Digital dietetics : practices and attitudes to technology use among Australian dietitians

Recent advancements in the capabilities of information and communication technologies (ICT) offer unique avenues to support the delivery of nutrition care. Despite ICTs being widely available, evidence on the practices and attitudes with regard to ICT use among dietitians is limited. A cross-sectional survey of Dietitians Association of Australia members was administered online in August 2011. All dietitians who responded (n=87) had access to a computer at work. Half reported providing non face-to-face consultations, with the telephone and email the most common modes of delivery. The use of smart phones was prevalent for 49% of practitioners, with 30% recommending nutrition-related applications and/or programs to clients. Benefits to technology use in practice most commonly reported included improvements in access to information/resources, time management, and workflow efficiency. Barriers identified related to cost and access to technology, and lack of suitable programs/applications. Technology was viewed as an important tool in practice among 93% of dietitians surveyed, however only 38% were satisfied with their current level of use. The majority (81%) believed more technology should be integrated within dietetics, while 85% indicated that the development of suitable and practical applications andprograms is necessary for future practice. Technology is regarded as an important tool by Australian dietitians, with an expressed need for theirinclusion to further facilitate nutrition care. Regular and ongoing evaluation of technology use among dietitians is vital to ensure thatapplications and use are evidence based and relevant to consumers in the digital world

A bioética e a dor em odontologia: uma aproximação humanista

In dental clinical practice, moral aspects cannot be forgotten; leaving values aside can turn to be a dangerous and sense­less exercise. Understanding and becoming part of the goals involved in health care marks a dedication that goes beyond the sickness and its treatment. Understanding what the patient is going through, his/her fragility and vulnerability will allow us to place every effort into the search of what is best for him/her, with full respect for his/her interests and quality of life, without looking away from his/her interiority, which is, as I can understand, the final purpose of our work. The patient’s pain, so very frequent in dentistry, as a symptom as much as fear or experience, makes a moral and value-searching approach a necessity. Pain represents much more than disease, it actually involves a break in integrality. [that will not be avoided just by prescribing drugs,] (Integrality will not be achieved just by prescribing drugs,) but also with the intimate will of the profes­sional to restore vitality in the widest sense of the word. We want a reflection into a matter that we consider of maximum transcendence, but which has been at the same time forgotten by the great technological advancement of our profession.En la práctica clínica odontológica, los aspectos morales no pueden olvidarse, restarse a los valores puede resultar un ejercicio tan peligroso como carente de todo sentido. Comprender y hacerse parte de los fines inherentes al cuidado de la salud marca una dedicación más allá de la enfermedad y su tratamiento. Comprender en el paciente su vivencia, fragilidad y vulnerabilidad nos permitirá hacer todos nuestros esfuerzos hacia la búsqueda de su mejor bien, respetando sus intereses y calidad de vida sin abstraer nuestra mirada hacia su interioridad, siendo esta el fin último de nuestro quehacer. El dolor, por su parte, tan frecuente en la odontología, ya sea como síntoma, como temor o como vivencia, hace necesario una aproximación moral y valórica. El dolor representa mucho más que la dolencia, involucra en realidad un quiebre en la integralidad, la que no se logrará única y exclusivamente con la prescripción de fármacos, sino también con la íntima voluntad del profesional de restituir la vitalidad en el más amplio sentido de la palabra. Queremos una reflexión en un tema que nos parece de amplia trascendencia, pero que simultáneamente ha estado olvidado por el gran desarrollo tecnológico de nuestra profesión.Na prática clínica odontológica, os aspetos morais não podem ser esquecidos; deixar de lado os valores pode vir a ser um exercício tão perigoso quanto falto de todo sentido. Compreender e tornar-se parte das metas envolvidas no cuidado da saúde marca uma dedicação que vai além da doença e seu tratamento. Compreender no paciente sua ex­periência, sua fragilidade e vulnerabilidade permitir-nos-á fazer todos os nossos esforços para a procura do seu melhor bem, respeitando seus interesses e qualidade de vida sem abstrair a nossa atenção para o seu interior, sendo este o objetivo final do nosso trabalho. A dor, por sua vez, é tão comum em odontologia, seja como sintoma, como medo ou como experiência, faz necessária uma aproximação moral e baseada em valores. A dor representa muito mais do que a doença, na realidade envolve uma rutura na integridade, que não vai-se conseguir somente pela prescrição de medi­camentos, mas também com a íntima vontade do profissional de restituir a vitalidade no mas amplo sentido da palavra. Nós queremos refletir num tema que nós achamos de muita transcendência, mas ao mesmo tempo foi esquecido pelo grande desenvolvimento tecnológico da nossa profissão

