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التوصل للرعاية الصحية بطريقة \ستيب\
يصف هذا الكتاب الاستراتيجات والتكتيكات العملية التي استخدمتها منظمة بايلور للرعاية الصحية \"مبرص\" للتشغيل العملياتي لتوصيل الرعاية الصحية بطريقة (ستيب) أي بأمان وفي الوقت المناسب وبفاعلية وكفاءة وبعدالة بحيث يكون مركزها هو المريض والتزمت منظومة (مبرص) بتوصيل رعاية صحية بجودة مرتفعة منذ تأسست المنظمة في 1903 باعتبارها المصحة التذكارية المعمدانية\" في تكساس.
Book
Assessing the Spiritual Needs of Long-Term Paediatric Patients and Identifying Chaplaincy Interventions Which Address Those Needs
In order to offer holistic, patient-centred care, attention needs to be paid to spiritual needs. For long-term paediatric patients, this need can be crucial as they may be facing a range of challenges, including life-limiting or life-changing illnesses. This article is based on two pieces of case study research. The first developed a phenomenological definition of spirituality drawing on both the literature and thirty-six case studies of oncology patients where interpretive spiritual encounters (ISEs) were used to identify spiritual needs. The spiritual needs identified were meaning-making, transcendence, connectedness, security, hope, and significance. A challenge for chaplains is then to identify interventions which can respond to the spiritual needs assessed; examples are offered demonstrating this. The second piece of case study research draws on existing taxonomy research in which thirteen paediatric case studies were analysed for practice-based methods of responding to spiritual needs. This offers the possibility of a common language to describe the chaplain’s response to identified spiritual needs, which informs the interventions chosen.
Journal Article
The Role of Food Antioxidants, Benefits of Functional Foods, and Influence of Feeding Habits on the Health of the Older Person: An Overview
This overview was directed towards understanding the relationship of brain functions with dietary choices mainly by older humans. This included food color, flavor, and aroma, as they relate to dietary sufficiency or the association of antioxidants with neurodegenerative diseases such as dementia and Alzheimer’s disease. Impairment of olfactory and gustatory function in relation to these diseases was also explored. The role of functional foods was considered as a potential treatment of dementia and Alzheimer’s disease through inhibition of acetylcholinesterase as well as similar treatments based on herbs, spices and antioxidants therein. The importance of antioxidants for maintaining the physiological functions of liver, kidney, digestive system, and prevention of cardiovascular diseases and cancer has also been highlighted. Detailed discussion was focused on health promotion of the older person through the frequency and patterns of dietary intake, and a human ecology framework to estimate adverse risk factors for health. Finally, the role of the food industry, mass media, and apps were explored for today’s new older person generation.
Journal Article
Prion Remains Infectious after Passage through Digestive System of American Crows (Corvus brachyrhynchos)
Avian scavengers, such as American crows (Corvus brachyrhynchos), have potential to translocate infectious agents (prions) of transmissible spongiform encephalopathy (TSE) diseases including chronic wasting disease, scrapie, and bovine spongiform encephalopathy. We inoculated mice with fecal extracts obtained from 20 American crows that were force-fed material infected with RML-strain scrapie prions. These mice all evinced severe neurological dysfunction 196–231 d postinoculation (= 198; 95% CI: 210–216) and tested positive for prion disease. Our results suggest a large proportion of crows that consume prion-positive tissue are capable of passing infectious prions in their feces (= 1.0; 95% CI: 0.8–1.0). Therefore, this common, migratory North American scavenger could play a role in the geographic spread of TSE diseases.
Journal Article
Possible new role for NF-κB in the resolution of inflammation
Inflammation involves the sequential activation of signaling pathways leading to the production of both pro- and anti-inflammatory mediators. Although much attention has focused on pro-inflammatory pathways that initiate inflammation, relatively little is known about the mechanisms that switch off inflammation and resolve the inflammatory response. The transcription factor NF-κB is thought to have a central role in the induction of pro-inflammatory gene expression and has attracted interest as a new target for the treatment of inflammatory disease. We show here that NF-κB activation in leukocytes recruited during the onset of inflammation is associated with pro-inflammatory gene expression, whereas such activation during the resolution of inflammation is associated with the expression of anti-inflammatory genes and the induction of apoptosis. Inhibition of NF-κB during the resolution of inflammation protracts the inflammatory response and prevents apoptosis. This suggests that NF-κB has an anti-inflammatory role
in vivo
involving the regulation of inflammatory resolution.
