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    exercise for UTI by ShuHui Yuan and ShunHua Yang

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    Lucy Yuan

    Posts : 15
    Join date : 2009-06-23

    exercise for UTI by ShuHui Yuan and ShunHua Yang

    Post  Lucy Yuan on Fri 03 Jul 2009, 7:19 pm

    BMC Geriatr. 2008; 8: 31.
    Published online 2008 November 25. doi: 10.1186/1471-2318-8-31. PMCID: PMC2605742

    Mobility and other predictors of hospitalization for urinary tract infection: a retrospective cohort study
    Mary AM Rogers,1,2 Brant E Fries,3,4,5 Samuel R Kaufman,1,2 Lona Mody,5,6 Laurence F McMahon, Jr,1,2 and Sanjay Saint1,2,7
    Background
    Many hospitalizations for residents of skilled nursing facilities are potentially avoidable. Factors that could prevent hospitalization for urinary tract infection (UTI) were investigated, with focus on patient mobility.
    Methods
    A retrospective cohort study was conducted using 2003–2004 data from the Centers for Medicare and Medicaid Services. The study included 408,192 residents of 4267 skilled nursing facilities in California, Florida, Michigan, New York, and Texas. The patients were followed over time, from admission to the skilled nursing facility to discharge or, for those who were not discharged, for 1 year. Cox proportional hazards regression was conducted with hospitalization for UTI as the outcome.
    Results
    The ability to walk was associated with a 69% lower rate of hospitalization for UTI. Maintaining or improving walking ability over time reduced the risk of hospitalization for UTI by 39% to 76% for patients with various conditions. For residents with severe mobility problems, such as being in a wheelchair or having a missing limb, maintaining or improving mobility (in bed or when transferring) reduced the risk of hospitalization for UTI by 38% to 80%. Other potentially modifiable predictors included a physician visit at the time of admission to the skilled nursing facility (Hazard Ratio (HR), 0.68), use of an indwelling urinary catheter (HR, 2.78), infection with Clostridium difficile or an antibiotic-resistant microorganism (HR, 1.20), and use of 10 or more medications (HR, 1.31). Patient characteristics associated with hospitalization for UTI were advancing age, being Hispanic or African-American, and having diabetes mellitus, renal failure, Parkinson's disease, dementia, or stroke.
    Conclusion
    Maintaining or improving mobility (walking, transferring between positions, or moving in bed) was associated with a lower risk of hospitalization for UTI. A physician visit at the time of admission to the skilled nursing facility also reduced the risk of hospitalization for UTI.
    Reference
    Grabowski DG, O'Malley J, Barhydt NR. The costs and potential savings associated with nursing home hospitalizations. Health Aff (Millwood). 2007;26:1753–1761. doi: 10.1377/hlthaff.26.6.1753. [PubMed]
    Murtaugh CM, Freiman MP. Nursing home residents at risk of hospitalization and the characteristics of their hospital stays. Gerontologist. 1995;35:35–43. [PubMed]
    High KP, Bradley S, Loeb M, Palmer R, Quagliarello V, Yoshikawa T. A new paradign for clinical investigation of infectious syndromes in older adults: assessment of functional status as a risk factor and outcome measure. Clin Infect Dis. 2005;40:114–122. doi: 10.1086/426082. [PubMed]
    Schnelle JF, Alessi CA, Simmons SF, Al-Samarrai NR, Beck JC, Ouslander JG. Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents. J Am Geriatr Soc. 2002;50:1476–1483. doi: 10.1046/j.1532-5415.2002.50401.x. [PubMed]
    Ouslander JG, Griffiths PC, McConnell E, Riolo L, Kutner M, Schnelle J. Functional incidental training: a randomized, controlled, crossover trial in Veterans Affairs nursing homes. J Am Geriatr Soc. 2005;53:1091–1100. doi: 10.1111/j.1532-5415.2005.53359.x. [PubMed]
    van Houten P, Achterberg W, Ribbe M. Urinary incontinence in disabled elderly women: a randomized clinical trial on the effect of training mobility and toileting skills to achieve independent toileting. Gerontology. 2007;53:205–210. doi: 10.1159/000100544. [PubMed]
    McCormick KA, Cella M, Scheve A, Engel BT. Cost-effectiveness of treating incontinence in severely mobility-impaired long term care residents. QRB Qual Rev Bull. 1990;16:439–443. [PubMed]
    Grabowski DG, O'Malley J, Barhydt NR. The costs and potential savings associated with nursing home hospitalizations. Health Aff (Millwood). 2007;26:1753–1761. doi: 10.1377/hlthaff.26.6.1753. [PubMed]
    Murtaugh CM, Freiman MP. Nursing home residents at risk of hospitalization and the characteristics of their hospital stays. Gerontologist. 1995;35:35–43. [PubMed]
    High KP, Bradley S, Loeb M, Palmer R, Quagliarello V, Yoshikawa T. A new paradign for clinical investigation of infectious syndromes in older adults: assessment of functional status as a risk factor and outcome measure. Clin Infect Dis. 2005;40:114–122. doi: 10.1086/426082. [PubMed]
    Schnelle JF, Alessi CA, Simmons SF, Al-Samarrai NR, Beck JC, Ouslander JG. Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents. J Am Geriatr Soc. 2002;50:1476–1483. doi: 10.1046/j.1532-5415.2002.50401.x. [PubMed]
    Ouslander JG, Griffiths PC, McConnell E, Riolo L, Kutner M, Schnelle J. Functional incidental training: a randomized, controlled, crossover trial in Veterans Affairs nursing homes. J Am Geriatr Soc. 2005;53:1091–1100. doi: 10.1111/j.1532-5415.2005.53359.x. [PubMed]
    van Houten P, Achterberg W, Ribbe M. Urinary incontinence in disabled elderly women: a randomized clinical trial on the effect of training mobility and toileting skills to achieve independent toileting. Gerontology. 2007;53:205–210. doi: 10.1159/000100544. [PubMed]
    McCormick KA, Cella M, Scheve A, Engel BT. Cost-effectiveness of treating incontinence in severely mobility-impaired long term care residents. QRB Qual Rev Bull. 1990;16:439–443. [PubMed]
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    gillegarda/joanalynbalino

