Nursing Period Research Articles

Effects of whole-day versus half-day cow-calf contact on cows’ and calves’ performance

Cow-calf contact systems (CCCs), where dairy cows nurse their own calves for several weeks while being milked, have some advantages in terms of animal welfare. However, one major challenge is the loss of collected milk due to suckling and milk ejection problems during milking. Reducing daily CCC can decrease milk losses. Our study investigated the effect of half-day CCC during daytime (HC, n = 11 cows) compared to whole-day contact (WC, n = 13) and no contact (NC, n = 14) on harvested milk yield, milk content, udder health, calving interval, and calf weight gain in a dual purpose breed-herd with concentrate-free feeding. ‘Nursing’ (9 weeks postpartum) was followed by separation of cow and calf, but still with visual CCC and twice daily milk feeding by nipple buckets (6 l per day, ‘in sight/milk feeding’). During the 11th–12th week, calves were housed out of sight and gradually weaned. Calves of NC were separated from their mothers 1 day postpartum, obtained 6 l whole-milk per day and were gradually weaned. During ‘nursing’, NC and HC cows gave more milk than WC in the morning. In the evening, HC and WC gave less milk than NC, but HC cows had also a slightly lower milk yield than WC. During ‘nursing’, a reduced fat content (−1% point) pointed at milk ejection problems in both CCC treatments independent from daytime. After separation from the calf (periods: ‘in sight/milk feeding’ and ‘out of sight/weaning’) and over the whole lactation, milk yield between HC and the other treatments did not significantly differ while WC cows gave less milk than NC cows. Protein contents were higher in dams than in NC. There were no indications of differences in the incidence of mastitis, somatic cell score or calving interval between treatments. During ‘nursing’, NC calves gained about 0.3 kg less per day than CCC-calves (nNC = 12, nHC = 7, nWC = 10). After separation from the mother, there was a growth check in both CCC groups. During ‘in sight/milk feeding’, HC gained less weight than NC and WC (nNC = 11, nHC = 9, nWC = 10). Hereafter, weight development did not differ. Two weeks after weaning, nursed calves were still significantly heavier than NC (n = 5–8). Nine weeks of HC during the day compared to WC helped to reduce losses of sellable milk during the nursing period and over the whole lactation while calf development was similar.

Effects of high-quality neurosurgical nursing care on improving clinical nursing quality.

With continuous advancements in medical technology, neurosurgical nursing is constantly developing and improving to provide higher-quality nursing services. To explore the effects of different types of high-quality nursing care on clinical nursing quality and patient satisfaction in neurosurgical nursing. Eighty patients who received neurosurgical treatment in the Affiliated Hospital of Southwest Medical University from June to December 2020 were selected as study participants and categorised into study and control groups. The study group comprised 40 patients who received 4 different types of high-quality nursing care, whereas the control group comprised 40 patients who received conventional nursing care. After a specific period, nursing satisfaction levels and adverse event and complication rates were compared between the two groups. Satisfaction with high-quality care was higher than that with conventional care, and high-quality health services and regional services showed the highest satisfaction levels, with an average score of 12 on the Glasgow scale. The satisfaction levels of the study and control groups were 75% and 57%, respectively, with a statistically significant difference (t = 7.314, P < 0.05). During the nursing period, the adverse event and complication rates were the highest in patients with level III pathology grade and those who underwent neurosurgery (40.02% and 85.93%, respectively), and the difference was statistically significant. In neurosurgical nursing, employing appropriate high-quality nursing methods can effectively reduce adverse event and complication rates in patients, thereby improving the quality of nursing care and increasing clinical nursing value.

