Early Feeding After a Total Abdominal Hysterectomy

Background: Oral fluids and food are traditionally introduced slowly after total abdominal hysterectomy (TAH). This descriptive study examined the effect and tolerance of early oral intake following this surgery. Methods: A retrospective chart review was conducted on 164 patients who had been on a clinical pathway following TAH. Comparisons in initiation of fluids and foods, and gastrointestinal effects were made between the early fed group (n=82) and the traditionally fed group (n=82). Results: Both groups had the similar gastrointestinal symptoms postoperatively, but the early fed group had an earlier bowel movement. The early fed group had a statistically significant shorter length of stay. Similar usage of anti-nausea medication and pain medication usage was noted between the two groups, except for a lower usage of Tylenol #3 (acetaminophen with codeine) in the early fed group. Conclusions: This study found that early feeding could be tolerated well in TAH patients, with statistically significant improvements in usage of some pain medication and length of stay were noted in the early fed group

Impact of infection preventionists on Centers for Medicare and Medicaid quality measures in Maryland nursing homes.

BackgroundHealth care-associated infections are the leading cause of morbidity and mortality in US nursing homes (NHs). The objective of the research is to assess the impact of Maryland NH infection preventionists (IPs) on NH quality measures.MethodsTwo hundred thirty-four NHs were queried through mailed survey. These survey data were then linked with 2008 quality data from Nursing Home Compare and the On-line Survey Certification of Automated Records.ResultsThree of the 8 quality measures examined-influenza vaccination for both short- and long-stay residents and pressure ulcer prevention in high-risk residents-were significantly associated with the number of IPs. None of the quality measures were shown to be significant with IPs who received specialized training on infection prevention and management compared with those who did not receive specialized training.ConclusionIPs play a critical role in preventing and managing health care-associated infections in nursing homes, especially in the areas of influenza vaccination and pressure ulcer prevention among high-risk nursing home residents. Quality measures that reflect the effects of IP training may not have been elucidated yet. Further research is needed to support the IP role in order for policy to advocate for increased IP funding

Postnatal expression of transport proteins involved in acid-base transport in mouse kidney

The kidney plays a major role in maintaining and controlling systemic acid-base homeostasis by reabsorbing bicarbonate and secreting protons and acid-equivalents, respectively. During postnatal kidney development and adaptation to changing diets, plasma bicarbonate levels are increasing, the capacity for urinary acidification maturates, and the final morphology and distribution of intercalated cells is achieved. In adult kidney, at least two types of intercalated cells (IC) are found along the collecting duct characterised either by the expression of AE1 (type A IC) or pendrin (non-type A IC) where non-type A IC are found only in the convoluted distal tubule, connecting tubule and cortical collecting duct. Here we investigated in mouse kidney the relative mRNA abundance, protein expression levels and distribution of several proteins involved in renal acid-base transport, namely, the Na+/HCO3 − cotransporter NBC1 (SLC4A4), the Na+/H+-exchanger NHE3 (SLC9A3), two subunits of the vacuolar H+-ATPase [ATP6V0A4 (a4), ATP6V1B1 (B1)], the Cl−/HCO3 − exchangers AE1 (SLC4A1) and pendrin (SLC26A4). Relative mRNA abundance of all transport proteins was lowest at day3 after birth and increased thereafter in parallel with protein levels. The numbers of type A and non-type A IC in the cortical collecting duct (CCD) increased from day3 to days18 and 24, whereas the number of IC in the CCD with apical staining for the vacuolar H+-ATPase subunits a4 and B1 decreased from day3 to days18 and 24, respectively. In addition, cells with characteristics of non-type A IC (pendrin expression, basolateral expression of vacuolar H+-ATPase subunits) were found in the inner and outer medulla 3days after birth but were absent from the medulla of 24-day-old mice. Taken together, these results demonstrate massive changes in mRNA and protein expression levels of several acid-base transporters during postnatal kidney maturation and also show changes in intercalated cell phenotype in the medulla during these processe

Perceptions of Medical Students of the Role of the Speech-language Pathologist in HIV/AIDS Intervention

Survey research was utilized to explore Medical students’ perceptions of Speech-Language Pathologists’(SLP) and Medical Practitioner’s roles in meeting the healthcare needs of people living with HIV/AIDS(PLWHA). Results identified participants’ knowledge and perceptions. Recommendations suggest interprofessional education and training for both professions, at the pre-professional and professional levels

Impact Procedures

No abstract availabl

The Challenge of Adolescent Health: Views from Catholic Social Teaching and the Social and Medical Sciences

