Comprehensive assessment of pediatric acute and inpatient care at a tertiary referral hospital in Malawi: opportunities for quality improvement.

Background: Despite the reduction in global under-5 mortality over the last decade, childhood deaths remain high. To combat this, there has been a shift in focus from disease-specific interventions to use of healthcare data for resource allocation, evaluation of performance and impact, and accountability. This is a descriptive analysis of data derived from a prospective cohort study describing paediatric admissions to a tertiary referral hospital in Malawi for the purpose of process evaluation and quality improvement.

Examining trait-like factors as predictors of state-level responses to food intake in women with bulimia nervosa, purging disorder, and controls.

Objective: Theories suggest that elevated negative affect and weight/shape concerns explain both who is affected by bulimic symptoms as well as when bulimic symptoms occur, suggesting that individual differences predict within-subject differences. However, few studies have tested this theoretical premise.

Method: In the present study, participants (N = 119) diagnosed with bulimia nervosa (N = 57), purging disorder (N = 31), and non-eating disorder controls (N = 31) completed measures of negative affect and weight/shape concerns and later made momentary affect and weight/shape concerns ratings before and after an ad lib meal.

Mortality by Admission Diagnosis in Children 1-60 Months of Age Admitted to a Tertiary Care Government Hospital in Malawi.

Diagnosis-specific mortality is a measure of pediatric healthcare quality that has been incompletely studied in sub-Saharan African hospitals. Identifying the mortality rates of multiple conditions at the same hospital may allow leaders to better target areas for intervention. In this secondary analysis of routinely collected data, we investigated hospital mortality by admission diagnosis in children aged 1-60 months admitted to a tertiary care government referral hospital in Malawi between October 2017 and June 2020.

Prolylcarboxypeptidase Alleviates Hypertensive Cardiac Remodeling by Regulating Myocardial Tissue Angiotensin II.

Background Prolonged activation of angiotensin II is the main mediator that contributes to the development of heart diseases, so converting angiotensin II into angiotensin 1-7 has emerged as a new strategy to attenuate detrimental effects of angiotensin II. Prolylcarboxypeptidase is a lysosomal pro-X carboxypeptidase that is able to cleave angiotensin II at a preferential acidic pH optimum. However, insufficient attention has been given to the cardioprotective functions of prolylcarboxylpeptidase.

Evaluating the role of negative affect and negative interpretation biases in emotional eating behavior.

Objective: The study of emotional eating, or (over)eating in response to emotions, may inform transdiagnostic interventions for eating pathology. Prior work has focused on the role of negative affect in promoting emotional eating. The present study sought to extend this work through examining the role of cognitive biases.

Interventions to Eliminate Cervical Cancer in Nicaragua: An Integrative Review of the Literature.

Nicaragua has one of the highest cervical cancer death rates (19.4 per 100,000) compared to other Central American countries. This integrative review of the literature synthesizes cervical cancer prevention interventions in Nicaragua.

Relationship between distance of referring facilities and haemoglobin change in children in Malawi.

Background: Anaemia is a significant cause of mortality in children in sub-Saharan Africa where blood transfusion is often available only at referral hospitals. Understanding the pattern of referrals by health facilities is essential to identify the delays that affect child survival.

Aim: To determine if there was a correlation between change in haemoglobin (Hb) level and distance from referring facilities to Kamuzu Central Hospital (KCH) in Malawi, and whether distance affected mortality rates.

Tuberculosis in children with severe acute malnutrition.

Introduction: With growing attention globally to the childhood tuberculosis epidemic after decades of neglect, and with the burden of severe acute malnutrition (SAM) remaining unacceptably high worldwide, the collision of these two diseases is an important focus for improving child health.

Areas Covered: This review describes the clinical and public health implications of the interplay between tuberculosis and SAM, particularly for children under the age of five, and identifies priority areas for improved programmatic implementation and future research. We reviewed the literature on PubMed and other evidence known to the authors published until August 2021 relevant to this topic.

Effects of Clinical Nurse Educator Professional Role Development: An Evidence-Based Quality Improvement Project.

Centralization of clinical nurse educators (CNEs) from medical-surgical and critical care in a rural Midwestern hospital created role confusion and poor role outcomes. An evidence-based quality improvement project was developed to integrate the Association of Nursing Professional Development's transition to practice fellowship and practice model. Outcomes were focused on CNE self-assessed competency and three nurse-sensitive quality outcomes.

Chest radiography in children aged 2-59 months enrolled in the Innovative Treatments in Pneumonia (ITIP) project in Lilongwe Malawi: a secondary analysis.

Background: Pneumonia is the leading infectious cause of death in children aged under 5 years in low- and middle-income countries (LMICs). World Health Organization (WHO) pneumonia diagnosis guidelines rely on non-specific clinical features. We explore chest radiography (CXR) findings among select children in the Innovative Treatments in Pneumonia (ITIP) project in Malawi in relation to clinical outcomes.

Improving recognition and management of children with complicated severe acute malnutrition at a tertiary referral hospital in Malawi: a quality improvement initiative.

