The Use of Fecal Microbiota Transplants for the Treatment of Reccurent Clostridium Difficile Infections
Brittany Adair, Hannah Bujnevicie, Jessica Morissette, Kathryn Thomas, and Nicole Whitney
Clostridium Difficile Infections (CDI’s) are spore forming gram positive anaerobic bacillus and are one of the leading hospital acquired infections (Brown, 2014). They can be transmitted from person to person or through the environment. Symptoms can include severe diarrhea, fever, abdominal pain, and weight loss. Long term antibiotic use can suppress the bowels microbes that would normally limit the expansion of CDI’s. C diff has become an epidemic. Diagnoses doubled between 1996-2003. In 2010 the yearly incidence rate was estimated at 500,000 a year (Lessa, 2012).
CDI's are often treated with vancomycin, however, the recurrence rate of CDI with this treatment is 44.8%. Fecal microbiota transplants (FMT’s) replace the destroyed flora in the intestines allowing microbes to re-grow and protect the intestinal flora (Deshpande, 2013). A study done by Arondiadis and Brant (2013) involving 317 patients who had 3 recurrent episodes of CDI with Fecal microbiota transplant‘s, that resulted in 92% of patients being cured of their CDI. Other studies have shown similar results with post FMT stool samples from recipients being similar to that of a healthy donor. FMT's can be given via intestinal enemas, gastroscopes, or nasojejunal (Surawicz, 2013). FMT's from a related donor have a 93% resolution rate, compared to an 84% resolution rate with an unrelated donors stool. FMT's have minimal risk, rapid effect, are relatively low in cost, and have been shown to reestablish colon microbiota.
Jennifer Goodnow, Shannon Tarbox, Erin Zamore, and Victoria Zimmerman
Patients residing in long-term care facilities face many changes and challenges. Many seniors have grown up with pets as part of their daily lives, and animals have provided them with companionship as they age. The purpose of this literature review is to assess the state of the science related to the use of animal-assisted therapy (AAT) with canines in long-term care facilities and their effect on the physical and mental health of residents. The introduction will give an overview of why this issue is of importance to Nursing. Next, the methodology section will cover the databases used in our search; our search terms (canine, dog, animal assisted therapy, nursing home, geriatric long term care, long term care, stress, depression, social isolation, withdrawal, grieving, loneliness, and anxiety); and the criteria used to select or reject the articles used in the literature review. Thirdly, the discussion section will discuss theoretical frameworks, the instrumentation used during data collection by the various researchers, sample sizes and limitations of the studies. The discussion section will also give a brief summary of the findings in the research articles used in this literature review. Lastly, the conclusion will show that that the results of animal-assisted therapy on the physical and mental health of long-term care residents are promising, but inconclusive; further study is needed to prove the efficacy of animal-assisted therapy.
The Safety of Planned Home Births Attended by Certified Nurse Midwives as Defined by Neonatal Mortality
Kristina McGuirk, Savannah Steevens, Megan Robinson, and Andra Lasanen
The safety of planned home births is an ongoing debate in the United States. This controversy stems from conflicting data found in a limited number of studies. Hutton, Reltsma, and Kaufman (2009), found that there is no significant difference between perinatal and neonatal mortality in the home as compared to hospital births. However, the American College of Obstetricians and Gynecologists (ACOG) report that planned home births have a two-fold increase in neonatal death (Women’s Healthcare Physicians, 2013). The American College of Nurse Midwives (ACNM), the American Public Health Association (APHA), and the World Health Organization (WHO) state that planned home births are safe, as long as the patient falls under certain criteria, such as a low-risk pregnancy, singleton, cephalic fetus at term, and the absence of pre-existing conditions (Declerq and Stotland, 2015). The purpose of this review is to examine the literature related to the safety of planned home births attended by certified nurse midwives as measured by infant mortality rates.