Nursing Period Research Articles

Teaching, service and community integration as a strategy for reorienting undergraduate health training

The teaching-service-community integration is an important strategy for achieving changes in the training of human resources in health, in order to train professionals with a profile to work in the Brazilian Unified Health System (SUS, as per its Portuguese acronym). This study analyzed how it occurs and what are the contributions of the teaching-service-community integration in the view of professors from the first to the seventh period of Medicine, Nursing and Dentistry programs at a university in northeastern Brazil. This is an exploratory and descriptive study, with a quantitative approach. Data were collected using an interview form and analyzed with the help of SPSS software. The descriptive analysis of the data, the chi-square test and the calculation of the internal consistency of the evaluation scale were used. The study had the participation of 106 professors. Results show that practices were still predominantly performed in university clinics and hospitals, 76 (71.7%). Most professors, 59 (56.7%), consider the teaching-service-community interaction very important for the quality of training and recognize its importance in strengthening SUS, 89 (85.6%). Although there was resistance on the part of some professors to follow-up students in extramural services, most of them, 94 (89.5%), consider the role of professors as essential for changing health practices, especially professors in nursing and dentistry professors that carry out extramural practices (p < 0.01). Interdisciplinary practices were performed more frequently in the first two periods of the three courses and by the nursing course (p = 0.001). In turn, multiprofessional interaction predominates in the practical classes of the nursing course and practices held outside the university domain (p < 0.01). It is evident the need to institutionalize the teaching-service-community interaction, as well as to value initiatives that streamline and make teaching more flexible in multiprofessional and interdisciplinary activities, fundamental for the amendment of training in health.

A Postoperative Nursing Experience Applying Swanson`s Caring Theory in a Teenager With Pectus Excavatum

A nursing experience applying Swanson`s caring theory in the care of a teenage patient who received Nuss procedure for his pectus excavatum is described in this article. After the operation, the patient suffered from postoperative pain, lack of knowledge, and body-image disturbance. These symptoms influenced the patient`s physical and mental health, and prompted the author to do an in-depth investigation and discussion of this case. The nursing period lasted from July 3rd to 10th, 2019. The author conducted a comprehensive nursing assessment using observation, interviews, listening, and telephone interviews. The major problems identified were acute pain, lack of knowledge, and body-image disturbance. During the nursing period, the author established a good therapeutic relationship with the patient. The author applied Swanson`s caring theory to understand the patient`s healthcare needs and provide appropriate care. The author discussed the treatment direction with the patient, applied cognitive-behavioral strategies to relieve pain, educated the patient on developing and implementing individualized rehabilitation plans to establish correct posture in daily activities, and helped the patient adapt to post-operative changes in appearance and maintain a positive attitude toward the future. The age gap between the author and the patient required that the author spend additional time communicating with the patient to encourage him to open up his mind. It is recommended that hospitals offer youth communication skills lessons for nurses to enhance their communication and care skills with people of different age groups. In sharing this nursing experience, we hope to provide medical staff with a reference for caring for adolescent patients with disease-related body-image disturbance.

Conventional study and discussion on premature infants nursing essentials and feeding methods

Abstract Explore the nursing essentials and feeding methods for premature infants and their clinical effects. We selected 90 premature infants born in the neonatology department of our hospital over the past year, implemented the nursing measures combined with several nursing methods and reasonable and effective feeding methods according to the clinical manifestations of the premature infants, and observed the clinical effects. After a period of careful nursing, among these 90 premature infants, 2 infants died unfortunately, 4 infants abandoned the treatment, the remaining premature infants were discharged in good condition in all respects, could autonomously suck milk and reach the minimum daily suction volume, their weights increased to some extent, and their body temperatures could maintain normal under normal room temperature condition. According to the clinical experience, timely implementing the nursing measures combined with several nursing methods and reasonable and effective feeding methods to the premature infants can effectively reduce the morbidity and mortality of premature infants, and improve the survival rate and living quality of the premature infants, so that it is suitable for clinical promotion.

