ONLINE REGISTRATION OPEN!!! sürekli desteklerinden Renal Bakımda Eğitim & Yenilikler en iyi. Konferansın içeriği: Birlikte daima ileriye:

European Dialysis and Transplant Nurses Association/ European Renal Care Association News Başkan ın Mesajı Bülten 2010 39. EDTNA/ERCA Dublin Konferansı ONLINE REGISTRATION OPEN!!! Dublin şehri Do not miss the chance to register for Early registration EDTNA/ fee that is 1st July 2010. You can manzarasıyla find more about yeni ve the modern registration bir binadır. fees and guidelines ERCA ya HYPERLINK Sayın meslektaşlarım ve davetliler, "http://www.edtna-erca-dublin2010.com/registration-guidelines.html" \t "_blank" here. Konferansın içeriği: Birlikte daima ileriye: sürekli desteklerinden dolayı Renal Bakımda Eğitim & Yenilikler en iyi Sizleri Dublin de, 18 21 Eylül klinik uygulama için sürekli eğitimin önemini tüm endüstri 2010 tarihleri arasında gerçekleşecek vurgulamak. partnerlerine teşekkür ederiz. 39. Uluslararası EDTNA/ERCA tarafından multidisipliner renal Dünyanın her tarafından gelen meslektaşla- EDTNA/ERCA Konferansı na bakımla ilgili klinik konularda konuşmacı rınızla buluşma ve nefrolojide bakımın gele- ceği hakkında fikir alışverişi yapma ve görüşlerinizi paylaşma sansına sahip olacaksınız. davet etmek benim için çok konuklar davet edildi. büyük bir onurdur. Aynı zamanda, nefroloji bakımında günümüz Sizleri güzel Dublin de aramızda görmek için Konferansın yapılacağı alan, mükemmel teknolojisi, araştırma ve gelişmeleri içe- sabırsızlanıyorum! imkanları olan, son teknoloji lie donatılmış, ren ilgi çekici nefroloji sergisini ziyaret etme Anastasia Laskari merkezi yerleşim alanı ve panoromik güzel fırsatını da bulacaksınız. EDTNA/ERCA Başkanı2010-2011 2010 Yaz Sayısı Türkçe Önemli Bilgi!!!! Bu yıl Kongre etkinlikleri önceki yıllara gore daha erken başlayacaktır. Aşağıda yer alan ve 18 Eylül, Açılış Seremonisi nden önce gerçekleştirilecek oturumlara ve workshoplara katılmak istiyorsanız seyahat programınızı ona gore düzenlemenizi öneririz: 14:00 15:30 EDTNA/ERCA ve Endüstri işbirliği projeleri Workshop Kardiovasküler master class EDTNA/ERCA & Fresenius Medical Care moving forward the Go Green in Dialysis Project 1st meeting of Project Group participants. More information in page 3 15:45 17:15 Klinik Uygulamalarda Kalite Geliştirme Teknik master class 18:00 Açılış Seremonisi İrlanda Başkanı Mary McAleese katılımı ile İçindekiler Başkan ın Mesajı Editörün Mesajı Gönüllü aranıyor EDTNA/ERCA & Fresenius Medical Care projesi: Çevreye Duyarlı Diyaliz 39 EDTNA/ERCA Dublin Konferansı ile ilgili son haberler Anketi cevaplayın, ödülünüzü alın HIV e maruz kalma ile ilgili öneriler Üyelik kampanyası...ve daha fazlası!!

Editörün Yazısı Sevgili Arkadaşlar, Çoğunluğunuz Gazetenin bu baskısını kabul ettiğiniz zaman, iyice hakketiğiniz yaz tatilinizin tadını çıkarıyor olabilirsiniz, hepinize rahatlatıcı ve keyifli zaman geçirmeyi diliyorum. EDTNA/ERCA ve gönüllüleri, yaz veya kış farketmeden sizi bilgilendirerek, sürekli olarak güncel projeler ve faaliyetler üzerinde çalışıyoruz. Ayrıca, Konferansın tarihi yaklaştıkça bu önemli olayların lojistik ve organizasyonel görevlerini bitirmek için yoğun çalışmalarımızı sürdürüyoruz. Konferans günleri sırasında, Gazete takımı EDNTA / ERCA standında sizi bekliyor olacaktır. Bizi ziyaret etmeniz, fikirlerinizi, önerilerinizi düşüncelerinizi paylaşmanız bizi sonsuz mutlu edecektir. Gazetenin bu baskısında Topluluğun bu yıl tamamladığı birçok proje ve aktiviteler ve gelecek amaç ve hedefleri hakkında bilgi bulabilirsiniz. Hala gönüllüler tarafından doldurulacak boşluklar vardır. Birçok yıl gönüllülük yaptıktan sonra size şunu söyleyebilirim; bu harika bir deneyimdir ve her gün bu Toplulukta olduğum için memnuniyet hissediyorum. Harika bir yaz diliyorum! Dublin de görüşmek umudu ile! María Cruz Casal Gazete Editörü mcruzcasal@ibertelecom.com Join the EDTNA/ERCA Volunteers Team The EDTNA/ERCA is looking for a volunteer to cover the following vacancies: Scientific Programme Committee Chair Transplant Consultant Nutrition Consultant Technician Consultant All volunteer applicants must: Be a current Member or Lifetime Member. Be able to communicate in writing and orally in the English language. Not hold an elected position in another national or international renal care related association, society or similar organization. Recommended Qualifications for Scientific Programme Committee Chair: Experienced in and familiar with the Scientific Programme of EDTNA/ERCA Conferences. Able to coordinate the Scientific Programme of the Conference with the collaboration of the Conference Department. Have the ability and approval to devote discretionary time to fulfil the obligations related with the post. The ability to use modern office software and electronic mail including word processing, spreadsheet and graphic presentation applications. (Especially Microsoft Word, Excel and Power Point). Prior volunteer positions are an advantage. If you are interested or would like to recommend someone for one of these posts please send your CV or immediately contact Maria Saraiva the Nomination Committee Chair at: mariasaraiva@yahoo.com or Eva Petrová, EDTNA/ERCA Secretariat Manager at: queries@edtnaerca.org