Journal Article
COX-1, COX-2, and COX-3 and the future treatment of chronic inflammatory disease
A new generation of non-steroidal anti-inflammatory drugs has been described that selectively targets the inducible isoform of cyclo-oxygenase, cyclo-oxygenase 2 (COX-2). This isoform is expressed at sites of inflammation, which has led to the speculation that its inhibition could provide all the benefits of current nonsteroidal anti-inflammatory drugs, but without their major side-effects on the gastrointestinal system (which are due to inhibition of COX-1). We have shown that COX-2 (identified by use of specific antibodies) is induced during the resolution of an inflammatory response, inhibition of COX-2 resulting in persistence of the inflammation due to the prevention of the synthesis of a range of anti-inflammatory prostanoids. We propose that there is a third isoform of this enzyme family, COX-3, a proposal that will have implication for the prescription of both existing and new generation anti-inflammatory drugs, and might represent a new therapeutic target.
Journal Article
Spiritual Care with Sick Children and Young People : A Handbook for Chaplains, Paediatric Health Professionals, Arts Therapists and Youth Workers
Exploring both principles and best practice of the spiritual care of sick children and young people, this remarkable and inspiring book equips the reader to think critically and creatively about how to provide care in hospitals, hospices and other care contexts for ill and disabled children. Written for staff from any allied health discipline, the authors explore the potential spiritual needs and issues faced by sick children and young people. They provide evidence-based practice principles, and a range of activity-based interactions that empower the child or young person and expand discussion of meaning and identity. The book includes stories and multidisciplinary practice examples, as well as many ideas; practical activities; discussion of work with families, and also of the various tensions and issues that can emerge. Based on evidence-based practice and research carried out by the Chaplaincy Team at Birmingham Children's Hospital, the book will be helpful and inspiring reading for chaplains, nurses, play and youth workers, therapists and anyone else involved in the care of sick children and young people.
eBook
Dichotomy in duration and severity of acute inflammatory responses in humans arising from differentially expressed proresolution pathways
Lipoxins (Lxs) and aspirin-triggered epi-Lxs (15-epi-LxA₄) act through the ALX/FPRL1 receptor to block leukocyte trafficking, dampen cytokine/chemokine synthesis, and enhance phagocytic clearance of apoptotic leukocytes--key requisites for inflammatory resolution. Although studies using primarily inbred rodents have highlighted resolution as an active event, little is known about the role resolution pathways play in controlling the duration/profile of inflammatory responses in humans. To examine this, we found two types of responders to cantharidin-induced skin blisters in male healthy volunteers: those with immediate leukocyte accumulation and cytokine/chemokine synthesis followed by early resolution and a second group whose inflammation increased gradually over time followed by delayed resolution. In early resolvers, blister 15-epi-LxA₄ and leukocyte ALX were low, but increased as inflammation abated. In contrast, in delayed resolvers, 15-epi-LxA₄ and ALX were high early in the response but waned as inflammation progressed. Elevating 15-epi-LxA₄ in early resolvers using aspirin increased blister leukocyte ALX but reduced cytokines/chemokines as well as polymorphonuclear leukocyte and macrophage numbers. These findings show that two phenotypes exist in humans with respect to inflammation severity/longevity controlled by proresolution mediators, namely 15-epi-LxA₄. These data have implications for understanding the etiology of chronic inflammation and future directions in antiinflammatory therapy.
Journal Article
Acetaminophen-Induced Hypothermia in Mice Is Mediated by a Prostaglandin Endoperoxide Synthase 1 Gene-Derived Protein
Acetaminophen is a widely used antipyretic analgesic, reducing fever caused by bacterial and viral infections and by clinical trauma such as cancer or stroke. In rare cases in humans, e.g., in febrile children or HIV or stroke patients, acetaminophen causes hypothermia while therapeutic blood levels of the drug are maintained. In C57/BL6 mice, acetaminophen caused hypothermia that was dose related and maximum (>2°C below normal) with a dose of 300 mg/kg. The reduction and recovery of body temperature was paralleled by a fall of >90% and a subsequent rise of prostaglandin ( PG) E2concentrations in the brain. In cyclooxygenase ( COX)-2-/-mice, acetaminophen (300 mg/kg) produced hypothermia accompanied by a reduction in brain PGE2levels, whereas in COX-1-/-mice, the hypothermia to this dose of acetaminophen was attenuated. The brains of COX-1-/-mice had ≈70% lower levels of PGE2than those of WT animals, and these levels were not reduced further by acetaminophen. The putative selective COX-3 inhibitors antipyrine and aminopyrine also reduced basal body temperature and brain PGE2levels in normal mice. We propose that acetaminophen is a selective inhibitor of a COX-1 variant and this enzyme is involved in the continual synthesis of PGE2that maintains a normal body temperature. Thus, acetaminophen reduces basal body temperature below normal in mice most likely by inhibiting COX-3.
Journal Article