Comparative juvenile performance assessment of genetically improved Nile tilapia ( Oreochromis niloticus L.) under commercial conditions in Bangladesh

Two on-farm juvenile performance trials were conducted at a hatchery in Bangladesh to compare a genetically improved strain of farmed Nile tilapia (GIFT) and a local strain (LS) produced by commercial operators. A 21-day early nursing trial was conducted in five replicate hapas followed by a 27-day advanced nursing trial in six replicate hapas. The mean feed conversion ratios (FCR), mean specific growth rates (SGR), mean individual final weights, mean production yields and mean survival rates were calculated for both strains. During the early nursing trial, GIFT fry survival rate and overall yield were significantly (p < 0.05) greater than LS values, which in contrast demonstrated better FCR and SGR. Improved performance was demonstrated in terms of FCR, SGR and yield for GIFT during the advanced nursing trial and mean final individual weights were 78% greater for GIFT than LS fish (2.26 g and 1.27 g respectively). Economic analysis indicated GIFT fish produced a net return 84% greater than that of LS fish at the end of the early nursing period, and by the end of the advanced nursing period, this difference had grown further such that GIFT generated a gross return over double that of LS. The results from a survey of tilapia grow-out farmers suggested producers from poor, medium and better-off backgrounds agreed GIFT performed better than traditional strains and is beneficial for aquaculture growth in Bangladesh. However, the results also indicate there may be a greater propensity for better-off farmers to appreciate the potential benefits of improved strains over poorer farmers.

Long term monitoring of the reproductive behavior of wild Chinese pangolin (Manis pentadactyla)

Observations of Chinese pangolin (Manis pentadactyla) in the wild are extremely rare and challenging because of their nocturnal and cryptic activity patterns and low population density. The present article reported the first field observation in eastern Taiwan, from October 4, 2012 to June 16, 2016, on the reproductive behavior of the Chinese pangolin based on the monitoring of a female (LF28) using radiotelemetry and camera traps. During this period, LF28 aged from 1–4.5 years old and gave two single-births, both took place in early December, at 3 and 4 years old, respectively. We recorded the entire 157 days of the first nursing period from parturition to maternal separation. For the second infant, the gestation period was estimated to be around 150 days based on the evidence that the pregnancy started in early Jul. 2015 and the offspring was born on Dec. 9, 2015. During the entire nursing period, LF28 frequently moved the offspring from one nursing burrow to another staying various durations ranging from 1 day to more than 35 days, and almost all (= 15/16) of these burrows were located in the core (MCP75) of LF28’s home range. Started from the month of parturition and lasting throughout the whole nursing period, different adult males constantly visiting the nursing burrows were recorded. Mating behavior was recorded once outside the burrow in March, which provided evidence of the occurrence of post-partum estrus in this species. Delayed implantation was proposed based on the observation of a several months lag between copulation and the estimated pregnancy initiation date. The present study demonstrated the advantage of using remote technologies to learn the life history of resting fossorial species.

Proteobacteria abundance during nursing predicts physical growth and brain volume at one year of age in young rhesus monkeys.

Over the last decade, multiple studies have highlighted the essential role of gut microbiota in normal infant development. However, the sensitive periods during which gut bacteria are established and become associated with physical growth and maturation of the brain are still poorly defined. This study tracked the assembly of the intestinal microbiota during the initial nursing period, and changes in community structure after transitioning to solid food in infant rhesus monkeys (Macaca mulatta). Anthropometric measures and rectal swabs were obtained at 2-month intervals across the first year of life and bacterial taxa identified by 16S rRNA gene sequencing. At 12months of age, total brain and cortical regions volumes were quantified through structural magnetic resonance imaging. The bacterial community structure was dynamic and characterized by discrete maturational phases, reflecting an early influence of breast milk and the later transition to solid foods. Commensal microbial taxa varied with diet similar to findings in other animals and human infants; however, monkeys differ in the relative abundances of Lactobacilli and Bifidobacteria, two taxa predominant in breastfed human infants. Higher abundances of taxa in the phylum Proteobacteria during nursing were predictive of slower growth trajectories and smaller brain volumes at one year of age. Our findings define discrete phases of microbial succession in infant monkeys and suggest there may be a critical period during nursing when endogenous differences in certain taxa can shift the community structure and influence the pace of physical growth and the maturational trajectory of the brain.

