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Cole Hooper posted an update 6 months, 3 weeks ago
We performed a single-center teaching intervention with nursing providers on nasogastric tube (NG tube) clinical practice. The initial purpose of this study was the validation of whether the training was sufficient enough to be retained at a later time point.
We performed a prospective pre-post study examining participants’ knowledge before, immediately after, and 4weeks after training in NG tube management. selleck products Training was delivered in face-to-face classroom sessions. Knowledge was assessed using a multiple-choice test (pretest, posttest #1and #2).
A total of 137 nursing providers participated in the training intervention. Immediately after training (posttest #1) and again 4weeks later (posttest #2), participants overwhelmingly recalled and retained the knowledge of NG tube management as compared to pretest results. Paired
-tests showed each participant increased their test score from pretest to posttest #1,
(134) = 12.64,
= .0001. Similarly, participants who took posttest #2 significantly improved their scores from the pretest to posttest #2,
(71) = 10.629,
< .0001. Secondary analysis showed that the NG tube management comfort level and age of provider were not significant in predicting test results. However, years of professional experience and frequency of NG tube care were significant predictors for higher test scores.
To minimize the risk of NG tubes for patients, it is critical to follow clinical guidelines. This study shows that teaching interventions for providers to increase knowledge on NG tubes are beneficial. In addition, the knowledge is retained at later time points.
To minimize the risk of NG tubes for patients, it is critical to follow clinical guidelines. This study shows that teaching interventions for providers to increase knowledge on NG tubes are beneficial. In addition, the knowledge is retained at later time points.Modern global surgery, which aims to provide improved and equitable surgical care worldwide, is a product of centuries of international care initiatives, some borne out of religious traditions, dating back to the first millennium. The first hospitals (xenodochia) were established in the 4th and 5th centuries CE by the early Christian church. Early “missions,” a term introduced by Jesuit Christians in the 16th century to refer to the institutionalized expansion of faith, included medical care. Formalized Muslim humanitarian medical care was marked by organizations like the Aga Khan Foundation and the Islamic Association of North America in the 20th century. Secular medical humanitarian programs developed in the 19th century, notably with the creation of the International Committee of the Red Cross (1863) and the League of Nations Health Organization (1920) (which later became the World Health Organization ). World War II catalyzed another proliferation of nongovernmental organizations, epitomized by the quintessential humanitarian health provider, Médecins Sans Frontières (1971). “Global health” as an academic endeavor encompassing education, service, and research began as an outgrowth of departments of tropical medicine and international health. The American College of Surgeons brought a surgical focus to global health beginning in the 1980s. Providing medical care in distant countries has a long tradition that parallels broad themes in history faith, imperialism, humanitarianism, education, and service. Surgery as a focus of academic global health is a recent development that continues to gain traction.While there is a growing body of research examining resilient development in adolescents with a history of maltreatment, it remains unclear whether youth resilient functioning changes over time and what factors predict such change. The current study aimed to identify the socio-ecological predictors of the change in resilient functioning over time among adolescents with a history of maltreatment. Multinomial logistic regression analyses were conducted with a sample of 771 adolescents drawn from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Over 18 months, 23.2% of the adolescents remained in the less resilience group, 45.4% stayed in the greater resilience group, 17.4% moved from the greater resilience group to the less resilience group, and 14.0% moved from the less resilience group to the greater resilience group. Younger age, better parent-child relationship quality, and neighborhood safety were associated with stable and continued resilient functioning over time. Conversely, child physical abuse, affiliation with deviant peers, and receipt of behavioral services were negatively associated with continued resilience. Our findings suggest that interventions that support adolescents in building positive relationships with their parents and peers may prevent a loss of resilience over time and ensure continued resilient functioning in child welfare-involved adolescents.The liver is one of the most commonly injured solid organs in blunt abdominal trauma. Non-operative management is considered to be the gold standard for the care of most blunt liver injuries. Angioembolization has emerged as an important adjunct that is vital to the success of the non-operative management strategy for blunt hepatic injuries. This procedure, however, is fraught with some possible serious complications. The success, as well as rate of complications of this procedure, is determined by degree and type of injury, hepatic anatomy and physiology, and embolization strategy among other factors. In this review, we discuss these important considerations to help shed further light on the contribution and impact of angioembolization with regards to complex hepatic injuries.
With advances in multimodal therapy, survival rates in gastric cancer have significantly improved over the last two decades. Neoadjuvant therapy increases the likelihood of achieving negative margins and may even lead to pathologic complete response (pCR). However, the impact of pCR on survival in gastric cancer has been poorly described. We analyzed the rate and predictors of pCR in patients receiving neoadjuvant therapy as well as impact of pCR on survival.
We conducted a National Cancer Database (NCDB) analysis (2004-2016) of patients with gastric adenocarcinoma who received neoadjuvant chemotherapy followed by surgical resection.
The pCR rate was 2.2%. Following adjustment, only neoadjuvant chemoradiation, non-signet histology, and tumor grade remained as significant factors predicting pCR. pCR was a statistically significant predictor of survival.
In this NCDB study, pCR was a predictor of survival. Though chemoradiation rather than chemotherapy alone was a predictor of pCR, it was not a predictor of survival.
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