Evaluating a brief intervention for mealtime difficulty on older adults with dementia.

AIMS AND OBJECTIVE: To test a spaced retrieval intervention using spaced retrieval to alleviate mealtime difficulties in older people with dementia. DESIGN: A single-case study design. SETTING: Nursing Homes in North Central England, United Kingdom. PARTICIPANTS: Older people with Alzheimer's disease. METHODS: A single-case study using an ABA design was used. Data were collected using the Edinburgh Feeding Evaluation in Dementia scale, Mini Nutritional Assessment, and Body Mass Index before intervention, postintervention and following 3 months of postintervention. Realist evaluation was used to identify for which participants the intervention was effective, and an economic evaluation was also carried out. FINDING: Of 15 participants who entered the study, eight completed all phases of the study. A mean 104.4 h were needed to deliver the intervention. The number of sessions required ranged from 90-222. The length of time each participant retained information (for all sessions) ranged from 13-28 min. Participants had most difficulty with: "putting food into mouth and chewing it"; "realizing it was mealtime"; and "eating a whole meal continuously." A reduction in the difficulty with mealtimes occurred between phase A1-A2 for most participants. Six participants maintained this in phase A3. Similar patterns were evident for nutritional scores. For most participants, the effect size of the intervention was moderate or large. CONCLUSIONS: Spaced retrieval is useful in reducing mealtime difficulties in older participants with dementia. While the results of this study are promising, further large and multicentre trials are needed to explore the effectiveness of the intervention in diverse populations.

Feto-Maternal Outcomes Of Maternal Sepsis: A Snapshot Of The Illness.

BACKGROUND: Maternal sepsis is a life-threatening condition with serious adverse feto-maternal outcomes. This descriptive cross-sectional study aimed to study the incidence of common feto-maternal outcomes of maternal sepsis in our hospital. METHODS: Pregnant females with singleton pregnancy as per inclusion/exclusion criteria were enrolled in the study. A detailed medical history was taken and physical and obstetrical examination was done. They were investigated for the cause of their febrile illness and managed as per department protocols. Data was recorded in a pre-designed pro forma. RESULTS: The most common cause of infection was UTI (32; 42.6%) followed by genital infections (20; 26.7%) and respiratory tract infections (15; 20%). In 8 (10.7%) patients, the cause couldn't be found. Only one patient developed sepsis and was admitted to the medical ICU. That pregnancy resulted in PROM and an infant with low birth weight was delivered. Both the mother and the child survived and were discharged from the hospital. There was no mortality in our study group. CONCLUSIONS: Though sepsis was associated with adverse feto-maternal outcomes in our study, the study design prevents us from drawing any conclusions from this study concerning maternal sepsis in our region. Further research is needed to determine the true magnitude of the problem.

Outcome Of B-Lynch Application In Patients With Post-Partum Hemorrhage Following Cesarean Section.

BACKGROUND: The most common cause of post partum hemorrhage after a cesarean section is uterine atony. Aims and Objective: The main aim of this study was to examine the outcomes of the B-Lynch procedure in patients who experienced primary PPH after cesarean section. METHODS: This study spanned one year, from August 2020 to August 2021, at Ayub Teaching Hospital. Patients who developed post-partum hemorrhage after a cesarean section were enrolled in this study and a thorough review of their records was conducted to identify those who received B-Lynch sutures and assess the resulting outcomes. RESULTS: Out of the 87 patients who experienced PPH, 24 (27.6%) patients received the B-Lynch procedure. Among these 24 patients, only two (8.3%) needed hysterectomy, while the remaining 22 successfully recovered after receiving the B-Lynch procedure. CONCLUSIONS: The B-Lynch technique proves to be a safe, effective, and easily applicable method for stopping hemorrhage in patients who experienced significant initial postpartum hemorrhage due to uterine atony.

Intimate partner violence screening in emergency department: a rapid review of the literature.