A Protein Subunit Filovirus Vaccine Facilitates Maternal Immunization in Mice

Abstract Ebola virus disease (EVD) is highly pathogenic and virulent and has caused large scale outbreaks in Central and West Africa. To date there are no known correlates of protection however, recently the FDA and EMA have approved a vaccine, Ervebo. This vaccine utilizes a replication competent viral vector which may be contraindicated in immunocompromised individuals, pregnant women, and infants. Our lab has developed a recombinant protein subunit vaccine, a platform that is generally considered safe for immunocompromised, pregnant women, and infants. Our vaccine, when properly adjuvanted, demonstrates protection in non-human primates and may also induce maternal immunization. Maternal Immunization is the phenomena of inducing passive immunity via maternal antibody. This occurs via transfer of IgG using the FcRn. This receptor binds the Fc portion of IgG in a pH dependent manner which facilitates transcytosis of IgG across the placental, mammary tissue, as well as gut epithelial layer. In rodents, maternal IgG is transferred across the gut epithelia throughout the nursing period. This project demonstrates in mice the immunogenicity of a protein subunit vaccine comprised of Ebola glycoprotein and adjuvant administered during gestation as well as the transfer of antigen specific maternal antibody to offspring through milk. To investigate maternal immunization we vaccinated female Swiss Webster mice during gestation and measured antigen specific IgG levels in both the mothers and pups as well as in the milk. Antigen specific maternal antibody titers found in pup sera mimic those found in fully immunized adult females weeks after weaning, indicating the potential for maintaining an antigen specific humoral response in neonates.

Evolved changes in maternal care in high-altitude native deer mice.

At high altitude (HA), unremitting low oxygen and persistent cold push small mammals close to their metabolic ceilings, leaving limited scope for aerobically demanding activities. However, HA breeding seasons are relatively short and endemic rodents compensate with larger litters than low altitude (LA) conspecifics. Rodent mothers are the sole source of heat and nutrition for altricial offspring and lactation is energetically costly. Thus, it is unclear how HA females balance energy allocation during the nursing period. We hypothesized that HA female rodents invest heavily in each litter to ensure postnatal survival. We measured maternal energetic output and behaviour in nursing deer mice (Peromyscus maniculatus) native to LA (400 m a.s.l.) and HA (4350 m a.s.l.) under control (24°C, 760 mmHg) and cold hypoxia conditions, simulating HA (5°C, 430 mmHg). Strikingly, resting metabolic rates of lactating HA and LA females under cold hypoxia were 70-85% of their maximum aerobic capacity. In cold hypoxia, LA mothers increased both nursing time and milk fat content, however their pups were leaner and severely growth restricted at weaning. HA mothers also increased nursing in cold hypoxia but for far less time than LA mothers. Despite receiving less care, HA pups in cold hypoxia only experienced small growth restrictions at weaning and maintained body composition. As adults, HA mice raised in cold hypoxia had increased aerobic capacity compared to controls. These data suggest that HA mothers prioritize their own maintenance costs over investing heavily in their offspring. Pups compensate for this lack of care, likely by reducing their own metabolic costs during development.

Potential role of L-ascorbic acid with Field cricket (Gryllus bimaculatus) meal in diets of Nile Tilapia (Oreochromis niloticus) during sex reversal and nursing

A synthetic androgen 17-α methyltestosterone (MT) commonly used in the production of mono-sex fry of Nile tilapia (Oreochromis niloticus) during the first 21 days for sex reversal has been considered to suppress immunity thereby reduce survival. Present trial was conducted to evaluate whether vitamin C (L-ascorbic acid, AA) supplementation would benefit in terms of survival, growth, and stress resistance. Nile tilapia fry were fed with isonitrogenous (57.8±0.2% CP) diets formulated using Field cricket (Gryllus bimaculatus) meal (approx. 79%) and fish meal (approx. 20%) to use as control, and five other diets were prepared by supplementing 10, 20, 30 40 and 50 g of vitamin C (L-ascorbic acid per kg diet). Eighteen aquaria or glass tanks (100 L) were used having three replicates per treatment. Each aquarium was stocked with 300 fish (0.01±0.00 g). Fry were nursed for another 91 days to check their sex-ratio. Gonad histology showed increased number of spermatogonia when L-ascorbic dose was 30g/kg diet. At the end of the feeding trial results indicated significant increase (P&lt;0.05) in growth, feed utilization and survival when fed with vitamin C at the dose of 10 g/kg diet during sex-reversal and nursing periods as compared to the control. Similarly, hematological information also showed 10 g vitamin C dose per kg diet. Polynomial regression showed that the optimum dietary ascorbic acid doses were calculated at 15.9, 10.0 and 12.0 g AA per kg diet for highest survival (83.5% max), weight gain and SGR, respectively, but the doses higher than 20 g of L-ascorbic acid/kg diet was not beneficial. Highest apparent digestibility (AD%) of protein (84.1%) was at 15.37g and AD% of lipid (91.4% max) was 17.8g of vitamin C/kg diet. Salinity challenge test also showed highest survival can be achieved at 15.8 g AA per kg diet. As the survival of fry is the most important parameter at these stages, the dose which resulted highest survival i.e., 15 g/kg diet is recommended.

