Lee Child Personal Epub 207 =LINK=
The main aim of this article is to describe current developmental care nursing practices among registered nurses (RNs) working in neonatal intensive care units (NICUs) in China and to explore selected personal and unit characteristics related to developmental care implementation. A convenience sample of 207 RNs participated in this descriptive, cross-sectional exploratory study. A tool of Practice Standards for Individualized, Family-Centered Developmental Care was used to collect the data. The findings indicate that Chinese NICU nurses are not implementing developmental care consistently. Higher patient caseloads, fewer work hours per day, higher level of education, and fewer years worked in NICUs are the significant predictors for lower implementation of developmental care. NICU nurses in China currently carry out developmental care based mainly on their accumulated clinical experience rather than their educational experience. More systematic developmental care training for NICU nurses and more support at both unit and hospital levels are necessary in China.
lee child personal epub 207
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Background: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.
Methods: We pooled 2416 population-based studies with measurements of height and weight on 1289 million participants aged 5 years and older, including 315 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).
Interpretation: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.
At every age studied, children were slower and less accurate on the congruent block than on the incongruent block. That effect is completely absent in adults, who are as fast and as accurate on the incongruent block as on the congruent one. The memory demands of those two blocks were the same; they differ only in that the incongruent block requires inhibitory control and the congruent block does not (based on Davidson et al. 2006; this is now called Hearts and Flowers.).
Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Layout table for eligibility information Ages Eligible for Study: 18 Years to 65 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria:
To be eligible for inclusion in the review, the articles had to a) be published in a peer-reviewed English journal; b) include children (4- to 19-year-olds) and/or related adults (e.g., parent, teacher) as participants; c) be about active commuting, e.g., walking, biking, skateboarding, not passive commuting; d) have school as the origin or destination of active commuting; e) present empirical studies; f) use ACS as the outcome variable; and g) investigate perceived barriers to ACS, rather than objective barriers only. Further, we focused only on studies that used quantitative measures to examine perceived barriers for the present review to facilitate the process of synthesizing and comparing. A separate systematic review is in progress to analyze the findings of the qualitative studies. The date of the last search was February, 2013, and we limited the search to all studies published before that date.
Regarding participants recruitment, 12 (30.8%) studies recruited parent/child pairs, and 27 (69.2%) recruited only children, parents, or other stakeholders. Two studies (5.1%) did not report any participant characteristics, and 11 studies (28.2%) did not present any information about the school characteristics. Among the studies that reported school characteristics, 26 had the participating schools at different locations, and two studies focused on a single school.
Our findings also highlighted the common use of the Social Ecological Models (SEM). All except two of the reviewed studies that identified a theoretical framework used SEM. Our result was in line with findings from previous reviews of physical activity research that SEM has been the most commonly adopted theoretical framework ,. SEM provides a comprehensive framework for understanding the multi-level determinants of health behaviors ,. Recently, researchers have used SEM to support a new emphasis on environmental causes of behaviors ,. While the consistent use of the SEM facilitated the process of synthesizing and comparing findings, the SEM lacks sufficient specificity regarding specific characteristics at each level. Consequently, other significant factors that may work with hypothesized factors at each level may be neglected. For example, perceived barriers as a personal level construct may be influenced by other social cognitive factors at the same level such as attitudes, self-efficacy, and intention; neglecting these constructs may result in an incomplete picture and consequently biased results. Unfortunately, these important social cognitive constructs were rarely investigated within the ACS context ; it might be time to put these factors back into equation.
Following rigorous assessment process, this systematic review has provided a detailed discussion of empirical, methodological, and theoretical issues in the current literature of active transport, in regard to perceptions of barriers preventing children from ACS. Based on our findings and in light of the limitations of this review, we have several empirical, methodological, and theoretical recommendations for advancing the quality of future studies on perceived barriers to ACS.
Cardiovascular magnetic resonance (CMR) has taken on an increasingly important role in the diagnostic evaluation and pre-procedural planning for patients with congenital heart disease. This article provides guidelines for the performance of CMR in children and adults with congenital heart disease. The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols. Variations in practice are highlighted and expert consensus recommendations are provided. Indications and appropriate use criteria for CMR examination are not specifically addressed.
Following safety screening, physiological monitoring devices and hearing protection (for both awake and sedated patients) are put in place. Young children dissipate body heat faster than adults; thus, patient temperature should be monitored and blankets applied as needed to minimize heat loss. A high-quality electrocardiogram (ECG) signal is essential for optimum data quality in cardiac-gated sequences. The adequacy of the signal should be checked not only at the onset when the patient is outside the scanner bore, but also once inside it and during actual scanning. In patients with dextrocardia, ECG leads are best placed on the right chest.
The consensus group authors recommend performance of the vasodilator perfusion acquisition first followed by the rest acquisition with at least 15 minutes between the two so as to minimize contamination of the rest images by residual contrast given during the vasodilator infusion. An adenosine dose of 0.14 mg/kg/min is typically used though the adequacy and safety of this dose has not been thoroughly established in the pediatric age group. After the adenosine has been infusing for 3 minutes, a GBCA (0.05-0.1 mmol/kg) is rapidly injected followed by a saline flush. In adult-size patients, rates of 5 ml/s with 25 ml of flush are recommended. In children, a minimum rate of 3 ml/s through an appropriate size intravenous line and 10 ml flush is suggested. The perfusion imaging sequence is started simultaneously with the contrast agent infusion, and its scanning duration should be set to acquire approximately 60 heartbeats. In order to minimize respiratory motion artifact, breathing should be suspended as long as possible during the image acquisition. If breath-holding is not possible, the patient should be instructed to breathe shallowly. Once the imaging is completed, the adenosine infusion is discontinued. Adenosine should be terminated earlier if the patient develops persistent or symptomatic heart block, significant hypotension, or severe respiratory difficulty. An intravenous dose of aminophylline can be used to rapidly counteract the effects of adenosine. The same contrast infusion protocol and pulse sequence parameters as used in the adenosine perfusion segment should be used later for the rest perfusion imaging.
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