Evaluation the Role of Nutrition Support Team for Monitoring the Types, Complication, Nutrients and Drugs Provision in the Parenteral Nutrition

Parenteral nutrition (PN) is a form of administering nutrients, include water, macro and micronutrients and is one of widely used mode of therapy used in patients who are unable to tolerate oral or enteral feeding. Therefore, the success of nutritional therapy depends chiefly on nutrition support teams. The aim of the present work to evaluation the provision of parenteral nutrition in the Benghazi medical center. A total of 86 patients were involved in the study and numbers of questions were answered from nutrition support team at the hospital. The result revealed that PPN (IV drip) most common used and mixture of dextrose and sodium chloride were highly provision in the hospital. Furthermore the Doctors at the ward were shown have fully responsibility for provided PN but there were neglected role of dietitian and pharmacist. Patients monitoring were not carried out routinely. Most drug delivered by PN found NSAIDs and insulin. Dextrose and sodium chlorides commonly used in the hospital for delivery medication. The present study also demonstrated that, PN did not fulfill the patients requirement and there were no patients monitoring. PN found to be used most frequently in some condition were where in real need such as pulmonary disease, GIT disorder and renal disease. Furthermore, TPN provided for the admitted patients include in emergencies, therapeutic and for unconscious patients. There were reported a number of complication in patient received PN due to lack of monitoring and prolong replacements of PN drainage. PPN (Iv drips) were the most common uses at the hospital and longer duration was proved which might led to patients burden in the hospital. Furthermore, due to the uses of PPN for longer times this could contribute for patients malnutrition. Our data suggested that, comprehensive nutrition support team and provision of intervention programs in order to increased quality and reduced patients burden and also the result of our study needed to be validated in large sample to know the real role of dietitian and pharmacist for ordered of drugs and nutrients and nutrients drug interactions. Keywords: Nutrients, Provision, TPN, PN, complication, medications.

Sources of Resilience in Frontline Health Professionals during COVID-19

Background: While the challenges for psychological well-being for Australian healthcare workers have been documented, there has been a dearth of qualitative research on the sources of resilience that sustained workers during the COVID-19 pandemic. This study identified sources of resilience that clinicians used to cope with frontline challenges during the COVID-19 pandemic. Methods: Semi-structured interviews were conducted with 20 frontline health professionals, across five Australian hospitals, between October 2020 and April 2021. The interviews were recorded and transcribed, and the results were analysed using thematic analysis based on a phenomenological approach. Results: Three sources of resilience were identified by respondents: personal, relational, and organisational. A positive mindset, sense of purpose, and self-care behaviours emerged as key sources of personal resilience. Teamwork, altruism, and social support from family and friends contributed to relational resilience. Leadership, effective communication, and effective implementation of COVID-19 policies were associated with resilience at the organisational level. Frontline healthcare workers also voiced the need for the implementation of further strategies to support personal resilience whilst nurturing resilience within clinical teams and across entire healthcare organisations. Conclusions: Trust in healthcare systems, organisation leaders, colleagues, and personal support teams was an overarching theme supporting resilience.

Early support: Evaluation of the pilot projects and the development of an implementation model

Early support is an overall concept of health promoting and preventive measures for families with children up to 3 years. This includes direct interventions for children as well as offers and measures for parents and other caregivers. Based on a first research project, which showed that health and social services are repeatedly confronted with stressful family situations, but that families are often only supported late or too late, there were implemented two pilot projects in an urban and rural area of Northern Italy (called South Tyrol). The projects were evaluated using a multimethod approach, analysing existing documentation, and through focus groups, interviews, and qualitative questionnaires. The results of all the different research methods show very uniformly that many professionals and responsible persons were insufficiently informed about the health promotional and preventive potential of early support and about the importance of a good collaboration and network for a healthy start in live at the beginning of the projects. It took two years of intensive process to improve cooperation, but also knowledge and competences in this area. Through the intensive coordinated cooperation in a core team of public social and health services and psychologists (family counselling), a significant improvement could be achieved not only for these members of this core team, but above all also for the entire departments of the collaborating services. Professionals reported that not only has the quality of their work improved significantly because of this process, but there is also a noticeable lightening of the workload, which must be of great importance in the burdening fields of social and health services. Building on the results of the evaluation of these projects a model was developed of how a system of early support that accompanies families in a healthy start can be implemented in the whole region. The implementation is approved for 2022. Key messages The aim of early support is to build systems to strengthen and support all families preventively. Interdisciplinary cooperation in early support teams led to improved quality of work and lower workloads.