Assessment of milk yield and nursing calf feed intake equations in predicting calf feed intake and weaning weight among breeds.

Nutrition models are important tools in management decisions, but improvements are needed for cow-calf producers to accurately predict nursing calf performance. Therefore, the objective of this study was to assess the ability of published milk yield (MY) and forage intake equations to predict calf feed intake and weaning weight (WW) using an independent, multi-breed dataset. A dataset with 406 nursing calves was used to evaluate two MY equations: 1) National Academies of Sciences, Engineering, and Medicine (2016) (NASEM) and 2) Wood (1967) (WOOD) and five feed intake equations: 1) equations from Table 9.1 in Tedeschi et al. (2006) (TED06), 2) equations 2 to 7 in Baker et al. (1976) (BAK76), 3) equation 25 in Tedeschi and Fox (2009) (TED09A), 4) equations 17, 19, and 24 in Tedeschi and Fox (2009) (TED09B), and 5) equation from Holloway et al. (1982) (HOL82). MY was measured at 14-d interval by hand milking, and individual feed intake of nursing calves was determined during a 240-d nursing period. Calf birth and WW were measured on days 0 and 240, respectively. Each combination of MY and feed intake equation was used to predict calf feed intake and WW from observed MY, calf birth weight, and calf slaughter weight. Predicted and observed values were compared using concordance correlation coefficient (CCC) and mean bias (MB). Factors affecting the deviation between observed and predicted values were analyzed using regression, and a revised equation was developed. Feed intake equations poorly predicted observed feed intake with CCC < 0.4 and MB ranged from -108% to 69%. However, statistics were slightly improved when using WOOD rather than the NASEM MY equation. BAK76 and TED09B feed intake equations were considerably more accurate (MB = -14.4% to 13.0%) in predicting feed intake but still not precise (CCC < 0.30). Predictions of WW had CCC ranging from 0.19 to 0.71 and MB ranging from -25.9% to 41.8% and were not significantly affected by the MY equation. TED06 and BAK76 feed intake equations were the most precise (CCC > 0.60) and accurate (MB = 1.7% to 8.5%) in predicting WW. Sire breed accounted for significant variation in the deviation between observed and predicted values of feed intake and in a revised equation to predict total feed energy intake from total milk energy intake. In conclusion, refinements of feed intake equations for nursing calves need to account for breed to improve current nutrition models.

PSIX-19 The impact of piglet nursing location along the sow udder line on piglet gain and subsequent weaning weight

Abstract Piglet weaning weight is a critical factor that influences post-weaning growth and performance. Weaning weight is a function of birth weight and the amount and nutrient density of the milk consumed during lactation. Milk production is influenced by sow mammary gland development and diet consumption but may also be a biological function of teat location along the udder line. The objective of this study was then to determine the effects of piglet nursing location along the udder on overall piglet gain and weaning weight. A total of 1,078 individual piglets were observed during the nursing period at three time points during lactation. The teat pairs along the udder line were labeled from anterior to posterior (1-7, respectively) to define nursing location. At the end of the lactation period, the observed piglet nursing location was evaluated for both actual weaning weight and overall piglet weight gain during lactation. Data were evaluated by analysis of variance with the statistical model utilizing litter size as a covariate. As expected, when litter size was utilized as a covariate, there was a significant effect on piglet weaning weight (P &amp;lt; 0.0001), and there was both a linear and quadratic effect of location (L, P &amp;lt; 0.0001; Q, P = 0.0009) on both weaning weight and lactation piglet gain. Heavier piglets were weaned from more anterior teats (teat pairs 1-4), with the numerically heaviest piglets weaned from teat pair 4 (6.12 kg), with the lowest weight piglets being weaned from teat pair 7 (5.17 kg). Piglet weight gain during lactation was impacted by litter size (P &amp;lt; 0.0001), but nursing location did not affect lactation weight gain (P = 0.57). Due to the differences in piglet weights at weaning, it can be concluded that piglet nursing location influences overall piglet weaning weight.

