A possible association between low-level lead exposure and elevated blood pressure has been recognized for some time. Such a connection is plausible in view of findings in animal studies that lead directly affects cardiaccontractility and excitability, alters the compliance of vascular smooth muscle, and acts on central nervous system areas involved in regulating blood pressure. Lead also might influence blood pressure through the renin-angiotensin syndrome. This study examined the relation between lead exposure and blood pressure in a population-based sample of 2165 perimenopausal and postmenopausal women who participated in the Third National Health and Nutrition Examination Survey (NHANES) from 1988 to 1994. Hypertension was defined as a systolic blood pressure of 140 mm Hg or higher, a diastolic pressure of at least 90 mm Hg, or current antihypertensive medication. Blood lead levels were estimated, by spectrophotometry. The overall mean blood lead level in women 40 to 59 years of age was 2.9 μg/dL. Women with higher levels tended to be older, to smoke and drink regularly, and to be poorer and less educated than the rest of the sample. Hypertension was found in 604 women. Blood lead levels correlated with systolic, but not with diastolic, blood pressure. In addition, there was a significant dose-response relationship, with the prevalence of hypertension ranging from 19% of women in the lowest quartile of blood level to 28% in the highest quartile. Multivariate analyses showed blood lead levels to be significantly related to both systolic and diastolic blood pressure. After adjusting for age, race/ethnicity, smoking, body mass index, alcohol intake, and kidney function, a difference in blood lead levels between the lowest and highest quartiles correlated with a difference of 1.7 mm Hg systolic and 1.4 mm Hg diastolic blood pressure. The relationship between lead levels and systolic hypertension was significant in postmenopausal women but not in the premenopausal group. Diastolic hypertension as well was most closely related to blood lead quartile in postmenopausal women. These findings suggest that small increments in blood lead levels above 1 μg/dL increase blood pressure in women. This level is well below that considered to be harmful to adults. Continued efforts are needed to limit lead exposure, especially in women.

Blood lead, blood pressure, and hypertension in perimenopausal and postmenopausal women

https://www.magonlinelibrary.com/doi/pdf/10.12968/jowc.2020.29.Sup2a.S1

Device-related pressure ulcers: SECURE prevention

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Medical Surgical Nursing Assessment And Management Of Clinical Problems

Diabetes mellitus is a serious, life-long condition that is the sixth leading cause of death in North America. Dermatologists frequently encounter patients with diabetes mellitus. Up to 25% of patients with diabetes mellitus will develop diabetic foot ulcers. Foot ulcer patients have an increased risk of amputation and increased mortality rate. The high-risk diabetic foot can be identified with a simplified screening, and subsequent foot ulcers can be prevented. Early recognition of the high-risk foot and timely treatment will save legs and improve patients' quality of life. Peripheral arterial disease, neuropathy, deformity, previous amputation, and infection are the main factors contributing to the development of diabetic foot ulcers. Early recognition of the high-risk foot is imperative to decrease the rates of mortality and morbidity. An interprofessional approach (ie, physicians, nurses, and foot care specialists) is often needed to support patients' needs.

Iconography : Diabetic foot ulcers : Part I. Pathophysiology and prevention

Pain is a major problem in sick newborn infants, especially for those needing intensive care. Pharmacological pain relief is the most commonly used, but might be ineffective and has side effects, including long-term neurodevelopmental sequelae. The effectiveness and safety of alternative analgesic methods are ambiguous. The objective was to review the effectiveness and safety of non-pharmacological methods of pain relief in newborn infants and to identify those that are the most effective. PubMed and Google Scholar were searched using the terms: “infant”, “premature”, “pain”, “acupuncture”, “skin-to-skin contact”, “sucrose”, “massage”, “musical therapy” and ‘breastfeeding’. We included 24 studies assessing different methods of non-pharmacological analgesic techniques. Most resulted in some degree of analgesia but many were ineffective and some were even detrimental. Sucrose, for example, was often ineffective but was more effective than music therapy, massage, breast milk (for extremely premature infants) or non-invasive electrical stimulation acupuncture. There were also conflicting results for acupuncture, skin-to-skin care and musical therapy. Most non-pharmacological methods of analgesia provide a modicum of relief for preterm infants, but none are completely effective and there is no clearly superior method. Study is also required to assess potential long-term consequences of any of these methods.

https://www.mdpi.com/2227-9067/5/10/130/pdf

A Review of Non-Pharmacological Treatments for Pain Management in Newborn Infants.

