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Status Assessment (status + assessment)
Selected AbstractsCurrent Technique of Fluid Status AssessmentCONGESTIVE HEART FAILURE, Issue 2010FACEP, W. Frank Peacock MD Congest Heart Fail. 2010;16(4)(suppl 1):S45,S51. ©2010 Wiley Periodicals, Inc. Early in the management of acute illness, it is critically important that volume status is accurately estimated. If inappropriate therapy is given because of errors in volume assessment, acute mortality rates are increased. Unfortunately, as the gold standard of radioisotopic volume measurement is costly and time-consuming, in the acute care environment clinicians are forced to rely on less accurate measures. In this manuscript, the authors review the currently available techniques of volume assessment for patients presenting with acute illness. In addition to discussing the accuracy of the history, physical examination, and radiography, acoustic cardiography and bedside ultrasonography are presented. [source] The Importance of Geriatric-Specific Instruments and Functional Status Assessment in Infectious Diseases Research: Time to Start Preaching to the Congregation Instead of the ChoirJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Kevin P. High MD No abstract is available for this article. [source] Dialysis adequacy and nutritional status of hemodialysis patientsHEMODIALYSIS INTERNATIONAL, Issue 1 2008Fernanda TEIXEIRA NUNES Abstract To characterize the nutritional status of renal failure patients and its relationship with hemodialysis adequacy measured by Kt/V, a study was carried out with a population of 44 adult patients with renal failure and mean age 51±15 years. Anthropometric data, such as dry weight, height, arm circumference, triceps skinfold thickness, mid-arm muscle circumference, and body mass index were assessed, and biochemical tests were conducted for urea, potassium, creatinine, serum albumin, and phosphorus levels, in addition to hemogram and quarterly urea reduction rate average (Kt/V). In order to evaluate calorie intake, a dietary questionnaire on habitual daily food ingestion was administered, taking into consideration the hemodialysis date. The patients were divided into 2 separate groups for the statistical analysis, with 50% of the patients in each group: A (Kt/V<1.2) and B (Kt/V>1.2). The data were tabulated as mean and standard deviation, with differences tested by Student's t test. The correlations between variables were established by the coefficient p of Pearson. Most of the patients (43%) were considered eutrophic, based on the BMI, and presented inadequate calorie intake, corresponding to 88.5±24% (30.8 kcal/kg actual weight) of the total energy required and adequate protein intake, reaching 109.9±40% of the recommended daily allowance (1.24 g/kg of actual weight). There was a correlation of Kt/V with anthropometric parameters such as body mass index, arm circumference, and mid-arm muscle circumference. The biochemical parameters related to dialysis adequacy were albumin, ferritin, and urea (predialysis). Well-dialyzed patients presented better levels of serum albumin. There was an influence of gender and age on correlations of the analyzed variables. Female and younger patients presented better dialysis adequacy. The dialysis adequacy was related to the nutritional status and influenced by the protein intake and body composition. Gender and age had an important influence in the dialysis adequacy, as men presented lower dialysis adequacy and younger adults presented better dialysis adequacy. Further research is necessary to understand better how to facilitate effective and efficient techniques for the nutritional status assessment of hemodialysis patients. [source] Improved preoperative iron status assessment by soluble transferrin receptor in elderly patients undergoing knee and hip replacementINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 6 2006M. BASORA Summary A poor preoperative haemoglobin (Hb) status is frequently encountered among adult patients scheduled for corrective surgery of the locomotive system, representing the main risk factor for blood transfusion. The soluble transferrin receptor (sTfR) has become a highly specific parameter for the detection of iron deficits as it can differentiate between iron deficiency anaemia and anaemia of chronic disease, because of the lack of effect by associated inflammation, unlike ferritin. The objectives of this study were to evaluate patients with the prevalence of risk for transfusion, the effect of inflammation on ferritin (F) values and functional iron deficiency in elderly patients with advanced degenerative arthropathy scheduled for hip or knee replacement. This observational, prospective study included patients over 50 years, operated for hip or knee replacements between April and June 2004. Of 218 patients studied, 87 (39%) presented with Hb levels between 10 and 13 g/dl. The prevalence of functional iron deficit was 27% (sTfR > 1.76 mg/l), while only 8.6% of patients displayed F levels below normal. As expected, C-reactive protein levels were elevated in 24.8% of patients and erythrocyte sedimentation rate was elevated in 50%. These inflammatory markers did not correlate with levels of either F or sTfR. Multiple factors can affect F levels, such as the inflammatory status of osteoarthritis in the elderly, obesity, nonsteroidal anti-inflammatory drugs therapy and low physical performance. As sTfR is not affected by inflammation, it has emerged as a primary parameter for the evaluation of iron status during preoperative assessment among patients scheduled for arthroplasty surgery. Our data strongly suggest that sTfR measurement contributes to improve patient management. [source] Outcome Predictors of Pneumonia in Elderly Patients: Importance of Functional AssessmentJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Olga H. Torres MD Objectives: To evaluate the outcome of elderly patients