Background: Severe acute malnutrition (SAM) is common in low-income countries and is associated with high mortality in young children.

Objective: To improve recognition and management of SAM in a tertiary hospital in Malawi.

Methods: The impact of multifaceted quality improvement interventions in process measures pertaining to the identification and management of SAM was assessed.

How changing life roles predict eating disorder pathology over 30-year follow-up.

Epidemiological data support higher prevalence of eating disorders in midlife than previously believed. Yet, few studies have examined risk factors unique to adult development. The present study examined how changes in life roles (educational, marital, and parental status) predicted disordered eating as participants transitioned from their 20s to their 50s.

Blood transfusion and mortality in children with severe anaemia in a malaria-endemic region.

Background: In children in sub-Saharan Africa, severe anaemia (SA) is an important cause of mortality, and malaria is a primary cause. The World Health Organization (WHO) recommends blood transfusion for all children with haemoglobin (Hb) <4 g/dL and for those with Hb 4-6 g/dL with signs of instability. In sub-Saharan Africa, evidence of the effect on mortality of transfusion in children with SA with and without malaria is mixed.

Enduring value of perfectionism and maturity fears for predicting eating disorder maintenance over 10-, 20-, and 30-year follow-up.

Objective: The Eating Disorder Inventory provides a theoretically informed multidimensional assessment of eating disorder symptoms and associated psychological factors widely used to examine the development and maintenance of eating disorders. Yet, mixed findings for some factors raise questions about whether their prognostic value varies as a function of duration of follow-up or type of eating pathology studied.

Method: The current study compared prognostic value of perfectionism, maturity fears, and interpersonal distrust as predictors of restrictive versus bulimic symptom patterns at 10-, 20-, and 30-year follow-up in N = 127 individuals diagnosed with eating disorders at baseline.

Lessons learned from the development and implementation of an electronic paediatric emergency and acute care database in Lilongwe, Malawi.

As the field of global child health increasingly focuses on inpatient and emergency care, there is broad recognition of the need for comprehensive, accurate data to guide decision-making at both patient and system levels. Limited financial and human resources present barriers to reliable and detailed clinical documentation at hospitals in low-and-middle-income countries (LMICs). Kamuzu Central Hospital (KCH) is a tertiary referral hospital in Malawi where the paediatric ward admits up to 3000 children per month.

Persistent and emerging hazards contributing to work-related fatalities in Alaska.

Background: Workers in Alaska have an elevated risk of dying on the job compared to workers in the rest of the United States. The purpose of this study was to measure and describe the trend in fatalities during the 15-year period 2004 to 2018, and to identify lingering and emerging hazards that result in fatalities.

Methods: Data on fatal work-related injuries in Alaska during 2004 to 2018 were obtained from the Alaska Occupational Injury Surveillance System.

Risk factors for mortality and management of children with complicated severe acute malnutrition at a tertiary referral hospital in Malawi.

Background: Severe acute malnutrition (SAM) is a major cause of childhood mortality in resource-limited settings. The relationship between clinical factors and adherence to the 'WHO 10 Steps' and mortality in children with SAM is not fully understood.

Methods: Data from an ongoing prospective observational cohort study assessing admission characteristics, management patterns and clinical outcome in children aged 6-36 months admitted to a tertiary hospital in Malawi from September 2018 to September 2019 were analysed.

Nurse Case Manager: Measurement of Care Coordination Activities and Quality and Resource Use Outcomes When Caring for the Complex Patient With Hematologic Cancer.

Background: The lack of coordination of care for complex patients in the hematology setting has prompted nurse case managers (NCMs) to coordinate that care.

Objectives: This article aimed to identify the frequency of NCM care coordination activities and quality and resource use outcomes in the complex care of patients in the hematology setting.

Methods: NCM aggregate data from complex outpatients with hematologic cancer were retrieved from electronic health records at a comprehensive cancer center in the midwestern United States.

A Congregation Transition of Care Program Using Faith Community Nurses and Volunteer Faith-Based Nurses.

Transition of Care Models can reduce the 30-day hospital readmission rate up to 67% by offering coordination and continuity of care. The purpose of this project was to evaluate a Congregation Transition of Care (CTOC) program in faith-based communities with the use of a faith community nurse and volunteer faith-based registered nurses. Descriptive statistics were used to describe findings, revealing a CTOC program can be effective in reducing 30-day readmissions in the faith community.

Assessing Intercultural Development Pre- and Post Education Abroad.

Background: There is a need to identify objective measures for growth in the development of intercultural competence for students who engage in education abroad programs of study. The Intercultural Development Inventory® (IDI) identifies the participant's orientation on the Intercultural Development Continuum™ (IDC).

Method: Students completed the IDI 4 weeks prior to departure and 8 weeks upon completion of an education abroad program.

Youth Speak Out on School Food Environments.

In Philadelphia, over 40% of youth are overweight or obese. The objective in this assessment was to learn about urban residents' perspectives regarding the local food environment and its impact on eating behaviors. Using photo-elicitation, 20 adolescents reflected on their food environments through photographs and corresponding interviews.