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Determination of functional prognosis in hospitalized patients following an intensive care admission

World Journal of Critical care Medicine 2016年第4期5卷 219-227页

作者： Natália A Ferreira Agnaldo José Lopes Arthur S Ferreira George Ntoumenopoulos Jerffesson Dias Fernando S Guimaraes Rehabilitation Sciences Post-Gradua-tion Program Augusto Motta University Centre Physical Therapy Department Barra D’Or Hospital Post-Graduation Program in Medical Sciences State University of Rio de Janeiro Graduate School of Health Sciences University of Technology Sydney Physical Therapy Department Federal University of Rio de Janeiro

AIM To investigate the factors associated with the functional progress of hospitalized patients following an intensive care *** Retrospective study including data from a cohort of 198 hospitalized patients following an intensive care admission and not requiring mechanical ventilation in a single tertiary referral hospital. A generalized linear model was used to identify the main effects of clinical and demographic variables on the outcomes of functionality(KATZ Index of Independence in Activities of Daily Living) and muscle strength(MRC Scale). The covariates identified as independent predictors were analysed using the receiver operating characteristic curves. The analysis differentiated the periods in the intensive care unit(ICU), in the Ward(WARD) and the total time of hospital stay(TOT).RESULTS Considering the functional outcome(ΔKATZ), the variables that significantly contributed to the model(P < 0.05) were the KATZ and MRC on admission, age, sepsis(no), and total length of stay(TLS). Regarding the muscle strength outcome model(ΔMRC), the predictors were MRC on admission, Simplified Acute Physiology Score III, previous stroke, TLS, and sex(female). The variable age(AUC = 0.664) discriminated the ΔKATZICU. The variables age(AUC = 0.712), KATZ in ICU(AUC = 0.590) and on ward admission(AUC = 0.746), and MRC on ward admission(AUC = 0.721) were discriminative for ΔKATZWARD. For ΔKATZTOT the variables KATZ on ICU admission(AUC = 0.621) and TLS(AUC = 0.617) were discriminative. For ΔMRCICU the variables SAPSIII(AUC = 0.661) and MRC on ICU admission(AUC = 0.653) were discriminative. MRC on ICU(AUC = 0.681) and ward admission(AUC = 0.553) were discriminative for ΔMRCWARD. TLS(AUC = 0.649) and MRC on ward admission(AUC = 0.696) discriminative for the Δ*** Specific functional, clinical and demographical variables at ICU admission are associated with the functional prognosis during the hospitalization period.

关键词： Muscle strength intensive care units Activities of daily living Rehabilitation Early mobilization Post-intensive care unit syndrome

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Incidence, risk factors, and cumulative risk of delirium among ICU patients: A case-control study

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International Journal of Nursing Sciences 2019年第3期6卷 247-251页

作者： Yanbin Pan Jianlong Yan Zhixia Jiang Jianying Luo Jingjing Zhang Kaihan Yang Huadu District People's Hospital Southern Medical University Guangzhou China Zunyi Medical University Zunyi China Affiliated Hospital of Zunyi Medical University Zunyi China

Objectives: Delirium is a common acute cognitive impairment syndrome among intensive care unit (ICU) *** study was aimed to investigate the incidence,risk factors,and cumulative risk of delirium among ICU ***: A case-control study including clinical records of 452 patients were retrospectively *** was assessed using the Confusion Assessment Method for the ICU and Richmond Agitation -Sedation ***: We found that 163 out of the 452 patients (36.1%) had *** analysis showed that use of sedatives,length of ICU hospitalization,and physical restraint were independent risk factors for *** additive effect of all three factors resulted to an odds ratio of ***: The incidence of delirium remained ***,nurses shall strengthen the monitoring of delirium,regularly access the patient's level of calmness,and limit the use of physical restraint.

关键词： Delirium intensive care units Risk factors Cumulative risk Case-control studies

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Chinese expert recommendations on ketogenic diet therapy for super-refractory status epilepticus

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Acta Epileptologica 2022年第1期5卷 5-15页