39 Effects of increasing iron dextran dosage at birth on the hematological profile and growth performance of piglets during the lactation period

Abstract The objective of the experiment was to critically monitor the blood profile and growth performance of piglets during the lactation period after receiving various amounts of injectable iron at birth. A total of 70, newborn pigs (initial BW 1.51 ± 0.26 kg) from 7 litters were assigned to 1 of 5 iron dosage treatments on d 0. Injectable iron dosage treatments were 0, 50, 100, 200, and 300 mg iron from iron dextran. BW and blood samples were collected on d 0, 1, 2, 3, 4, 6, 8, 11, 14, 17, and 22 (weaning) and blood was analyzed for a complete blood count (CBC). Blood was only sampled from 50 of the 70 pigs as the pigs not sampled were used for tissue collection at weaning and postweaning. Data were analyzed as repeated measures using the individual pig as the experimental unit. As early as d 1 after the injection, hemoglobin concentration (Hb) improved (linear: P &amp;lt; 0.05). The Hb response was both linear (P &amp;lt; 0.001) and quadratic (P ≤ 0.01) from d 3 through weaning at d 22. For the 50 and 100 mg iron treatments, Hb peaked at d 6, whereas Hb for the 200 and 300 mg iron treatments peaked on d 17. Other CBC measures followed a similar pattern of improvement from d 2-3 through weaning as the iron dosage increased. Average daily gain was greater (linear: P = 0.04 and quadratic: P = 0.05) from d 0 to 22 which, in turn, led to a linear improvement (P ≤ 0.05) in weaning BW. Increasing iron injection dosage at birth leads to an improved blood profile and greater ADG during the nursing period (d 0-22). The dosage provided also affects the timing and magnitude of the peak Hb response.

Maternal-infant nutrition and development programming of offspring appetite and obesity.

In the United States and Mexico, the obesity epidemic represents a significant public health problem. Although obesity is often attributed to a Western-style, high-fat diet and decreased activity, there is now compelling evidence that this, in part, occurs because of the developmental programming effects resulting from exposure to maternal overnutrition. Human and animal studies demonstrate that maternal obesity and high-fat diet result in an increased risk for childhood and adult obesity. The potential programming effects of obesity have been partly attributed to hyperphagia, which occurs as a result of increased appetite with reduced satiety neuropeptides or neurons. However, depending on maternal nutritional status during the nursing period, the programmed hyperphagia and obesity can be exacerbated or prevented in offspring born to obese mothers. The underlying mechanism of this phenomenon likely involves the plasticity of the appetite regulatory center and thus presents an opportunity to modulate feeding and satiety regulation and break the obesity cycle.

A importância da educação em saúde para as gestantes durante o acompanhamento do ciclo graví­dico puerperal

Introdução: A gravidez é um evento de muita significação na vida da mulher e permeada por valores, transformações e momentos especiais, sendo experimentados de formas diferentes na vida de uma mulher. Objetivo: Descrever a importância da educação em saúde para as gestantes durante o acompanhamento do ciclo graví­dico-puerperal em uma Unidade Básica de Saúde em Belém do Pará. Método: produto de um projeto de extensão institucionalizado pelo Centro Universitário do Pará (CESUPA), composto por uma equipe multidisciplinar de acadêmicos dos cursos de: do 7º perí­odo de Enfermagem, 4º perí­odo de Medicina, 6º perí­odo de Odontologia e 5º perí­odo de Nutrição. A ação foi na Unidade Básica de Saúde, no Bairro do Guamá em Belém-Pa. Participaram 12 gestantes, foram inclusas as que frequentavam regularmente o pré-natal, exclui-se as que iniciaram o pré-natal no 2º trimestre. A captação foi durante as consultas pelos profissionais de saúde. A análise foi de Bardin. Resultados: As gestantes devem ter acesso í ação educação para esclarecer e prepará-la para alterações vivenciadas, prepara-las para decisões ao parto, puerpério e amamentação. Considerações finais: O conhecimento das gestantes sobre o pré-natal contribui para o cuidado ao binômio mãe-filho, a extensão universitária e um fator contributivo para melhorar a inter-relação com os profissionais de saúde, academia e comunidade.

Factors Affecting Mistreatment of the Elderly in Long-Term Care Facilities.

