The oral hygiene status of people with dysphagia: a descriptive study.

Masters Degree. University of KwaZulu-Natal, Durban.The aim of the study was to assess and describe the oral hygiene problems of adults admitted to a sub-acute rehabilitation hospital who presented with dysphagia. A descriptive, cross-sectional survey study design was followed and took place at a sub-acute rehabilitation hospital, based in the private sector. The 40 participants, 57.50% (n=23) male and 42.50% (n=17) female, were identified using non-probability, purposive sampling and underwent various assessments during the two phases of data collection. Phase I consisted of three steps: (1) assess the swallow function of participants, using the Mann Assessment of Swallow Ability (MASA), (2) screening the oral hygiene of participants with confirmed dysphagia, using an adapted version of the Oral Health Assessment Tool to identify any oral hygiene problems, and (3) sample the oral microbia to detect bacteria not considered part of the normal oral flora. Phase II of the study refers to the descriptive and statistical analysis of the data. A high likelihood for aspiration was a common feature for most participants who presented with dysphagia (42.50%). The main swallowing problems were related to lingual strength, the ability to manage saliva, bolus clearance and effectiveness of the cough. A high prevalence of deficient oral hygiene and oral colonization (62.50%) was found. The most commonly occurring bacteria groups and species were: (1) Candida albicans and (2) respiratory pathogens, e.g. Klebsiella pneumoniae and Staphylococcus aureus growth. The oral hygiene status of people who presented with dysphagia showed that it increases the likelihood for poor oral hygiene, which creates favourable environments for bacteria to flourish, as well as the prevalence of pathogenic oral bacteria, which is associated with the development of aspiration pneumonia. The management of oral health issues for persons with dysphagia should receive greater attention during hospitalization

Pathogenic oral bacteria in hospitalised patients with dysphagia: The silent epidem

© 2021. The Authors.Background: Aspiration pneumonia is a serious and fatal complication of dysphagia, secondary to the ingestion of bacteria-laden secretions. However, no studies have documented the oral hygiene features present in patients who present with dysphagia. Objectives: The purpose of this study was to describe the oral hygiene problems of adults admitted to a sub-acute rehabilitation hospital and who presented with dysphagia. Methods: A descriptive, cross-sectional survey was conducted, during which 40 participants – 57.5% (n = 23) male and 42.5% (n = 17) female – underwent a clinical swallow evaluation using the Mann Assessment of Swallowing Ability (MASA) augmented with cervical auscultation (CA) and pulse oximetry (PO), an oral hygiene assessment using an adapted version of the Oral Health Assessment Tool (OHAT), followed by microbiology laboratory analysis of buccal swab samples to detect bacteria not considered part of the normal oral flora. Results: Results indicated that poor oral hygiene status was a common feature amongst all participants who presented with dysphagia. The most prevalent oral hygiene issues were related to abnormalities concerning saliva (60%), oral cleanliness (82.5%), the tongue (80%) and the use of dentures (71.4%). A high prevalence, 62.5% (n = 25), of opportunistic bacteria was found. The most commonly occurring bacteria groups were: (1) Candida albicans (47.5%) and (2) respiratory pathogens (37.5%) such as Klebsiella pneumoniae and Staphylococcus aureus. Conclusion: Persons with dysphagia have poor oral hygiene which creates favourable environments for bacteria to flourish and increases the prevalence of pathogenic oral bacteria associated with the development of aspiration pneumonia. The management of oral health issues for persons with dysphagia should receive greater attention during hospitalisation.fals

Hur tillväxt och fosforupptag hos potatis (Solanum tuberosum L.) odlad i en jord med högt pH påverkas av mineralkväveform och inokulering med fosforlösande bakterier och mykorrhiza