Nursing Experience Applying Transition Theory to Assist the Family of an Infant With Complex Congenital Gastroschisis

This article describes the application of transition theory to assist a family with an infant with congenital complex gastroschisis. The nursing period, from March 3, 2023 to May 9, 2023, encompassed care from hospitalization to discharge. The author employed transition theory as a guide and used physical assessments, observations, and interviews for data collection as well as behavioral processes records. The primary nursing problem was identified as "preparation for family operation process enhancement/child's congenital disease and complex care needs, and the family's response to the challenges of the disease and care adaptation." The three phases of nursing care were summarized as: (1) the family adjustment to uncertainty, (2) undertaking caregiving roles and responsibilities, and (3) role development and family reconnection. The author established specific goals for each phase and provided corresponding interventions for the family. In the first phase, the author guided the family in expressing their concerns, and offered personalized health education information as well as psychological support to help them understand the progression of their child's disease and alleviate related anxiety and confusion. In the second phase, the author offered sleep guidance and customized home care schedules to support coping skill development and role functioning. In the third phase, the family was encouraged to explore the meaning of life while accompanying their child's growth in order to achieve spiritual growth and deepen the reconnection within the family. Ultimately, the family strengthened their confidence and capabilities in caregiving and embraced optimism and expectations for the future, enabling them to adapt smoothly to life after their child's return home. When families are confronted with their child's diagnosis with a congenital disease, they often find themselves in a state of self-doubt and faced with continuous challenges. Nurses may employ transition theory throughout the nursing process to better understand and address the evolving needs of both children and their families during the transition phase. Furthermore, transition theory may be applied to help nurses better assess, plan, and care for their patients, which can enhance the capabilities of families and facilitate their successful navigation through the challenging transition journey.

Nursing Experience of A Young Girl with IgA Nephropathy who Received Initial Hemodialysis

&lt;p&gt;本文為一位青少女因IgA腎病初次接受血液透析治療，疾病進展快速，使個案及案父母產生焦慮及照護認知不足之護理經驗。護理期間自2020年06月15日至07月10日，運用Gordon十一項健康功能型態評估，以直接照護、會談、身體評估及跨科部會議等方式收集資料，確立個案健康問題有:營養不均衡、焦慮、照顧者角色緊張。照護過程中，透過陪伴、傾聽與案家建立信任之護病關係，藉由飲食日誌設計個別性菜單、透過跨科部會議調整飲食攝取模式，以改善營養不均衡；利用漫畫繪本、健康管理工具，提升自我照護技能，減輕其焦慮；同理父母心理壓力，討論照護工作之分配、喘息減壓方式，降低照顧負荷，使個案學會自主健康管理，進而達到親子共責之健康管理模式。因應蔬食飲食人口的增加，建議偕同營養師設計「透析素食菜單」，讓病人保有自己喜好的飲食模式，以增加疾病的適應性，藉此護理經驗作為日後照護此類病人之參考。&lt;/p&gt; &lt;p&gt; &lt;/p&gt;&lt;p&gt;We reported a young girl who began to receive hemodialysis due to IgA nephropathy. Our nursing experience focus on her and her parents&amp;rsquo; anxiety and lack of caring cognition due to rapidly progressive disease. During our nursing period from June 15th to July 10th, 2020, we used the &amp;ldquo;Gordon 11 Function Health Patterns&amp;rdquo; to collect data by direct care, interviews, physical examination and multi-disciplinary discussion. We found that our case had health problems including nutritional imbalance, anxiety and caregiver role strain. Furthermore, we established a trusting relationship by accompany, listening and building trust with her family. We used diet diaries to create individualized menu, used interdisciplinary team meetings to improve nutritional imbalances, and used comic books and health management tools to improve self-care skills and reduce anxiety. We empathized with parents&amp;rsquo; psychological pressure, discussed the distribution of care work, provided respite care, reduced care load, taught her self-health management and then achieved the health management model of parent-child shared responsibility. In response to the increase in the population of vegetarian, we designed a &amp;quot;vegetarian menu for dialysis&amp;quot; with our dietitian. Therefore, the patients could maintain their own dietary preference to increase the adaptability to diseases. We took this nursing experience as a reference for the care of such patients in the future.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Comparing the effects of contact duration on cow and calf performance beyond separation - a prospective cohort study