In long-term care facilities, elderly mistreatment occurs routinely and frequently. However, few studies have empirically explored the multifaceted risk factor of mistreatment. The purpose of this paper was to explore the factors affecting elderly mistreatment by care workers in Japanese long-term care facilities and to examine the relationship between these factors and mistreatment. This analysis was based on a sample of 1473 care workers from long-term care facilities and used multiple regression analyses. The results revealed that the nursing care level, work period, resilience, and attitude towards mistreatment among residents and staff were factors significantly associated with the degree of mistreatment. Facility size, an institutional environment that does not limit the behavior of residents, and family and community support for the elderly were among the institutional environment factors that had significant relationships with mistreatment. Staff gender, care-related qualifications, and workload were not associated with mistreatment. These findings suggest that strengthening the staff’s attitude and coping skills to prevent mistreatment, as well as interventions for changes in the institutional environment, are needed to prevent and reduce the prevalence of mistreatment in Japan. In addition, raising staff resilience to stress situations and building a resident-centered facility care environment is an important measure to reduce mistreatment.

Prolonged maternal investment in northern bottlenose whales alters our understanding of beaked whale reproductive life history.

Nursing and weaning periods are poorly understood in cetaceans due to the difficulty of assessing underwater behaviour in the wild. However, the onset and completion of weaning are critical turning points for individual development and survival, with implications for a species' life history including reproductive potential. δ15N and δ13C deposited in odontocete teeth annuli provide a lifetime record of diet, offering an opportunity to investigate variation and trends in fundamental biology. While available reproductive parameters for beaked whales have largely been inferred from single records of stranded or hunted animals and extrapolated across species, here we examine the weaning strategy and nursing duration in northern bottlenose whales (Hyperoodon ampullatus) by measuring stable isotopes deposited in dentine growth layer groups (GLGs). Using a collection of H. ampullatus teeth taken from whales killed during the whaling era (N = 48) and from two stranded specimens, we compared ontogenetic variation of δ15N and δ13C found in annual GLGs across all individuals, by sex and by region. We detected age-based trends in both δ15N and δ13C that are consistent across regions and males and females, and indicate that nursing is prolonged and weaning does not conclude until whales are 3-4 years old, substantially later than previous estimates of 1 year. Incorporating a prolonged period of maternal care into H. ampullatus life history significantly reduces their reproductive potential, with broad implications for models of beaked whale life history, energetics and the species' recovery from whaling.

May rotavirus vaccine be affect food allergy prevalence?

ABSTRACT Incidence of food allergy (FA) during nursing period is 6–8% globally and It is reported %5,7 in Turkey. In our study, the aim is to determine whether the prevalence of food allergy (FA) increases in children vaccinated against rotavirus. The files of 681 infants who are still followed-up were retrospectively evaluated. Children who did not come to our clinic for all of their well-child follow-up visits were excluded from the study. Moreover, children diagnosed with allergy before vaccination and children with known gastrointestinal system disease were excluded from the study. The number of patients diagnosed with food allergy after being vaccinated against rotavirus was 12 (1.76%). Three children had a family history of allergy. Of 12 patients who were diagnosed after vaccination, 3 (n:104) were vaccinated with pentavalent vaccine and 9 (n:507) with monovalent vaccine. In the monovalent vaccination group, food allergy was found in 9 children (1.55%), and in the pentavalent vaccination group, food allergy was found in 3 children (2.88%). The difference between the two vaccination groups in terms of food allergy prevalence was not significant (p > .05). Although it is believed that food allergy, and even cow’s milk protein allergy (CMPA) prevalence increases in infants vaccinated against rotavirus, in this study, no significant increase was observed in the prevalence of food allergy after rotavirus vaccination. Both types of vaccine had similar rates to each other.

