Effect of dietary supplementation with glutamine and a combination of glutamine-arginine on intestinal health in twenty-five-day-old weaned rabbits1

The effect of dietary supplementation with 1% l-glutamine and a combination of 1% l-glutamine and 0.5% l-arginine on intestinal health was examined in weaned rabbits. A basal diet was formulated to meet nutrient recommendations. Another 2 diets were formulated by adding 1% (as-fed basis) Gln or a mixture of 1% (as-fed basis) Gln + 0.5% (as-fed basis) Arg (Gln-Arg) to the basal diet. In Exp. 1, a total of 357 rabbits were blocked by litter and assigned at random to the experimental diet to determine mortality (119 per diet) and growth performance (35 per diet; from weaning at 25 to 56 d of age). Rabbits were fed the experimental diets for a 2-wk period and thereafter received a commercial diet. Rabbits weaned at 25 d (blocked by litter and assigned at random to diets) were slaughtered at 35 d and used to determine apparent ileal digestibility of DM, CP, and AA (Exp. 2, a total of 60 rabbits), intestinal morphology, N-aminopeptidase and myeloperoxidase intestinal activity, the expression of PPARgamma at the ileum and kidney, serum immunoglobulin in healthy and sick rabbits (Exp. 3, a total of 24 rabbits), and ileal and cecal microbial composition by PCR-RFLP (Exp. 4, a total of 45 rabbits). Dietary treatment did not affect ADG, ADFI, or G:F, during the entire fattening period. Supplementation with Gln reduced mortality during the first 2 wk and the whole fattening period from 18.5 to 8.4% (P = 0.023) and from 31.9 to 20.2% (P = 0.039), respectively, whereas no effect was detected for Arg supplementation. Among all the variables studied, the reduction on mortality due to Gln was related to a reduced intestinal colonization (Eimeria lesions) and changes on microbial ecosystem in the ileum and cecum, reducing the frequency of detection of Clostridium spp. (from 86.7 to 33.3%, P = 0.003) at the ileum, and Helicobacter spp. at the ileum (from 86.7 to 46.7%, P = 0.003) and at the cecum (from 86.7 to 46.7, P = 0.028), whereas no effect was detected for Arg supplementation. In conclusion, 1% l-Gln supplementation to postweaned rabbit diets decreased fattening mortality and modified the intestinal microbiota (although no consistent effects were observed on mucosal histology or inflammatory and systemic immune response). Diets containing a combination of 1% Gln and 0.5% Arg were of little additional benefit.Depto. de Genética, Fisiología y MicrobiologíaFac. de Ciencias BiológicasTRUEpu

Time use of advanced practice nurses in hospitals: A cross‐sectional study

Aims To examine the use of time by advanced practice nurses and time use differences according to type of healthcare organization, work experience, and supervisor. Design A cross-sectional, observational study. Methods Non-participant observations were executed in Belgium (October 2015-January 2016). Time use was categorized in domains (patient/family, team, healthcare organization) and roles (clinical expert, educator/coach, change agent/innovator, researcher, leader, collaborator, and ethical decision-making facilitator). Proportional working time in domains and roles was calculated. Chi-squared tests identified differences in time use according to type of healthcare organization, number of years of work experience, and type of hierarchical/functional supervisor. Results Participants mainly devoted time to the patient/family domain (30.78%) and the clinical expert role (34.19%). The role of leader and ethical decision-making facilitator covered, respectively, 4.84% and 0.07% of participants' time. Time distribution in domains and roles differed between participants in university and peripheral hospitals. Conclusion Activities were executed in all domains and roles, except for the ethical decision-making facilitator role. Further research could uncover barriers and facilitators for role execution, especially about leadership and ethical decision-making. Impact Advanced practice nurses, supervisors and policymakers could act to optimize advanced practice nurses' scope of practice