BackgroundConsumers, the industry, and many farmers have shown increased interest in alternative management systems that allow for cow-calf contact (CCC) and this topic has become an important focus of research for a sustainable dairy industry. Among the many knowledge gaps still existing in this novel research field, there is a need for further research to investigate effects of CCC beyond the nursing period (i.e., after cow-calf separation). Moreover, multi-herd observational studies are scarce. Therefore, the aim of this study was to investigate the within-herd effect of CCC on machine milk yield and calf growth beyond separation. In this prospective cohort study, we studied all cows and their calves (Norwegian Red breed) born between September 1st 2021 and January 31th 2022 at three Norwegian dairy farms, investigating the impact of CCC on machine milk yield and calf average daily gain (ADG) after separation of the cow-calf pair. The follow-up period was 305 d for cows and six months for calves. Machine milk yield was automatically registered at each milking and calf heart girth was measured once a month. As various contact durations emerged, they were categorized into three groups: no contact (NC 0–3 d), short duration (4–30 d) and long duration (> 30 d). Data were analyzed with linear mixed models with the individual animal as the unit of interest. For cows, days in milk (DIM) from date of separation up to 305 DIM were included in the analysis as a continuous variable. For calves, age up to 195 d was used in the statistical analysis.ResultsWe found no differences in machine milk yield after separation across the different contact groups: cows with no contact (n = 28), short duration (n = 51) and long duration (n = 27) of contact, all exhibited comparable milk yields from the time of separation until the end of lactation. Furthermore, in the case of calves, no disparities in average daily gain (ADG) were identified for any of the contact groups: calves with no contact (n = 39), short duration (n = 61) and long duration (n = 38) of contact, displayed comparable growth during the first six months of life.ConclusionsOur findings indicate no negative effects of CCC on machine milk yield after separation, nor any sustained effects on calf growth under the conditions of this study. More multi-herd observational studies conducted on-farm is needed to expand the understanding of effects of CCC on cow and calf performance after separation.

Stone’s sheep (Ovis dalli stonei) lambing and nursery habitat selection

Wildlife conservation often focuses on mitigating disturbance in critical habitats like reproductive ranges. We studied lambing and nursery habitat selection by Stone’s sheep ( Ovis dalli stonei (J.A. Allen, 1897)) in the Cassiar Mountains in British Columbia. We estimated the timing of parturition and delineated lambing and nursery habitats based on movement behaviours of collared females ( n = 18) and vaginal implant transmitters. We identified 23 lambing events in 2018 ( n = 4), 2019 ( n = 13), and 2020 ( n = 6). The median birth date was 17 May and ranged from 3 May to 14 June. Females remained in lambing habitats from 1.5 to 11.3 days with a median of 5.5 days. We examined habitat selection during the lambing and nursery periods at the home-range scale using resource selection functions, and at a finer scale using integrated step-selection analyses. Females selected southwest slopes in rugged terrain at mid-elevations, suggesting selection for warmer micro-climates and features that facilitate predator avoidance. Females avoided habitats near roads during the lambing period but showed selection for habitats near roads during the nursing period. We developed predictive maps of suitable lambing and nursery ranges to inform land planning to help reduce overlap of anthropogenic disturbance with potential reproductive habitats.

THE RELATIONSHIP OF PARENTS 'ORIGINAL PARENTS ON THE STYLE OF THE TEENAGE OF ADOLESCENT GRADUATES IN STIKES ABDI NUSANTARA JAKARTA, 2020

Background: Parenting is very important for adolescent growth and development, adolescents must get good care from their parents to avoid deviant relationships. One of the associations that deviate dating style, if this is ignored by parents, it will have a negative impact on adolescents who are in a relationship.Objective: To find out the relationship between parenting style and dating style of adolescent nursing students at STIKes Abdi Nusantara Jakarta in 2020.Research Methods: This study uses a descriptive analytic research design using Cross Sectional. The population in this study were ordinary students who were active during the undergraduate nursing period from semester 1 to 6 of the best undergraduate nursing students at STIKes Abdi Nusantara Jakarta in 2020. In this study the researchers used a random sample to take a sample of 120 respondents of data related to Independent and dependent variables are collected at the same time and the questionnaire is distributed only once or for a moment.Results: From the study it can be concluded that there is a relationship between dating style and parenting style evidenced by the value of p value 0.002.

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke.