Background: Palliative care is an approach that focuses on improving a patient's quality of life. This research aimed to develop a path model of the relationships between the variables of nursing care (information, emotional support, technical support, and palliative care), patient coping, family support, patient spirituality, and patient comfort expressed through physical and emotional mediators. Method: This cross-sectional study involved 308 breast cancer patients from 3 referral hospitals in Jakarta, Indonesia. A structural equation model with Kolcaba's theory was used to develop a theoretical model estimating the path or relationships between the key variables. Results: The results showed that palliative care significantly improved breast cancer patient comfort by reducing anxiety and depression. Furthermore, the study demonstrated a significant positive relationship between spirituality and emotional well-being. Conclusion: Spirituality-focused palliative care is fundamentally importance for breast cancer patients. Nurses play an essential role in providing spirituality-focused palliative care to promote comfort in breast cancer patients in Indonesia.

Spirituality-Focused Palliative Care to Improve Indonesian Breast Cancer Patient Comfort.

Pneumonia pada balita masih menjadi masalah kesehatan utama di Indonesia. Hal ini terlihat dengan tingginya angka morbiditas dan mortalitas akibat pneumonia. Salah satu upaya untuk menurunkannya adalah dengan mengetahui faktor risiko yang menyebabkan terjadinya pneumonia. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian pneumonia pada anak balita di rumah sakit. Desain yang digunakan adalah cross sectional dengan 138 sampel. Hasil penelitian dengan regresi logistik didapatkan 4 faktor risiko yang berhubungan secara bermakna yaitu usia balita, riwayat pemberian ASI, status gizi balita dan kebiasaan merokok keluarga. Kegiatan edukasi tentang peningkatan pemberian ASI dan nutrisi kepada orangtua balita perlu ditingkatkan untuk mencegah terjadinya pneumonia.

/pdf/faktor-risiko-terjadinya-pneumonia-pada-anak-balita-4cs1f972xa.pdf

Faktor Risiko Terjadinya Pneumonia Pada Anak Balita

The correlation between sleep quality and levels of stress among students in Universitas Indonesia.

Motivation as a factor affecting nurse performance in Regional General Hospitals: A factors analysis

Medical devices that are attached to children put pressure on their skin or mucous membranes, and the devices can lead to injuries. The objective of this study was to determine the effectiveness of injury-prevention guidance about children who need to have medical devices attached to their bodies as part of their treatment. The research used a randomized controlled trial method, along with a cross-over design in 50 respondents with age ranges from 1 day to 18 years. The control group was treated in accordance to hospital routine, while the intervention group was given medical treatment based on Kiss and Heiler’s guidelines. Skin assessment was conducted for 3 days. Incidence of Grade 1 pressure injuries on the respondent’s skin or mucous membranes with a mean score of Neonatal Skin Risk Assessment Scale  15 were observed. Health devices that caused pressure injuries on respondents were: ETT (13%), OGT (12%), NGT (11%), and SpO2 probe (6%). There were no significant...

Dewi Gayatri

Papers

Spirituality-Focused Palliative Care to Improve Indonesian Breast Cancer Patient Comfort.

Faktor Risiko Terjadinya Pneumonia Pada Anak Balita

The correlation between sleep quality and levels of stress among students in Universitas Indonesia.

Motivation as a factor affecting nurse performance in Regional General Hospitals: A factors analysis

Medical-Device Related Pressure Injuries to Children in the Intensive Care Unit.