Implementing Post-Discharge 48-Hour Scripted Call for Patients with Heart Failure: An Evidence-Based Practice Quality Improvement Project

Post-discharge call programs are a simple and effective way to identify and intervene for patient care issues that may occur after discharge. Nurses play a key role in these programs and can lead quality improvement projects on their units to improve patient care during the transition from hospital to home

Transitions in Care From Acute Care Telemetry Unit to Home: An Evidence-Based Quality Improvement Project

The article reports on a study that used the Institute for Healthcare Improvement\u27s Model for Improvement as framework to guide the planning, implementation, and evaluation phases of an evidence-based practice quality improvement project. The six steps of the model were mentioned. The seven-day follow-up appointment based practices questionnaire is shown. The outcomes of appointments scheduled, kept appointments, and readmissions before and after change implementation were compared

Trends in the use of natural antioxidants in active food packaging: a review

The demand for natural antioxidant active packaging is increasing due to its unquestionable advantages compared with the addition of antioxidants directly to the food. Therefore, the search for antioxidants perceived as natural, namely those that naturally occur in herbs and spices, is a field attracting great interest. In line with this, in the last few years, natural antioxidants such as -tocopherol, caffeic acid, catechin, quercetin, carvacrol and plant extracts (e.g. rosemary extract) have been incorporated into food packaging. On the other hand, consumers and the food industry are also interested in active biodegradable/compostable packaging and edible films to reduce environmental impact, minimise food loss and minimise contaminants from industrial production and reutilisation by-products. The present review focuses on the natural antioxidants already applied in active food packaging, and it reviews the methods used to determine the oxidation protection effect of antioxidant active films and the methods used to quantify natural antioxidants in food matrices or food simulants. Lastly consumers' demands and industry trends are also addressed.Tania Albuquerque is grateful for a research grant [grant number BRJ/DAN-2012] funded by the National Institute of Health Dr Ricardo Jorge, I. P. This work was supported by Project Number PTDC/AGR-TEC/3366/2012 with the acronym Rose4Pack (Biodegradable active packaging with rosemary extract (Rosmarinus officinalis L.) to improve food shelf life) and funded by the Foundation for Science and Technology (FCT) and COMPETE Programme [grant number FCOMP-01-0124-FEDER-028015]

Resuscitation of preterm infants with different inspired oxygen fractions

Objective To test the hypothesis that an initial fraction of inspired oxygen (FiO(2)) of 30% during resuscitation of preterm infants results in less oxidative stress and is associated with improved clinical outcomes compared with an FiO(2) of 65%. Study design Preterm infants of gestational age <32 weeks (n = 193) were randomized to start resuscitation with either 30% oxygen (low-oxygen group) or 65% oxygen (high-oxygen group), after which the FiO2 was adjusted based on oxygen saturation values. The primary outcome was bronchopulmonary dysplasia (BPD) assessed at 36 weeks postmenstrual age. Secondary outcomes included major neonatal illnesses and markers of oxidative stress. Results The median gestational age of included infants was 28 6 /7 weeks (IQR, 26 5 /7-30 3 /7 weeks). The incidence of BPD was not significantly different between the low-oxygen and high-oxygen groups (24% vs 17%; P = .15). The FiO(2) in both groups was adjusted to a mean of 40% by 7 minutes in the low-oxygen group and by 11 minutes in the high-oxygen group. No differences in markers of oxidative stress were noted between groups. Conclusion Initial supplementation of preterm infants with 30% oxygen during the fetal-to-neonatal transition is as safe as 65% oxygen, with no differences in oxidative stress markers or BPD

Glutathione synthesis rates in early postnatal life.

Preterm infants have diminished antioxidant defenses. Glutathione (GSH), the main intracellular antioxidant, increases upon amino acid (AA) administration in preterm infants, without an accompanying rise of the fractional synthesis rate of GSH (FSRGSH) This study investigated the mechanism behind this increased GSH concentration by determining GSH synthesis in the first days after birth using stable isotope techniques in very low-birth-weight (VLBW) infants receiving i.v. AAs. Advanced oxidized protein products (AOPPs) were determined to quantify oxidative stress. Eighteen infants (birth weight 989 +/- 241 g, gestational age of 27/7 +/- 1/7 weeks) were studied either on postnatal day 1 or 2 (7 or 31 h postnatally, respectively). Concentration of GSH increased with postnatal age (1.45 +/- 0.48 mM versus 1.99 +/- 0.40 mM, p = 0.019). FSRGSH was not significantly different, but the absolute synthesis rate of GSH (ASRGSH) tended to be higher in the infants studied on day 2 [8.1 +/- 2.7 mg/(kg . d) versus 10.6 +/- 2.4 mg/(kg . d), p = 0.054]. AOPP concentrations were not different between groups. In conclusion, GSH concentration in VLBW infants increases significantly after birth. A concomitant increased synthesis rate was not found, suggesting that GSH consumption decreases upon AA administration.Preterm infants have diminished antioxidant defenses. Glutathione (GSH), the main intracellular antioxidant, increases upon amino acid (AA) administration in preterm infants, without an accompanying rise of the fractional synthesis rate of GSH (FSRGSH) This study investigated the mechanism behind this increased GSH concentration by determining GSH synthesis in the first days after birth using stable isotope techniques in very low-birth-weight (VLBW) infants receiving i.v. AAs. Advanced oxidized protein products (AOPPs) were determined to quantify oxidative stress. Eighteen infants (birth weight 989 +/- 241 g, gestational age of 27/7 +/- 1/7 weeks) were studied either on postnatal day 1 or 2 (7 or 31 h postnatally, respectively). Concentration of GSH increased with postnatal age (1.45 +/- 0.48 mM versus 1.99 +/- 0.40 mM, p = 0.019). FSRGSH was not significantly different, but the absolute synthesis rate of GSH (ASRGSH) tended to be higher in the infants studied on day 2 [8.1 +/- 2.7 mg/(kg . d) versus 10.6 +/- 2.4 mg/(kg . d), p = 0.054]. AOPP concentrations were not different between groups. In conclusion, GSH concentration in VLBW infants increases significantly after birth. A concomitant increased synthesis rate was not found, suggesting that GSH consumption decreases upon AA administratio