Ischemic stroke (IS) is a widely recognized disease characterized by high prevalence, mortality, morbidity, disability, and recurrence rates. It ranks prominently in terms of mortality, constituting 60%-80% of stroke cases. To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS. This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021. The participants were divided into two groups, namely the control group (n = 80) receiving routine care and the research group (n = 92) receiving comprehensive care. Various assessment scales, including the standard swallowing function assessment scale (SSA), National Institutes of Health Stroke scale (NIHSS), European stroke scale (ESS), self-rating anxiety scale (SAS), self-rating depression scale (SDS), Barthel index (BI), and the motor function assessment scale (MAS), were employed to evaluate the improvement in swallowing function, neurological deficits, clinical outcomes, anxiety, depression, daily living activities, and motor function before and after care. Furthermore, the study compared the occurrence of adverse reactions during the nursing period, life quality before and after the intervention, rehabilitation compliance, and nursing satisfaction between the two groups. After the nursing intervention, the research group exhibited significantly improved SSA and NIHSS scores compared to the control group (P < 0.05). Moreover, both groups demonstrated significant reductions in SAS and SDS scores (P < 0.05), with the research group showing more obvious advantages (P < 0.05). Compared to the control group, the research group displayed significantly better ESS, BI, and MAS scores (P < 0.05), coupled with a lower incidence of adverse reactions (P < 0.05). Additionally, the research group demonstrated markedly higher levels of life quality, rehabilitation compliance, and nursing satisfaction compared to the control group (P < 0.05). Comprehensive nursing effectively improved swallowing function, quality of life, and patient satisfaction, highlighting its clinical significance.

Nursing Experience Using Art Therapy to Help Women With Breast Cancer Face Changes in Body Image

The subject in this study was a female professional painter who underwent bilateral mastectomy because of bilateral breast cancer, experienced postoperative wound scarring, and developed alopecia due to the side effects of chemotherapy, which caused the patient to lose body image confidence and the motivation to engage in artistic creativity. The patient had shed tears early in the intervention and complained of difficulties with body image adjustment due to her altered appearance. Mastectomy patients must not only undergo drug treatment but also adjust psychologically to body image changes to decrease negative emotions. This was the author's motivation for involvement in this case. The nursing period was from 23 September to 30 December 2021. Physical, mental, spiritual, social, and family data were collected using observations and interviews. These data were evaluated and the main problems were determined to be disturbed body image related to altered body perception post-surgery, alopecia caused by chemotherapy, impaired physical mobility due to upper limb mobility limitations post-surgery, and nausea due to chemotherapy. The patient was encouraged to paint again and to use artistic creativity to comfort herself. Moreover, she was guided to express her innermost thoughts to face the impact of her changes in appearance. In addition, a care consultation channel was provided to facilitate experience sharing with other breast cancer patients, thus assisting the patient to cope with the mental impact of her treatments and face subsequent cancer treatments with a more positive attitude. Art therapy embraces a diverse variety of methods, including drawing and music. Art therapy is a valuable tool that facilitates both physical and mental healing. Based on this experience, nurses should include patients' close relatives when performing art therapy to facilitate shared care to overcome difficulties. We hope this nursing experience provides a practical reference for nurses.

Research on the intelligent internet nursing model based on the child respiratory and asthma control test scale for asthma management of preschool children.

Childhood asthma is a common respiratory ailment that significantly affects preschool children. Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver. With the rise of digital healthcare and the need for innovative interventions, Internet-based models can potentially offer relatively more efficient and patient-tailored care, especially in children. To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test (TRACK) on asthma management in preschool children. The study group comprised preschoolers, aged 5 years or younger, that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022. Total of 200 children were evenly and randomly divided into the observation and control groups. The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma. In addition to above treatment, the observation group was introduced to an intelligent internet nursing model, emphasizing the TRACK scale. Key measures monitored over a six-month period included the frequency of asthma attack, emergency visits, pulmonary function parameters (FEV1, FEV1/FVC, and PEF), monthly TRACK scores, and the SF-12 quality of life assessment. Post-intervention asthma control rates were assessed at six-month follow-up. The observation group had fewer asthma attacks and emergency room visits than the control group (P < 0.05). After six months of treatment, the children in both groups had higher FEV1, FEV1/FVC, and PEF (P < 0.05). Statistically significant differences were observed between the two groups (P < 0.05). For six months, children in the observation group had a higher monthly TRACK score than those in the control group (P < 0.05). The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period (P < 0.05). Furthermore, the groups showed statistically significant differences (P < 0.05). The asthma control rate was higher in the observation group than in the control group (P < 0.05). TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children, improve lung function, quality of life, and the TRACK score and asthma control rate. The effect of nursing was significant, allowing for development of an asthma management model.

