The prevalence of obesity in the United States has more than doubled from 1980 to 2008. Obesity leads to a multitude of comorbidities, most notably diabetes and cardiovascular diseases, resulting in more than $147 billion annually in healthcare costs. Bariatric surgery is becoming a common weight loss option for morbidly obese individuals. Studies in this review examine patients who have undergone laparoscopic adjustable gastric banding or Roux-en-Y gastric bypass surgery. Patients initially lose large amounts of weight postoperatively; unfortunately, around 30% of these individuals begin to regain weight 18-24 months after surgery. The purpose of this article is to analyze the current literature to ascertain which self-care variables are predictors of successful long-term weight loss after bariatric surgery. The studies analyzed in this review found that patients who undergo a surgical weight loss intervention lose more weight faster than patients who do not have a surgical weight loss intervention. However, patients reported feeling unprepared for the extreme psychosocial and lifestyle changes after bariatric surgery. Findings from these studies point to the need for future research in the area of postsurgical psychosocial support for successful long-term weight loss maintenance.

Despite its benign, natural course, colic is a significant problem in babies and imparts a psychological and physical burden to parents. This study has examined the relief of colic symptoms when using BornFree ActiveFlow baby bottles by comparing observed symptoms of 30 otherwise healthy newborns (ages 2-21 weeks) who had all been diagnosed as having colic symptoms. Twenty of the babies were switched to feeding with BornFree bottles (the experimental group), while the other 10 babies continued feeding with bottles by other manufacturers (the control group). A significant improvement was exhibited in the experimental group after 1 week of feeding with BornFree bottles, with a further significant improvement in the second week. Although they had different venting systems, the control group maintained the same level of colic symptoms as in the beginning of the study. We conclude that using BornFree baby bottles can effectively reduce colic symptoms in diagnosed babies.

Hepatocellular carcinoma is a cancer with increasing incidence in the veteran population. This type of cancer can be treated with transarterial chemoembolization, an invasive procedure performed by specially trained interventional radiologists. The most common serious complications are liver failure, sepsis secondary to ischemic cholecystitis or liver abscess, gastrointestinal bleeding, and death. However, nursing staff and physicians often have little or no experience in caring for patients in the hospital who have had this procedure. Patient safety can be threatened by this lack of knowledge. Sources of threat to patient safety are described by the Institute of Medicine as falling into 4 categories: management, workforce, work processes, and organizational culture. To promote patient safety, defenses need to be deployed to address each category. In this article, the author provides a case example, describes threats to the patient's safety, and describes a plan to improve the care of all patients undergoing this procedure.

The purpose of this study was to examine bacterial growth in colonoscopes in a series of graduated shelf times. There is no conclusive evidence on the length of time colonoscopes can be safely stored before requiring redisinfection. Standards for processing scopes after use are described and supported by the professional organizations of gastroenterology and infection control; however, shelf life varies from 3 to 5 days and most recommendations are based on clinical consensus. In this study, four colonoscopes were used in a clinical procedure, underwent automated high-level disinfection with 2.6% buffered glutaraldehyde, and cultured after 3, 5, 7, 14, 21, 28, 42, and 56 days of shelf time. Two investigators collected all the cultures after interrater reliability was established. Cultures were processed in the microbiology laboratory. No medically significant growth was detected at any of the culture points. At Day 14 and Day 42, one of four scopes grew fewer than two colony-forming units of a medically insignificant bacterium. Using professional standards for high-level disinfection growth was suppressed for up to 8 weeks. Further evidence to assess fungal or viral growth is needed to be able to make suggestions for colonoscope shelf life.

A new purpose-built facility for the care of patients with Hepatitis C was opened at Gartnavel General Hospital in Glasgow, Scotland, in 2009, bringing together infectious diseases and gastroenterology disciplines. An addiction liaison nurse outpatient service was established alongside existing Hepatitis C outpatient clinics in October 2010. This service supports staff and patients with Hepatitis C and addiction issues. The purpose of this study was to evaluate the usefulness of combining the Addiction Liaison Nurse outpatient service with the Hepatitis C outpatient clinic. Two methods were used in data collection. A brief questionnaire asking staff their view on the addiction liaison service and addiction issues with regard to Hepatitis C was distributed and completed by personnel assigned to the clinics. Staff were also queried about their view on the number and quality of referrals generated by the addiction liaison clinic. The results from the questionnaire indicate that staff agreed that patients should be abstinent from alcohol and illicit drugs before and during treatment of Hepatitis C. Further research is called for with regard to abstinence from alcohol and drugs before and during Hepatitis C treatment.

With the increasing number of patients with inflammatory bowel disease (IBD) and consequently limited available resources, the organization and quality of care that patients receive require ongoing attention. Many initiatives have been introduced, but few have begun by asking the patients about their support for planned changes to their care. The aim of this project was to investigate the willingness and concerns of outpatients with IBD to change regular outpatient visits to annual telephone calls from an IBD nurse. We also wanted to illuminate any potential barriers to introducing self-management (SM) to this population. One way to accomplish this is by introducing SM that replaces routine appointments in the outpatient clinic with annual blood sample collection, followed by a telephone call from an IBD nurse and direct acute access to the clinic, if needed. We consecutively included 150 IBD patients who attended the outpatient clinic at Aarhus University Hospital, Aarhus C, Denmark. They were asked to which extent they were willing to shift to the SM approach from their current routine. The survey showed that 87% of the patients agreed to adopt the SM approach. Many patients commented that it was an excellent and timesaving idea. Those who had doubts were mainly older, retired patients. Their concerns were mainly due to hearing loss, disease activity, medical treatment monitoring, and worries about the competence of the IBD nurse.