Articles: human.
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Dimens Crit Care Nurs · Jul 2014
Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study.
Preparation for replacing the large proportion of staff nurses reaching retirement age in the next few decades in the United States is essential to continue delivering high-quality nursing care and improving patient outcomes. Retaining experienced critical care nurses is imperative to successfully implementing the orientation of new inexperienced critical care nurses. It is important to understand factors that affect work engagement to develop strategies that enhance nurse retention and improve the quality of patient care. ⋯ Moral distress scales were elevated, whereas work engagement scales were low. This finding was congruent with Lawrence's study and may reflect ongoing need for greater supports for experienced intensive care unit nurses, from both education and management. Future recommendations for research include examining the interaction of these variables in larger samples to examine additional explanatory factors as well as strategies for self-care, motivation, and behavior change.
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Probiotics may improve intestinal health by modulating intestinal microbiota. However, the age-related variation in response to probiotic consumption is understudied. The aim of this study was to determine the effect of oral consumption of Lactobacillus plantarum P-8 (Lp-8) on human intestinal microflora, secretary immunoglobulin A (SIgA), total bile acids (TBAs), and short-chain fatty acids (SCFAs) of different aged adults. ⋯ Lp-8 administration could improve human gastrointestinal health. However, some of these effects were transient and gradually disappeared once the intervention was discontinued. Moreover, the extent of these desirable effects was age-related.
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Mild traumatic brain injury (mTBI) is a common neurological disorder. Whether oral anticoagulation (OAC) use is a risk factor for secondary deterioration in mTBI patients after a normal computed tomography (CT) scan is unclear. Therefore data were retrospectively collected on patients with mTBI who used OAC to determine the incidence of secondary clinical deterioration after an initial normal head CT scan. ⋯ A low risk of secondary deterioration within 24 h in mTBI patients taking OAC with a normal first head CT scan was found. Our study does not support the recommendation of the current guidelines that these patients should be clinically observed for at least 24 h. The fact that in our series the majority of secondary deteriorations occurred between 2 and 28 days after trauma underscores the importance of patient instructions upon discharge from the hospital.
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Prehospital spine immobilization has long been applied to victims of trauma in the United States and up to 5 million patients per year are immobilized mostly with a cervical collar and a backboard. ⋯ The implementation of a SMR training program significantly decreases the use of backboards and allows alternative methods of maintaining spine precautions.
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The purpose of this study was to assess blood flow responses to changes in carbon dioxide (CO2) in the internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) during normothermic and hyperthermic conditions. Eleven healthy subjects aged 22 ± 2 (SD) yr were exposed to passive whole body heating followed by spontaneous hypocapnic and hypercapnic challenges in normothermic and hyperthermic conditions. Right ICA, ECA, and VA blood flows, as well as left middle cerebral artery (MCA) mean blood velocity (Vmean), were measured. ⋯ Heat stress did not alter CO2 reactivity in the MCA and VA. However, CO2 reactivity in the ICA was decreased (3.04 ± 1.17 vs. 2.23 ± 1.03%/mmHg; P = 0.039) but that in the ECA was enhanced (0.45 ± 0.47 vs. 0.95 ± 0.61%/mmHg; P = 0.032). These results indicate that hyperthermia is capable of altering dynamic cerebral blood flow regulation.