A Nurse's Experience Providing Care to a Mother of a Toddler With Cohen's Syndrome Facing Tracheostomy Decision-Making Conflict Using Watson's Caring Theory

This case involved a 17-month-old toddler with Cohen's syndrome and cerebral palsy who had experienced multiple hospitalizations and operations since birth. During hospitalization, the patient suffered from tracheomalacia and poor swallowing and coughing abilities and had experienced two cardiopulmonary resuscitation events, after which a tracheotomy was suggested. Decision-making regarding the tracheotomy placed the mother under tremendous pressure, who was facing both the life-threatening disease of her son and her burden of care. During the nursing care period from 19th September to 6th December 2022, the author identified the main nursing problem as "decision-conflict: decision-making in relation to tracheotomy procedure" and distinguished the nursing process into (1) escape period, (2) conflict period, and (3) coping period after decision-making. Adopting the ten carative factors in Watson's Caring Theory as the core of her care approach, the author was able to establish a mutually trusting relationship with the mother and to understand her needs by means of listening, consistency, and empathy. This involved providing sufficient information and holding family meetings to facilitate communication in combination with palliative medical resources to provide follow-up care support as well as helping the family find meaning in their lives.

Experimental manipulation of perceived predation risk alters survival, cause of death, and demographic patterns in juvenile snowshoe hares

Perceived predation risk alters prey behaviour and physiology, but few studies have examined downstream consequences on prey demography in wild populations. Perceived predation risk could alter adult reproductive performance via reduced investment in offspring quality and post-birth care. We manipulated perceived predation risk in snowshoe hare ( Lepus americanus Erxleben, 1777) by exposing pregnant mothers to chases by a domestic dog ( Canis familiaris Linnaeus, 1758). Litter size was comparable between risk-augmented and control groups, but treated females had more stillbirths and gave birth to leverets of lower body condition. Leverets from risk-augmented females had 88% higher 40-day mortality rate. Maternally preventable causes of death like starvation or predation by red squirrel ( Tamiasciurus hudsonicus (Erxleben, 1777)) caused this difference, particularly during the nursing period. Risk-augmented mothers were always more active than controls, but the difference was greatest during the nursing period. We found that perceived predation risk reduces maternal productivity pre- and post-partum, implying downstream consequences to populations. Because our treatment ended before parturition, we can link offspring performance such as survival and behaviour specifically to maternal life-history trade-offs, which has not been shown in a wild mammal.

Post-nursing early life macronutrient balance promotes persistent and malleable biometric and metabolic traits in mice.

It is known that dietary factors within the gestational and nursing period affect early life and stably affect later life traits in animals. However, there is very little understanding of whether dietary factors within the early life period from post-nursing to adulthood affect traits in adulthood. To address this, we conducted studies on male C57Bl/6J mice fed from 3weeks (immediately post-nursing) until 12weeks (full maturity) using nine different diets varying in all three major macronutrients to parse out the effects of individual macronutrients. Early life macronutrient balance affected body composition and glucose homeostasis in early adulthood, with dietary protein and fat showing major effects. Despite this, mice showed rapid reversal of the effects on body composition and glucose homeostasis of early life diet feeding, upon standard diet feeding in adulthood. However, some traits were persistent, with early life low dietary protein levels stably affecting lean and muscle mass, and early life dietary fat levels stably affecting serum and liver triglyceride levels. In summary, macronutrient balance in the post-nursing early life period does not stably affect adiposity or glucose homeostasis but does impact muscle mass and lipid homeostasis in adulthood, with prominent effects of both protein and fat levels. KEY POINTS: Early life dietary low protein and high fat levels lowered and heightened body mass, respectively. These effects did not substantially persist into adulthood with rapid catch-up growth on a normal diet. Early life protein (negative) and fat (positive) levels affected fat mass. Early life low protein levels negatively affected lean mass. Low protein effects on lower lean and muscle mass persisted into adulthood. Early life macronutrient balance effects did not affect later life glucose homeostasis but early life high fat level affected later life dyslipidaemia. Effects of dietary carbohydrate levels in early and later life were minor.