作者： Xin Tong Qianyun Cai Dezhi Cao Lifei Yu Dan Sun Guang Yang Jiwen Wang Hua Li Zengning Li Juan Wang Shaoping Huang Meiping Ding Fang Fang Qun Wang Rong Luo Jianxiang Liao Jiong Qin Department of Pediatrics West China Second University HospitalSichuan UniversityChengdu 610041China Department of Neurology Shenzhen Children's HospitalShenzhen 518035China Department of Neurology Children’s Hospital of Fudan UniversityShanghai 200032China Department of Neurology Wuhan Children's HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430015China Department of Pediatrics The First Medical CenterChinese PLA General HospitalBeijing 100036China Department of Neurology Shanghai Children's Medical CenterShanghai Jiaotong University School of MedicineShanghai 200127China Epilepsy Center Guangdong 999 Brain HospitalGuangzhou 510510China Department of Nutrition The First Hospital of Hebei Medical UniversityShijiazhuang 050000China Department of Neurology Children's Hospital of Chongqing Medical UniversityChongqing 401122China Department of Pediatrics The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi'an 710004China Department of Neurology Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310009China Depart-ment of Neurology Beijing Children’s HospitalCapital Medical UniversityBeijing 100045China Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China Department of Pediatrics Peking University People's HospitalBeijing 100044China

Super-refractory status epilepticus(SRSE)is a serious and life-threatening neurological *** diet(KD)is a diet characterized by high fat,low carbohydrate,and moderate *** KD shows effectiveness in controlling seizures in more than half of SRSE patients,it can be a treatment option for ***,KD treatment for SRSE is based on personal experience and observational evidence has been *** the context of a lack of a validated guideline,we convened a multicenter expert panel within the China Association Against Epilepsy(CAAE)Ketogenic Diet Commission to work out the Chinese expert recommendations on KD for *** summarize and discuss the latest clinical practice of KD for SRSE in critical care *** are given on patient selection,the timing of KD,diet implementation,and *** research data are needed in this area to support better clinical practice.

关键词： Super-refractory status epilepticus Ketogenic diet intensive care units Consensus China

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intensive care unit adaptations in the COVID-19 pandemic:Lessons learned

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World Journal of Virology 2022年第6期11卷 394-398页

作者： Anwar Khedr David Rokser Jeanine Borge Hannah Rushing Greta Zoesch Wade Johnson Han-Yin Wang April Lanz Brian N Bartlett Jessica Poehler Salim Surani Syed A Khan Department of Medicine BronxCare Health SystemBronxNY 10457United States Department of Critical care Medicine Mayo Health SystemMankatoMN 56001United States Department of Critical care Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Administration Mayo Clinic Health SystemMankatoMN 56001United States Hospital Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Emergency Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine Texas A&M UniversityHealth Science CenterCollege StationTX 77843United States

The coronavirus disease 2019 pandemic had deleterious effects on the healthcare systems around the *** increase intensive care units(ICUs)bed capacities,multiple adaptations had to be made to increase surge *** this editorial,we demonstrate the changes made by an ICU of a midwest community hospital in the United *** changes included moving patients that used to be managed in the ICU to progressive care units,such as patients requiring noninvasive ventilation and high flow nasal cannula,ST-elevation myocardial infarction patients,and post-neurosurgery ***,newer tactics were applied to the processes of assessing oxygen supply and demand,patient care rounds,and post-ICU monitoring.

关键词： COVID-19 Pandemics Oxygen intensive care units ST elevation myocardial infarction Nasal cannula

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Physical fitness level and the risk of severe COVID-19:A systematic review

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Sports Medicine and Health Science 2023年第3期5卷 174-180页

作者： Fortunato JoséCardoso David Romeiro Victor JoséRoberto da Silva Angélica C.Guimarãaes Carla Adriane Leal Michelle Ribeiro Taveira João Guilherme Alves Departament of Hepatology Instituto de Medicina Integral Prof.Fernando Figueira(IMIP)RecifePernambucoBrazil Graduate Unit Universidade de Pernambuco(UPE)RecifePernambucoBrazil Department of Pediatrics Hospital Dom MalanPetrolinaPernambucoBrazil

To verify systematically the association between the status of physical fitness and the risk of severe Coronavirus disease 2019(COVID-19).This systematic review is in accordance with the Preferred Reporting Items for Systematic Review and Meta Analyses(PRISMA)statement and the eligibility criteria followed the Population,Intervention,Comparison,Outcomes and Study(PICOS)***,Embase,SciELO and Cochrane electronic databases were *** studies that explored the relationship between the pattern of physical fitness and COVID-19 adverse outcomes(hospitalization,intensive care unit admission,intubation,or mortality),were *** quality of the studies was assessed by the specific scale of the Newcastle-Ottawa Scale.A total of seven observational studies were identified in this systematic review;13468 patients were included in one case-control study,two cohort studies,and four cross-sectional *** studies reported an inverse association between high physical fitness and severe COVID-19(hospitalization,intensive care admission,or mortality).Only some studies reported comorbidities,especially obesity and cardiovascular disorders,but the results remained unchanged after controlling for *** quality of the seven studies included was moderate according to the Newcastle-Ottawa Quality Assessment *** methodological heterogeneity of the studies included did not allow a meta-analysis of the *** conclusion,higher physical fitness levels were associated with lower risk of hospitalization,intensive care admissions,and mortality rates among patients with COVID-19.