This book provides a multidisciplinary examination of the complex social issues surrounding adolescent health and health care delivery. It draws specifically on the resources of Catholic social teaching, presents an overview of the medical problems common among young people, and explores the social and familial contexts in which these problems arise. It provides a framework within which to view the conditions limiting the health and well-being of adolescents and to understand the resultant deterioration of the physical and mental health of adolescents in this country. The insights gained from Catholic moral teaching are included with those of social science and medicine in order to formulate specific recommendations for creative and effective delivery of health care to adolescents

The All of Us Research Program: Engaging the Community for the Future of Health

The All of Us Research Program (AoURP), funded by the National Institutes of Health, is an ambitious ten-year effort to enroll over one million participants across the country. The AoURP is a key part of the Precision Medicine Initiative and seeks to build a national cohort collecting self-reported health data, medical record data, biospecimen samples and physical measurements to accelerate precision medicine. Precision Medicine is an emerging approach for healthcare treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. Researchers at the Meyers Primary Care Institute and the University of Massachusetts Medical School have partnered with Reliant Medical Group to enroll over 10,000 participants in 5 years. The Meyers/Reliant team is actively working to engage the local community, educational institutions, and community organizations to increase awareness of the program and encourage participation. Our efforts have focused specifically on populations previously underrepresented in biomedical research, including older adults, racial and ethnic minority group members, and others. We are hoping to grow new relationships and build strong community partnerships to help us achieve our enrollment goals and communicate the great potential of the AoU Research Program to change the future of medical research with a focus on precision medicine

Guidance and standard operating procedures for functional exercise testing in cystic fibrosis

Regular exercise testing is recommended for all people with cystic fibrosis (PwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in PwCF and has led to the development of novel exercise tests which may be applied to PwCF. This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for PwCF. Importantly, this document also highlights previously used tests that are no longer suggested for PwCF and areas where research is mandated. This collaboration, on behalf of the European Cystic Fibrosis Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of PwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated

LA EFICACIA DE LA RESOLUCIÓN 1742/2006 PARA GARANTIZAR LOS DERECHOS HUMANOS DE LAS MINORÍAS EN LAS INSTITUCIONES MILITARES DE EUROPA

En el artículo se examina la Resolución 1742/2006 y sus recomendaciones, que tratan de los Derechos Humanos en las Fuerzas Armadas de Europa. En este sentido, buscaremos verificar si estas recomendaciones fueron o son efectivas para la inclusión de homosexuales y transexuales en las Fuerzas Armadas, ya que en esas Instituciones son un entorno en el que, históricamente, predomina el patriarcado y la heteronormatividad. Dicho esto, se utilizó el método bibliográfico para realizar la investigación, es decir, la verificación a través de datos, artículos y libros. La investigación concluyó que la resolución 1742/2006 era efectiva al incluir a homosexuales y transexuales en las Fuerzas Militares, ya que sus recomendaciones defienden los derechos fundamentales y, por lo tanto, hacen que los países miembros incorporen estos derechos a sus Fuerzas Nacionales

Antenatal Determinants of Bronchopulmonary Dysplasia and Late Respiratory Disease in Preterm Infants

RATIONALE: Mechanisms contributing to chronic lung disease after preterm birth are incompletely understood. OBJECTIVES: To identify antenatal risk factors associated with increased risk for bronchopulmonary dysplasia (BPD) and respiratory disease during early childhood after preterm birth, we performed a prospective, longitudinal study of 587 preterm infants with gestational age less than 34 weeks and birth weights between 500 and 1,250 g. METHODS: Data collected included perinatal information and assessments during the neonatal intensive care unit admission and longitudinal follow-up by questionnaire until 2 years of age. MEASUREMENTS AND MAIN RESULTS: After adjusting for covariates, we found that maternal smoking prior to preterm birth increased the odds of having an infant with BPD by twofold (P = 0.02). Maternal smoking was associated with prolonged mechanical ventilation and respiratory support during the neonatal intensive care unit admission. Preexisting hypertension was associated with a twofold (P = 0.04) increase in odds for BPD. Lower gestational age and birth weight z-scores were associated with BPD. Preterm infants who were exposed to maternal smoking had higher rates of late respiratory disease during childhood. Twenty-two percent of infants diagnosed with BPD and 34% of preterm infants without BPD had no clinical signs of late respiratory disease during early childhood. CONCLUSIONS: We conclude that maternal smoking and hypertension increase the odds for developing BPD after preterm birth, and that maternal smoking is strongly associated with increased odds for late respiratory morbidities during early childhood. These findings suggest that in addition to the BPD diagnosis at 36 weeks, other factors modulate late respiratory outcomes during childhood. We speculate that measures to reduce maternal smoking not only will lower the risk for preterm birth but also will improve late respiratory morbidities after preterm birth