Nursing experience of caring a teenager with end-stage renal disease undergoing kidney transplantation

&lt;p&gt;本文描述一位罹患末期腎病變之青少年接受腎臟移植手術的護理經驗。筆者於2019年1月6日至1月30日護理期間，運用身、心、靈、社會整體性評估，確認個案有急性疼痛、焦慮、潛在危險性感染及知識缺失等健康問題。&lt;/p&gt; &lt;p&gt;在疼痛方面，除教導使用固定帶固定傷口和使用別針固定引流管避免拉扯外，並鼓勵採深呼吸放鬆等技巧，以轉移疼痛的注意力；在執行護理活動前均詳細說明步驟與目的，並使用通訊軟體參與病友團體討論，藉由正向經驗分享，來增加對未來生活的信心並降低焦慮感；此外也指導傷口照護、協助認識感染徵兆及瞭解配戴口罩和勤洗手的重要，以降低危險性感染。最後，與個案共同訂定學習目標、提升移植術後自我照顧知識和增進其對藥物的瞭解及記憶，並鼓勵養成良好生活習慣、提醒按時回診追蹤，最終使問題獲得解決。期望藉此經驗分享提供臨床照護參考。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This article describes a nursing experience of a teenager with end-stage renal disease who successfully underwent kidney transplantation. During the nursing period from January 6 to January 30, 2019, the author confirmed that the patient had health problems of acute pain, anxiety, potential risks for infection, and a lack of knowledge through holistic assessments.&lt;/p&gt; &lt;p&gt;The care processes for reducing his pain perception included the use of tapes or pins to fix the wound and drainage tubes and ways to divert attention from pain. In terms of lowering his anxiety, we explained the purpose and process comprehensively before each nursing care. In addition, we encouraged him to use communication software to participate in group discussions and share positive experiences to increase confidence for future life. We also educated the patient on how to reduce the risk of infection by performing good wound care, recognizing early signs of infection, and understanding the importance of wearing a mask and washing his hands frequently. Finally, we set the same learning goals together, enhanced his knowledge and memory of immunosuppressive drugs, encouraged good living habits, and reminded him to return to the outpatient department on time, eventually solving the problems. We want to share these experiences to provide a reference for clinical care.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

The Experience of Caring a Hemodialysis Patient with Hopelessness

&lt;p&gt;本文個案因透析低血壓影響生活，感到失去對身體的控制感，加上長期慢性病與需終生依賴透析產生無望感引起筆者動機。筆者於2019年9月2日至10月28日護理期間，運用Gordon十一項功能性健康評估工具，收集主、客觀資料，確立個案有體液容積過量、便秘及無望感的健康問題。在生理層面讓個案瞭解適當攝水量之計算，並每日測量體重，有效控制兩次透析間增加的體重，使用藥物及非藥物的方式，協助個案養成每日排便的習慣；在心理層面以貝克無望感量表作為評估工具，運用家庭支持、腎友經驗分享，協助個案面對血液透析帶來的挑戰，建立有效策略面對疾病，提升個案對生活的控制感並積極參與治療，成功適應血液透析的生活，並表達對未來的期待與規劃。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This article describes the patient’s poor quality of life owing to hemodialysis hypotension. He felt a sense of loss of motor control. Because of his chronic disease that mandated continued hemodialysis, the patient felt hopeless. Have caused the author’s motivation. During the nursing period from September 2 to October 28, 2019, the author used Gordon’s 11 functional health assessment tools to collect subjective and objective data to establish the patient&amp;rsquo;s health complications, such as excess fluid volume, constipation, and hopelessness. For physiological improvement, the patient was educated of water intake regulation, daily weight measurement for effective weight control between 2 dialysis sessions, and use of drug- and non-drug methods to help develop a daily bowel habit. For psychological support, the Beck Hopelessness Scale was used as a mental state assessment tool. Family support and nephrologist&amp;rsquo;s sharing of their experience were used to help the patient overcome the challenges from hemodialysis. Basis this study, we recommend establishing effective strategies to cope with disease, improving the individual’s sense of control over life and encouraging active participation in treatment, successfully adapting to the changes in daily life effected by hemodialysis, and expressing expectations and plans for the future.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