关键词： Physical fitness COVID-19 Hospitalization intensive care units Mortality

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Importance of recognizing and managing delirium in intensive care unit

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Chinese Journal of Traumatology 2009年第6期12卷 370-374页

作者：谢郭豪方向明 Department of Anesthesiology First Affiliated HospitalCollege of Medicine Zhejiang Univesity Hangzhou310003 China

Delirium is an acute and fluctuating change in mental status, with inattention and altered levels of consciousness. It is a common comorbidity in intensive care units （ICU）, resulting in delayed withdrawal of mechanical ventilation, prolonged length of stay in ICU, increased ICU mortality and impaired long-term cognitive function of the survivors. Narcotic or psychoactive medication is one of the major risk factors that contribute to ICU delirium. Surveys conducted in several countries indicated that delirium in ICU was inad- equately monitored, underdiagnosed and lacked standardized treatment. In order to improve the prevention and treatment of ICU delirium, it is imperative that the ICU professionals should enrich their knowledge about this comorbidity, familiarize themselves with its screening and management, as well as standardize the administration of narcotic and psychoactive medications.

关键词： intensive care units Critical care Delirium

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The development and implementation of a model to facilitate self-care of the professional nurses caring for critically ill patients

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International Journal of Nursing Sciences 2022年第1期9卷 26-35,I0002页

作者： Mpho G Chipu Charlene Downing Department of Nursing Faculty of Health SciencesUniversity of JohannesburgDoornfontein CampusJohannesburgSouth Africa

Objectives This article aimed to describe the development,implementation,and evaluation of the model’s effectiveness to facilitate self-care of professional nurses caring for critically ill patients in *** The methods of Chinn and Kramer,Walker and Avant were utilized to generate this *** study included four steps to develop,implement and evaluate the model:Step 1-concept analysis;Step 2-placing the concept in relationship statements;Step 3-description and evaluation of the model;and Step 4-implementation and evaluation of the *** implementation and evaluation of the model included two phases:a one-day workshop to present the model,and three months of model *** study was conducted in a specific tertiary hospital in Gauteng Province,South ***-five participants were identified amongst the five ICUs,and only eight participants accepted the *** of the eight participants,only six professional nurses working in different ICUs in the public sector were *** The model was divided into three stages:relationship,working,and termination;it comprised the primary and secondary contexts in which the facilitation of self-care *** model process occurred in a spiral *** registered nurses benefitted holistically from the three presenters at the workshop,and the social worker contributed to their emotional self-care *** themes emerged:The model brought positive experiences,change,and self-awareness;the model benefitted the registered nurses holistically;role modeling self-care practices motivated and benefitted *** The model implementation assisted the registered nurses’in developing self-awareness and *** gained more knowledge regarding self-care,and the model encouraged them to implement improved self-care *** became role models of self-care and motivated their friends and families.

关键词： intensive care units Nurses Self-care Self-management

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Clinical leadership behaviors among critical care nurses in private and governmental hospital:A cross-sectional survey

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International Journal of Nursing Sciences 2022年第3期9卷 357-363,I0004页

作者： Heba Mohamed Al Anwer Ashour Maram Ahmed Banakhar Naglaa Abd Elaziz Elseesy Nursing Administration Department Faculty of NursingAlexandria UniversityAlexandriaEgypt Department of Public Health Nursing Faculty of NursingKing Abdulaziz UniversityJeddahSaudi Arabia

Objectives This study aimed to investigate clinical leadership behaviors among critical care nurses and compare the differences between nurses in private and public *** A cross-sectional survey including 365 critical care nurses with a bachelor’s degree in nursing science were recruited in two Egyptian hospitals(a government teaching hospital and one private hospital from January to March 2019.A socio-demographic characteristics form and the Clinical Leadership Behaviors Questionnaire(CLB-Q)were used to collect *** comparison and analysis,the mean score was calculated and converted to a percentage *** Results showed that the overall mean score of nurses’clinical leadership behaviors was 77.11±11.87,the level was higher,and the highest score of the communication dimension was 91.84±*** mean score of nurses at a private hospital(90.48±5.53)was higher than that at a government teaching hospital(68.29±4.21)(Pcare nurses to practice clinical excellence and encouraging their attendance in training programs on quality and *** in government hospitals need improvement in clinical leadership behaviors regarding all dimensions.

