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This novel approach allowed students the opportunity to practice important therapeutic communication skills while enhancing their knowledge of palliative nursing care.
In dedicated education units (DEUs), nurses serving as clinical teaching partners (CTPs) provide formative feedback about student performance. The Creighton Competency Evaluation Instrument (C-CEI) has demonstrated validity and reliability by faculty in both the simulated and clinical environments. The purpose of this pilot study was to determine the content validity of the C-CEI in the direct patient care environment when used by staff nurses functioning as CTPs in the DEU setting. Results indicate that the items of the C-CEI demonstrated necessity, fittingness, and understanding. CTPs reported the C-CEI is a valid instrument for use in the DEU setting.
In dedicated education units (DEUs), nurses serving as clinical teaching partners (CTPs) provide formative feedback about student performance. The Creighton Competency Evaluation Instrument (C-CEI) has demonstrated validity and reliability by faculty in both the simulated and clinical environments. The purpose of this pilot study was to determine the content validity of the C-CEI in the direct patient care environment when used by staff nurses functioning as CTPs in the DEU setting. Results indicate that the items of the C-CEI demonstrated necessity, fittingness, and understanding. CTPs reported the C-CEI is a valid instrument for use in the DEU setting.Patients with autism spectrum disorder present with an extensive range of communication and social skills that require healthcare workers to have a comprehensive understanding of best practices for providing holistic care. This article presents the planning, curriculum development, implementation, and evaluation of a professional development program aimed at providing interprofessional staff with strategies and resources to use when caring for patients with autism spectrum disorder.
This study investigated whether gastric hyperplastic polyps (GHPs) shrink after discontinuation of proton pump inhibitor (PPI) alone.
Long-term use of PPIs has been reported to increase the incidence of GHPs, which sometimes bleed and cause anemia. HS173 We experienced a patient whose recurrent hemorrhagic GHPs associated with long-term use of PPIs had disappeared after discontinuation of PPIs.
This study was conducted retrospectively at Kyoto University Hospital. Patients with histologically confirmed GHPs who had been taking PPIs for >6 months and who had undergone a repeat endoscopy within 2 years were included. Polyp shrinkage was defined as the disappearance of polyps or a reduction of >50% in the long diameter of the largest polyp.
Six patients who discontinued PPIs were compared with 17 patients who continued PPIs. Polyp shrinkage was significantly more frequent in the PPI-discontinuation group (5/6, 83%) than in the PPI continuation group (0/17, 0%) (P<0.001). In 2 patients in the PPI-discontinuation group, the polyps completely disappeared finally.
These findings suggest that discontinuation of PPIs can shrink GHPs in patients using PPIs.
These findings suggest that discontinuation of PPIs can shrink GHPs in patients using PPIs.
We aimed to assess outcomes of patients with liver cirrhosis who underwent therapeutic or diagnostic endoscopic retrograde cholangiopancreatography (ERCP) to determine whether these patients had different outcomes relative to patients without cirrhosis.
ERCP is an important procedure for treatment of biliary and pancreatic disease. However, ERCP is relatively technically difficult to perform when compared with procedures such as esophagogastroduodenoscopy or colonoscopy. Little is known about how ERCP use affects patients with liver cirrhosis.
Using patient records from the National Inpatient Sample (NIS) database, we identified adult patients who underwent ERCP between 2009 and 2014 using International Classification of Disease, Ninth Revision coding and stratified data into 2 groups patients with liver cirrhosis and those without liver cirrhosis. We compared baseline characteristics and multiple outcomes between groups and compared outcomes of diagnostic versus therapeutic ERCP in patients with cirrhoent population are needed.
To examine the influence of hip abductor strength, neuromuscular activation, and pelvis & femur morphology in contributing to sex differences in hip adduction during running. In addition, we sought to determine the best predictors of hip adduction during running for both males and females.
Fifteen female and 14 male runners underwent strength testing, instrumented overground running (e.g., kinematics and muscle activation), and computed tomography scanning of pelvis and femur. Morphologic measurements included bilateral hip width to femur length ratio, acetabulum abduction, acetabulum anteversion, femoral anteversion, and femoral neck-shaft angles. Sex differences for all variables were examined using independent t-tests. Linear regression was used to assess the ability of each independent variable of interest to predict peak hip adduction during the late swing and stance phase of running.
Compared to males, females exhibited significantly greater peak hip adduction during both late swing (8.5 ± 2.6° vs 6.2 ± 2.8°, p = 0.04) and stance phases of running (13.4 ± 4.2° vs 10.0 ± 3.2°, p = 0.02). In addition, females exhibited significantly lower hip abductor strength (1.8 ± 0.3 vs 2.0 ± 0.3 Nm/kg, p=0.04), greater femoral neck-shaft angles (134.1 ± 5.0° vs 129.9 ± 4.1°, p=0.01), and greater hip width to femur length ratios than males (0.44 ± 0.02 vs 0.42 ± 0.03, p=0.03). Femoral anteversion was the only significant predictor of peak hip adduction during late swing (r=0.36, p=0.05) and stance (r=0.41, p=0.03).
Our findings highlight the contribution of femur morphology as opposed to hip abductor strength and activation in contributing to hip adduction during running.
Our findings highlight the contribution of femur morphology as opposed to hip abductor strength and activation in contributing to hip adduction during running.
To examine the efficacy of creatine (Cr) supplementation and any sex differences during supervised whole-body resistance training (RT) on properties of bone and muscle in older adults.