The Nursing Experience of Caring for a Patient Undergoing Peritoneal Dialysis for Leakage of Catheter

&lt;p&gt;本文描述一位罹患末期腎病病人初次接受腹膜透析治療因導管滲漏引發傷口皮膚不適及焦慮情緒之護理經驗。護理期間為2019年1月2日至2019年3月8日，筆者運用Gordon十一項健康功能評估為指引，透過直接照護、會談、觀察和查閱病歷等方式收集資料分析，確立個案有：營養狀況少於身體所需、潛在危險性感染及焦慮等健康問題。護理過程中，會診營養師並藉手機APP、衛教單張及影片來增進其對透析飲食的認知，以達到營養狀況改善；協助指導導管傷口的照護，遵守無菌原則換藥，避免皮膚受損預防感染發生；採取主動關懷，鼓勵說出內心感受，協同醫師說明再次手術過程增進信心，教導放鬆技巧及精油按摩，以減低焦慮感。希望此照顧經驗，能提供臨床照護類似個案之參考。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This article describes the nursing experience of a patient suffering from end-stage renal disease undergoing peritoneal dialysis for the first time because of catheter leakage caused by wound skin discomfort and anxiety. The nursing period is from January 2 to March 8,2019.The author used Gordon’s eleven health function assessments as a guide to collect data and analyze through direct care, interviews, observations, and medical records. The problems are as follows: Health problems such as nutritional status less than what the body needs, potentially dangerous infections and anxiety. During the nursing process, consult a nutritionist and use the mobile phone APP and Health Education Leaflet and video to enhance the cognition of dialysis diet, so as to improve the nutritional status; assist in guiding the care of catheter wounds, follow the principle of aseptic techniques, and avoid skin damage to prevent infection；Take active care, encourage patient present inner feelings, cooperate with the doctor to explain the procedure again to increase confidence, teach relaxation techniques and massage with essential oils to reduce anxiety. I hope that this care experience can provide a reference for clinical care of similar cases.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Advanced Practice Nursing Experience of a Female Adolescent With Leigh Syndrome and Her Family: A Family Strengths-Oriented Therapeutic Conversations Approach

This article applied a family strengths-oriented therapeutic conversations approach to explore the advanced practice nursing experience of a female adolescent with Leigh Syndrome and her family. During the nursing care period from September 20 to November 19, 2022, the author collected data through direct care, observation, interview, telecare, home visits, and medical record reviews and confirmed the nursing problems to be the inadequate coping capability of the family. The author leveraged her advanced nurse practitioner role and used family strength-oriented therapeutic conversations to enable the parents of the patient to reflect on their experiences with this disease and to improve their quality of life and satisfaction with healthcare services. Three modes of care, including accessibility, coordination, and comprehensiveness, were offered to the female adolescent patient and her family to achieve the goal of family-centered, community-based, and medical-system-centered care. It is suggested that before making healthcare decisions, patients and their families should be given the opportunity to participate in the healthcare process and reach consensus on healthcare decisions based on existing evidence and their values and preferences. The medical decisions made by patients and their families after carefully considering their current situation and needs should be supported and assisted.

