ABSTRACT
INTRODUCTION: The prevalence of atopic diseases remains high. Initial studies suggest that primary prevention with regular basic care may influence the incidence of atopic dermatitis in infants; however, data are unclear. Midwives play an important role in the care of women in the peripartum period and therefore also in providing advice on topics such as skin care, breastfeeding and nutrition of the newborn and young infant. The aim of this study was to determine the care recommendations for newborns by midwives. METHODS: We conducted a cross-sectional survey among German midwives using questionnaires on the topic of newborn skin care. RESULTS: A total of 128 questionnaires were analyzed. The most common recommendations were oil-based herbal topicals (34.9%) and plain water (34.0%). Approximately 70% of midwives reported recommending various options when there was a known family history of atopic diathesis. It was remarkable that most of the midwives' recommendations were identical regardless of the presence of an atopic diathesis. Essential care products are only used "when necessary". CONCLUSION: Training programs for midwives on the topic of "care and strengthening of the skin barrier", taking into account the current guidelines for allergy prevention, should be implemented.
ABSTRACT
Nursing organizations are expected to make contributions to innovation in Healthcare. However, they are often not innovation ready. How do nursing organizations know how Innovation Ready they are? What should nursing organizations do to become more Innovation Ready? In literature, there exists no consolidated resource to help nursing organizations to answer these questions. Therefore, this research aimed to support nurse-led innovation by developing an Innovation Readiness Inventory to be used as an assessment tool to qualitatively assess the innovation readiness of nursing organizations and support decision-making on actions to be implemented towards innovation readiness. The researchers performed a literature review to provide the theoretical basis for the assessment tool. Thereafter, the researchers engaged innovation experts and end-users in the form of nurse directors and managers, and frontline nurses. The researchers conducted semi-structured interviews, surveys, and design workshops and performed directed qualitative content analysis where relevant. Throughout, emphasis was placed on the scientific rigor of the research methodology with the intent to ensure the "trustworthiness" of the outcomes. To this end, the researchers implemented published best practices, when relevant and appropriate. As contribution to the discussion around nurse-led innovation, this research delivers the innovation readiness inventory that focusses the discussion on nursing organizations and the nurses within, and discusses challenges and opportunities related to the use thereof.
ABSTRACT
Delirium is a common complication seen after surgery and anesthesia, in particular in older patients. Although the etiology of postoperative delirium is only incompletely understood, various lines of evidence suggest that proinflammatory signaling from the peripheral site of inflammation to central nervous system results in a decrease of cerebral acetylcholine (ACh) levels thereby inducing neuroinflammation. To corroborate this theory, we applied an animal model for characterization of the neuroinflammatory response after partial hepatectomy (HPx). In this model, the surgery-induced decrease in cerebral ACh levels can be prevented by intraoperative application of physostigmine. Thus, ACh-associated changes in the expression and secretion of inflammation-related compounds can be assessed by comparing the results obtained after surgery, in physostigmine-treated and untreated controls. This way we were able to show that the decrease of cerebral ACh triggers increased secretion of IL-1ß, IL-6, TNFα, MIP-2 (CCL3), RANTES, MCP1, IFNgamma, and IP-10. A gene array covering the expression of 370 inflammation-related genes indicated 13 candidates that are induced upon cerebral ACh decrease after HPx. Quantification of the changes in the expression of these candidates by the comparative CT method revealed a significant increase (> 1.5-fold) in the expression of IL-1ß, IL-6, TNFα, MIP2, RANTES, MCP1, TLR2, TLR4, HMGB1, TNFSF6, TNFSF12, IL1R1 and ILR6. Thus, our results suggest that peripheral surgery induces a reduction of cerebral ACh levels which trigger a complex neuroinflammatory response. From a clinical point of view, manipulating cerebral ACh levels by procholinergic drugs such as physostigmine could become an option to therapeutically target this kind of neuroinflammation.