Endüstri Güncellemesi Derneğin amaçlarından biri, nefroloji endüstrisi ile sınırsız ortaklık için kapıları açmaktır ve bu yüzden dünya çapında sektör ortaklarıyla güçlü bir işbirliğini korumaya devam ediyoruz. Bu iyi bilinen bağlantılar, Derneğin yeni fikirler üretmesini ve projeleri dünya çapındaki gelişmelerle birlikte ilerletebilmesini sağlamaktadır. Çevreci Diyaliz ilk proje grubu toplantısı İlk proje grubu toplantısı, Haziran da Almanya da gerçekletirildi. Farklı ülkelerden ve iş ortamlarından gelen 15 kişi dört ayrı proje alt grubunda bir araya geldiler. Tüm katılımcılar arasındaki heyecan, bilgi ve beceri seviyesi son derece cesaretlendirici oldu ve eminiz ki proje amaçlarımıza kararlaştırılan zaman aralığında erişebileceğiz. Eğitim gereçleri ve ilkeler hemşireler ve diğer renal bakım meslekleri arasında diyalizin çevresel yönleri hakkında farkındalık yaratmak, diyaliz bakımındaki alıkanlıkları değiştirmek ve tedavileri daha çevre dostu bir diyalize doğru yönlendirmek için kullanılacak. Proje güncellemesi Dublin Konferansı nda sunulacaktır. Bunun ardından sunumları misafir konumacılarla tartışmak için bir fırsat olacak ve proje grubu deneyimini günlük klinik pratiğinizle karşılaştırma olanağı sağlanacak. Ven İğnesinin Yerinden Çıkması (VND) Projesi Bölüm II EDTNA/ERCA ve Redsense Medical 2008de VND projesinin ilk bölümünü halihazırda bitirmişlerdi ve VND durumlarını en aza indirmek için 12 öneri tespit etmişlerdi. VND proje grubunun ikinci bölüm toplantısı Mayıs 2010 da Malmö, İsveç te başladı ve düşük, orta ve yüksek VND riskli hastaları tanımlamak üzerine odaklandı. VND hemşirenin bir hatasından değil, her hastanın başına her yerde her Susanne Olausson, Senior Vice President, Redsense Medical Dr. Elisabeth Lindley, EDTNA/ERCA Jitka Pancirova, Executive Director EDTNA/ERCA Maria Sundström, Product & Marketing Manager, Redsense Medical Jean-Pierre van Waeleghem, E&RB, EDTNA/ERCA Melissa Chamney, E&RB, EDTNA/ERCA Dr. James Tattersall, EDTNA/ERCA olabilir. Ayrıca tamamlanan anketler üzerinden günlük bir piyango çekilişi de yapılacaktır. Lütfen VND hakkında daha fazla bilgi almak için Dublin Konferansı nda VND proje grubuyla iletişime geçiniz. Endüstri Toplantıları Dublin de yapılacak 39. EDTNA/ERCA Konferansı giderek yaklaşıyor ve Derneğimiz halihazırda EDTNA/ERCA Konferansının 2011 de yapılacak 40. Yıldönümünü planlama çalışmalarını yürütmektedir. Endüstri ortaklarıyla bireysel toplantılarımız, hepiniz için bu özel eğitim etkinliğini hazırlamak adına devam etmektedir. Konferansta ilginç genel oturumlar, atölyeler ve endüstri sempozyumları yer alacaktır. Derneğimiz Gambro ile elmas ortaklığı 2008 yılında kurdu ve Gambro nın EDTNA/ERCA nın 40. Yıldönümünde de ana ortaklardan biri olacağını duyurmaktan mutluluk duyuyoruz. Juergen Kastl, Project Director, Application Development, FMC Jitka Pancirova, EDTNA/ERCA Executive Director zaman gelebilecek bir durumdur. Dolayısıyla raporlama, VND riskine sahip hastaları tespit edebilmemiz için VND nin tetikleyicilerini anlamakta çok kritiktir. Amacımız VNC eğitim gerecini Dublin Konferansında sunup aynı zamanda delegelere basılı malzemeler de dağıtmaktır. Elektronik kopyalar EDTNA/ERCA web sitesinde Konferanstan sonra 15 dilde sunulacaktır. VND üzerine bir anket Genel Oturumda dağıtılacak ve aynı zamanda EDTNA/ERCA ve Redsense Medical standlarından da edinilebilecektir. VND proje takımı bu anketi doldurarak yapacağınız katkıya çok değer vermektedir zira bu projeye sunacağınız girdiler, tüm diyaliz hastaları için emniyeti artırmaya yardımcı Anki Davidson, Director Branding & Market Communication Gambro Jitka Pancirova, EDTNA/ERCA Executive Director Her bültende sizlerle kurduğum iletişimi Dublin de de sürdürmekten sonsuz mutluluk duyacağım. Sizlerli EDTNA/ERCA ve sendüstri ortakları projelerine atanan genel oturumda birlikte olmayı diliyorum. Saygılarımla, Jitka Pancirova EDTNA/ERCA Önceki Dönem Başkanı/Yönetici Müdür

Ne kadar biliyorsunuz? Aşağıdaki soruları şekilde cevaplandırabiliyor musunuz bakın. Bültenin son sayfasında cevapları bulacaksınız. (Bilgi Orta Seviye) Tüm sorular EDTNA/ERCA kitaplarından alınmıştır: Hematoloji & Kronik Böbrek Hastalığı, Klinik Uygulama için Periton Diyalizi Kılavuzu 1. Periton Diyalizi Aşağıdakilerden hangisi hipervolemi veya dehidrasyon nedeni ile kontrolsüz TA için bir çözümdür? a. 0.5 1 kg dan daha yüksek ideal kuru ağırlıklı hastalar için %2.5 luk dektroz çözeltisi önerilmektedir. b. 1 kg dan daha yüksek ideal kuru ağırlıklı hastalar için %4.25 lik dektroz çözeltisi önerilmektedir. c. İdeal kuru ağırlıktan daha az olan hastalar için %1.5 lik dektroz çözeltisi hedeflenmiştir. d. Yukarıdakilerin hepsi. Adimea Precise real-time measurement of dialysis dose NOW available for all treatment modes Achieve high treatment results in every dialysis session UV-light measurement in spent dialysate Continuous Kt/V monitoring Adapt treatment parameters if required See results immediately Comprehensive Clinical Data Excellent correlation between the blood-spkt/v and the Adimea-spKt/V Documented for all treatment modes (HD/HDF/SNCO) 2. 