with community-acquired pneumonia (CAP) seen at an acute-care hospital, analyzing the importance of CAP severity, functional status, comorbidity, and frailty. Design: Prospective observational study. Setting: Emergency department and geriatric medical day hospital of a university teaching hospital. Participants: Ninety-nine patients aged 65 and older seen for CAP over a 6-month recruitment period. Measurements: Clinical data were used to calculate Pneumonia Severity Index (PSI), Barthel Index (BI), Charlson Comorbidity Index, and Hospital Admission Risk Profile (HARP). Patients were then assessed 15 days later to determine functional decline and 30 days and 18 months later for mortality and readmission. Multiple logistic regression was used to analyze outcomes. Results: Functional decline was observed in 23% of the 93 survivors. Within the 30-day period, case-fatality rate was 6% and readmission rate 11%; 18-month rates were 24% and 59%, respectively. Higher BI was a protective factor for 30-day and 18-month mortality (odds ratio (OR)=0.96, 95% confidence interval (CI)=0.94,0.98 and OR=0.97, 95% CI=0.95,0.99, respectively; P<.01), and PSI was the only predictor for functional decline (OR=1.03, 95% CI=1.01,1.05; P=.01). Indices did not predict readmission. Analyses were repeated for the 74 inpatients and indicated similar results except for 18-month mortality, which HARP predicted (OR=1.73; 95% CI=1.16,2.57; P<.01). Conclusion: Functional status was an independent predictor for short- and long-term mortality in hospitalized patients whereas CAP severity predicted functional decline. Severity indices for CAP should possibly thus be adjusted in the elderly population, taking functional status assessment into account. [source] Smoking Cessation Counseling for Pregnant Women Who Smoke: Scientific Basis for Practice for AWHONN's SUCCESS ProjectJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2004FAAN, Susan A. Albrecht PhD Objectives: To review the literature addressing smoking cessation in pregnant women. To develop the project protocol for the Association of Women's Health, Obstetric and Neonatal Nurse's (AWHONN) 6th research-based practice project titled "Setting Universal Cessation Counseling, Education and Screening Standards (SUCCESS): Nursing Care of Pregnant Women Who Smoke." To evaluate the potential of systematic integration of this protocol in primary care settings in which women seek care at the preconception, pregnant, or postpartum stages. Literature Sources: Computerized searches in MEDLINE and CINAHL, as well as references cited in articles reviewed. Key concepts in the searches included low-birth-weight infants and effects of prenatal smoking on the infant and the effects of preconception and prenatal smoking cessation intervention on premature labor and birth weight. Literature Selection: Comprehensive articles, reports, and guidelines relevant to key concepts and published after 1964 with an emphasis on new findings from 1996 through 2002. Ninety-eight citations were identified as useful to this review. Literature Synthesis: Tobacco use among pregnant women and children's exposure to tobacco use (secondhand smoke) are associated with pregnancy complications such as placental dysfunction (including previa or abruption), preterm labor, premature rupture of membranes, spontaneous abortions, and decreased birth weight and infant stature. Neonates and children who are exposed to secondhand smoke are at increased risk for developing otitis media, asthma, other respiratory disorders later in childhood; dying from sudden infant death syndrome; and learning disorders. The "5 A's" intervention and use of descriptive statements for smoking status assessment were synthesized into the SUCCESS project protocol for AWHONN's 6th research-based practice project. Conclusions: The literature review generated evidence that brief, office-based assessment, client-specific tobacco counseling, skill development, and support programs serve as an effective practice guideline for clinicians. Implementation and evaluation of the guideline is under way at a total of 13 sites in the United States and Canada. [source] Solving the barriers to diabetes education through the use of multimediaNURSING & HEALTH SCIENCES, Issue 1 2010Chartchalerm Isarankura-Na-Ayudhya phd Abstract Diabetes mellitus is a chronic disease that affects > 180 million people worldwide. It is persistent in Thai communities in spite of much effort in prevention and control. This study examined the knowledge capacity of villagers in the Klongmai community of Nakhon Pathom, Thailand, regarding diabetes by way of action research. A health status assessment and a survey of the community were carried out and used as the basis for designing an educational video on diabetes that is accessible regardless of age and educational background. Evaluations of the pre- and poststudy questionnaires were carried out using statistical analysis. The results indicated that the devised educational materials were effective in encouraging the community's self-awareness and perception of diabetes at the significance level of 0.05. Most importantly, the participants demonstrated proficiency in adapting the knowledge gained from the workshop to their own lifestyle. [source] The Need to Rationalize and Prioritize Threatening Processes Used to Determine Threat Status in the IUCN Red ListCONSERVATION BIOLOGY, Issue 6 2009MATT W. HAYWARD carnivora; competencia; estatus de conservación; procesos amenazantes Abstract:,Thorough evaluation has made the International Union for Conservation of Nature (IUCN) Red List the most widely used and accepted authority on the conservation status of biodiversity. Although the system used to determine risk of extinction is rigorously and objectively applied, the list of threatening processes affecting a species is far more subjectively determined and has not had adequate review. I reviewed the threats listed in the IUCN Red