https://www.um.edu.mt/library/oar/handle/123456789/2292 2026-04-06T12:13:01Z https://www.um.edu.mt/library/oar/handle/123456789/2546 Title: Nutrition supplementation for faster healing of pressure ulcers in immobile hospitalized elderly patients Abstract: Overview of topic: The incidence of PUs is on the increase especially in elderly patients who have impaired mobility, are malnourished and this presents a major concern in the health care system. The current standard treatment consist of wound cleansing, change of dressings, wound debridement, use of pressure releasing devices and repositioning of patients every 2 hours. Oral nutritional supplementation (ONS) is not yet an integral part of wound care. Evidence indicates that ONS consisting of high energy, protein, enriched arginine, vitamin C and zinc aid in various processes of wound healing. The Research Question: Is applying a standard diet with ONS more effective than merely a standard diet for faster wound healing of PUs, in immobile hospitalized elderly patients aged 65 years and over? The PICO elements: Population Immobile patients with pressure ulcers aged 65 and over Intervention Applying a standard diet with oral nutritional supplementation Comparison A standard diet Outcome Faster wound healing Inclusion and Exclusion Criteria: The main criteria included papers selected in the English language, dating from year 2000 onwards about PU care. Participants who were not immobile elderly patients, aged 65years and over with PUs were excluded. The Search: The search resulted in six studies consisting of four randomized controlled trials and two non-randomized controlled trials. Methods of Appraisal: These were appraised using the Critical Appraisal Skills Programme checklists. Results of the Study: The intervention group as compared with the control group showed acceleration of PU healing. Main conclusion: ONS has been found to be effective in increasing rate of wound healing, not if only macro nutrients such as proteins are given but if a set of supplements specifically to target wound healing are administered. Implications and Recommendations: Introducing a new product for PU care may be susceptible to various controversies such as an extra expense, its adverse effects and its suitability on the patients. Prior to its implementation ONS can be given for a period of time and health care professionals can evaluate its effects. Description: B.SC.(HONS)NURSING 2014-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/2545 Title: Effectiveness of virtual reality systems in the rehabilitation process of adult stroke patients Abstract: Stroke is a major health problem as it results in devastating conditions on the sufferers, consequently altering the lifestyle of the patient and their families. It also poses a financial burden on healthcare resources. The prevalence of stroke in adults is increasing due to risk factors such as an unhealthy diet, smoking and lack of physical activity. Virtual reality (VR) systems, an innovative rehabilitative therapy, have shown positive benefits in regaining motor functions in the affected limbs of post-stroke patients. The purpose of this dissertation is to compare the clinical effectiveness of VR systems with conventional rehabilitative therapies in the treatment of improving body limb functions of post-stroke patients. The PICO framework was utilised to generate the research question for this study. The PICO framework enabled an evidence-based approach to literature searching. The formulated research question is as follows: Are virtual reality systems effective in the rehabilitation process of stroke patients? A computerised search on online databases and relevant information through personal contact with various companies was conducted using the devised inclusion and exclusion criteria. Main criteria applied were papers conducted in English involving either immersive or non-immersive VR systems. Post-stroke patients needed to be over 18 years of age. The search yielded six studies which were ranked according to the hierarchy of evidence and appraised using the Critical Appraisal Skills Programme (CASP) checklist. The main outcome measures were evaluating improvements in motor limb functions of the post-stroke participants. Safety and feasibility, cost-effectiveness of VR systems and client satisfaction were secondary outcome measures. VR systems have been found to have positive benefits on the regaining of motor function in the affected limbs of the participants in the studies selected. However, the benefits of VR systems are not conclusive due to the small sample sizes of the studies selected. Description: B.SC.(HONS)NURSING 2014-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/2544 Title: Using different lengths of anti-embolic stockings to prevent deep vein thrombosis in post-operative patients Abstract: Deep vein thrombosis is a serious complication following major surgical interventions and there is an ever growing interest for research and discussion regarding the prophylaxis of such a complication. Graduated compression elastic stockings are non-invasive, non-pharmacological and an effective form of reducing the incidence of deep vein thrombosis in conjunction with pharmacological prophylaxis. Despite their efficiency there is still debate over the preferred choice of length; knee-length or thigh-length. Therefore, the following research question was formulated: ‘How do knee length graduated compression stockings and thigh length graduated compression stockings compare in reducing the incidence of deep vein thrombosis in post abdominal surgery patients?’ Included in this disseratation were English language publications from 2002 onwards involving adult patients undergoing major abdominal surgery, and considered the comparison between knee-length and thigh-length graduated compression stockings for reducing the incidence of deep vein thrombosis as the main outcome. The search was performed using the combination of 19 keywords in five databases, resulting in 380 hits. 21 were found to be highly relevant and following the use of the CASP and PRISMA tools, five studies were selected (two meta-analyses, two systematic reviews and one randomised control trial). Current literature found that an insignificant statistical difference has been found between the effectiveness of both lengths of stockings. However, taking into consideration patient compliance, ease of application and cost-effectiveness, the use of knee-length stockings was recommended. Future research and data collection regarding the local situation is still highly recommended to establish this difference, further enhance prophylactic care and allow the formulation of policies and protocol in relation to the use of the stockings. Training sessions and informative seminars should allow the multidisciplinary team to remain abreast with developments regarding this issue, in addition to raising awareness of the importance of the prevention of deep vein thrombosis in postoperative patients. 2014-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/2543 Title: Weight-loss : low-fat against low-carbohydrate diets in overweight/obese adults Abstract: Introduction: Obesity is a disorder which can result in serious health problems, such as; heart disease, diabetes and breast cancer (WHO, 2006). Lately, low-carbohydrate diet has become popular to lose weight; however there are still queries about which diet is best for weight loss (Hession, 2009). Objective: To investigate which diet (Low-fat or low-carbohydrate) is more effective in weight loss, with the research question being; Is a low-carbohydrate diet more effective than a low-fat diet to achieve weight loss in overweight/obese persons? Method: Research which was conducted between 2003 to date was considered for this dissertation. The following databases were used to identify relevant studies: PubMed, Academic Search Complete, BioMed Central, AgeLine, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL and Medline. Ten papers met the inclusion and exclusion criteria. The AMSTAR and PEDro critical appraisal tools were used. Throughout this dissertation, ethical issued were taken into consideration. Findings: Although the studies chosen for this study provided different percentages of carbohydrates and fats, it resulted that a low-carbohydrate diet is better to achieve weight loss in a shorter period of time. Conclusion: Results showed that participants on low-fat diet kept losing weight throughout the year, while those on a low-carbohydrate diet lost significant weight in the first six months. However, after 12 months, there was no significant difference in the total weight lost between the diets. Therefore, the difference between the diets is the rate at which weight is lost. It is recommended that low-carbohydrate diet can be used to achieve rapid weight loss in a short period of time, even though it is not known if the weight loss achieved is maintained or regained. Evidence based practice between lowfat and low-carbohydrate diets in order to identify which one results in weight regain is recommended. Description: B.SC.(HONS)NURSING 2014-01-01T00:00:00Z