3. 4. Aşağıdakilerden hangisi Orak Hücre Hastalığında doğrudur? a. Her iki β globin gen allelleri bir mutasyon taşırlar. b. Her iki α globin gen allelleri bir mutasyon taşırlar. c. Bir α ve bir β globin gen allelleri bir mutasyon taşırlar. d. A.Sadece bir β globin gen alleli bir mutasyon taşır. Periton Diyalizi Diyaliz kateter bağlantısı sırasında dikkat edilmesi gereken nokta nedir? a. Eldiven takmadığın sürece hiçbirşey. b. Eller kuru ve stabil olmalıdır. c. Bağlantı noktasını işlemek için parmaklarınızı kullanın. d. Temizliği sağlamak ve mikropları önlemek için ellerinizi alkole batırın. Myeloma hastalarında böbrek yetmezliği için aşağıdakilerden hangisi genellikle sorumludur? a. Anemi b. Hiperkalsemi B. Braun Avitum AG Schwarzenberger Weg 73-79 34212 Melsungen Germany Tel. +49 5661 71-2624 Fax +49 5661 75-2624 dialysis@bbraun.com www.bbraun-dialysis.com c. Cast nefropati d. Dehidrasyon 100706_Anz_EDTNA_A5.indd 1 06.07.10 15:08 5. 6. Periton Diyalizi - Aşağıdakilerden hangisi belirsiz bir enfekte çıkış yeri özelliğidir: a. Çıkış çevresinde granülasyon dokusu vardır, fakat aktif hiperemi yoktur b. Ağrı, şişlik ve dışa drenaj görülebilir. c. Sinüsün dışında pürülan veya kanlı drenaj. d. Eritem mevcuttur fakat çapı en az 13mm olmalıdır. PD tedavisi sırasında B12 vitamini için aşağıdakilerden hangisi a. Hastalar yıllık kontrol edilen B12 seviyelerine sahip olmalıdır- lar. b. Vitamin B12, PD sırasında her zaman uzaklaştırılır. c. Flux diyaliz olan hastalarda vitamin B12 yetersizliği oluşabilir. d. Yukarıdakilerin hiçbiri.

39 th EDTNA/ERCA Conference in Dublin Fresenius Medical Care Renal Pharma Corporate Education Session Please also visit us at our booth: The Liffey A, booth no. 7 New aspects of an optimized drug therapy for dialysis patients Monday 20 th Angel LM de Francisco - Santander, Spain Cathy Johnson - Derby, UK Jacques Rottembourg - Paris, France Additional Czech translation Courtesy of Fresenius Medical Care

Reference: 1. De Francisco ALM, et al. A controlled randomized comparison of calcium acetate/magnesium carbonate (OsvaRen ) to Sevelamer Hydrochloride (Renagel ) in Haemodialysis Patients: The CALMAG Study, Poster no. TH-P0615, Poster presentation, Renal Week, 42nd Annual Meeting of American Society of Nephrology, San Diego, CA, 29.10.2009. OsvaRen 435 mg / 235 mg film-coated tablets. Composition: Each film-coated tablet contains: Calcium acetate, 435.00 equivalent to 110 mg calcium and magnesium carbonate, heavy 235.00 mg equivalent to 60 mg magnesium. Excipients: Tablet core: Starch, pregelatinised, from maize, maize starch, sucrose, gelatine, croscarmellose sodium, magnesium stearate. Film coating: Castor oil, refined, hypromellose. Indications: Treatment of hyperphosphataemia associated with chronic renal insufficiency in patients undergoing dialysis (haemodialysis, peritoneal dialysis). Contraindications: OsvaRen is contraindicated in patients with Hypophosphataemia, Hypercalcaemia with or without clinical symptoms, e.g. as a result of an overdose of vitamin D, a paraneoplastic syndrome (bronchial carcinoma, breast cancer, renal cell carcinoma, plasmacytoma), bone metastases, sarcoidosis or immobilisation osteoporosis; Elevated serum magnesium levels of more than 2 mmol/l, and/or symptoms of hypermagnesaemia; AV-block III ; Myasthenia gravis; Hypersensitivity to the active substances or to any of the excipients. Side effects: Very common ( 1/10), common ( 1/100 and <1/10), uncommon ( 1/1,000 and <1/100), rare ( 1/10,000 and <1/1,000), very rare (<1/10,000), not known (cannot be estimated from the available data). Gastrointestinal disorders: Common: Soft stools, gastrointestinal irritation like nausea, anorexia, sensation of fullness, belching and constipation, diarrhoea. Metabolism and nutrition disorders: Common: Hypercalcaemia either asymptomatic or symptomatic, asymptomatic hypermagnesaemia. Uncommon: Moderate to severe symptomatic hypercalcaemia, symptomatic hypermagnesaemia. Very rare: Hyperkalaemia, magnesium-induced osteal mineralisation disturbances. Special warning: Contains sodium (not more than 5.6 mg per each film coated tablet) and sucrose. Read the package leaflet before use. Supply classification: Prescription only medicine. Fresenius Medical Care Nephrologica Deutschland GmbH. 61346 Bad Homburg v. d. H., Germany. Date: February 2010 The names of this medicinal product in the Member States of the EEA are as follows: B: Renepho, Other countries: OsvaRen. OsvaRen has received marketing authorisations in: A, B, CY, CZ, D, DK, E, EST, F, FIN, GB, GR, H, IRL, IS, L, LT, LV, M, N, NL, P, PL, S, SK, SLO, SRB (status: February 2010). The registration procedure for other countries is currently in progress. Combined for effective phosphorus control Everything under control in phosphate lowering therapy? Sounds good! OsvaRen. 1 1 1 Contact: Fresenius Medical Care Deutschland GmbH 61346 Bad Homburg v. d. H. Germany Phone: +49 (0) 6172-609-0 Fax: +49 (0) 6172-609-5638 E-mail: renalpharma@fmc-ag.com Head office: Else-Kröner-Straße 1 61352 Bad Homburg v. d. H. www.fmc-renalpharma.com