    Posts : 31
    Join date : 2009-06-19
    Age : 30

    Re: exercise for UTI by ShuHui Yuan and ShunHua Yang

    Post  gillegarda/joanalynbalino on Fri 03 Jul 2009, 10:24 pm

    RESPONSE: UTI-ACTIVITY
    By: Dyad 2: Gil Legarda and Joanalyn Balino

    Does Post coital voiding prevent urinary tract infections in young women?
    Clinical inquiries: from the family practice inquiries network
    By: Bert Beisel, Wayne Hale, Rebecca S. Graves

    This research was done in a single case-control study by Beisel et al. to identify risk factors for developing urinary tract infection among young, healthy women than women who do not urinate. There were about 225 women enrolled in this study. Randomized control trial was not used in this study to prove that post coital voiding is an effective intervention. Pregnancy, diabetes, catheterization 4 weeks prior to study enrollment, vaginitis, hospitalization, candidiasis, a history of <1 prior UTI were the exclusion criteria used. The setting of the study was held in University of California at Los Angeles student health center. The subjects were surveyed regarding their dietary habits, sexual and urinary habits, clothing, and birth control methods they used. Laboratory exams specifically urine test was done for identifying presence of UTI. Analysis of having a UTI was based on laboratory results with having a presence of more than 50,000 colony forming units of single species of bacteria per milliliter of urine also a report of one or more signs and symptoms of UTI, blood in the urine, frequent urination, urgent need to urinate, painful urination, and urination at night. Not having a prior history of UTI was defined as primary UTI and had reported 1 before was categorized as secondary UTI. This research study had several limitations it was not done in randomization or randomized control trial to prove that post coital voiding is an effective intervention to prevent UTI also this study included only young healthy women and small number of sexually active patients who may benefit from the study. The study lacked adequate sample size to detect a small to moderate effect of post coital voiding.

    By the use of midstream urine samples there were 44 cases of UTI and 181 controls showed to the health center without urinary symptoms or history of UTI identified by the researchers. Women urinated more than 15 mins after intercourse showed a significant risk of 0.40 or 95 percent confidence interval, 0.09-2.17 for developing a primary case of urinary tract infection and estimated relative risk of 0.92 or 95 percent confidence interval, 0.18-4.88 for developing a secondary urinary tract infection. The results were not statistically significant but the power was too low to rule out a potential effect.

    The result of the study is not showing or claiming a strong evidence of the effectiveness of post coital voiding for women as an intervention to prevent UTI due to some reasons such as small number of sample size and limitations of participants. The study should involve also men and adult and a bigger sample size to have a strong evidence that post coital voiding will be an effective intervention to prevent UTI. However there are studies suggesting women with frequent UTI should empty their bladder before sexual intercourse according to Griffith and also it was recommended by Furthermore, the American College of Obstetricians and Gynecologists District II NYS to prevent of having cystitis.

