Setting up a nurse-led nutrition service

2019 ◽  
Vol 10 (8) ◽  
pp. 404-409
Author(s):  
Ronald Jan Corbee ◽  
Rilana van de Lande ◽  
Inge van Duiven
Keyword(s):  
Nutritional Assessment ◽  
Companion Animal ◽  
Nutrition Service ◽  
Nutritional Recommendation ◽  
Set Up

Nutrition is a very important aspect of basic veterinary care. This is recognised by the WSAVA, as nutritional assessment is regarded as the 5th vital assessment. Veterinary nurses play a key role is nutritional assessment, nutritional recommendation, and follow up. This article will describe how to set up a nurse-led nutrition service, with Utrecht University Companion Animal Clinic as an example.

scholarly journals 829 Is There an Ongoing Role For 'Telephone Triage Clinics' Post COVID-19?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Holmes ◽  
U Mirza ◽  
C Manning ◽  
R Cooke ◽  
R Jugdey
Keyword(s):  
Common Theme ◽  
Telephone Triage ◽  
Telephone Consultation ◽  
Face To Face ◽  
Clinician Satisfaction ◽  
Set Up ◽  
Local Protocol ◽  
Telephone Questionnaire

Abstract Introduction COVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this. Method We carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics. Results From 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management. Conclusions Overall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

Association of GDF15 With Inflammation and Physical Function During Aging and Recovery After Acute Hospitalization: A Longitudinal Study of Older Patients and Age-Matched Controls

2021 ◽  
Author(s):  
Juliette Tavenier ◽  
Line Jee Hartmann Rasmussen ◽  
Aino Leegaard Andersen ◽  
Morten Baltzer Houlind ◽  
Anne Langkilde ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Physical Function ◽  
Plasma Levels ◽  
Older Patients ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Acute Illness ◽  
Urokinase Plasminogen Activator Receptor

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.

scholarly journals MAGIC electromagnetic follow-up of gravitational wave alerts

2016 ◽  
Vol 12 (S324) ◽  
pp. 287-290
Author(s):  
Barbara De Lotto ◽  
Stefano Ansoldi ◽  
Angelo Antonelli ◽  
Alessio Berti ◽  
Alessandro Carosi ◽  
...  
Keyword(s):  
Black Hole ◽  
Data Analysis ◽  
Gravitational Wave ◽  
Laser Interferometer ◽  
Cherenkov Telescopes ◽  
Direct Observations ◽  
Binary Black Hole ◽  
Set Up

AbstractThe year 2015 witnessed the first direct observations of a transient gravitational-wave (GW) signal from binary black hole mergers by the Advanced Laser Interferometer Gravitational-wave Observatory (aLIGO) Collaboration with the Virgo Collaboration. The MAGIC two 17m diameter Cherenkov telescopes system joined since 2014 the vast collaboration of electromagnetic facilities for follow-up of gravitational wave alerts. During the 2015 LIGO-Virgo science run we set up the procedure for GW alerts follow-up and took data following the last GW alert. MAGIC results on the data analysis and prospects for the forthcoming run are presented.

scholarly journals Relationship between five Epigenetic Clocks, Telomere Length and Functional Capacity assessed in Older Adults: Cross-sectional and Longitudinal Analyses

2021 ◽  
Author(s):  
Valentin Max Vetter ◽  
Christian Humberto Kalies ◽  
Yasmine Sommerer ◽  
Dominik Spira ◽  
Johanna Drewelies ◽  
...  
Keyword(s):  
Telomere Length ◽  
Time Course ◽  
Nutritional Assessment ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
Epigenetic Clock ◽  
Cross Sectional ◽  
Biomarkers Of Aging ◽  
Functional Assessments

AbstractDNA methylation age acceleration (DNAmAA, derived from an epigenetic clock) and relative leukocyte telomere length (rLTL) are widely accepted biomarkers of aging. Nevertheless, it is still unclear which aspects of aging they represent best. Here we evaluated longitudinal associations between baseline rLTL and DNAmAA (estimated with 7-CpG clock) and functional assessments covering different domains of aging. Additionally, we made use of cross-sectional data on these assessments and examined their association with DNAmAA estimated by five different DNAm age measures.Two-wave longitudinal data was available for 1,083 participants of the Berlin Aging Study II (BASE-II) who were re-examined on average 7.4 years after baseline as part of the GendAge study. Functional outcomes were assessed with Fried’s frailty score, Tinetti mobility test, falls in the past 12 months (yes/no), Finger-floor distance, Mini Mental State Examination (MMSE), Center for Epidemiologic Studies Depression Scale (CES-D), Activities of Daily Living (ADL), Instrumented ADL (IADL) and Mini Nutritional Assessment (MNA).Overall, we found no evidence for an association between the molecular biomarkers measured at baseline, rLTL and DNAmAA (7-CpG clock), and functional assessments assessed at follow-up. Similarly, a cross-sectional analyses of follow-up data did also not show evidence for associations of the various DNAmAA measures (7-CpG clock, Horvath’s clock, Hannum’s clock PhenoAge, and GrimAge) with functional assessments.In conclusion, neither rLTL nor 7-CpG DNAmAA were able to predict impairment in the analyzed assessments over a ∼7 year time-course. Similarly, DNAmAA as estimated by five epigenetic clocks was not a good cross-sectional marker of health deterioration either.