39 th EDTNA/ERCA in Dublin Fresenius Medical Care Corporate Education Session Sunday, 19 th Sept. 2010, 09:00 10:30 Main Hall Liffey Suite B Additional Czech translation Courtesy of Fresenius Medical Care Please attend our Corporate Education Session Necessity or Choice: Debating the Central Venous Catheter Ne kadar biliyorsunuz? Doğru Cevaplar 1. D. Yukarıdakilerin hepsi. Hastalığında her iki β globin gen alelleri 5. D. Eritema mevcuttur fakat çapı en az 0.5-1kg dan daha ağır bir ideal kuru bir mutasyon taşımaktadır. 13mm olmalıdır. ağırlıklı hastalar için %2.5 dektroz çözeltisi önerilmektedir. 1kg dan daha ağır bir kuru ağırlıklı hastalar için %4.25 3. B. Eller kuru ve stabil olmalıdır. Kateter- diyaliz torbası bağlanıldığında Belirsiz enfekte olmuş bir iltihaplı ve/ veya kanlı drenaj sinus un dışında düşünülemez. Çıkış veya sinüsün etrafında lik bir dektroz çözeltisi önerilmektedir. alkol çözeltisi ile elleriniz temizlenmiş, sıklıkla herhangi bir şekilde aktif görü- İdeal kuru ağırlığın altındaki hastalar kuru ve stabil olmalıdır. Bağlantı yerine nen biraz bol granülasyon dokusu ola- için %1.5 lik bir dektroz çözeltisi hedeflenmiştir. asla dokunmamanız önemlidir. caktır. Ağrı, şişme ve dışa drenaj oluşmamıştır. 2. A. Her iki β globin gen allelleri bir mutasyon taşırlar. Orak Hücre Hastalığı, kırmızı kan hücrelerinin hemoglobinini etkileyen kalıtsal bir kan hastalığıdır. Hemoglobinler 2-tipi ve 2-tipi globin polipeptit zincir- 4. C. Cast nefropatisi Genel olarak miyomalı böbrek yetmezliğinden sorumlu olan patoloji cast nefropatisi dir. Çünkü yüksek bir hafif zincir sekresyon oranı, hafif zincirleri glomeruliden süzüldükçe böbrek tüplerinde 12 6. B. Vitamin B PD sırasında her zaman uzaklaştırılır. B 12 vitamini periton diyalizi sırasında genellikle uzaklaştırılmamaktadır, fakat daha büyük membranlar kullanıldığı zaman uzaklaştırılabilir (molekülün boyu- li tetrametrik moleküllerdir. Orak Hücre tıkanmaya neden olmaktadır. tundan dolayı)

Management of Violence Önemli Bilgi EACCME EDTNA/ERCA Uluslararası Konferansı için kredileri arttırır! Avrupa Akreditasyon Konseyi devam eden Tıbbi Eğitim (EACCME) için 18-21 Eylül de Dublin de 18 Avrupa CME kredisi ile 39. EDTNA/ERCA Uluslararası Konferansını düzenlemiştir! Bu kredilendirme Bilimsel Programın kalitesinden dolayıdır. Bilimsel oturumlarda kredileri elde etmeyi ihmal etmeyin ve lütfen aşağıdaki noktaları hatırlayın: Her bir bilimsel kısım 90 dakika sürer. Tam kredi almak için en az 60 dakikalık bir bölüme katılmanız gerekiyor. 60 dakikadan önce gitmeyi seçerseniz, sistem size kredi veremez. Hepinizi Dublin de görmeyi umuyoruz! Nefroloji Ünitelerinde Şiddeet ve Saldırganlığın Önlenmesine Yönelik EDTNA/ERCA Önerileri Caring together EDTNA/ERCA Recommendations for Prevention and You can find more about the registration fees and guidelines at: "http://www.edtna-erca-dublin2010.com/registration-guidelines.html" \t "_blank" here. and Aggression in renal units Zampieron, Alessandra Saraiva, Maria Pranovi, Rebecca Bu kitapçık Dublin Konferansı sırasında sınırlı sayıda dağıtılacaktır Konu ile ilgili oturuma katılın ve kitapçığı elde etme şansını kaçırmayın Diyaliz Birimlerinde Uygulamalı Hijyen İçin Kılavuz Diyalizde Uygulamalı Hijyen için Çalışma Grubu Önerileri: HIV e maruz kalma durumunda bir profesyonel ve yetkili ofis ile derhal iletişime geçilmelidir. Kazanın dokümante edilmesi ve girilmesi gereklidir. 6-12 24 hafta HIV e maruz kalmadan hemen sonra, HIV AB (antikor) kontrolleri gerçekleştirilmelidir. Kirlenmeden hemen sonra uygulamaların alınması gerekir: ɶɶ İğne yaralaması: En az 1 dakika kanamasına izin ver Eğer mümkün ise sıkma veya yarayı yayma yolu ile kanamayı teşvik edin Antiseptik bir ajanı uygulayın (alkol-içeren deri dezenfektanı veya iyot en az 10 dakika boyunca yara yerine sürülmeli) ɶ ɶ Göze bulaş: İzotonik %2.5 iyot çözeltisi ile gözü yıkayın. Eğer o anda mevcut değil ise, saf su ile yıkayın ɶɶ Oral Kavite içinde Absorpsiyon: Ağız içini temizleyin, dezenfeksiyon için alkol kullanın veya gerekli ise saf su ile seyreltin İlaç - bazlı HIV Maruziyet Sonrası Profilaksi (PPP) Sadece ilaç bazlı PPP ye ilk 2 saat içinde başladığında, maksimum koruma elde edilebilir Bir mukoza maruziyetinden 72 saat sonra veya sırası ile bir perkütan, iv maruziyetinden 24 saat sonra oluşur ise büyük olasılık ile etkisizdir Şüpheli durumlarda, biri ayrıca ilk PPP ilacını acilen yönetmeye başlayabilir Laboratuar değerlerini kontrol ederken ilaç-bazlı PPP, 28 gün için gerçekleştirilebilir Bu kitapta daha fazla bilgi ve öneriyi bulabilirsiniz. Elde etmek için www.edtnaerca.org veya EDTNA/ERCA Sekreteryası, queries@edtnaerca.org adresinden talep formu isteyebilirsiniz.