In soils with relatively high pH (pH > 7), potatoes (Solanum tuberosum L.) and other phosphorus (P) demanding crops might suffer from P deficiency despite P fertilization and significant reserves of P in the soil. Also, a high risk for P deficiency for potatoes may be expected when the soil is cold and the root system undeveloped. Therefore, the risk of Plimitation in high-pH soils is probably greatest for early varieties. In this study a trial was set up with two objectives: (i) To assess the effect of ammonium sulphate (T1) on P uptake, vegetative growth and tuber yield in potatoes grown without addition of P in soils with relatively high pH (7.5) and P-AL class IVB (12.5 mg P/100 g soil), under climatic conditions similar to those for early potatoes in the south of Sweden. The effect of ammonium sulphate was compared with the effect of ammonium nitrate (T2), ammonium chloride (T3) and potassium nitrate (T4). (ii) To assess the impact of inoculation with spores of arbuscular mycorrhizal fungi (AMF) Rhizophagus irregularis (T5) and the phosphorus solubilizing bacteria (PSB) Bacillus megaterium (T6) on the said parameters and under the same conditions. The trial was limited to the early potato variety ‘Solist’ grown with one level of nitrogen fertilizer. After harvesting, data was collected on fresh and dry matter and shoots and tubers were analysed for P content. The potato plants in the trial did not reach full maturity, probably due to salt toxicity, which made any possible differences between the treatments difficult to discern. At harvest the P concentration in all plants in all treatments was lower than normal levels. No significant differences were found between treatments on the effect on total dry weight of tubers or shoots. Also, no significant differences were found between treatments in number of tubers produced. The plants which received ammonium chloride (T3) had a significant smaller concentration of P compared to T1, T2 and T5. The difference can probably be explained by the fact that T3 had the highest salt concentration of all treatments. AMF colonization in the roots were found in all pots in both the control T2 and the inoculated T5. In conclusion, the result did not support the hypothesis that it would be possible to control P availability for early potatoes, grown in alkaline soils with relatively high P content, through the choice of nitrogen source or through inoculation with PSB or AMF

IPM-strategier för kålmjöllusen Aleyrodes proletella

Kålmjöllusen, Aleyrodes proletella är en allvarlig skadegörare i kålodling, främst brysselkål och grönkål, i Europa. Likt andra vita flygare sitter lössens nymfstadium på undersidan av bladen och suger växtsaft och kontaminerar dem med skalrester och honungsdagg där sotdaggssvampar kan tillväxa. Sedan mitten av 1990-talet har en drastisk ökning av skadegöraren ägt rum, p.g.a. ett varmare klimat, ökad odling av höstraps där arten kan övervintra samt indragningen av vissa insekticider. Aleyrodes proletella har tidigare bara observerats på skelört, Chelidonium majus i Sverige men 2014 hittades den första kålmjöllusen i odlad grönkål. Det är högst sannolikt att A. proletella kommer att bli en allvarlig skadegörare med en invasiv spridningsmekanism i södra Sverige. Sedan 2014 tillämpar alla EU-stater integrerat växtskydd (IPM). I detta arbete görs en översyn av alla tillgängliga metoder för att bekämpa A. proletella. Dessa innefattar manipulation av värdväxten, skadegöraren och miljön och kan användas för att förebygga eller bekämpa angrepp. Förebyggande åtgärder består i odlingstekniska åtgärder samt bevarande biologisk bekämpning. Idag bekämpas arten främst med kemisk bekämpning, en metod som inte är långsiktigt hållbar. Insektsnät kan minska angreppen avsevärt men medför problem med ogräsrensning. Potential finns för biologisk bekämpning, främst med bankplantor med parasitstekeln Encarsia tricolor, samt för fångstplantor, biopesticider och utveckling av en prognosmodell. Ett diversifierat odlingslandskap som innebär mindre övervintringshabitat, fler naturliga fiender och barriärer som hindrar inflygning är av stor vikt för att hindra att A. proletella blir invasiv i Sverige.The cabbage whitefly, Aleyrodes proletella is a serious pest in cultivated brassicas, mainly kale and brussels sprouts, in Europe. Like other whiteflies, the inmature stages feeds on the floem, sitting underneath the leaves and contaminating them with insect residues and honeydew where sooty molds grows. Since the middle of the 1990s a drastic increase of the pest has taken place, caused by a warmer climate, increased cultivation of winterrape where the species can overwinter and the withdrawal of certain insecticides. Aleyrodes proletella has previously only been seen on celandine, Chelidonium majus, in Sweden but in 2014 the first cabbage whitefly was found in cultivated kale. It is highly probable that A. proletella will become a serious pest with an invasive dispersal mechanism in southern Sweden. Since 2014 all EU states conform to Integrated pest management (IPM). I this thesis all avaliable feasible control tactics against A. proletella are reviewed. These include the manipulation of the host plant, the pest and the environment and are used to prevent or combat attacks. Preventive measures consist in agronomic measures and conservation biological control. Today the species is controlled mainly with chemical control, a method that is not sustainable in long terms. The use of insect nets can reduce attacks significantly but causes problems with weeding. There is a potential for biological control, mainly by banking plants with the parasitic wasps Encarsia tricolor, and for trap plants, biopesticides and development of a forecasting model. A diversified agricultural landscape that provide less wintering habitats, more natural enemies and barriers of immigration are of great importance to prevent A. proletella to become invasive in Sweden

