Significance of Capnography in Pediatric Post Anesthesia Care

Updated clinical guidelines and professional practice standards for pediatric post-anesthesia care call for the use of capnography until the patient is awake. The purpose of this project was to champion the implementation of capnography in the pediatric post-anesthesia care unit at the project site. Monitoring capnography in addition to pulse oximetry for all pediatric post-anesthesia patients until awake was the practice change implemented. Capnography led to an increase in the number of appropriate respiratory-related nursing care interventions provided, earlier response to changes in respiratory status, and a decrease in the pediatric post-anesthesia care unit length of stay. The implications for practice include increasing the efficiency and effectiveness of nursing care as well as increasing the affordability of healthcare in the pediatric post-anesthesia care unit

Grandmother Kinship Care Providers: Predictors of Elevated Psychological Distress

Most children in kinship care with grandmothers in the U.S. have been abandoned or maltreated. The challenges these caregivers encounter often include poverty, social isolation, and diminished health. These factors may hinder the grandmother’s ability to provide a supportive family environment. The purpose of the present study was to determine levels of psychological distress in African American caregiving grandmothers and identify predictors of increased distress in African American custodial grandmothers. We hypothesized that diminished grandmother health, family resources and support, as well as increased child behavior problems, will predict psychological distress

Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey

Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis). Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents’ physical and emotional capacities

Perceptions of Family Empowerment in African American Custodial Grandmothers Raising Grandchildren: Thoughts for Research and Practice

Empowerment practice is an approach to help marginalized families reduce their sense of powerlessness. The present study explores empowerment practice with a sample of low-income African American custodial grandmothers. It specifically describes how the effects of a strengths-based community service program influenced caregivers’ sense of empowerment. Using the Family Empowerment Scale, the results suggest that the service intervention supports the empowerment dimensions and three subscales (knowledge, advocacy, and self-efficacy); the results did not support the competency subscale. Although all age groups experienced an increase in empowerment, older grandmothers had significant differences in perceptions regarding social systems, as well as a sense of competency as compared with younger grandmothers. Implications for service delivery and future research are presented

A Global Perspective on Intersecting Social and Systemic Barriers Experienced by Grandparent-Caregivers: A Qualitative Systematic Review

Globally, many grandparents are taking on the caregiving role for their grandchildren without public or government interjection of support, particularly financial assistance for basic needs such as housing, health care and living expenses. This paper aimed to broaden understanding of social and systemic barriers experienced by grandparent-caregivers across the globe. Of the 2,828 relevant grandparent caregiving studies identified in the literature, 34 representing eight countries met our inclusion criteria to answer the research question and the focus of this paper: What are the social and systemic barriers experienced by grandparent-caregivers across the globe? We utilized Noblit’s and Hare’s (1988) meta-ethnography method and phases of the eMERGe reporting guidelines (France et al., 2019) to improve the completeness and clarity of the synthesis. Bronfenbrenner\u27s socioecological model informed the qualitative analysis that consisted of three interactive levels that impacted the various aspects of grandparent-caregivers and their grandchildren: the exosystem (physical environment and programs and services), macrosystem (systemic barriers, culture, religion, and spirituality), and chronosystem (time and historic influences). The use of both the meta-ethnography approach and eMERGe guidelines increased transparency, reproducibility and credibility of the synthesis, while the socioecological model enabled us to effectively identify common global and cross-cultural needs among grandparent-caregivers. Our findings have potential to: (1) identify gaps in, and barriers to, available resources for grandparent-caregivers and (2) inform the design of comprehensive intervention models and screening tools needed to address perceived support needs. Further research is needed on comprehensive assessment of support needs and health risks unique to each setting

Legislators\u27 Perceptions about Poverty: Views from the Georgia General Assembly

This study sought to explore legislators perspectives about causes of poverty. Members of the Georgia General Assembly rated the importance of 10 behavioral and structural explanations of poverty, and indicated whether they thought poor women and children would be better served under AFDC or TANF. Whereas all groups of legislators found behavioral explanations moderately important, there was significant variation by race, gender, and political party about the importance of structural explanations of poverty. Support for several structural explanations of poverty correlated with a preference for AFDC, but no correlations were found with behavioral explanations. This study holds implications for affecting future debates about TANF

The long-term safety and efficacy of vestronidase alfa, rhGUS enzyme replacement therapy, in subjects with mucopolysaccharidosis VII

Vestronidase alfa (recombinant human beta-glucuronidase) is an enzyme replacement therapy (ERT) for Mucopolysaccharidosis (MPS) VII, a highly heterogeneous, ultra-rare disease. Twelve subjects, ages 8-25 years, completed a Phase 3, randomized, placebo-controlled, blind-start, single crossover study (UX003-CL301; NCT02377921), receiving 24-48 weeks of vestronidase alfa 4 mg/kg IV. All 12 subjects completed the blind-start study, which showed significantly reduced urinary glycosaminoglycans (GAG) and clinical improvement in a multi-domain responder index, and enrolled in a long-term, open-label, extension study (UX003-CL202; NCT02432144). Here, we report the final results of the extension study, up to an additional 144 weeks after completion of the blind-start study. Three subjects (25%) completed all 144 weeks of study, eight subjects (67%) ended study participation before Week 144 to switch to commercially available vestronidase alfa, and one subject discontinued due to non-compliance after receiving one infusion of vestronidase alfa in the extension study. The safety profile of vestronidase alfa in the extension study was consistent with observations in the preceding blind-start study, with most adverse events mild to moderate in severity. There were no treatment or study discontinuations due to AEs and no noteworthy changes in a standard safety chemistry panel. Out of the eleven subjects who tested positive for anti-drug antibodies at any time during the blind-start or extension study, including the baseline assessment in the blind-start study, seven subjects tested positive for neutralizing antibodies and all seven continued to demonstrate a reduction in urinary GAG levels. There was no association between antibody formation and infusion associated reactions. Subjects receiving continuous vestronidase alfa treatment showed a sustained urinary GAG reduction and clinical response evaluated using a multi-domain responder index that includes assessments in pulmonary function, motor function, range of motion, mobility, and visual acuity. Reduction in fatigue was also maintained in the overall population. As ERT is not expected to cross the blood brain barrier, limiting the impact on neurological signs of disease, and not all subjects presented with neurological symptoms, outcomes related to central nervous system pathology are not focused on in this report. Results from this study show the long-term safety and durability of clinical efficacy in subjects with MPS VII with long-term vestronidase alfa treatment.This work was supported by Ultragenyx Pharmaceutical Inc. LZ, TC, DM, and AJ, authors of this manuscript, are employees of Ultragenyx Pharmaceutical and contributed to the conduct of the research; the study design; data collection, analysis and interpretation; development of this manuscript; and the decision to submit this article.info:eu-repo/semantics/publishedVersio

Cutting cardiovascular risk in barbershops

http://dx.doi.org/10.1016/j.jomh.2009.07.00