    Reference:
    Beisel B. (2002). Does Post coital voiding prevent urinary tract infections in young women?Clinical inquiries: from the family practice inquiries network. Journal of Family Practice, Nov, 2002. Retrieved July 3, 2009 from http://www.jfponline.com/pdf%2F5111%2F5111JFP_ClinicalInquiries2.pdf
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    rodel_perez_rn

    Posts : 22
    Join date : 2009-06-19

    D1 - R.Perez & N. Dumlao (reply #4)

    Post  rodel_perez_rn on Sat 04 Jul 2009, 10:11 pm

    Preventing Catheter-Associated Urinary Tract Infections
    Laura A. Stokowski, RN, MS
    Published: 02/03/2009

    Catheter-related urinary tract infection (CAUTI) is common problem but may result to less severe complications. Almost 40% of the total nosocomial infections were related to CAUTI. It is usually associated with the use of indwelling urinary catheters, post-operative bladder drainage, or management of retention or incontinence disorders. The colonization of catheters is expected. Once the microorganism colonizes the urine, within 72 hours it may have lead to increase in concentrations. The longer duration for catheter use is done, the more likely for infections to occur. Most infectious microorganism causing the infection was from the patient’s own colonic and perineal flora, including E. Coli, or microorganism from the hands of the health care personnel during the insertion or manipulation of the catheter system. This journal report is done to investigate cases leading to CAUTI and identify new approaches to this problem.

    Several studies evaluate 2 methods of obtaining urine cultures. In comparison with old catheters, a consistent reduction in the number and types of microorganisms were found and isolated from fresh catheters. Samples that were collected from the new catheter were likely to reflect the environment of the bladder rather than that of the biofilm-coated catheter. In this case, patients respond to better treatment. Based on these research findings, some institution changed their method of urine collection.

    Many hospitals are fervent to avoid or reduce their incidence of this CAUTI, and are examining their urinary catheter management practices. Evidence-based strategies are accessible, but not universally pursued. Understanding and educating nurses about the pathogenesis of CAUTI is an important first step in the prevention of this common healthcare-associated infection.

    Authors and Disclosures
    Laura A. Stokowski, RN, MS, Staff Nurse, Inova Fairfax Hospital for Children, Falls Church, Virginia; Editor, Medscape Ask the Experts: Advanced Practice Nurses
    Disclosure: Laura A. Stokowski, RN, MS, has disclosed that she has served as a consultant for Draeger Medical
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    guomanman

    Posts : 30
    Join date : 2009-06-23
    Age : 34
    Location : China

    activity for UTI

    Post  guomanman on Sun 05 Jul 2009, 9:29 am

    Dyad 6 guomanman and chenya


    Ab Exercise Programs
    Published by Jim John on Jul 8th, 2007 in Health and wellbeing with No Comments
    by Jim John

    It can be difficult deciding which ab exercise program is the right one for you. Ultimately, the one you choose should be decided between you and your doctor. It doesn’t matter if you are trying to lose weight or simply create a healthier lifestyle, healthy eating choices should always coexist with any exercise plan.

    Calculate your body weight and based on that figure, decide how much weight you want to lose on your program before beginning. If you know the number of pounds that you need to lose, designing a ab exercise program that is directly tailored to your needs will be easy. Breaking up this large goal into smaller, more manageable goals is also a smart idea to keep you motivated and focused.

    You could look online and try to create your own personalized work out plan, or you could hire a personal trainer who can help design the perfect weight loss exercise program for you. Also, exercise plans that are pre-designed in as books, charts, or computer software are available for purchase. You will be better able to follow your progress in order to obtain your weight loss goal.

    If you really want to lose weight, get your heart pumping and figure out how you can get your heart beating hard in the daily chores that you do. Include things like vacuum cleaning or scrubbing your shower into your daily routine and do the household chores while you keep your heart in shape. Once your body is adapted to cardiovascular exercises it’s quite easy and you should be able to do cardio exercises several times a week for 20-50 minutes each session.

    If your health is good, you may want to look into a strength training type weight loss exercise program. With strength training, you not only build muscle, but you tone and shape the muscles that you already have. Simultaneously, fat melts off your body. An assortment of push-ups, curl ups, and ball squats comprise the core of strength training exercises. If you’re new to strength training, choose one exercise per day and do 16 repetitions for best results.

    Your body will tire of any workout that’s done repeatedly, so vary the exercises and routines in the weight loss exercise program you are doing in order to lose weight. That way, every muscle group will continue to work, because your body will not know what to expect. Switch between cardio and weight training exercises in order to get the desired results of training different parts of the body.

    You can supplement your ab exercise program by keeping journals that track which foods you eat, how much exercise you get, and how you feel. You should stop exercising immediately if you feel faint or dizzy. As you gradually increase the amount of exercise you do, you will also increase your strength and endurance.