关键词： Behavior Cross-sectional studies intensive care units Leadership Nurses

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Effects of white noise on procedural pain-related cortical response and pain score in neonates:A randomized controlled trial

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International Journal of Nursing Sciences 2022年第3期9卷 269-277,I0001页

作者： Xuyan Ren Li Li Siya Lin Chunxia Zhong Bin Wang Clinical Nursing Education&Research Section Zhujiang HospitalSouthern Medical UniversityGuangzhouChina School of Nursing Southern Medical UniversityGuangzhouChina Department of Pediatrics Zhujiang HospitalSouthern Medical UniversityGuangzhouChina

Objectives To evaluate the effects of white noise on pain-related cortical response,pain score,and behavioral and physiological parameters in neonates with procedural *** A double-blind,randomized controlled trial was ***-six neonates from the Neonatal intensive care Unit in a university-affiliated general hospital were randomly assigned to listen to white noise at 50 dB(experimental group)or 0 dB(control group)2 min before radial artery blood sampling and continued until 5 min after needle ***-related cortical response was measured by regional cerebral oxygen saturation(rScO_(2))monitored with near-infrared spectroscopy,and facial expressions and physiological parameters were recorded by two video *** assessors scored the Premature Infant Pain Profile-Revised(PIPP-R)independently when viewing the *** outcomes were pain score and rScO_(2)during arterial puncture and 5 min after needle *** outcomes were pulse oximetric oxygen saturation(SpO_(2))and heart rate(HR)during arterial puncture,and duration of painful *** study was registered at the Chinese Clinical Trial Registry(ChiCTR2200055571).Results Sixty neonates(experimental group,n=29;control group,n=31)were included in the final *** maximum PIPP-R score in the experimental and control groups was 12.00(9.50,13.00),12.50(10.50,13.75),respectively(median difference−0.5,95%CI−2.0 to 0.5),and minimum rScO_(2)was(61.22±3.07)%,(61.32±2.79)%,respectively(mean difference−0.325,95%CI−1.382 to 0.732),without significant *** arterial puncture,the mean rScO_(2),HR,and SpO_(2)did not differ between *** needle withdrawal,the trends for rScO_(2),PIPP-R score,and facial expression returning to baseline were different between the two groups without statistical *** The white noise intervention did not show beneficial effects on pain-related cortical response as well as pain score,behavioral and physio

关键词： Facial expression intensive care units Neonates Procedural pain Premature infant pain profile-revised Radial artery Regional cerebral oxygen saturation White noise

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Role of social distancing in tackling COVID-19 during the first wave of pandemic in Nordic region:Evidence from daily deaths,infections and needed hospital resources

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International Journal of Nursing Sciences 2021年第2期8卷 145-151,I0001页

作者： Arshia Amiri Department of Nursing Science University of TurkuTurkuFinland School of Health and Social Studies JAMK University of Applied SciencesJyvaskylaFinland

Objectives:To measure the effect of social distancing on reducing daily deaths,infections and hospital resources needed for coronavirus disease 2019(COVID-19)patients during the first wave of the pandemic in Nordic ***:The observations of social distancing,daily deaths,infections along with the needed hospital resources for COVID-19 patient hospitalizations including the numbers of all hospital beds,beds needed in ICUs and infection wards,nursing staffs needed in ICUs and infection wards were collected from the Institute for Health Metrics and Evaluation(IHME)by the University of *** observations of social distancing were based on the reduction in human contact relative to background levels for each location quantified by cell phone mobility data collected from *** weighted data per 100,000 population gathered in a 40-day period of the first wave of the pandemic in Denmark,Finland,Iceland,Norway and *** technique of panel data analysis is used to measure the associations between social distancing and COVID-19 indicators in ***:Results of dynamic long-run models confirm that a 1%rise in social distancing by reducing human contacts may decline daily deaths,daily infections,all hospital beds needed,beds/nurses needed in ICUs and beds/nurses needed in infection wards due COVID-19 pandemic by 1.13%,15.26%,1.10%,1.17%and 1.89%,***,results of error correction models verify that if the equilibriums between these series are disrupted by a sudden change in social distancing,the lengths of restoring back to equilibrium are 67,62,40,22 and 49 days for daily deaths,daily infections,all hospital beds needed,nurses/beds needed in ICUs and nurses/beds needed in infection wards,***:Proper social distancing was a successful policy for tackling COVID-19 with falling mortality and infection rates as well as the needed hospital resources for patient hospitalizations in Nordic *** re

关键词： COVID-19 intensive care units Health resources Hospitalization Mortality Nursing staff Pandemics Physical distancing

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