High frequency oscillatory ventilation and prone positioning in a porcine model of lavage-induced acute lung injury

BACKGROUND: This animal study was conducted to assess the combined effects of high frequency oscillatory ventilation (HFOV) and prone positioning on pulmonary gas exchange and hemodynamics. METHODS: Saline lung lavage was performed in 14 healthy pigs (54 ± 3.1 kg, mean ± SD) until the arterial oxygen partial pressure (PaO(2)) decreased to 55 ± 7 mmHg. The animals were ventilated in the pressure controlled mode (PCV) with a positive endexpiratory pressure (PEEP) of 5 cmH(2)O and a tidal volume (V(T)) of 6 ml/kg body weight. After a stabilisation period of 60 minutes, the animals were randomly assigned to 2 groups. Group 1: HFOV in supine position; group 2: HFOV in prone position. After evaluation of prone positioning in group 2, the mean airway pressure (P(mean)) was increased by 3 cmH(2)O from 16 to 34 cmH(2)O every 20 minutes in both groups accompanied by measurements of respiratory and hemodynamic variables. Finally all animals were ventilated supine with PCV, PEEP = 5 cm H(2)O, V(T )= 6 ml/kg. RESULTS: Combination of HFOV with prone positioning improves oxygenation and results in normalisation of cardiac output and considerable reduction of pulmonary shunt fraction at a significant (p < 0.05) lower P(mean )than HFOV and supine positioning. CONCLUSION: If ventilator induced lung injury is ameliorated by a lower P(mean), a combined treatment approach using HFOV and prone positioning might result in further lung protection

High tidal volume mechanical ventilation-induced lung injury in rats is greater after acid instillation than after sepsis-induced acute lung injury, but does not increase systemic inflammation: an experimental study

<p>Abstract</p> <p>Background</p> <p>To examine whether acute lung injury from direct and indirect origins differ in susceptibility to ventilator-induced lung injury (VILI) and resultant systemic inflammatory responses.</p> <p>Methods</p> <p>Rats were challenged by acid instillation or 24 h of sepsis induced by cecal ligation and puncture, followed by mechanical ventilation (MV) with either a low tidal volume (Vt) of 6 mL/kg and 5 cm H₂O positive end-expiratory pressure (PEEP; LVt acid, LVt sepsis) or with a high Vt of 15 mL/kg and no PEEP (HVt acid, HVt sepsis). Rats sacrificed immediately after acid instillation and non-ventilated septic animals served as controls. Hemodynamic and respiratory variables were monitored. After 4 h, lung wet to dry (W/D) weight ratios, histological lung injury and plasma mediator concentrations were measured.</p> <p>Results</p> <p>Oxygenation and lung compliance decreased after acid instillation as compared to sepsis. Additionally, W/D weight ratios and histological lung injury scores increased after acid instillation as compared to sepsis. MV increased W/D weight ratio and lung injury score, however this effect was mainly attributable to HVt ventilation after acid instillation. Similarly, effects of HVt on oxygenation were only observed after acid instillation. HVt during sepsis did not further affect oxygenation, compliance, W/D weight ratio or lung injury score. Plasma interleukin-6 and tumour necrosis factor-α concentrations were increased after acid instillation as compared to sepsis, but plasma intercellular adhesion molecule-1 concentration increased during sepsis only. In contrast to lung injury parameters, no additional effects of HVt MV after acid instillation on plasma mediator concentrations were observed.</p> <p>Conclusions</p> <p>During MV more severe lung injury develops after acid instillation as compared to sepsis. HVt causes VILI after acid instillation, but not during sepsis. However, this differential effect was not observed in the systemic release of mediators.</p