    About the Author:
    If you would like more advice about review of the truth about six pack abs then visit Six Pack Abs Where we’ll show you how to get six pack abs. http://www.thetruthaboutsixpackabsreviews.com/
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    byron webb romero

    Posts : 25
    Join date : 2009-06-19
    Age : 30
    Location : Pasay City

    DYAD RESPONSE TO ACTIVITY FOR UTI

    Post  byron webb romero on Thu 09 Jul 2009, 6:06 pm

    Dyad Three (3)
    Byron Webb A. Romero
    Von Deneb H. Vitto
    Raymond C. Ursal

    DYAD RESPONSE TO: ACTIVITY FOR PATIENTS WITH UTI

    Generally, exercise keeps muscles toned and improves lymphatic flow. Pelvic floor muscles (sphincter urethral muscle, deep transverse perineal muscles, levator ani) and associated fascia help to maintain the anatomy of urinary tract. Kegel exercises are designed to improve the tone of this muscular sling in women and to prevent bladder prolapsed and urethral obstruction (Rotblatt & Ziment, 2002). In Kegels exercise, patients are instructed to tighten and release the vaginopelvic muscles for 10 second intervals in a series of 10 contractions and to repeat the exercise at least 3 times/ day for optimal conditioning. During acute infections, it is best to avoid activities such as prolonged motorcycles, horseback riding, and bicycling.

    Sexual hygiene is another difficult topic to address with patients and may cause even more discomfort for patients of certain ethnic backgrounds. A portion of the world’s population has culture-based values regarding touch and discussions about sex, which may be difficult for health care providers to appreciate. Periods of increased sexual intercourse resulting in “honeymoon cystitis” are caused by inflammation of the bladder due to infections arsiSing as bacterial flora move from the perineum and vagina into the urethral canal. This problem can often be prevented with effective hygienic techniques.

    From the above information, as nurses, basic issues would include the importance of urinating before or after intercourse, hand-washing, avoiding genital intercourse immediately after anal intercourse, techniques for safe anal-genital contact, washing the perineum carefully after mechanical trauma, and techniques for clean oral-genital contact. Patients should be advised that the use of spemicides with or without a diaphragm increases the frequency of vaginal colonization with uropathogens and UTIs because of the change in pH and the change in the epithelial lining due to the cell-damaging chemicals in spermicides. In most postmenopausal women who use lubricants during intercourse, it is important to emphasize that lubricants can also alter the vaginal flora. Perhaps the details of some of the above topics/ issues which can be incorporated during health teaching as part of our promotive and preventive aspect of nursing care may not be immediately relevant for each sexually active patient with predisposition to UTIs, but nurses should be prepared to explore and discuss such issues.

    Reference:

    Rotblatt, M,.& Ziment, I. (2002). Evidence-Based Herbal Medicine. Hanley and Belfus: Philadelphia. Pp 300-301.
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    alkhaloidz

    Posts : 27
    Join date : 2009-06-19
    Age : 31
    Location : Sampaloc, Manila

    D4 RESPONSE TO ACTIVITIES OF UTI PATIENTS

    Post  alkhaloidz on Fri 10 Jul 2009, 11:06 pm

    DYAD 4
    BALAJADIA, BOND
    ZANO, ALEXIS

    Validation of a patient-administered questionnaire to measure the activity impairment experienced by women with uncomplicated urinary tract infection: the Activity Impairment Assessment (AIA)


    The primary aim of this study is to validate a questionnaire in order to assess the activity impairment associated with uncomplicated urinary tract infection (uUTI). The Activity Impairment Assessment (AIA) assesses the amount of time an individual's work or regular activities have been impaired as a result of their UTI. The measure was completed by 276 women with uUTI who had participated in a prospective, open-label, non-comparative multi-centre clinical trial of CIPRO® XR (extended-release ciprofloxacin). Baseline scores on the King's Health Questionnaire (KHQ) and clinical symptom evaluations were collected for validation purposes.

    An exploratory factor analysis showed that all items loaded >0.84 on a single component. This uni-dimensional structure was supported by Rasch analysis. The AIA was found to have excellent levels of internal consistency (Cronbach's alpha = 0.93), convergent validity (all rs >.70) and divergent validity (rs = .078). The AIA displayed excellent discriminant validity in relation to clinical evaluations, and was found to be responsive to change across all clinical evaluations.

    According to the authors of this study, and based on the results, the AIA questionnaire enables the assessment of the amount of time an individual's work or regular activities have been impaired as a result of their UTI. The questionnaire is composed of one domain, a total score, which has been found to have excellent psychometric properties. While the measure was designed specifically for use in a clinical setting, it is likely that it will also be suitable for use in an epidemiological context and beyond. Furthermore, although the AIA is validated here in the context of UTI it could also easily be adapted and used to assess activity impairment in other disease areas.

    Reference: Wild D, et. al. Validation of a patient-administered questionnaire to measure the activity impairment experienced by women with uncomplicated urinary tract infection: the Activity Impairment Assessment (AIA). PMC. July 2005

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