Curative effect observation on deformed auricle treated with EarWell Infant Ear Correction System with modular parents’ nursing education

Abstract Objective To investigate the efficacy and patient satisfaction of the EarWell Infant Ear Correction System combined with modular parents’ nursing education's curative effect on deformed auricle. Methods A total of 42 patients (29 boys and 13 girls; 73 ears; age ≤3 months) with auricle deformities who had received EarWell Infant Ear Correction System's treatment and modular parents’ nursing education in Guangzhou Children and Women's Medical Center between April and October 2018. The modular parents’ education program is standardized by EarWell system. Physician and patients’ parents compared the severity of auricle deformity separately before and after the treatment by using the auricle deformities visual analogue scales (VAS) rating system. Patient satisfaction was evaluated by using global aesthetic improvement scale (GAIS). The data collected of auricle deformities VAS and GAIS satisfaction score were applied to measure the treatment's effectiveness. Results All the 42 patients (73 external ears) completed the treatment with EarWell Infant Ear Correction System and modular parents’ nursing education. The mean age at initiation of treatment was 37.87 ± 19.44 days and the therapeutic time span was 47.21 ± 17.36 days. At the end of treatment, the physician's and patients’ guardians rating of the severity of auricle deformity were significantly improved separately compared to the initial rating (8.33 ± 1.27 vs. 6.51 ± 0.84; P &lt; 0.005) (5.77 ± 1.59 vs. 8.19 ± 2.38 P &lt; 0.05). During the treatment and parents’ home nursing care period, the side effect and complications were minor like skin eczema and irrigation; there were no severe complications such as necrosis of the skin and cartilage. The patient tolerance for the treatment was acceptable with the adequate parents’ nursing care. Most patients’ guardians were satisfied with the treatment outcomes of EarWell Infant Ear Correction System with more engagement of nursing care, the GAIS's rating were increased from pretreatment stage's 26.19% to treatment completed stage's 90.48%, and the difference was statistically significant (P &lt; 0.05). Conclusions In this study, we proved that EarWell Infant Ear Correction System with its unique parents’ modular nursing care education, as a noninvasive treatment, reasonably improved auricle morphological malformation, and patients’ guardians satisfaction with few complications, which is worthy of a wildly clinical promotion.

Conhecimento dos discentes de enfermagem sobre cuidados paliativos

Objetivo: identificar o conhecimento dos discentes de Enfermagem sobre cuidados paliativos. Métodos: Trata-se de uma pesquisa qualitativa descritiva e exploratória que foi realizado em uma Instituição de Ensino Privada de Teresina-PI, com 23 acadêmicos do 9º período de Enfermagem. A coleta de dados foi realizada por meio de entrevista semiestruturada e agrupados conforme a temática de Minayo, perfazendo três categorias. A pesquisa obedeceu à resolução 466/2012 e foi aprovada sob nº de parecer 1.968.914. Resultados: o conhecimento sobre Cuidados Paliativos ainda é um pouco fragmentado e empírico, construído pela pouca prática cotidiana que tiveram. Porém, isso não os impediu de pensarem sobre as ações que poderiam ser paliativas e sobre a importância da família nestes cuidados. Conclusão: é necessário que haja um maior número de projetos e ações dispostos a espalhar conhecimento sobre esse tema, bem como, a importância de adicionar esse tema na grade curricular dos alunos da área da saúde, em especial o de Enfermagem.

Association between nursing care delivery models and patients' health outcomes in a university hospital: A retrospective cohort study based on the Diagnostic Procedure Combination database.

This study aims to examine the association between nursing delivery models (fixed-team nursing model and Partnership Nursing System® [PNS®]) and patients' health outcomes (30-day in-hospital mortality and functional decline, indicated by a decline in Barthel Index or in-hospital mortality). This study used a retrospective cohort design based on the data from the Diagnostic Procedure Combination database, which included routinely collected health data for Japanese administrative claims. Participants were inpatients aged 20-99 years admitted between July 2010 and August 2012 (fixed-team nursing period) and July 2014 and August 2017 (PNS® period) to an academic teaching hospital in Japan. Odds ratios and 95% confidence intervals were estimated using multivariable logistic models. We included 24,108 and 23,872 patients for the analyses of 30-day in-hospital mortality and functional decline, respectively (median age: 62 years; 52% women). The 30-day mortalities in both fixed-team nursing and PNS® groups were 0.5%. There was no significant association between the nursing delivery models and 30-day in-hospital mortality (adjusted odds ratio = 1.15, 95% confidence interval = 0.78-1.70). However, the PNS® group was found to have a higher proportion of patients with functional decline (2.7%) than the fixed-team nursing group (2.2%; p = .030). The adjusted odds ratio of declined function in the PNS® group, compared to the fixed-team nursing group, was 1.40 (95% confidence interval = 1.17-1.68, p < .001). Further studies are needed to examine how the PNS® model influences patient outcomes, especially nurse-sensitive patient outcomes.