RESUMEN
Introduction Head and neck cancer (HNC) is the seventh leading cause of cancer worldwide. Approximately 35%-60% patients with HNC are malnourished from the disease onset, malnutrition being associated with worsened health outcomes among these patients. This study aimed to review and synthesize existing guidelines regarding nutritional interventions in HNC patients and assess providers' knowledge, opinions, and practice of guidelines for the nutritional management of HNC patients. Methods This is a multimethod study that includes a systematic review of guidelines for nutritional intervention in HNC patients and a providers' survey regarding their knowledge and opinions regarding nutrition therapy guidelines for HNC patients. Results Our review yielded seven guidelines. Of the seven guidelines reviewed, all were specific to cancer patients, however, only three were specific for HNC patients. Three of the guidelines recommended using a nutritional screening tool, however, only two mentioned a specific screening tool. Out of 193 surveys included in our analysis, the highest percentage of respondents were physicians (52.4%), followed by registered nurses (33.5%). The majority of respondent (77.5%) worked in a hospital-based practice, while 18.8% worked in clinic-based practice. A large proportion (46.6%) of respondents were not aware of nutritional guidelines for HNC patients; with 23.6% not aware of any, and 23.0% aware of their existence but not aware of their content. The majority (81.5%) of respondents said that a more detailed guideline should be available for HNC patient with regards to nutrition. Conclusion Nutritional deficiencies in HNC patients continue to cause significant complications in treatment and recovery. Existing practice guidelines are limited and lack specific recommendations. A universal standard of care with regard to addressing nutrition in HNC patients is needed to improve healthcare outcomes among NHC patients.
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We conducted a pilot project to evaluate the potential of Personal Digital Assistant (PDA) technologies to improve the oral health of people with mild to moderate intellectual disabilities, chronic health problems and a long-standing history of poor oral health self-care. Oral health video and audio materials were prepared and transferred to PDAs. Patients were trained in the use of the PDAs at a regular dental appointment and the utilization of the PDA and any change in oral health status was tracked over the next six months. More than half of the 36 patients reported problems in keeping the PDAs functioning properly (mainly problems of keeping the batteries charged) for the duration of the project and 11 patients dropped out of the study. Ten of the remainder (40%) achieved improvement in at least three areas of oral health. The pilot project potentially brings a range of health promotion activities within the reach of people with limited health literacy which may produce better self-management of chronic health conditions.
Asunto(s)
Computadoras de Mano/estadística & datos numéricos , Atención Dental para Enfermos Crónicos/métodos , Salud Bucal/normas , Personas con Discapacidades Mentales , Autocuidado/métodos , Telemedicina/métodos , Enfermedad Crónica , Humanos , Enfermedades de la Boca/prevención & control , Cooperación del Paciente , Educación del Paciente como Asunto , Proyectos PilotoRESUMEN
Christiana Care Visiting Nurse Association (VNA) developed a fall risk assessment using information obtained from the Outcomes and Assessment Information Set (OASIS) assessment. The fall risk assessment tool has been tested using a retrospective record review. A risk-specific intervention guide and postfall algorithm also are parts of the Fall Prevention Program. The Fall Prevention Program has improved patient safety and reduced emergent care related to injury from a fall.
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Accidentes por Caídas/prevención & control , Enfermería en Salud Comunitaria/organización & administración , Servicios de Atención de Salud a Domicilio/organización & administración , Evaluación en Enfermería/organización & administración , Medición de Riesgo/organización & administración , Accidentes por Caídas/estadística & datos numéricos , Anciano , Algoritmos , Atención Integral de Salud/organización & administración , Continuidad de la Atención al Paciente/organización & administración , Árboles de Decisión , Delaware , Femenino , Evaluación Geriátrica/métodos , Humanos , Tamizaje Masivo/organización & administración , Persona de Mediana Edad , Investigación en Evaluación de Enfermería , Evaluación de Resultado en la Atención de Salud , Planificación de Atención al Paciente/organización & administración , Evaluación de Programas y Proyectos de Salud , Derivación y Consulta/organización & administración , Estudios Retrospectivos , Gestión de la Calidad Total/organización & administraciónAsunto(s)
Enfermería Geriátrica , Personal de Enfermería en Hospital , Indicadores de Calidad de la Atención de Salud/organización & administración , Gestión de la Calidad Total/organización & administración , Accidentes por Caídas/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Anciano , Curriculum , Delaware , Utilización de Medicamentos , Educación Continua en Enfermería/organización & administración , Medicina Basada en la Evidencia , Evaluación Geriátrica , Enfermería Geriátrica/educación , Enfermería Geriátrica/organización & administración , Humanos , Capacitación en Servicio/organización & administración , Tiempo de Internación/estadística & datos numéricos , Sistemas Multiinstitucionales/organización & administración , Investigación en Educación de Enfermería , Investigación en Evaluación de Enfermería , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/organización & administración , Evaluación de Resultado en la Atención de Salud , Úlcera por Presión/epidemiología , Úlcera por Presión/prevención & control , Evaluación de Programas y Proyectos de Salud , Cateterismo Urinario/estadística & datos numéricos , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/prevención & controlRESUMEN
Down syndrome is one of the most frequently encountered and easily recognizable of all developmental disabilities. Patients with Down syndrome exhibit mental retardation and often present with associated medical conditions, such as cardiac defects, immune deficiencies and musculoskeletal disorders. It is important for the dental practitioner to be familiar with the medical aspects of Down syndrome, as well as the potential behavioral issues. We present a brief review of Down syndrome for the dental provider and suggest that with a little knowledge and some patience, most private practitioners can easily accommodate these patients in their practice.