La bioética y el dolor en odontología: una aproximación humanista

In dental clinical practice, moral aspects cannot be forgotten; leaving values aside can turn to be a dangerous and sense­less exercise. Understanding and becoming part of the goals involved in health care marks a dedication that goes beyond the sickness and its treatment. Understanding what the patient is going through, his/her fragility and vulnerability will allow us to place every effort into the search of what is best for him/her, with full respect for his/her interests and quality of life, without looking away from his/her interiority, which is, as I can understand, the final purpose of our work. The patient’s pain, so very frequent in dentistry, as a symptom as much as fear or experience, makes a moral and value-searching approach a necessity. Pain represents much more than disease, it actually involves a break in integrality. [that will not be avoided just by prescribing drugs,] (Integrality will not be achieved just by prescribing drugs,) but also with the intimate will of the profes­sional to restore vitality in the widest sense of the word. We want a reflection into a matter that we consider of maximum transcendence, but which has been at the same time forgotten by the great technological advancement of our profession.Na prática clínica odontológica, os aspetos morais não podem ser esquecidos; deixar de lado os valores pode vir a ser um exercício tão perigoso quanto falto de todo sentido. Compreender e tornar-se parte das metas envolvidas no cuidado da saúde marca uma dedicação que vai além da doença e seu tratamento. Compreender no paciente sua ex­periência, sua fragilidade e vulnerabilidade permitir-nos-á fazer todos os nossos esforços para a procura do seu melhor bem, respeitando seus interesses e qualidade de vida sem abstrair a nossa atenção para o seu interior, sendo este o objetivo final do nosso trabalho. A dor, por sua vez, é tão comum em odontologia, seja como sintoma, como medo ou como experiência, faz necessária uma aproximação moral e baseada em valores. A dor representa muito mais do que a doença, na realidade envolve uma rutura na integridade, que não vai-se conseguir somente pela prescrição de medi­camentos, mas também com a íntima vontade do profissional de restituir a vitalidade no mas amplo sentido da palavra. Nós queremos refletir num tema que nós achamos de muita transcendência, mas ao mesmo tempo foi esquecido pelo grande desenvolvimento tecnológico da nossa profissão.En la práctica clínica odontológica, los aspectos morales no pueden olvidarse, restarse a los valores puede resultar un ejercicio tan peligroso como carente de todo sentido. Comprender y hacerse parte de los fines inherentes al cuidado de la salud marca una dedicación más allá de la enfermedad y su tratamiento. Comprender en el paciente su vivencia, fragilidad y vulnerabilidad nos permitirá hacer todos nuestros esfuerzos hacia la búsqueda de su mejor bien, respetando sus intereses y calidad de vida sin abstraer nuestra mirada hacia su interioridad, siendo esta el fin último de nuestro quehacer. El dolor, por su parte, tan frecuente en la odontología, ya sea como síntoma, como temor o como vivencia, hace necesario una aproximación moral y valórica. El dolor representa mucho más que la dolencia, involucra en realidad un quiebre en la integralidad, la que no se logrará única y exclusivamente con la prescripción de fármacos, sino también con la íntima voluntad del profesional de restituir la vitalidad en el más amplio sentido de la palabra. Queremos una reflexión en un tema que nos parece de amplia trascendencia, pero que simultáneamente ha estado olvidado por el gran desarrollo tecnológico de nuestra profesión