Competence in Practice: A multi-country approach to clinical education EDTNA/ERCA Conference in Dublin - Main Hall 9.00 am Monday 20th September 2010 A skilled and competent workforce is essential to the advancement and maintenance of quality in healthcare. An education programme must define training needs and must also consider the knowledge, skills, values and competencies that develop the nurses ability to work in new and innovative ways. In 2004 the Competence in Practice programme was implemented for the dialysis care givers in our organisation and in 2010 more than 2500 staff has completed the programme. We would like to share some of our experiences with you during this Corporate Education Session. Competence in Practice: A multi-country approach to clinical education EDTNA/ERCA Conference in Dublin - Main Hall 9.00 am Monday 20th September 2010 A skilled and competent workforce is essential to the advancement and maintenance of quality in healthcare. An education programme must define training needs and must also consider the knowledge, skills, values and competencies that develop the nurses ability to work in new and innovative ways. In 2004 the Competence in Practice programme was implemented for the dialysis care givers in our organisation and in 2010 more than 2500 staff has completed the programme. We would like to share some of our experiences with you during this Corporate Education Session. Competence in Practice: A multi-country approach to clinical education EDTNA/ERCA Conference in Dublin - Main Hall 9.00 am Monday 20th September 2 A skilled and competent workforce is essential to the advancement and maintena in healthcare. An education programme must define training needs and must also knowledge, skills, values and competencies that develop the nurses ability to wo innovative ways. In 2004 the Competence in Practice programme was implemented for the dialysis our organisation and in 2010 more than 2500 staff has completed the programme. to share some of our experiences with you during this Corporate Education Sessio Hypertension Management: Lifestyle Intervention - Professional Handout Author: Tai Mooi Ho, RN, RM. Unitat d HTA i Risc Vascular, Servei de Nefrologia, Hospital del Mar (Parc de Salut MAR), Barcelona, Catalunya (Spain) Brief overview of the Spanish culture Language It is important to note that there is no one single culture and language in Spain. The Spanish territory has different geographical and climatic features, thus influencing in people characters and ways of life. Administratively, it has 17 autonomous regions, each having its own cultural heritage and a few having their own historical identities and languages, such as País Vasco, the Catalan-Valencian-Balearic area, and Galicia. The remaining regions share the official Castilian Spanish. The Castilian Spanish, as well as the Catalan & Galician languages, have Romanic roots, where as the Basque language (Euskera) is not demonstrably related to any other languages. An important aspect of spoken Spanish is the selective use of polite and informal form. Normally, in an unfamiliar encounter, the formal form is used in situations of age differences (younger person to elder) and social ranking, as a sign of respect. For more information: http://en.wikipedia.org/wiki/spanish_language. Hello: HolaThank you: Gracias Good-bye: Adiós I m your nurse: Soy su / tu enfermera (male nurse = enfermero) My name is: Mi nombre es Note: Su = your (polite form) and tu = your (informal form). Communication Style People from Spain are usually expressive in terms of facial expressions, tone of voice and gestures, especially in demonstrating one s emotions and feelings. This is probably why outsiders may consider the Spaniards to be effusive. In familiar social encounters, embracing each other and giving a kiss on both cheeks is usual among men/women and women/women. (See: http://rua.ua.es/dspace/bitstream/10045/4184/2/the%20invisible%20face%20of%20culture.pdf) Family/ Social Structure Despite of social changes, family unity remains an important element in the Spanish people s life (For more information: http://www.demogr.mpg.de/papers/workshops/010623_paper22.pdf) Traditional Values and Democratic Impulses: The Gender Division of Labor in Contemporary Spain All Spanish citizens bear 2 surnames (paternal & maternal), and women conserve their birth surnames at marriage. Spain is declared as a non-confessional state but Catholic traditions still prevail, as Catholicism was the official religion for most of its history. Hence, one has to understand this phenomenon in order to understand its existing cultures. The traditional Spanish diet is embedded in the products of an agrarian, pastoral, and horticultural inland society, and of seafood in the coastal regions. Principal staples are bread, legumes, rice, vegetables, eggs, chicken, rabbit, lamb, veal, game, pork and cured pork products, fish (fresh and salted), shellfish; olives and olive oil; fruits and nuts; grapes and wine made from grapes; cow milk and cured milk products. Honey and condiments such as parsley, thyme, oregano, paprika, saffron, onions, garlic are popular in Spanish cuisine. The family meals, lunch and supper, are still considered as an important part of family life. Some Spanish, due to various factors, have shifted from a healthy traditional diet to less