List for randomly selected groups within the three most threatened orders of mammals: Artiodactyla, Carnivora, and Primates. These groups are taxonomically related and often ecologically similar, so I expected they would suffer relatively similar threats. Hominoid primates and all other terrestrial fauna faced similar threats, except for bovine artiodactyls and large, predatory carnivores, which faced significantly different threats. Although the status of bovines and hominoids and the number of threats affecting them were correlated, this was not the case for large carnivores. Most notable, however, was the great variation in the threats affecting individual members of each group. For example, the endangered European bison (Bison bonasus) has no threatening processes listed for it, and the lion (Panthera leo) is the only large predator listed as threatened with extinction by civil war. Some threatening processes appear spurious for the conservation of the species, whereas other seemingly important factors are not recorded as threats. The subjective nature of listing threatening processes, via expert opinion, results in substantial biases that may be allayed by independent peer review, use of technical manuals, consensus among multiple assessors, incorporation of probability modeling via decision-tree analysis, and adequate coordination among evaluators. The primary focus should be on species-level threats rather than population-level threats because the IUCN Red List is a global assessment and smaller-scale threats are more appropriate for national status assessments. Until conservationists agree on the threats affecting species and their relative importance, conservation action and success will be hampered by scattering scarce resources too widely and often by implementing conflicting strategies. Resumen:,La evaluación exhaustiva ha hecho que la Lista Roja de la Unión Internacional para la Conservación de la Naturaleza (UICN) sea la autoridad más aceptada y ampliamente utilizada respecto al estatus de conservación de la biodiversidad. Aunque el sistema utilizado para determinar el riesgo de extinción es aplicado rigurosa y objetivamente, la lista de procesos amenazantes que afectan a las especies es determinado muy subjetivamente y no es revisado adecuadamente. Revisé las amenazas consideradas en la Lista Roja UICN para grupos seleccionados aleatoriamente en los tres órdenes de mamíferos más amenazados: Artyodactila, Carnivora y Primates. Estos grupos están relacionados taxonómicamente y a menudo son ecológicamente similares, así que esperaba que tuvieran amenazas relativamente similares. Los primates homínidos y toda la demás fauna terrestre enfrentan amenazas similares, excepto por los bovinos artiodáctilos y los carnívoros depredadores mayores, que enfrentan amenazas significativamente diferentes. Aunque el estatus de los bovinos y homínidos y el número de amenazas que los afectan estuvieron correlacionados, este no fue el caso para los carnívoros mayores. Sin embargo, lo más notable fue la gran variación en las amenazas que afectan a miembros individuales de cada grupo. Por ejemplo, no hay procesos amenazantes enlistados para el bisonte europeo (Bison bonasus), y el león (Panthera leo) es el único depredador mayor enlistado como amenazado de extinción por la guerra civil. Algunos procesos amenazantes parecen espurios para la conservación de las especies, mientras que otros factores aparentemente importantes no están registrados como amenazas. La naturaleza subjetiva de los procesos de enlistado, por medio de la opinión de expertos, resulta en sesgos sustanciales que pueden disiparse por la revisión independiente por pares, el uso de manuales técnicos, el consenso de múltiples asesores, la incorporación del modelado probabilístico mediante análisis de árboles de decisión y la adecuada coordinación entre evaluadores. El enfoque principal debería ser sobre amenazas a nivel de especies en lugar de amenazas a nivel de poblaciones porque la Lista Roja UICN es una evaluación global y las amenazas a menor escala son más apropiadas para evaluaciones nacionales de estatus. Hasta que los conservacionistas estén de acuerdo sobre las amenazas que afectan a las especies y su importancia relativa, las acciones de conservación y su éxito estarán obstaculizados por la dispersión demasiado amplia de recursos limitados y a menudo por la implementación de estrategias contrapuestas. [source] Age-based life history parameters and status assessments of by-catch species (Lethrinus borbonicus, Lethrinus microdon, Pomacanthus maculosus and Scolopsis taeniatus) in the southern Arabian GulfJOURNAL OF APPLIED ICHTHYOLOGY, Issue 3 2010E. Grandcourt Summary Life history and demographic parameters for Lethrinus borbonicus, Lethrinus microdon, Pomacanthus maculosus and Scolopsis taeniatus in the southern Arabian Gulf were estimated using a combination of size frequency, biological and size-at-age data. Defined structural increments consisting of alternating translucent and opaque bands in transverse sections of sagittal otoliths were validated as annuli. The maximum age estimates ranged from 5 years for Scolopsis taeniatus to 36 years for Pomacanthus maculosus. The size-at-age relationships were highly asymptotic in form with the majority of growth being achieved early in life. There were significant differences in the growth characteristics between sexes for Pomacanthus maculosus, with males approaching a larger asymptotic size at a faster rate than females. With the exception of Scolopsis taeniatus, the mean age at which fish became vulnerable to capture was lower than the mean age at first sexual maturity. The stocks of L. microdon, P. maculosus and S. taeniatus were exploited within sustainable limits, conversely, L. borbonicus was found to be overexploited and recruitment overfishing may have occurred as the relative spawner biomass per recruit was below 30% of the unexploited state. [source] | ||||||||||