A bioética e a dor em odontologia: uma aproximação humanista

In dental clinical practice, moral aspects cannot be forgotten; leaving values aside can turn to be a dangerous and sense­less exercise. Understanding and becoming part of the goals involved in health care marks a dedication that goes beyond the sickness and its treatment. Understanding what the patient is going through, his/her fragility and vulnerability will allow us to place every effort into the search of what is best for him/her, with full respect for his/her interests and quality of life, without looking away from his/her interiority, which is, as I can understand, the final purpose of our work. The patient’s pain, so very frequent in dentistry, as a symptom as much as fear or experience, makes a moral and value-searching approach a necessity. Pain represents much more than disease, it actually involves a break in integrality. [that will not be avoided just by prescribing drugs,] (Integrality will not be achieved just by prescribing drugs,) but also with the intimate will of the profes­sional to restore vitality in the widest sense of the word. We want a reflection into a matter that we consider of maximum transcendence, but which has been at the same time forgotten by the great technological advancement of our profession.En la práctica clínica odontológica, los aspectos morales no pueden olvidarse, restarse a los valores puede resultar un ejercicio tan peligroso como carente de todo sentido. Comprender y hacerse parte de los fines inherentes al cuidado de la salud marca una dedicación más allá de la enfermedad y su tratamiento. Comprender en el paciente su vivencia, fragilidad y vulnerabilidad nos permitirá hacer todos nuestros esfuerzos hacia la búsqueda de su mejor bien, respetando sus intereses y calidad de vida sin abstraer nuestra mirada hacia su interioridad, siendo esta el fin último de nuestro quehacer. El dolor, por su parte, tan frecuente en la odontología, ya sea como síntoma, como temor o como vivencia, hace necesario una aproximación moral y valórica. El dolor representa mucho más que la dolencia, involucra en realidad un quiebre en la integralidad, la que no se logrará única y exclusivamente con la prescripción de fármacos, sino también con la íntima voluntad del profesional de restituir la vitalidad en el más amplio sentido de la palabra. Queremos una reflexión en un tema que nos parece de amplia trascendencia, pero que simultáneamente ha estado olvidado por el gran desarrollo tecnológico de nuestra profesión.Na prática clínica odontológica, os aspetos morais não podem ser esquecidos; deixar de lado os valores pode vir a ser um exercício tão perigoso quanto falto de todo sentido. Compreender e tornar-se parte das metas envolvidas no cuidado da saúde marca uma dedicação que vai além da doença e seu tratamento. Compreender no paciente sua ex­periência, sua fragilidade e vulnerabilidade permitir-nos-á fazer todos os nossos esforços para a procura do seu melhor bem, respeitando seus interesses e qualidade de vida sem abstrair a nossa atenção para o seu interior, sendo este o objetivo final do nosso trabalho. A dor, por sua vez, é tão comum em odontologia, seja como sintoma, como medo ou como experiência, faz necessária uma aproximação moral e baseada em valores. A dor representa muito mais do que a doença, na realidade envolve uma rutura na integridade, que não vai-se conseguir somente pela prescrição de medi­camentos, mas também com a íntima vontade do profissional de restituir a vitalidade no mas amplo sentido da palavra. Nós queremos refletir num tema que nós achamos de muita transcendência, mas ao mesmo tempo foi esquecido pelo grande desenvolvimento tecnológico da nossa profissão