healthy eating habits (e.g. consume of fast foods and commercialised precooked meals). Spanish people who live out of Spain may adopt the local diet. Examples of some dishes and foods with comments on compositions which are important to consider in the management of hypertension: Various versions of cocidos (may be rich in salt and cholesterol depending on ingredients used) Paella (a rice dish which contains seafood. It is rich in purines, cholesterol and potassium) Tortilla española (a thick egg-omellette with sliced potatoes). Cured hams and sausages (high salt and saturated fats content). Gazpacho (a cold tomato-based raw vegetable soup. It has a high potassium content) Examples of some common sweet desserts: Almond or almond-paste (e.g. turrón and mazapán): made with honey, egg and sugar (high in calories and potassium content) Flan (similar to custard): made of milk, egg and sugar (high caloric and cholesterol content) Examples of popular refreshments and alcoholic drinks: Leche de almendra: an almond drink. Horchata: made from the tuber chufa. Both beverages are rich in calories and potassium, Wine is the most common accompaniment to meals. Beer is drunk mostly before or between meals. Carajillo (coffee with brandy/rum) Cava (sparkling wine), cider, Sangría (wine punch), Sherry wine. Conceptualisation of Health Spain has a free and universal health care system. Folk beliefs regarding causes and cures of illness may be present in some, but people rarely forego their free medical coverage to depend solely on folk cures or curers, albeit at times people do self-medicate with over-the-counter medication from pharmacy. Nonetheless, Spanish are aware of the benefits of biomedicine. Note: Some people tend to use herbal drinks to lose weight [e.g. cola de caballo (Equisetum arvense): this has a diuretic effect; watch out for low serum potassium, especially if patient is already taking a diuretic as hypertension treatment!]. Smoking and alcohol consumption Regidor E. et al. Trends in cigarette smoking in Spain by social class. Prev Med. 2001; 33: 241-248 Current tobacco use: http://www.who.int/gho/countries/esp.pdf http://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf Note: Although Central & South Americans speak Spanish, their communication styles, lifestyles and world views are distinct from European Spanish. Hypertension Management: Lifestyle Intervention - Professional Handout Author: Nurit Cohen RN, MHA. Nephrology dept, Soroka University Medical Center, Beer-Sheva, Israel Brief overview of the Jewish culture Language The official language is Hebrew (תירבע = Ivrit), also some Jews use Yiddish or Ladino. Hebrew is a Semitic language. Culturally, it is considered the Jewish language in its modern form is spoken by most of the seven million in Israel, while Classical Hebrew has been used for prayer or study in Jewish communities around the world for over two thousand years. The Bible (Tanakh) is written in Classical Hebrew. For this reason, Hebrew has been referred to by Jews as Leshon HaKodesh "The Language", since ancient times. The Hebrew alphabet has 22 letters, five of which use different forms at the end of a word (תשרקצפעסנמלכיטחזוהדגבא). There are no distinct capital letters. It is an abjad consisting only of consonants. Hebrew is written from right to left. Hebrew letters are also used to denote numbers. Hello: Shalom (םולש) Thank you: Toda (הדות) Good-bye: Shalom or Leyitraot (תוארתהל וא םולש) I m your nurse: Ani ha-ahot shelkha ( ) ינא ךלש תוחאה My name is: Korim li (יל םיארוק) Communication Style There is no specific way for communication, although body language, gestures and tone of voice play a role in expression. When family or close friends are meeting they kiss on cheeks, or sometimes on both cheeks. Shaking a hand is common at business meeting and greetings especially among men. Religious people avoid touch between man and woman. Family and Holidays The traditional Jewish family is patriarchal, but mother has very important role in the family, since she is responsible for "Shalom bait"- home/family peace,; a man is Jewish only if his mother is. The term shalom ["peace"] also signifies completeness, wholeness, and fulfillment. In the last century, modernization caused a lot of changes among family structure. Jewish holidays are special days in the Jewish calendar, which celebrate moments in Jewish history, as well as central themes in the relationship between God and the world. Shabbat, the weekly day of rest, last from sundown on Friday night to shortly after sundown Saturday night, it commemorates God's day of rest after six days of creation. All "work" is restricted during Shabbat and the Holidays. Non-religious Jewish people celebrate Holidays among their families without the restrictive laws. Jewish Cuisine is the collection of cooking traditions that has been shaped by many cultures in which Jews have lived, including Middle Eastern, Mediterranean, Spanish, German and Eastern European styles of cooking, all influenced by Jewish dietary laws (kashrut). People who observe these laws