants.The scope of the work to be described in this thesis may be summarised as follows:1. The estimation of serum lipid and lipoprotein lipid concentrations in the cord blood of infants, including those with both normal and abnormal pre- and post natal histories. The term "lipid" includes total lipid, total cholesterol, total esterified fatty acid and phospholipid.2. The estimation of serum lipid and lipoprotein lipid concentrations in the first week of life in the infants of diabetic mothers.3. The estimation of the concentrations of 17- ketosteroids and 17- keto._,enic steroids excreted in the urine of normal infants on the first day of life and of infants of diabetic mothers during the first three days of life.4. A chromatographic investigation of amino acid patterns in cord blood and in venous blood and urine during the neonatal period in normal and some abnormal infants.The methods of chemical analysis used throughout the investigation are given in Appendix I and the methods of statistical analysis in Appendix II. Both appendices will be found at the end of the thesis.General conclusions are drawn at the end of each section and not at the end of the thesis