scholarly journals Proposal for an intelligent digital teacher’s textbook solution adapted to the Bachelor-Master-Doctorate system

2021 ◽  
Author(s):  
Ulrich Hermann Semevo Boko ◽  
Bessan Melckior Degboe ◽  
Samuel Ouya ◽  
Gervais Mendy
Keyword(s):  
Real Time ◽  
African Countries ◽  
Digital Textbook ◽  
Quality Of Higher Education ◽  
Teaching Content ◽  
Sub Saharan ◽  
Set Up ◽  
E Mail

This paper proposes an intelligent solution for course monitoring based on the use of a digital textbook coupled with an algorithm for verifying the conformity of the teaching content. The proposed solution allows to follow in real time the evolution of the courses and to alert the pedagogical managers in case of non-compliance with the syllabus. In most sub-Saharan African countries engaged in the Bachelor-Master-Doctorate (BMD) reform, incessant strikes prevent teachers from completing the program. Also, there is no way for the teacher to know whether students have the necessary prerequisites. In addition, constraints related to agendas sometimes prevent the holding of pedagogical animation meetings. To solve these problems, we propose the implementation of an intelligent digital teacher's textbook. The tool helps in the follow-up and the respect of the pedagogical objectives. It implements an algorithm to evaluate in real time the concordance between the courses given and the requirements of the syllabus. An SMS and e-mail alert system has also been set up to inform training actors in case of non-compliance with the syllabus. The proposed solution contributes to the overall improvement of the quality of higher education in Saharan Africa.

DOES MORE SPECIALIST PHARMACIST TIME IN A CLINICAL AREA EQUAL MORE ACTIVITY?

2016 ◽  
Vol 101 (9) ◽  
pp. e2.60-e2
Author(s):  
Rhian Isaac ◽  
Astrid Gerrard ◽  
Kevin Bazaz
Keyword(s):  
Ward Round ◽  
Pharmacy Service ◽  
Medicines Management ◽  
Clinical Area ◽  
Drug Assays ◽  
Set Up ◽  
Time Critical ◽  
Specialist Pharmacist ◽  
Safety Strategy

BackgroundFollowing a medication safety initiative proposed by the PICU Safety Strategy group a pilot was set up to extend the presence of a PICU trained pharmacist in the clinical area.One of the main safety initiatives was to assess whether increased pharmacist exposure decreased drug omission of time critical medicines, which was highlighted from incident reporting patterns on PICU.AimTo assess what impact extending a pharmacist with specific PICU training would have on the medicines management of the PICU patients.MethodThe pilot involved attendance on the afternoon ward round, review of all new admissions and follow up of priority patients as highlighted by the “day” PICU pharmacists. The pilot “late” PICU pharmacist was resident in the hospital, on PICU, for an hour longer than the pharmacy opening hours. A rota ofA basic data collection form was set up on Microsoft Excel. Data collected included start and finish times of the ward round, time leaving PICU, clinical interventions made, queries by staff on PICU and outside of PICU, supplies made, drug omissions prevented, number of times the presence on the unit prevented need to call in the on call pharmacist and interpretation of drug assays reported after pharmacy hours. Follow up of specific medicines management issues highlighted by the “day” pharmacists as requiring action prior to following day pharmacy visit were recorded.ResultsDuring the 74 days data were collected there was 395 drug related queries by PICU staff (252 by nursing staff, 143 by prescribers). The “late” PICU pharmacist was contacted for advice regarding non-PICU patients by the on call or dispensary pharmacist on 7 occasions and 11 times from clinical staff outside of PICU.The “late” pharmacist intervened on 412 prescriptions, some of the interventions arose from the 260 follow up reviews requested by the “day” pharmacists. Of the 236 drug assays reported after pharmacy hours, 126 required intervention by pharmacist.Omission of time critical medicines was prevented on 17 occasions following 79 supplies of non-stock medicines. Calling out the on-call pharmacist was circumvented 11 times.ConclusionThe Safety Strategy teams’ request for increased access to a “late” PICU pharmacist resulted in a number of clinical interventions, appropriate dosing advice on late-in-day reported drugs assays and prevention of delays in medicines, including time critical drugs. Benefits of the specialist pharmacist being on-site to the pharmacy service included less need to access the on call pharmacist for either advice or supplies of medicines. During a pharmacy 7 day working review these data were used to secure the increased clinical pharmacy service to PICU.

