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Educating Primary Care Nurses on Phosphorus Management in Chronic Kidney Disease PatientsSomuah, Lilian 01 January 2018 (has links)
Fifteen percent of adults in the United States have been diagnosed with chronic kidney disease (CKD). CKD is the slow, progressive, and irreversible loss of kidney function. The most effective means of controlling CKD is by managing dietary phosphorus intake. It is important that staff nurses be educated about effective patient education tools to improve dietary phosphorus management. The purpose of this project was to educate primary care nurses about phosphorus management in CKD patients through the introduction of the phosphorus pyramid as a visual tool. The project sought to understand if an educational intervention regarding phosphorus management in CKD patients could increase the primary care nurse's knowledge. The John Hopkins evidence-based practice model informed the development of this project. Ten primary care nurses participated in a 45-minute education program which focused on the use of the Phosphorus Pyramid. A pre and post-test of knowledge was completed via a Likert scale questionnaire that measured knowledge related to the educational objectives of the program. The posttest scores showed an increase of 15% overall in staff's knowledge regarding dietary phosphorus management, the participants were more likely to correctly answer questions related to the phosphorus content of food and drink. The phosphorus pyramid will serve as a user-friendly tool to assist patients in identifying high phosphorus foods that need to be avoided and low phosphorus foods that are recommended to incorporate in their renal diet. This project supports social change by improving the healthcare team's knowledge regarding dietary recommendations for CKD patients thereby contributing to improved patient outcomes and reduced healthcare costs.
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Calcined materials as components of soilless root media: phosphate sorption characteristics and effects on phosphate and water use in greenhouse production of Impatiens walleranaOgutu, Rose Atieno January 1900 (has links)
Doctor of Philosophy / Department of Horticulture, Forestry, and Recreation Resources / Kimberly A. Williams / The use of calcined clays contributes properties of nutrient and water retention to soilless root media, which varies greatly depending on the parent clay and calcining treatment. This research characterized phosphate (PO[subscript]4) sorption of various calcined clay products, including low volatile and regular volatile material (LVM and RVM) 2:1 Attasorb clays (Engelhard Corp.), 2:1 Terra Green LVM clays (Oil-Dri Co.), and Turface (Profile Products LLC) at various particle sizes; 1:1 kaolin clays (Thiele Kaolin Co.) in powder form, and diatomaceous earth (Diatomite, Eagle Picher Minerals, Inc.). Three of the calcined materials, Terra Green montmorillonite and Attasorb attapulgite (which had high PO[subscript]4-sorption based on isotherms), and diatomaceous earth (which had negligible PO[subscript]4-sorption) were evaluated as components of soilless root media in two separate greenhouse experiments. The effect of the calcined materials, rate of incorporation (0%, 5%, 10% and 20% by volume in a mix with peat and perlite), and PO[subscript]4-P application rate (0, 5, 15, 45 mg.L[superscript]-1 PO[subscript]4-P) on plant growth, effluent P content and water use were determined during production and post-production of Impatiens wallerana Hook f. 'Tempo Rose'. The calcined materials varied in their ability to adsorb PO[subscript]4-P and generally yielded L-type isotherms. Laboratory results indicated potential for substantive P retention by several of the calcined materials when used in container production. For most materials, PO[subscript]4-P sorption did not show pronounced pH dependence. During production and post-production, the test materials not only improved PO[subscript]4-P retention but also water retention and water use efficiency while still maintaining optimal physical properties at incorporation rates of 5 to 10%. Diatomaceous earth resulted in PO[subscript]4-P retention not significantly different from the calcined clays.
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Application of isotopic dilution methods to the study of the dissolution of phosphate fertilisers of differing solubility in the soilDi, Hong J. January 1991 (has links)
An injection technique, in which undisturbed soil cores are labelled with ³²P to study dissolution of phosphate fertilisers in the soil, was evaluated in field and glasshouse trials. When ³²P was injected between 0-150 mm depths of the undisturbed soil columns and fertilisers applied at the surface, the amounts of fertiliser P dissolved, as measured by the increases in the exchangeable P pools, were overestimated. Three possible reasons were suggested: (i) the interaction between surface-applied fertiliser, ³²P injected through the whole soil column, and the vertical decline in root density, (ii) the decline of specific activity in the exchangeable P pool due to losses of ³²P to nonexchangeable P pools and continuous addition of P from fertiliser dissolution, and (iii) non-uniform distribution of ³²P vis-a-vis ³¹P phosphate. The injection technique may be employed to assess the effectiveness of phosphate fertilisers by introducing a concept, the fertiliser equivalent (FE). The FE is a measure of the amounts of soil exchangeable P that the fertilisers are equivalent to in supplying P to plants, when applied at the specific location. Soluble single superphosphate (SSP) applied at the surface of undisturbed grassland soil cores (Tekapo fine sandy loam), was much more effective than surface-applied unground North Carolina phosphate rock (NCPR) and 30% acidulated NCPR with phosphoric acid (NCPAPR) within the 56 day period of plant growth. An isotopic dilution method, based on tracer kinetic theory, was developed to study the rates of dissolution (F in) and retention (F out) of phosphate fertilisers in the soil in growth chamber experiments. The estimation of F in and F out required labelling of the soils with carrier-free ³²P and determination of the corresponding values of the specific activities of the exchangeable P pools, SA₁ and SA₂, and the sizes of the exchangeable P pools, Q₁ and Q₂, at times t₁ and t₂. Most of the phosphate in the monocalcium phosphate (MCP) solution entered the exchangeable P pool immediately after addition to the soils (Tekapo fine sandy loam and Craigieburn silt loam), and there was little further phosphate input. With increasing periods of incubation, the phosphate was quickly transformed to less rapidly exchangeable forms. In the soils treated with ground North Carolina phosphate rock (<150 µm, NCPR) or partially acidulated (30%) NCPR with phosphoric acid (NCPAPR), the initial exchangeable P pools were not as large as those in the soils treated with MCP, but were maintained at relatively stable concentrations for extended periods, due to the continuous dissolution of PR materials and to lower rates of pretention. An increase in P-retention caused a slight rise in the rate of PR dissolution, but also a rise in the rate of P-retention by the soil. The rate of dissolution was higher at a lower application rate in relative terms, but smaller in absolute terms. The trends in the changes of plant-available P in the soils, measured by the water extractable P, Bray I P and Olsen P, correspond to those predicted by the F in and F out values. The average rates of dissolution between 1-50 and 50-111 days estimated by the F in, however, were higher than those estimated by extractions with 0.5 M NaOH followed by 1 M HCl, and with 0.5 M BaCl₂/TEA. This is partly because the Fin values reflect a plant growth effect on PR dissolution. The relative agronomic effectiveness of NCPR and NCPAPR with respect to MCP was higher after 50 and 111 days of incubation than after 1 day. The F in values were included in all the two-variable models constructed by stepwise regression to describe the relationship between plant P uptake and soil measurements. The amounts of variation in plant P uptake accounted for by the regression model was significantly improved by including F in in the model. This indicates the importance of fertiliser dissolution rates in affecting soil P supply, when phosphate fertilisers differing in solubility are applied.
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