Seventy participants (39 males, 31 females; mean age ± standard deviation 58 ± 6y) were randomized to supplement with Cr (0.1 g·kg-1·d-1) or placebo (Pl) during RT (3 d·wk-1 for 1 year). Bone geometry (radius and tibia) and muscle area and density (forearm and lower leg) were assessed using peripheral quantitative computed tomography.
Compared to Pl, Cr increased or maintained total bone area in the distal tibia (Cr Δ +17 ± 27 mm2; Pl Δ -1 ± 22 mm2; P = 0.031) and tibial shaft (Cr Δ 0 ± 9 mm2; Pl Δ -5 ± 7 mm2; P = 0.032). Males on Cr increased trabecular (Δ +28 ± 31 mm2; P < 0.001) and cortical bone areas in the tibia (Δ +4 ± 4 mm2; P < 0.05) whereas males on Pl increased trabecular bone density (Δ +2 ± 2 mg/cm3; P < 0.01). There were no bone changes in the radius (P > 0.05). Cr increased lower leg muscle density (Δ +0.83 ± 1.15 mg/cm3; P = 0.016) compared to Pl (Δ -0.16 ± 1.56 mg/cm3), with no changes in the forearm muscle.
One year of Cr supplementation and RT had some favorable effects on measures of bone area and muscle density in older adults.
One year of Cr supplementation and RT had some favorable effects on measures of bone area and muscle density in older adults.
Whether blood oxygen (O2) carrying capacity plays a substantial role in determining cardiorespiratory fitness, a strong predictor of mortality, remains uncertain in women and elderly individuals due to the scarcity of experimental investigations. This study experimentally assessed the role of blood O2 carrying capacity on cardiorespiratory fitness in middle-aged and older individuals.
Healthy women and men (n=31, 35-76 yr) matched by age and fitness were recruited. Transthoracic echocardiography, central hemodynamics and O2 uptake were assessed throughout incremental exercise in (i) control conditions and (ii) after a 10 % reduction of blood O2 carrying capacity via carbon monoxide administration, in a blinded manner. Effects on cardiac function, blood pressure, peak O2 uptake (VO2peak), and effective hemoglobin (Hb) were determined with established methods.
Blood O2 carrying capacity, represented by effective Hb, was similarly reduced in women (11.8±0.6 vs. 10.7±0.6 g·dl-1, P<0.001) and men (13.0±0.9 vs. 11.7±0.6 g·dl-1, P<0.001) (P for sex effect=0.580). Reduced O2 carrying capacity did not induce major effects on cardiac function and hemodynamics during exercise, except for a 10-15 % decrement in peak systolic blood pressure in both sexes (P≤0.034). VO2peak decreased from 35±6 to 31±6 ml·min-1·kg-1, P<0.001) in women and from 35±9 to 32±9 ml·min-1·kg-1 (P=0.024) in men in approximate proportion to the reduction of O2 carrying capacity, an effect that did not differ between sexes (P=0.778).
Blood O2 carrying capacity stands out as a major determinant of cardiorespiratory fitness in healthy mature women and men, with no differential effect of sex.
Blood O2 carrying capacity stands out as a major determinant of cardiorespiratory fitness in healthy mature women and men, with no differential effect of sex.
Females have been shown to experience less neuromuscular fatigue than males in knee extensors (KE) and less peripheral fatigue in plantar flexors (PF) following ultra-trail running, but it is unknown if these differences exist for shorter trail running races and whether this may impact running economy. The purpose of this study was to characterize sex differences in fatigability over a range of running distances and to examine possible differences in the post-race alteration of the cost of running (Cr).
Eighteen pairs of males and females were matched by performance after completing different races ranging from 40 to 171 km, divided into SHORT vs LONG races (< 60 and > 100 km, respectively). NM function and Cr were tested before and after each race. NM function was evaluated on both KE and PF with voluntary and evoked contractions using electrical nerve (KE and PF) and transcranial magnetic (KE) stimulation. Oxygen uptake, respiratory exchange ratio and ventilation were measured on a treadmill and used to calculate Cr.
Compared to males, females displayed a smaller decrease in maximal strength in KE (-36% vs -27%, respectively, p < 0.01), independent of race distance. In SHORT only, females displayed less peripheral fatigue in PF compared to males (Δ peak twitch -10% vs -24%, respectively, p < 0.05). Cr increased similarly in males and females.
Females experience less neuromuscular fatigue than men following both 'classic' and 'extreme' prolonged running exercises but this does not impact the degradation of the energy cost of running.
Females experience less neuromuscular fatigue than men following both 'classic' and 'extreme' prolonged running exercises but this does not impact the degradation of the energy cost of running.
To investigate the effects of a single session of either peristaltic pulse dynamic leg compressions (PPDC) or local heat therapy (HT) following prolonged intermittent shuttle running on skeletal muscle glycogen content, muscle function and the expression of factors involved in skeletal muscle remodeling.
Twenty-six trained individuals were randomly allocated to either a PPDC (n=13) or a HT (n=13) group. After completing a 90-min session of intermittent shuttle running, participants consumed 0.3 g/kg protein plus 1.0 g/kg carbohydrate and received either PPDC or HT for 60 min in one randomly selected leg, while the opposite leg served as control. Muscle biopsies from both legs were obtained prior to and after exposure to the treatments. Muscle function and soreness were also evaluated before, immediately after and 24 h following the exercise bout.
The changes in glycogen content were similar (P>0.05) between the thigh exposed to PPDC and the control thigh ~90 min (Control 14.9±34.3 vs. PPDC 29.6±34 mmol/kg wet wt) and ~210 min (Control 45.