AIMS AND OBJECTIVES: The aim of the review was to identify intimate partner violence screening interventions used in emergency departments and to explore factors affecting intimate partner violence screening in emergency departments. BACKGROUND: Intimate partner violence against women is now clearly recognised as a global health and societal issue. Nurses working in emergency and urgent care settings can play a crucial role in identification, prevention and management of intimate partner violence. Research exploring optimal methods of intimate partner violence screening and factors affecting intimate partner violence screening in emergency departments are relatively limited. DESIGN: Literature review: Rapid Evidence Synthesis. METHODS: Literature published between 2000-2015 was reviewed using the principles of rapid evidence assessment. Six electronic databases: CINAHL, MEDLINE, EMBASE, Psych Info, the Cochrane Library and Joanna Briggs Library. RESULTS: Twenty-nine empirical studies meeting the eligibility criteria were independently assessed by two authors using appropriate Critical Appraisal Skills Programme Checklists. Intimate partner violence screening in emergency departments is usually performed using electronic, face to face or pen- and paper-based instruments. Routine or universal screening results in higher identification rates of intimate partner violence. Women who screen positive for intimate partner violence in emergency departments are more likely to experience abuse in subsequent months. Factors that facilitate partner violence screening can be classified as healthcare professionals related factors, organisational factors and patient-related factors. CONCLUSIONS: Emergency departments provide a unique opportunity for healthcare professionals to screen patients for intimate partner violence. Competence in assessing the needs of the patients appears to be a very significant factor that may affect rates of intimate partner violence disclosure. RELEVANCE TO CLINICAL PRACTICE: Knowledge of appropriate domestic violence screening methods and factors affecting intimate partner violence screening in emergency can help nurses, and other healthcare professionals provide patient-centred and effective care to victims of abuse attending emergency department.

A review of factors affecting patient satisfaction with nurse led triage in emergency departments.

AIM: To determine the factors that affect patient satisfaction with nurse-led-triage in EDs using a systematic review. BACKGROUND: Nurses' involvement in the triage services provided in the Emergency Department has been an integral part of practice for several decades in some countries. Although studies exploring patient satisfaction with nurse-led ED triage exist, no systematic review of this evidence is available. METHODS: MEDLINE, CINAHL, PsycInfo, EMBASE, the Cochrane Library, Joanna Briggs Library and Google Scholar were searched (January 1980-June 2013). RESULT: Eighteen studies that met the inclusion criteria were reviewed. Factors that affect patient satisfaction with nurse-led-triage include nurses' abilities to provide patient centred care, communication skills, nurses' caring abilities, concern for the patient and competence in diagnosing and treating the health problem. Other factors include availability and visibility of nurses, provision of appropriate health related information in a jargon-free language, nurses' ability to answer questions, and an ability to provide patients with an opportunity to ask questions. CONCLUSION: There is continued scope for nurse-led-triage services in the ED. Patients are generally satisfied with the service provided by nurses in EDs and report a willingness to see the same professional again in the future if needed.

5H-Thio-chromeno[2,3-b]pyridine-5,10,10-trione.

The asymmetric unit of the title compound, C(12)H(7)NO(3)S, contains two independent mol-ecules with different geometric-al configurations. The dihedral angles between the benzene and pyridine rings in the two mol-ecules are 3.7 (2) and 5.40 (19)°. The central heterocyclic fused rings have different puckering parameters [Q = 0.122 (3) Å, θ = 100.4 (13), ϕ = 185.3 (19)° in one mol-ecule, 0.101 (3) Å, 101.4 (3) and 2 (2)° in the other]. The SO(2) group is oriented at dihedral angles of 81.06 (14) and 82.58 (15)° with the benzene and pyridine rings, respectively, in one mol-ecule [87.21 (14) and 87.66 (14)° in the second]. In the crystal, the mol-ecules are linked into zigzag polymeric chains along the b axis by inter-molecular C-H⋯O hydrogen bonding. π-π inter-actions with centroid-centroid distances in the range 3.825 (3)-4.153 (3) Šstabilize the structure. S-O⋯π and C-O⋯π inter-actions are also observed.

2-(Phenyl-sulfan-yl)pyridine-3-carboxylic acid.

The title compound, C(12)H(9)NO(2)S, belongs to the nitro-gen-containing group of heterocyclic organic compounds and crystallized with two mol-ecules per asymmetric unit. In the crystal, both molecules form inversion dimers linked by pairs of O-H-O hydrogen bonds. Weak symmetry-related C-H-O inter-actions link the carboxyl dimers along b axis. The dihedral angle between the two aromatic rings in the two mol-ecules are 55.75 (14) and 58.33 (13)°.