Couples Facing the Birth of a Newborn with a Congenital Anomaly: PTSD Symptoms in the First Year

2018 ◽  
Vol 35 (12) ◽  
pp. 1168-1172 ◽  
Author(s):  
Francesca Bevilacqua ◽  
Francesco Morini ◽  
Antonio Zaccara ◽  
Chiara De Marchis ◽  
Annabella Braguglia ◽  
...  
Keyword(s):  
First Year ◽  
Stressful Situation ◽  
Ptsd Symptoms ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Stress Symptoms ◽  
Parental Gender ◽  
Set Up ◽  
The Impact

Objective The objective of this study was to assess the presence of posttraumatic stress disorder (PTSD) symptoms in parental couples of newborn requiring early surgery at 6 and 12 months after birth. Study Design A longitudinal study was set up from January 2014 to June 2015. As a measure of PTSD, we used the Italian version of the Impact of Event Scale—Revised (IES-R). Results Thirty-four couples form the object of the study. At 6 months, half of mothers (52.9%) and fathers (44.1%) reported traumatic stress symptoms above the clinical cutoff. Percentages remained stable at 12 months. When parental gender and length of follow-up were compared with two-factor analysis of variance, none had an impact on IES-R score, nor an interaction between these factors was found. A significant correlation of IES-R total score was present within the couple both at 6 and 12 months (6 months—r: 0.6842, p < 0.0001 and 12 months—r: 0.4045, p = 0.0177). Conclusion Having a child with a repaired malformation represents a complex prolonged stressful situation with persistent burden for both parents who are at high risk of developing PTSD symptoms.

Pulmonary rehabilitation

2021 ◽  
pp. 515-522
Author(s):  
Terry Robinson ◽  
Jane Scullion
Keyword(s):  
Lung Disease ◽  
Social Isolation ◽  
Pulmonary Rehabilitation ◽  
Social Performance ◽  
Depression And Anxiety ◽  
Respiratory Impairment ◽  
Follow Up Care ◽  
Set Up ◽  
Programme Of Care

Pulmonary rehabilitation (PR) is an important component in the management, care, and treatment of patients with chronic lung disease, particularly with COPD and increasingly in ILD. Breathlessness is a symptom of the underlying lung disease, and can result in reduced patient activity, which in turn reduces fitness, leads to social isolation, and can exacerbate depression and anxiety. PR is a multidisciplinary programme of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy. This chapter describes the rationale for PR, how to set up an effective rehabilitation regime through education and physical exercise, and how to provide follow-up care.

Virtual clinics for follow-up of pacemakers and implantable cardioverter defibrillators in children

2019 ◽  
Vol 29 (10) ◽  
pp. 1243-1247
Author(s):  
Georgia Spentzou ◽  
Kaitlin Mayne ◽  
Helen Fulton ◽  
Karen McLeod
Keyword(s):  
Parent Satisfaction ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Devices ◽  
Digital Medicine ◽  
Implantable Cardiac Devices ◽  
System Data ◽  
Set Up ◽  
Cardioverter Defibrillators ◽  
Virtual Clinic

AbstractThere is growing interest in the use of digital medicine to reduce the need for traditional outpatient follow-up. Remote interrogation of pacemakers and implantable cardioverter defibrillators is now possible with most devices. The aim of our study was to evaluate the safety and efficacy of virtual pacing clinics in following up children with pacemakers and implantable cardioverter defibrillators, including epicardial systems.Methods:The study was retrospective over 8 years (2010–2017), with review of patient records and analysis of downloads from the implantable cardiac devices to the virtual clinics.Results:A total of 75 patients were set up for virtual clinic follow-up during the study period, 94.5% with a pacemaker and 5.5% an implantable cardioverter defibrillator. The majority (76.8%) had an epicardial system. Data on lead impedance, battery longevity, programmed parameters, detected arrhythmias, percentage pacing and delivered defibrillator therapies were obtainable by download. Lead threshold measurements were obtainable via download in 83.7% of the devices, including epicardial systems. No concerning device issue was missed. In 15% of patients a major issue was detected remotely, including three patients with lead fractures. The virtual clinics resulted in fewer hospital attendances while enhancing monitoring and enabling more frequent device checks. The vast majority (91.4%) of families who responded to a questionnaire were satisfied with the virtual clinic follow-up.Conclusions:Virtual clinics allow safe and effective follow-up of children with pacemakers and implantable cardioverter defibrillators, including those with epicardial systems and are associated with high levels of parent satisfaction.

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