are "keeping kosher". The laws of keeping kosher have influenced Jewish cooking in two primary ways: by prescribing what foods are permitted and how food must be prepared: certain foods, notably pork and shellfish, are forbidden; meat and poultry may not be combined with dairy products, and meat must be ritually slaughtered and salted to remove all traces of blood. At the end of this time the salt is washed off and the meat is ready for cooking. Health concept Illness prevention and maintenance of health are a very high priority. Health concept has been reflected by Judaism from ancient sources - the Bible -Torah. It says that person's life but not his body is given in his possession. He must keep the deposit and return fully to the Creator in due course. Saving the body and health is not the main purpose of man. It is means to achieve wholeness in all areas: virtue, intellectual integrity, spirit and mentally. Maimonides (Rambam), a prominent medieval Jewish physician, rabbi and philosopher, wrote in his commentaries on the Torah: Maintaining a healthy and sound body is among the ways of God for one cannot understand or have any knowledge of the Creator if he is ill. He advocated disease prevention with hygiene, fresh air, clean water, exercise and healthy diet. Smoking and alcohol consumption Drinking wine has a significant role as traditional blessing (Kiddush- sanctification) over a cup of wine on Sabbat, Jewish holiday meals, and all religious rituals. Smoking is prohibited on Shabbat and Jewish Holidays. Hypertension Management: Lifestyle Interventions - Patient Handout (Greek) Co-author: Anastasia Liossatou RN, MSc. Dialysis Unit Of Kefalonia, Greece Recommendations on Lifestyle Interventions adapted from the ESH/ESC 2007 Guidelines for the Management of Arterial Hypertension (To maintain a healthy lifestyle) Η Υπέρταση και η καρδιοαγγειακή νόσος συνδέονται άμεσα (Hypertension and cardiovascular disease are closely related) Η ρύθμιση της υψηλής αρτηριακής πίεσης είναι απαραίτητη για την πρόληψη των καρδιοαγγειακών επιπλοκών (To prevent cardiovascular disease complications it is necessary to control high blood pressure) Συνεπώς, είναι πολύ σημαντική η καλή ρύθμιση της αρτηριακής πίεσης (Therefore, it is very important that your blood pressure is well controlled) Η αντιμετώπιση της υπέρτασης επιτυγχάνεται με τα ακόλουθα: (The management of hypertension consists of): 1)Τη διατήρηση ενός υγιεινού τρόπου διαβίωσης (A healthy lifestyle) 2)Τη φαρμακευτική αγωγή (Medication) Το παρόν έντυπο περιλαμβάνει συστάσεις για έναν υγιεινό τρόπο διαβίωσης (This document contains recommendations for a healthy lifestyle) Η ελληνική μαγειρική βασίζεται στη μεσογειακή διατροφή, μολονότι μερικές φορές ο μοντέρνος τρόπος ζωής οδηγεί σε ανθυγιεινές διαιτητικές επιλογές. Παραδοσιακά, οι Έλληνες χρησιμοποιούν το ελαιόλαδο, τρώνε όσπρια, φρούτα λαχανικά, διάφορα είδη κρέατος (συμπεριλαμβανομένων των πουλερικών και του λαγού), γιαούρτι, τυρί και πίνουν κρασί μπύρα κα. Περιορίστε την κατανάλωση κρέατος και επιλέξτε για τη διατροφή σας περισσότερο ψάρι και θαλασσινά. Τα φαγητά σας να τα προτιμάτε ψητά ή βραστά αντί για τηγανιτά. Περιορίστε τα αλμύρα τυριά όπως είναι η φέτα και το κεφαλοτύρι. Να αποφεύγετε τα έτοιμα φαγητά και την μεγάλη κατανάλωση αλκοόλ. Διακόψτε το κάπνισμα αμέσως! Όταν μεταναστεύετε σε άλλες χώρες προσπαθήστε να διατηρείτε τη Μεσογειακή διατροφή σας. Αν είστε υπέρβαρος/ -η, προσπαθήστε να χάσετε βάρος με τη σωματική άσκηση και την υιοθέτηση υγιεινής διατροφής Greek cooking is typically Mediterranean although many times the modern way of life leads to unhealthy choices. The ingredients most often used are olive oil, grains and bread, wine, fish, various meats (including poultry and rabbit), yoghurts and cheese, and fresh vegetables. Restrict the consumption of meat products and choose more fish and seafood to your diet. Choose to roast, boil or grill your food instead of frying it. Avoid high consumption of very salty cheeses such as feta cheese and kefalotyri. Avoid junk food and limit your alcohol consumption. Greeks smoke a lot. Quit smoking immediately! When migrating to other countries try to maintain your Mediterranean eating habits and avoid diet rich in saturated fat, salt and low in fibre. Should you be overweight, try to lose weight effectively by doing physical exercise and eating a healthy diet. Αποφύγετε την καθιστική ζωή: να κινείστε όσο γίνεται περισσότερο! Καθημερινό περπάτημα, εάν είναι δυνατόν, για 30-45 λεπτά Άλλες ωφέλιμες μορφές άσκησης: ποδήλατο, κολύμβηση, χορός, καθώς και η αποφυγή χρήσης του ανελκυστήρα όπου μπορείτε να χρησιμοποιείτε τις σκάλες. : προκειμένου να είναι αποτελεσματική η σωματική άσκηση, θα πρέπει να γίνεται σε συστηματική βάση. Η πλέον πρακτική και οικονομική μορφή άσκησης είναι το περπάτημα! Τροφές Αύξηση της κατανάλωσης φρούτων και λαχανικών. Μείωση του προσλαμβανόμενου με τις τροφές λίπους ( π.