A bioética e a dor em odontologia: uma aproximação humanista

In dental clinical practice, moral aspects cannot be forgotten; leaving values aside can turn to be a dangerous and sense­less exercise. Understanding and becoming part of the goals involved in health care marks a dedication that goes beyond the sickness and its treatment. Understanding what the patient is going through, his/her fragility and vulnerability will allow us to place every effort into the search of what is best for him/her, with full respect for his/her interests and quality of life, without looking away from his/her interiority, which is, as I can understand, the final purpose of our work. The patient’s pain, so very frequent in dentistry, as a symptom as much as fear or experience, makes a moral and value-searching approach a necessity. Pain represents much more than disease, it actually involves a break in integrality. [that will not be avoided just by prescribing drugs,] (Integrality will not be achieved just by prescribing drugs,) but also with the intimate will of the profes­sional to restore vitality in the widest sense of the word. We want a reflection into a matter that we consider of maximum transcendence, but which has been at the same time forgotten by the great technological advancement of our profession.En la práctica clínica odontológica, los aspectos morales no pueden olvidarse, restarse a los valores puede resultar un ejercicio tan peligroso como carente de todo sentido. Comprender y hacerse parte de los fines inherentes al cuidado de la salud marca una dedicación más allá de la enfermedad y su tratamiento. Comprender en el paciente su vivencia, fragilidad y vulnerabilidad nos permitirá hacer todos nuestros esfuerzos hacia la búsqueda de su mejor bien, respetando sus intereses y calidad de vida sin abstraer nuestra mirada hacia su interioridad, siendo esta el fin último de nuestro quehacer. El dolor, por su parte, tan frecuente en la odontología, ya sea como síntoma, como temor o como vivencia, hace necesario una aproximación moral y valórica. El dolor representa mucho más que la dolencia, involucra en realidad un quiebre en la integralidad, la que no se logrará única y exclusivamente con la prescripción de fármacos, sino también con la íntima voluntad del profesional de restituir la vitalidad en el más amplio sentido de la palabra. Queremos una reflexión en un tema que nos parece de amplia trascendencia, pero que simultáneamente ha estado olvidado por el gran desarrollo tecnológico de nuestra profesión.Na prática clínica odontológica, os aspetos morais não podem ser esquecidos; deixar de lado os valores pode vir a ser um exercício tão perigoso quanto falto de todo sentido. Compreender e tornar-se parte das metas envolvidas no cuidado da saúde marca uma dedicação que vai além da doença e seu tratamento. Compreender no paciente sua ex­periência, sua fragilidade e vulnerabilidade permitir-nos-á fazer todos os nossos esforços para a procura do seu melhor bem, respeitando seus interesses e qualidade de vida sem abstrair a nossa atenção para o seu interior, sendo este o objetivo final do nosso trabalho. A dor, por sua vez, é tão comum em odontologia, seja como sintoma, como medo ou como experiência, faz necessária uma aproximação moral e baseada em valores. A dor representa muito mais do que a doença, na realidade envolve uma rutura na integridade, que não vai-se conseguir somente pela prescrição de medi­camentos, mas também com a íntima vontade do profissional de restituir a vitalidade no mas amplo sentido da palavra. Nós queremos refletir num tema que nós achamos de muita transcendência, mas ao mesmo tempo foi esquecido pelo grande desenvolvimento tecnológico da nossa profissão

Is there a place for pixels in our practice? Dietitians' attitudes towards the use of photographic dietary records within the nutrition care process

Photographic records of dietary intake (PhDRs) are an innovative method for the dietary assessment and may alleviate the burden of recording intake compared to traditional methods of recording intake. While the performance of PhDRs has been evaluated, no investigation into the application of this method had occurre within dietetic practice. This study examined the attitudes of dietitians towards the use of PhDRs in the provision of nutrition care. A web-based survey on the practices and beliefs with regards to technology use among Dietitians Association of Australia members was conducted in August 2011. Of the 87 dietitians who responded, 86% assessed the intakes of clients as part of individualised medical nutrition therapy, with the diet history the most common method used. The majority (91%) of dietitians surveyed believed that a PhDR would be of use in their current practice to estimate intake. Information contained in the PhDR would primarily be used to obtain a qualitative evaluation of diet (84%) or to supplement an existing assessment method (69%), as opposed to deriving an absolute measure of nutrient intake (31%). Most (87%) indicated that a PhDR would also be beneficial in both the delivery of the intervention and to evaluate and monitor goals and outcomes, while only 46% felt that a PhDR would assist in determining the nutrition diagnosis. This survey highlights the potential for the use of PhDRs within practice. Future endeavours lie in establishing resources which support the inclusion of PhDRs within the nutrition care process

ESTIMATION OF TECHNOLOGICAL CHANGE IN THE PASTORAL ZONE

Measurement of rates of technological change is frequently done in the context of the production function. While measurement suffers problems ranging from conceptual to statistical, this study focuses on the dependence of measurements on the algebraic form of the function specified and the statistical approach adopted. The data relate to an individual property in the central western Queensland sheep country