Association between time of day for rapid response team activation and mortality

PurposeTo evaluate the frequency of rapid response team (RRT) calls by time of day and their association with in-hospital mortality. Materials and methodsThis was a retrospective cohort study of all RRT calls at a tertiary teaching hospital in Porto Alegre, Brazil. Patients were categorized according to the time of initial RRT activation. Activations were classified as daytime (7:00–18:59) or nighttime (19:00–6:59). The primary outcome was in-hospital mortality rate. The secondary outcome was ICU admission within 48 h of RRT assessment. ResultsDuring the study period, 4522 patients were included in the final analysis. Cardiovascular and respiratory changes were more common causes of nighttime activation, whereas neurological and laboratory changes were more common during the daytime. The in-hospital mortality rate was 23.9% (1081/4522). Nighttime RRT calls were not associated with worse outcomes than daytime calls. However, a decrease in the number of calls was observed during nursing handover periods (7:00, 13:00 and 19:00). Two time periods were associated with increased adjusted odds for mortality: 12:00–13:00 (adjusted OR 2.277; 95% CI 1.392–3.725) and 19:00–20:00 (adjusted OR 1.873; CI 1.873; 95% 1.099–3.190). ConclusionWe found that nighttime RRT calls were not associated with worse outcomes than daytime RRT calls. However, a decrease in the number of calls and higher mortality was observed during nursing handover periods.

Spatiotemporal variation in pup abundance and preweaning survival of harbour seals (Phoca vitulina) in the St. Lawrence Estuary, Canada

Marine mammal populations worldwide greatly benefitted from conservation measures put in place since the 1970s following overexploitation, and many pinniped populations have recovered. However, threats due to bycatch, interspecific interactions or climate change remain, and detailed knowledge on vital rates, population dynamics, and their responses to environmental changes is essential for efficient management and conservation of wild populations. In this study, we quantified pup abundance and survival of individually marked harbour seal ( Phoca vitulina Linnaeus, 1758) pups during the preweaning period at Bic Island and Métis sites in the St. Lawrence Estuary from 1998 to 2019. We used mark-recapture models to evaluate competing hypotheses regarding variation in daily preweaning survival rates and capture probability during the pups’ first 30 days of life. Pup abundance increased from 76 [95% CI: 59, 101] to 323 [95% CI: 233, 338] in the past two decades at Bic Island and from 66 [95% CI: 47, 91] to 285 [95% CI: 204, 318] at Métis. Preweaning survival was generally higher at Bic (0.73 [95% CI: 0.58, 0.82]) than at Métis (0.68 [95% CI: 0.52, 0.79]). We hypothesize that differences between habitats and human disturbance contribute to lower preweaning survival at Métis, but behavioural studies are needed to understand the impacts of disturbance on mother–pup interactions during the nursing period.

Protein dan vitamin D3 meningkatkan kadar fosfor maksila anak tikus putih Rattus novergicus galur Wistar dengan berat badan lahir rendah

Protein and vitamin D3 increase the phosphorus levels of maxillary in malnourished mice pupBackground: Protein deficiency during pregnancy leads to malnutrition in the newborn. One of the signs is low birth weight, which impacts bone and teeth growth problems, most probably related to vitamin D and phosphorus deficiency. Adequate protein and vitamin D3 during the nursing period increase the phosphorus level of bone related to fosfor absorption, which increases in the gut.Objective: This research was conducted to determine the effect of protein and vitamin D3 during the nursing period on increasing phosphorus levels of maxillary in prenatal malnutrition mice.Methods: Experimental study with post-test-only control group design. Thirty the Rattus novergicus Wistar strain mice were divided into five groups (n=6). The positive control group (healthy mice suckle in mother who received a standard protein diet and vitamin D3 0.36 IU/g BW/day/oral), negative control group (malnourished mice suckle in mother who received a low protein diet), and three groups of malnutrition mice suckle in mother who receives intervention standard protein diet with vitamin D3 0.36 IU/g BW/day/oral, low protein diet with vitamin D3 0,36 IU/g BW/day/oral, and a standard protein diet without vitamin D3. The parameter measured was phosphorus levels in the maxillary.Results: ANOVA test results showed significant phosphorus level differences of maxillary between groups (p&lt;0.001), and the Post Hoc test showed differences between the control group with interventions 1, 2, and 3 groups.Conclusion: Intervention of a standard protein diet without vitamin D3 or a low protein diet with vitamin D3 0.36 IU/day/oral significantly increases the phosphorus level of maxillary in malnourished mice. However, combining a standard protein diet and vitamin D3 0.36 IU/day/oral is the most optimum for improving maxillary bone phosphorus levels in malnourished mice.