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Pediatric systemic lupus erythematosus: management issues in primary practice.

PURPOSE: To provide nurse practitioners (NPs) with an update on pediatric systemic lupus erythematosus (SLE) with an emphasis on management considerations for primary care practitioners. DATA SOURCES: An extensive literature review was conducted using both Medline and CINAHL databases. Research articles reflecting the most compelling findings were included in this review. CONCLUSIONS: NPs who care for children with SLE may be able to prevent or delay the morbidities associated with this disease and its treatments, if they keep abreast of the new information evolving in this realm of rheumatologic diseases. IMPLICATIONS FOR PRACTICE: As more is learned about pediatric SLE, better treatments have evolved such that the survival rates have increased. The primary care of pediatric SLE patients that is focused on preventing or delaying SLE morbidities may help to restore, maintain, or improve the quality of life for these patients.

Calcium, Dietary↗

Assessing the use of school public address systems to deliver nutrition messages to children: Shape up Somerville--audio adventures.

Given the current childhood obesity epidemic, it is especially important to find effective ways to promote healthful foods to children. School public address (PA) systems represent an inexpensive and a replicable way of reaching children with health messages. To test the effectiveness of this channel, messages were created to promote 2 dried bean (legume) dishes that had been added to the school lunch menu. Six elementary schools were pair matched, and 1 school from each pair was randomly chosen to play the messages. The impact of the intervention on choice of the 2 new entrees was assessed. Results indicate that for all schools combined, choice was not significantly affected. However, compared to their matched control schools, choice was significantly higher in the school that received the highest dose of the intervention and was significantly lower in the school that received the lowest dose. Choice was not changed in the school that received an intermediate dose. These results suggest that PA systems show promise as an effective and appropriate communications channel but only in schools that are able to play messages frequently.

Audiovisual Aids↗

Menu preferences of dental public health diplomates--a pilot study.

Forty-six of 103 dentists responded to a survey of their preferences for fish or chicken in preparation for the 1986 Dinner Meeting of the American Board of Dental Public Health in Miami, Florida. Approximately three-fourths of the respondents (74%) requested fish (F). Analysis of preferences with regard to geographic location indicated that almost half of the respondents requesting fish were from Region IV (Southeast), while preferences according to year of certification indicated that more than three-quarters of the respondents (77%) who had been certified since 1970 preferred fish. There were no significant differences between the two groups in mode of transportation, time since last visit, and number of denture wearers.

Animals↗

Nutritional aspects of acute renal failure.

The patient with acute renal failure is a very ill patient suffering from high urea levels causing poor appetite, nausea and vomiting. These patients are usually treated with a low sodium, low protein and, if the potassium in the blood is high, with a low potassium diet (1). This paper discusses whether or not this is the correct treatment. The symptoms of high urea levels in the blood together with increased needs for energy and protein makes it very hard to prevent the patient becoming malnourished. Often energy-enriched drinks are necessary to achieve recommendations and it is prudent to let the patient eat and drink what they desire. By calculating the energy and protein needs and comparing these with the intake and the state of illness and by following the patient's body weight over time we can obtain information about the state of nourishment. When we alter the food that's offered we achieve better intake and reduce the risk of malnourishment.

Acute Kidney Injury↗

Management of children with diabetes in the school setting. American Association of Diabetes Educators.

The AADE recognizes the special needs of children with diabetes in the school setting. This position statement has been developed to provide basic guidelines to assist these children, their parents, school personnel, and healthcare workers in promoting a safe school environment and successful learning experience for the child with diabetes. Diabetes educators are encouraged to support this endeavor by sharing their knowledge and resources with school personnel whenever possible.

Adolescent↗

2002 diabetes nutrition recommendations: grading the evidence.

Monitoring of blood glucose, A1C, lipids, and blood pressure is essential in patients with diabetes to assess the success of lifestyle strategies or to determine if changes in medication(s) are necessary. Patients also require ongoing education and support as they make and maintain lifestyle changes.

Blood Glucose Self-Monitoring↗

Euglycemic control of gestational diabetes mellitus by specific dietary manipulation: a case study presentation.

Gestational diabetes is the most common complication of pregnancy. If maternal hyperglycemia is not well controlled, excess glucose is transmitted to the fetus, which can lead to fetal macrosomia and maternal and fetal complications. Dietary treatment for gestational diabetes varies among practitioners. A case review is presented of a 32-year-old white woman with gestational diabetes whose condition was complicated by her blood glucose intolerance to lactose in milk. By following a carefully monitored regimen using specific dietary manipulation to maintain normoglycemia, the woman was able to deliver a normal, healthy baby by spontaneous vaginal delivery.

Adult↗

Factors influencing diabetic clients' ability to read and comprehend printed diabetic diet material.

Factors related to diabetic clients' abilities to read and comprehend printed diabetic diet material were explored by collecting data on social and demographic variables, prior knowledge, reading ability (using the Nelson-Denny Test), and comprehension of the diet (using the cloze technique) from 58 outpatient diabetic clients. A mean estimated reading grade level of 8.9 was obtained for the printed material, based on the use of three readability formulas. Analysis of cloze scores revealed that 62% of the clients scored less than 40%, indicating that the material was too difficult for them to comprehend; 21% scored between 40% and 59%, suggesting the need for supplemental instruction; and 17% scored 60% or above, indicating ability to fully comprehend. Clients scoring less than 40% tended to be older and obtained lower scores on the Nelson-Denny, as compared with those in the highest cloze category. Results of a stepwise regression analysis indicated that the Nelson-Denny vocabulary score, client age, and duration of diabetes were the strongest predictor variables for comprehension of the diet material.

Adolescent↗

Ingredients that replace fat: their role in today's foods and challenges in educating people with diabetes.

This article reviews the three categories of fat replacers and characteristics of the individual products. Most importantly, this update provides strategies for staying abreast of current and future foods, and stimulates considerations for diabetes educators when advising clients about fat-modified foods. Creative techniques and tools also are presented for educating clients about these foods.

Blood Glucose Self-Monitoring↗