Change in Care Dependency of Stroke Patients: A Longitudinal and Multicenter Study

Nursiswati Nursiswati,Ruud J.G. Halfens,Christa Lohrmann 한국간호과학회 2017 Asian Nursing Research Vol.11 No.2

Purpose: The study was conducted to investigate the change of care dependency in stroke patients from inpatient wards and outpatient units in Indonesia. Methods: This study is longitudinal and multicentered. One hundred and nine patients were included from four hospitals on the island of Java. Care dependency was assessed using the Indonesian version of the 15-item Care Dependency Scale (CDS) at five points in time: at inpatient wards for admission and discharge and at outpatient units after discharge in the 1st week, the 5th week, and the 13th week. Results: Most of the patients were male (65.1%), and diagnosed with ischemic stroke (71.5%). The results showed that care dependency in stroke patients decreased significantly from admission to discharge, as well as from the 5th to the 13th week as measured by the CDS. At admission, 23.0% of the patients were completely dependent on care, and at the 13th week about 1.0% were. Patients' care dependency decreased significantly in all care dependency items of the CDS in the inpatient ward, but five care dependency items of the CDS did not significantly decrease in the outpatient unit. Conclusions: Based on the findings of this study,we recommend that hospital-based andcommunity-based services should include continual care dependence monitoring using this comprehensive instrument. Care dependency is subject to change over time, therefore nurses have to plan and tailor adequate nursing care measures to patient needs in the different stages, especially with respect to the aspect of mobility.

Dietary Application for the Management of Patients with Hemodialysis: A Formative Development Study

Cosette Fakih El Khoury,Mirey Karavetian,Ruud J.G. Halfens,Rik Crutzen,Dayana El Chaar,Jos M. G. A. Schols 대한의료정보학회 2019 Healthcare Informatics Research Vol.25 No.4

Objectives: To describe the step-by-step person-centered, theory-based development of the KELA.AE app for Arabic speaking hemodialysis patients. Methods: A step-by-step person-driven theory-based approach was conducted to develop a self-monitoring and educational dietary app for hemodialysis patients. The development follows the Integration, Design, Assessment, and Sharing (IDEAS) framework. Qualitative, semi-structured interviews with 6 hemodialysis patients and 6 healthcare practitioners (dietitians and nephrologists) were performed to assess the need for an app, the willingness to use an app, and features desired in an app. Results: The KELA.AE app, which includes a self-monitoring feature, CKD-friendly recipes, and a theory-based, evidence-based educational feature was developed. Qualitative analysis of interviews revealed two predominant themes from patient interviews ‘Experience with the diet’, ‘App evaluation’, and one theme from interviews with healthcare practitioners ‘App evaluation’. Patients expressed frustration with current accessibility of dietary information along with the need for educational materials in the app. The review of the KELA.AE prototype was positive overall, and patients reported a willingness to use the app. Healthcare practitioners considered the app accurate, simple, and culturally sensitive but expressed concerns about app misuse and the replacement of healthcare practitioners. Conclusions: The KELA.AE app was found to be satisfactory and supportive of the participants’ needs. Changes were made to the app as suggested during the interviews.

Sulfur versus Iron Oxidation in an Iron−Thiolate Model Complex

McDonald, Aidan R.,Bukowski, Michael R.,Farquhar, Erik R.,Jackson, Timothy A.,Koehntop, Kevin D.,Seo, Mi Sook,De Hont, Raymond F.,Stubna, Audria,Halfen, Jason A.,Mü,nck, Eckard,Nam, Wonwoo,Que, American Chemical Society 2010 JOURNAL OF THE AMERICAN CHEMICAL SOCIETY - Vol.132 No.48

