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Hamilton, New Zealand

Tokem Y.,Izmir Katip Celebi University | Ozcelik H.,Nigde University | Cicik A.,Newborn Intensive Care Unit
Cancer Nursing | Year: 2015

Background: Family caregivers who provide care for cancer patients may have to cope with a variety of physical, social, and economic problems during the caregiving process. A sense of hopelessness seems to lead to increasingly negative evaluations of new situations and less effective coping strategies. Objective: The objective of the study was to examine the relationship between hopelessness and the coping strategies of the family caregivers of oncology patients. Methods: This cross-sectional, descriptive correlational design study was carried out in the adult oncology unit and outpatient radiation oncology units of a university hospital in Turkey. The research sample was composed of 110 family caregivers. A sociodemographic data form, the Coping Stress Strategies Scale, and the Beck Hopelessness Scale were used in face-to-face interviews. Results: Significant correlations were found between hopelessness and coping strategies. There was a positive correlation between hopelessness and the helpless approaches, which constitute a part of the emotion-focused coping strategies (r = 0.254, P <.01). There was a negative correlation between hopelessness and problem-focused coping strategies (optimistic approach and seeking social support) (r =-0.484, P <.01; r =-0.190, P <.05). Conclusion: In our study, we found that when the hopes of family caregivers are raised, they may adopt a more optimistic approach, and seek more social support, and display more effective coping strategies. Implications for Practice: This study could be used to help develop nursing interventions and efficient coping strategies. It suggests how oncology nurses may support family caregivers to increase their level of hope. © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

Beker F.,Neonatal Intensive and Special Care | Beker F.,Newborn Intensive Care Unit | Rogerson S.R.,Neonatal Intensive and Special Care | Hooper S.B.,Monash Institute of Medical Research | And 2 more authors.
Journal of Pediatrics | Year: 2014

Objective To assess the effects of different nasal continuous positive airway pressure (nCPAP) pressures on cardiac performance in preterm infants with minimal lung disease, we conducted a randomized, blinded crossover study. Study design We studied infants between 28 and 34 weeks' corrected gestational age, treated with nCPAP of 5 cm H2O, in air. Infants with significant cardiac shunts were excluded. Infants were randomly assigned to nCPAP levels of 4, 6, and 8 cm H2O for 15 minutes each. Right and left ventricular outputs and left pulmonary artery and superior vena cava flows were measured 15 minutes after each change. Results Thirty-four infants born at a mean gestational age of 29 weeks with a birth weight of 1.3 kg were studied. There were no significant differences in right and left ventricular outputs and left pulmonary artery and superior vena cava flows at different levels of nCPAP. Conclusion We investigated the effect of increasing nCPAP levels on cardiac output. We conclude that nCPAP levels between 4 and 8 cm H2O did not have an effect on cardiac output in stable preterm infants with minimal lung disease. © 2014 Mosby Inc. All rights reserved. Source

Harrington D.J.,Nutristasis Unit | Clarke P.,Norwich University | Card D.J.,Nutristasis Unit | Mitchell S.J.,Newborn Intensive Care Unit | Shearer M.J.,Nutristasis Unit
Pediatric Research | Year: 2010

Little is known about the metabolic turnover and excretion of vitamin K in healthy newborn infants and the metabolic consequences of prophylactic regimens designed to protect against vitamin K deficiency bleeding (VKDB). We measured the excretion of two urinary metabolites (≤24 h) of vitamin K (5C- and 7C-aglycones) in term infants before (n = 11) and after (n = 5) a 1000 μg i.m. dose of vitamin K1 (K1) and in preterm infants after 200 μg i.m. (n = 4), 500 μg i.m. (n = 4), or 200 μg i.v. (n = 5). In preterm infants, we also measured serum K1, vitamin K1 2,3-epoxide, and PIVKA-II at 5 d postpartum. Before prophylaxis, the rate of 5C- and 7C-aglycone excretion was 25 times lower than adults, reflecting low vitamin K stores at birth. After prophylaxis, the excretion rate correlated to K1 dose (r = 0.6) but was two orders of magnitude lower than that in adults, probably reflecting the immaturity of neonatal catabolism. All term and 10 of 13 preterm infants mainly excreted 5C-aglycone. We present evidence that increased excretion of the 7C-aglycone was associated with metabolic overload because of the exposure to high-tissue K1 concentrations. Measurement of the 5C- and 7C-aglycones may facilitate longitudinal studies of vitamin K status in neonates and aid the development of improved prophylactic regimens. © 2010 International Pediatric Research Foundation, Inc. Source

Powers R.J.,Newborn Intensive Care Unit | Wirtschafter D.W.,View Inc
Clinics in Perinatology | Year: 2010

Central Line Associated Bloodstream Infections (CLABSIs) have come to be recognized as preventable adverse events that result from lapses in technique at multiple levels of care. CLABSIs are associated with increased mortality and adverse outcomes that may have lifelong consequences. This review provides a summary of evidence-based strategies to reduce CLABSI in the newborn intensive care unit that have been described in the literature over the past decades. Implementation of these strategies in " bundles" is also discussed, citing examples of successful quality improvement collaboratives. The methods of implementation require an understanding of the scientific data and technical developments, as well as knowledge of how to influence change within the unique and complicated milieu of the newborn intensive care unit. © 2010 Elsevier Inc. Source

Visscher M.,Cincinnati Childrens Hospital Medical Center | Visscher M.,University of Cincinnati | Taylor T.,Newborn Intensive Care Unit
Scientific Reports | Year: 2014

Pressure ulcers (PU) are serious, reportable events causing pain, infection and prolonged hospitalization, particularly among critically ill patients. The literature on PUs in neonates is limited. The objective was to determine the etiology, severity and influence of gestational age on PUs among hospitalized infants. A two-year prospective study was conducted among 741 neonatal intensive care patients over 31,643 patient-days. Risk factors were determined by comparing the characteristics of infants who developed PUs with those who did not. There were 1.5 PUs per 1000 patient days with 1.0 PU per 1000 days in premature infants and 2.7 per 1000 days in term infants. The number of PUs associated with devices was nearly 80% overall and over 90% in premature infants. Infants with PUs had longer hospitalizations and weighed more than those who did not. Infants with device-related PUs were younger, of lower gestational age and developed the PU earlier than patients with PUs due to conventional pressure. The time to PU development was longer in prematurely born versus term infants. Hospitalized neonates are susceptible to device-related injury and the rate of stage II injury is high. Strategies for early detection and mitigation of device-related injury are essential to prevent PUs. © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

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