The Same, Yet Different: Understanding the Perceived Acceptability of Redface and Blackface

In recent years, several high-profile individuals were sanctioned (e.g., fired) when photos of them dressed in blackface surfaced. Yet, every weekend during sports seasons, fans dress in redface to support teams with Native mascots. Given the observed discrepancy, five studies examined whether and why the perceived acceptability of these two racialized representations differs. Across varying methods and designs, we found that redface was perceived as more acceptable than blackface. The differential acceptability was explained by the extent to which people believe that Native (vs. Black) Peoples: 1) largely do not exist within contemporary social contexts (i.e., social erasure) and 2) experience less racism. The results suggest that eliminating racialized representations requires understanding the role that sociocultural factors play in sustaining discrimination and prejudice.

Buried bumper syndrome: prevention and management in the community

Percutaneous endoscopic gastrostomy (PEG) is a well-established form of artificial nutrition. Buried bumper syndrome (BBS) is a rare but severe complication related to this type of feeding tube. BBS is described as when the internal bumper migrates into the stoma tract and/or the mucosa, and the inner lining of the stomach starts to grow around and over the internal bumper. It can result in pain, infection and the loss of the feeding tube as a port of entry for delivery of nutrition, hydration and medication into the stomach. When suspected, BBS requires urgent referral into specialist hospital services. It is somewhat preventable with appropriate aftercare; however, incidents do occur. The evidence and guidance on care of PEGs differs, and more data and research are needed into the incidence of BBS and what influences it. Access to appropriate nutrition support teams is essential to support patients and their caregivers with all aspects of enteral feeding.

Analysis of the Plan to Receive Emergency Fire Response Teams for Large-Scale Disasters in Japan

In the event of large-scale disasters requiring state-level responses in Korea, the Fire Commissioner of the National Fire Agency (NFA) mobilizes the fire-fighting forces from the cities or provinces of the entire country. Korea does not have a suitable system to receive support in disaster-affected cities or provinces. There is, however, a system to support disaster-ravaged cities or provinces in accordance with the fire-fighting force mobilization system under the Framework Act on Fire Services. Unlike Korea, Japan mobilizes registered emergency fire response teams (EFRTs) to address large-scale disasters. In addition, fire departments of all prefectures and municipalities have established plans to receive EFRTs to prepare for large-scale disasters within their jurisdictions. This study analyzes the plan to receive EFRTs when large-scale disasters occur and EFRTs are mobilized in disaster sites in Japan. The receiving plan includes the following: procedure for requesting EFRT mobilization; establishment of a fire support coordination headquarters within the emergency operations headquarters of prefectures; establishment of command headquarters and command support headquarters in municipalities; establishment of air command headquarters in the fire air corps of prefectures; and appointment of the heads of command for support units and command support teams. Additionally, the plan addresses the establishment of advance points, hutment places, fueling stations, command systems, communication operation systems, task assignment systems, and unit movement and withdrawal procedures.

Anorexia nervosa and the gastrointestinal tract

Anorexia nervosa (AN) is a complex eating disorder associated with a high morbidity and mortality, however, there is a lack of dedicated training for healthcare professionals outside of mental health specialities. There has been a reported increase in acute admissions of patients with AN, which may have been precipitated by the isolation and loss of support networks created by the COVID-19 pandemic. The purpose of this review is to highlight that AN can present with a wide variety of signs and symptoms relating to both the hollow and solid organs of the gastrointestinal (GI) tract some of which may even be life threatening. The overlap of symptoms with several other functional and organic GI diseases makes diagnosis challenging. Gastroenterologists and allied healthcare professionals need to be aware of the wide array of possible GI manifestations not only to help rationalise investigations but to also facilitate early involvement of the relevant multidisciplinary teams. Many of the GI manifestations of AN can be reversed with careful nutritional therapy under the guidance of nutrition support teams.