Hands-on approach during breastfeeding support in a neonatal intensive care unit: a qualitative study of Swedish mothers' experiences

BACKGROUND: Assisting mothers to breastfeed is not easy when babies experience difficulties. In a neonatal intensive care unit (NICU), nurses often help mothers by using hands-on-breast without their permission. Little is known about how mothers feel about this unusual body touching. To gain more knowledge from mothers who lived through this experience, this hands-on practice was studied in a NICU in Sweden. METHODS: Between January and June 2001, in-depth interviews were conducted with ten mothers of preterm or sick term infants and all of them experienced the hands-on approach. In this research, Radnitzky's seven principles of hermeneutic interpretation were applied in order to interpret the meaning of mothers' responses. This article presents results related to the period of initiation of breastfeeding. This qualitative study was based on a combination of the models of Gustafsson, Orem, and Aarts' Marte Meo. RESULTS: Five main themes were identified: Insult to integrity, Manipulating the baby, Understanding and adjustment, Breasts as objects, Alternatives to this practice. Hands-on help in the breastfeeding situation was experienced as unpleasant and the women experienced their breasts as objectified. The mothers accepted the hands-on help given by nursing staff, even though they considered it unpleasant. Most mothers expressed a need for assistance when starting breastfeeding, but could not suggest any alternative to hands-on help such as demonstrating with an artificial breast and a doll. CONCLUSION: The study provides information about how mothers experience unexpected hands-on help with breastfeeding in a NICU, which has not been described previously. Since most mothers in this study regarded this behavior as unpleasant and not helpful mostly because it was unexpected and unexplained, it would be important to either explain beforehand to mothers what type of physical approach could be attempted on their body or better, to avoid this type of approach completely

Diabetes, HIV and other health determinants associated with absenteeism among formal sector workers in Namibia

