Exploring the Efficacy of the Paula Method of Muscle Exercises in Managing Low Anterior Resection Syndrome Using an Integrative Approach: A Preliminary Study.

Background: Low anterior resection syndrome (LARS) is a post-proctectomy consequence characterized by variable and unpredictable bowel function, including clustering, urgency, and incontinence, which significantly impacts the quality of life. Currently, there is no established gold-standard therapy for LARS. Primary Study Objective: This study aimed to evaluate the effectiveness of the Paula method of exercise as part of an integrative treatment approach for patients with LARS. Design: This preliminary study utilized a single-arm pretest-posttest design. Setting: The study was conducted at a tertiary care medical center. Participants: Five patients diagnosed with LARS completed the study. Intervention: Participants underwent twelve weeks of individualized Paula method exercise sessions. Two questionnaires were employed to assess the severity of LARS and quality of life. Primary Outcome Measures: (1) Low Anterior Resection Syndrome (LARS) Score; (2) Memorial Sloan Kettering Cancer Bowel Function Instrument (MSK-BFI); (3) Global Quality-of-Life (QOLS) Score . Results: All participants completing the 12-week Paula exercise regimen reported no difficulty in engaging with the exercises. Statistically significant improvements were observed in both the LARS score and MSK-BFI (P = .039 and P = .043, respectively, Wilcoxon Rank Sum test). While there were improvements in the global quality-of-life score and functional scales of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, these improvements did not reach statistical significance. Conclusions: This preliminary study suggests that patients with LARS can successfully complete a 12-week exercise program using the Paula method, resulting in improved LARS scores. However, further investigation through larger, multicenter, randomized controlled trials is necessary to establish the efficacy of these exercises as a treatment for LARS.

Correlation between participation in a cardiac rehabilitation program and quality of life of patients with coronary artery disease.

PURPOSE: To examine the correlation between participation in a cardiac rehabilitation (CR) program and quality of life (QoL). DESIGN: A prospective study of patients with coronary artery disease (CAD). METHODS: Participants completed questionnaires before and after a 3-month CR program. Patients were surveyed using a cardiac history evaluation and the MacNew Heart Disease Health-Related QoL questionnaire. FINDINGS: Of those eligible, only 14% of the participants were women and 7% were of Arab ethnicity. Patients' QoL significantly improved following participation. Higher level of education was associated with improved QoL. Conversely, cardiac risk factor burden was associated with a decline in QoL. No association was found between cardiac risk stratification, age or religiosity and QoL. CONCLUSIONS: Improved QoL after CR program participation should raise awareness of the significant benefits of CR among healthcare professionals. CLINICAL RELEVANCE: CR for those patients with CAD should be implemented, with a focus on women and minorities.

Health promotion in Kenya: a volunteer nurse's experience.

This article presents a case study describing how nurses can improve the health behaviors of people living in developing countries. Difficulties and potential solutions are presented. Health promotion allows people to exert control over their health to improve it. A primary difficulty of health promotion in developing countries is communication between care providers and patients. One solution is the utilization of an interpreter; however, in the present study, no professional interpreters were available, thereby complicating the comprehension of new health-related concepts. Another challenge is to understand the patients' perspectives as related to healthcare values. Additionally, as a result of a dearth of evidence-based research in developing countries, difficulties arise in implementing, assessing, and evaluating health promotion programs. Despite these obstacles, nurses continue to travel to developing countries to promote health. Recommendations include respect for a community's health values and incorporation of these values into healthcare planning. To be accepted as a teacher by the local population, the nurse must be able to set aside his/her personal beliefs relating to healthcare, well-being, and disease. Health promotion initiatives should include the means for implementation, thereby enabling the local population to develop skills that will allow them to carry out health promotion projects.

[Different interventions during birth and delivery and their connection to pelvic floor damage].

Pelvic floor may be affected by birth and delivery since these are risk factors for muscles, connective tissue and nerve damage. Women with pelvic floor injuries may suffer in the long term from pelvic floor organs prolapse as well as from functional impairment such as urinary and fecal incontinence or other disturbances such as pain and sexual dysfunction. Several interventions have been conducted through birth and delivery by the midwifery team, in order to alleviate discomfort from the mother and to promote mother and infant wellness. Interventions pertaining to the mother's posture, mode of pushing or warm compresses can have an immediate affect and create complications at a later stage. This review aims to examine these interventions and possible pelvic floor damage, based on clinical trials. The authors assume that relying on evidence based practice during labour may promote women's health in both the short and long term.

Role of nurses in a university hospital during mass casualty events.

Mass casualty events due to terror attacks have escalated throughout Israel since September 2000, with a high proportion of these events occurring in the Jerusalem area. Immediately after news of a large-scale terror attack is received, family/public information centers are set up in all local hospitals to meet the needs of members of the public who call or arrive at hospitals anxious to obtain information about relatives who may have been at the site of the attack. The most urgent task facing these centers is the quick and accurate identification of victims whose identity is in question. To date, some 3000 casualties have been treated at Hadassah Hebrew University Medical Center (Hadassah), a level I trauma center. This number accounts for nearly half of Israel's total number of casualties from terror attacks during this period. Extensive experience has led the hospital to develop a unique organizational model for its family/public information center; in this model, members of the nursing staff identify casualties. The experience and knowledge gained in dealing with terror events also can be applied to other types of mass casualty events, such as major road or work accidents.