Implementing early feeding after liver transplant using implementation frameworks: A multimethod study.

Background: Evidence-based guidelines (EBGs) in the nutrition management of advanced liver disease and enhanced recovery after surgery recommendations state that normal diet should recommence 12-24 h following liver transplantation. This study aimed to compare postoperative nutrition practices to guideline recommendations, explore clinician perceptions regarding feeding after transplant surgery, and implement and evaluate strategies to improve postoperative nutrition practices.

Methods: A pre-post multimethod implementation study was undertaken, guided by the knowledge-to-action framework.

A stepwise approach to integrating the new essentials into a master's entry nursing curriculum.

The American Association of Colleges of Nursing (AACN) released updated nursing curriculum Essentials in 2021. The new Essentials document reflects an innovative and unique approach to nursing education and provides a framework for competency-based education and assessment to prepare students to work in a profession that is ever-changing. The first in the state of Oregon, a Masters Entry into Professional Nursing program was launched with a curriculum based on the new Essentials with the goal to remain true to the program's current concept-based approach while incorporating elements of a competency-based curriculum.

An assessment of facility readiness for comprehensive abortion care in 12 districts of Pakistan using the WHO Service Availability and Readiness Assessment tool.

Although Pakistan's Essential Package of Health Services was recently updated to include therapeutic and post-abortion care, little is known about current health facility readiness for these services. This study assessed the availability of comprehensive abortion care, and readiness of health facilities to deliver these services, within the public sector in 12 districts of Pakistan. A facility inventory was completed in 2020-2021 using the WHO Service Availability and Readiness Assessment, with a newly developed abortion module.

The Effect of Diet and Exercise Interventions on Body Composition in Liver Cirrhosis: A Systematic Review.

Alterations in body composition, in particular sarcopenia and sarcopenic obesity, are complications of liver cirrhosis associated with adverse outcomes. This systematic review aimed to evaluate the effect of diet and/or exercise interventions on body composition (muscle or fat) in adults with cirrhosis. Five databases were searched from inception to November 2021.

Telehealth-delivered, Cardioprotective Diet and Exercise Program for Liver Transplant Recipients: A Randomized Feasibility Study.

Unlabelled: Rapid excess weight gain and metabolic complications contribute to poor outcomes following liver transplant care. Providing specialist lifestyle intervention with equitable access is a challenge for posttransplant service delivery.

Methods: This study investigated the feasibility of a 12-wk telehealth delivered lifestyle intervention for liver transplant recipients (randomized controlled trial with a delayed intervention control group).

The inter- and intrarater reliability and feasibility of dietetic assessment of sarcopenia and frailty in potential liver transplant recipients: A mixed-methods study.

Sarcopenia and frailty are associated with poorer outcomes in potential liver transplant (LT) recipients. We examined the reliability and feasibility of dietitians assessing sarcopenia and frailty. Seventy-five adults referred for LT underwent assessments of muscle mass (abdominal CTs), physical function (handgrip strength; HGS, short physical performance battery; SPPB), and frailty (Liver Frailty Index; LFI).

Unique Issues of DNP Students: A Content Analysis.

Aim: The purpose of this study was to explore, analyze, and describe nursing doctoral students' perceptions of factors that impacted them during their doctoral program.

Background: There are two major pathways for nurses to earn a doctoral degree, the most recent of which is the doctor of nursing practice (DNP) degree. Enrollment in and graduates from nursing DNP programs have increased dramatically over the last decade.

Can community health workers play a greater role in increasing access to medical abortion services? A qualitative study.

Background: Despite being legally available in India since 1971, barriers to safe and legal abortion remain, and unsafe and/or illegal abortion continues to be a problem. Community health workers have been involved in improving access to health information and care for maternal and child health in resource poor settings, but their role in facilitating accurate information about and access to safe abortion has been relatively unexplored. A qualitative study was conducted in Rajasthan, India to study acceptability, perspectives and preferences of women and community health workers, regarding the involvement of community health workers in medical abortion referrals.

Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends.

Background: Information about the incidence of induced abortion is needed to motivate and inform efforts to help women avoid unintended pregnancies and to monitor progress toward that end. We estimate subregional, regional, and global levels and trends in abortion incidence for 1990 to 2014, and abortion rates in subgroups of women. We use the results to estimate the proportion of pregnancies that end in abortion and examine whether abortion rates vary in countries grouped by the legal status of abortion.

Accuracy of Assessment of Eligibility for Early Medical Abortion by Community Health Workers in Ethiopia, India and South Africa.

Objective: To assess the accuracy of assessment of eligibility for early medical abortion by community health workers using a simple checklist toolkit.

Design: Diagnostic accuracy study.

Setting: Ethiopia, India and South Africa.

Costs of postabortion care in public sector health facilities in Malawi: a cross-sectional survey.

Background: Health systems could obtain substantial cost savings by providing safe abortion care rather than providing expensive treatment for complications of unsafely performed abortions. This study estimates current health system costs of treating unsafe abortion complications and compares these findings with newly-projected costs for providing safe abortion in Malawi.