<p>Abstract</p> <p>Background</p> <p>As countries in sub-Saharan Africa develop their economies, it is important to understand the health of employees and its impact on productivity and absenteeism. While previous studies have assessed the impact of single conditions on absenteeism, the current study evaluates multiple health factors associated with absenteeism in a large worker population across several sectors in Namibia.</p> <p>Methods</p> <p>From March 2009 to June 2010, PharmAccess Namibia conducted a series of cross-sectional surveys of 7,666 employees in 7 sectors of industry in Namibia. These included a self-reported health questionnaire and biomedical screenings for certain infectious diseases and non-communicable disease (NCD) risk factors. Data were collected on demographics, absenteeism over a 90-day period, smoking behavior, alcohol use, hemoglobin, blood pressure, blood glucose, cholesterol, waist circumference, body mass index (BMI), HIV status, and presence of hepatitis B antigens and syphilis antibodies. The associations of these factors to absenteeism were ascertained using negative binomial regression.</p> <p>Results</p> <p>Controlling for demographic and job-related factors, high blood glucose and diabetes had the largest effect on absenteeism (IRR: 3.67, 95%CI: 2.06-6.55). This was followed by anemia (IRR: 1.59, 95%CI: 1.17-2.18) and being HIV positive (IRR: 1.47; 95%CI: 1.12-1.95). In addition, working in the fishing or services sectors was associated with an increased incidence of sick days (IRR: 1.53, 95%CI: 1.23-1.90; and IRR: 1.70, 95%CI: 1.32-2.20 respectively). The highest prevalence of diabetes was in the services sector (3.6%, 95%CI:-2.5-4.7). The highest prevalence of HIV was found in the fishing sector (14.3%, 95%CI: 10.1-18.5).</p> <p>Conclusion</p> <p>Both NCD risk factors and infectious diseases are associated with increased rates of short-term absenteeism of formal sector employees in Namibia. Programs to manage these conditions could help employers avoid costs associated with absenteeism. These programs could include basic health care insurance including regular wellness screenings.</p

Severe breastfeeding difficulties: Existential lostness as a mother—Women's lived experiences of initiating breastfeeding under severe difficulties

A majority of women in Sweden initiate breastfeeding but almost a quarter stop or wean the infant in the first few weeks after birth because of difficulties. In order to develop care that facilitates initiation of breastfeeding and enables mothers to realize their expectations concerning breastfeeding, it is necessary to understand what having severe breastfeeding difficulties means for women who experience them. The aim of this study is to describe the lived experiences of initiating breastfeeding under severe difficulties. A reflective lifeworld research design was used. Eight women, seven primiparous and one multipara, were interviewed within 2 months of giving birth. The essential meaning of the phenomenon is described as “Existential lostness as a mother forcing oneself into a constant fight”. This pattern is further explicated through its constituents; shattered expectations, a lost time for closeness, being of no use to the infant, being forced to expose oneself, and gaining strength through sharing. The results show that mothers with severe breastfeeding difficulties feel alone and exposed because of their suffering and are lost in motherhood. Thus, adequate care for mothers should enhance the forming of a caring relationship through sharing rather than exposing

Comparison of the Safety and Pharmacokinetics of ST-246® after IV Infusion or Oral Administration in Mice, Rabbits and Monkeys

ST-246® is an antiviral, orally bioavailable small molecule in clinical development for treatment of orthopoxvirus infections. An intravenous (IV) formulation may be required for some hospitalized patients who are unable to take oral medication. An IV formulation has been evaluated in three species previously used in evaluation of both efficacy and toxicology of the oral formulation. plasma concentrations. These effects were eliminated using slower IV infusions. associated toxicity. Shorter infusions at higher doses in NHP resulted in decreased clearance, suggesting saturated distribution or elimination. Elimination half-lives in all species were similar between oral and IV administration. The administration of ST-246 was well tolerated as a slow IV infusion

Safety profile of semaglutide versus placebo in the SELECT study: a randomized controlled trial.

ObjectiveThe objective of this study was to assess safety of once-weekly subcutaneous semaglutide 2.4 mg versus placebo, beyond reduction in major adverse cardiovascular events, in patients with established cardiovascular disease and overweight or obesity.MethodsSafety data focused on serious adverse events (SAEs), all adverse events (AEs) leading to permanent treatment discontinuation irrespective of seriousness, and prespecified AEs of special interest irrespective of seriousness. Tests of treatment differences were determined by two-sided p values.ResultsThe proportion of patients with SAEs was lower with semaglutide versus placebo (33.4% vs. 36.4%; p ConclusionsThe long-term safety profile observed in the Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity (SELECT) study is consistent with previously reported semaglutide studies. No new safety concerns were identified for once-weekly semaglutide 2.4 mg