<P>In the absence of base, the reaction of [Fe<SUP>II</SUP>(TMCS)]PF<SUB>6</SUB> (<B>1</B>, TMCS = 1-(2-mercaptoethyl)-4,8,11-trimethyl-1,4,8,11-tetraazacyclotetradecane) with peracid in methanol at −20 °C did not yield the oxoiron(IV) complex (<B>2</B>, [Fe<SUP>IV</SUP>(O)(TMCS)]PF<SUB>6</SUB>), as previously observed in the presence of strong base (KO<SUP>t</SUP>Bu). Instead, the addition of 1 equiv of peracid resulted in 50% consumption of <B>1</B>. The addition of a second equivalent of peracid resulted in the complete consumption of <B>1</B> and the formation of a new species <B>3</B>, as monitored by UV−vis, ESI-MS, and Mössbauer spectroscopies. ESI-MS showed <B>3</B> to be formulated as [Fe<SUP>II</SUP>(TMCS) + 2O]<SUP>+</SUP>, while EXAFS analysis suggested that <B>3</B> was an O-bound iron(II)−sulfinate complex (Fe−O = 1.95 Å, Fe−S = 3.26 Å). The addition of a third equivalent of peracid resulted in the formation of yet another compound, <B>4</B>, which showed electronic absorption properties typical of an oxoiron(IV) species. Mössbauer spectroscopy confirmed <B>4</B> to be a novel iron(IV) compound, different from <B>2</B>, and EXAFS (Fe?O = 1.64 Å) and resonance Raman (ν<SUB>Fe?O</SUB> = 831 cm<SUP>−1</SUP>) showed that indeed an oxoiron(IV) unit had been generated in <B>4</B>. Furthermore, both infrared and Raman spectroscopy gave indications that <B>4</B> contains a metal-bound sulfinate moiety (ν<SUB>s</SUB>(SO<SUB>2</SUB>) ≈ 1000 cm <SUP>−1</SUP>, ν<SUB>as</SUB>(SO<SUB>2</SUB>) ≈ 1150 cm <SUP>−1</SUP>). Investigations into the reactivity of <B>1</B> and <B>2</B> toward H<SUP>+</SUP> and oxygen atom transfer reagents have led to a mechanism for sulfur oxidation in which <B>2</B> could form even in the absence of base but is rapidly protonated to yield an oxoiron(IV) species with an uncoordinated thiol moiety that acts as both oxidant and substrate in the conversion of <B>2</B> to <B>3</B>.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/jacsat/2010/jacsat.2010.132.issue-48/ja1045428/production/images/medium/ja-2010-045428_0015.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/ja1045428'>ACS Electronic Supporting Info</A></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/ja1045428'>ACS Electronic Supporting Info</A></P>

Axial ligand tuning of a nonheme iron(IV)-oxo unit for hydrogen atom abstraction.

Sastri, Chivukula V,Lee, Jimin,Oh, Kyungeun,Lee, Yoon Jin,Lee, Junghyun,Jackson, Timothy A,Ray, Kallol,Hirao, Hajime,Shin, Woonsup,Halfen, Jason A,Kim, Jinheung,Que, Lawrence,Shaik, Sason,Nam, Wonwoo National Academy of Sciences 2007 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.104 No.49

<P>The reactivities of mononuclear nonheme iron(IV)-oxo complexes bearing different axial ligands, [Fe(IV)(O)(TMC)(X)](n+) [where TMC is 1,4,8,11-tetramethyl-1,4,8,11-tetraazacyclotetradecane and X is NCCH(3) (1-NCCH(3)), CF(3)COO(-) (1-OOCCF(3)), or N(3)(-) (1-N(3))], and [Fe(IV)(O)(TMCS)](+) (1'-SR) (where TMCS is 1-mercaptoethyl-4,8,11-trimethyl-1,4,8,11-tetraazacyclotetradecane), have been investigated with respect to oxo-transfer to PPh(3) and hydrogen atom abstraction from phenol O H and alkylaromatic C H bonds. These reactivities were significantly affected by the identity of the axial ligands, but the reactivity trends differed markedly. In the oxidation of PPh(3), the reactivity order of 1-NCCH(3) > 1-OOCCF(3) > 1-N(3) > 1'-SR was observed, reflecting a decrease in the electrophilicity of iron(IV)-oxo unit upon replacement of CH(3)CN with an anionic axial ligand. Surprisingly, the reactivity order was inverted in the oxidation of alkylaromatic C H and phenol O H bonds, i.e., 1'-SR > 1-N(3) > 1-OOCCF(3) > 1-NCCH(3). Furthermore, a good correlation was observed between the reactivities of iron(IV)-oxo species in H atom abstraction reactions and their reduction potentials, E(p,c), with the most reactive 1'-SR complex exhibiting the lowest potential. In other words, the more electron-donating the axial ligand is, the more reactive the iron(IV)-oxo species becomes in H atom abstraction. Quantum mechanical calculations show that a two-state reactivity model applies to this series of complexes, in which a triplet ground state and a nearby quintet excited-state both contribute to the reactivity of the complexes. The inverted reactivity order in H atom abstraction can be rationalized by a decreased triplet-quintet gap with the more electron-donating axial ligand, which increases the contribution of the much more reactive quintet state and enhances the overall reactivity.</P>