Methods: We conducted in-depth surveys of medications, supplies, and time spent by clinical personnel dedicated to postabortion care (PAC) for three treatment categories (simple, severe non-surgical, and severe surgical complications) and three uterine evacuation (UE) procedure types (manual vacuum aspiration (MVA), dilation and curettage (D&C) and misoprostol-alone) at 15 purposively-selected public health facilities.

ACCEPTABILITY OF THE INVOLVEMENT OF HEALTH EXTENSION WORKERS (HEWS) IN MEDICAL ABORTION (MA): THE PERSPECTIVES OF CLIENTS, SERVICE PROVIDERS AND TRAINED HEWS IN EAST SHOA AND ARSI ZONES, OROMIYA REGION, ETHIOPIA.

Background: Unsafe abortion remains a significant contributor of maternal morbidity and mortality in Ethiopia and other developing countries. Involvement of community based health workers, health extension workers (HEWs) in Ethiopia, is a vital step in increasing access and utilization of medical abortion and related services. In order to engage HEWs, it is important to understand the attitude of women and service providers.

Strengthening health systems capacity to monitor and evaluate programmes targeted at reducing abortion-related maternal mortality in Jessore district, Bangladesh.

Background: Abortion related deaths as a proportion of maternal mortality appears to have fallen dramatically in Bangladesh from 5 % in 2001 to 1 % in 2010. Yet complications from menstrual regulation (MR) and unsafe abortion continue to cause deleterious health, economic and social consequences for women in the country.

Methods: This quasi experimental design study with a baseline (January to December 2008) and an endline survey (August to October 2009) was conducted in 69 public, private, and NGO sector health facilities in Jessore district of Bangladesh with the objective of adapting and implementing a set of process indicators, specifically to supplement the indicators for monitoring emergency obstetric care interventions.

Measuring abortion-related mortality: challenges and opportunities.

Two recent efforts to quantify the causes of maternal deaths on a global scale generated divergent estimates of abortion-related mortality. Such discrepancies in estimates of abortion-related mortality present an important opportunity to explore unique challenges and opportunities associated with the generation and interpretation of abortion-related mortality estimates. While innovations in primary data collection and estimation methodologies are much needed, at the very least, studies that seek to measure maternal deaths due to abortion should endeavor to improve transparency, acknowledge limitations of data, and contextualize results.

Acceptability and feasibility of mifepristone-misoprostol for menstrual regulation in Bangladesh.

Context: Annually, more than 700,000 women turn to menstrual regulation, or uterine evacuation with vacuum aspiration; many more resort to unsafe abortion. Using pills for the evacuation of the uterus could increase women's access to safe menstrual regulation services and reduce the high levels of abortion- and menstrual regulation- related morbidity in Bangladesh.

Methods: At 10 facilities in Bangladesh, 651 consenting women who were seeking menstrual regulation services and who were 63 days or less past their last menstrual period received 200 mg of mifepristone followed 24 hours later by 800 mcg of buccal misoprostol, administered either at home or in the clinic.

Quality and efficiency of care for complications of unsafe abortion: a case study from Bangladesh.

Treating complications of unsafe abortion can be financially draining for health systems. This analysis assessed incremental health system costs of service delivery for abortion-related complications in the Bangladesh public health system and confirmed that providing postabortion care with vacuum aspiration is less expensive than using dilation and curettage (D&C). Implementing several evidence-based best practices, such as replacing D&C with vacuum aspiration, reducing use of high-level sedation, authorizing midlevel providers to offer postabortion care, and providing postabortion contraceptive counseling and services to women while still at the health facility, could increase the quality and cost efficiency of postabortion care in Bangladesh.

Public hospital costs of treatment of abortion complications in Nigeria.

Unsafe abortion is a significant contributor to maternal mortality in Nigeria, and treatment of postabortion complications drains public healthcare resources. Provider estimates of medications, supplies, and staff time spent in 17 public hospitals were used to estimate the per-case and annual costs of postabortion care (PAC) provision in Ogun and Lagos states and the Federal Capital Territory. PAC with treatment of moderate complications (US $112) cost 60% more per case than simple PAC (US $70).

Health system costs of menstrual regulation and care for abortion complications in Bangladesh.

Context: Treatment of complications of unsafe abortion can be a significant financial drain on health system resources, particularly in developing countries. In Bangladesh, menstrual regulation is provided by the government as a backup to contraception. The comparison of economic costs of providing menstrual regulation care with those of providing treatment of abortion complications has implications for policy in Bangladesh and internationally.

The group-lending model and social closure: microcredit, exclusion, and health in Bangladesh.

According to social exclusion theory, health risks are positively associated with involuntary social, economic, political and cultural exclusion from society. In this paper, a social exclusion framework has been used, and available literature on microcredit in Bangladesh has been reviewed to explore the available evidence on associations among microcredit, exclusion, and health outcomes. The paper addresses the question of whether participation in group-lending reduces health inequities through promoting social inclusion.