χ από τηγανητές τροφές, λιπαρά κρέατα όπως χοιρινό, αρνί, λουκάνικα και τροφές από fast foods ). : Οι τηγανητές τροφές έχουν υψηλό θερμιδικό φορτίο και η συχνή κατανάλωσή τους μπορεί να οδηγήσει στην παχυσαρκία. Επιπλέον το τηγανισμα αυξάνει την περιεκτικότητα του λαδιού στο φαγητό ενώ οξειδώνει τη σύστασή του, γεγονός που μπορεί να προκαλέσει αύξηση της χοληστερίνης και του κινδύνου για στεφανιαία νόσο. Συνίσταται η χρήση ελαιόλαδου/ ηλιέλαιου για την μαγειρική ή τα ψητά στο grill. Μειώστε την πρόσληψη νατρίου (αλατιού): αποφυγή των τροφών πλούσιων σε αλάτι.(π.χ κονσέρβες, αλλαντικά, αλμυρά τυριά, παστά ψάρια και θαλασσινά, τουρσί λαχανικά). : Χρησιμοποιείτε πολύ λίγο αλάτι στη μαγειρική σας ή στο τραπέζι. 5g ( 2 ). Να πίνετε τουλάχιστον 1500ml/ ημερησίως (7-8 ποτήρια). Αν έχετε προβλήματα με την καρδιά ή τα νεφρά σας, εξακολουθήστε τις οδηγίες του γιατρού ή του νοσηλευτή σας. Καφέδες: όχι πάνω από 2 την ημέρα. Αλκοόλ: όχι πάνω από 2 ποτήρια την ημέρα. :! Σταματήστε το κάπνισμα, αν καπνίζετε. : Μπορούμε να σας βοηθήσουμε να κόψετε το κάπνισμα αλλά χρειαζόμαστε τη συνεργασία σας! Physical Activity Avoid a sedentary lifestyle: try to be as active as possible! Everyday walk, if possible, for 30 to 45 minutes. Other beneficial exercises: cycling, swimming, dancing and using the staircase more often than the lift / elevator. Please note: To be effective, physical exercise should be done on a regular basis. The most practical and cheap exercise is walking! Food Increase consumption of vegetables and fruits. Reduce intake of fats and fried foods (For example: full fat meat like pork, sausages, lamp and fast foods). Please note: Fried foods contain high energy density, frequent consumption can easily lead to obesity. Moreover, the frying process increases higher oil content and oxide material in food, which can cause high cholesterol and coronary artery disease. It is better to use olive oil / sunflower seed oil for cooking or grill food instead. Reduce sodium (salt) intake; avoid salty foods (For example: packed chips, ready-made food, canned food, salty cheeses like feta cheese, dried and salted seafood snacks, pickled vegetables tinned.) Please note: Use very little salt in cooking and do not use extra salt during eating. Recommended daily salt intake is less than 5g (about 2 teaspoonful). Fluid Intake Drink at least 1500 ml/ day; about 7 to 8 glasses. If you have heart or kidney problems, follow your doctor s / nurse s instructions. Coffee: do not take more than 2 cups a day. Wine / beer: do not take more than 2 glasses a day. Please note: Limit intake of soft drinks and alcohol! Avoid unhealthy habits If you smoke, you should stop smoking. Please note: For your health, we can help you to stop smoking, but we need your collaboration! Hypertension Management: Lifestyle Interventions - Patient Handout (Spanish) Author: T. M. Ho, RN, RM. Unitat d Hipertensió i Risc Vascular, Servei de Nefrologia, Hospital del Mar (Parc de Salut MAR), Barcelona, Catalunya (Spain) Recommendations on Lifestyle Interventions adapted from the ESH/ESC 2007 Guidelines for the Management of Arterial Hypertension Mantener una vida saludable(to maintain a healthy lifestyle) La hipertensión y la enfermedad cardiovascular tienen una estrecha relación (Hypertension and cardiovascular disease are closely related) Para prevenir complicaciones, es necesario controlar la hipertensión. To prevent cardiovascular disease complications it is necessary to control high blood pressure) Por tanto, es importante que su presión arterial esté bien controlada. Therefore, it is very important that your blood pressure is well controlled) El manejo de la hipertensión consiste en: (Hypertension management consists of): 1) Estilo de vida saludablehealthy lifestyle)2)medicaciónmedication) Este documento contiene recomendaciones acerca de un estilo de vida saludable (This document contains recommendations for a healthy lifestyle) La dieta mediterránea está considerada una dieta equilibrada y saludable. Limitar el consumo de productos cárnicos. Comer pequeñas porciones de carne magra. Seleccionar pescado, conejo y aves como una alternativa a la carne roja. Antes de cocinar la carne, recortar toda la grasa visible. Utilizar métodos de cocción saludable: a la plancha, al horno, el hervido y al vapor, en lugar de fritura. En cuanto a comer en restaurantes, pedir comidas con poca sal y hechas a la planchas/ la brasa. Como guarnición, escoger verduras/ ensalada en lugar de patatas fritas. Postre: frutas. En caso de tener sobrepeso, tratar de perder peso con práctica regular de ejercicio físico y una dieta saludable. The Mediterranean diet is considered a balanced and healthy diet. Limit consumption of meat products. Eat small portions of lean meat. Select fish, rabbits and poultry as an alternative to red meat. Before cooking the meat, trim all visible fat. Use healthy cooking methods: grilled, baked, boiling and steamed, instead of frying. As for eating out, ask for foods with little salt and non-fried foods. As a side dish, choose vegetables / salad, instead of chips. Dessert: Fruit. Should you be overweight, try to lose weight effectively by doing physical exercise and eating a healthy diet. Actividad Física Evitar una vida sedentaria: tratar de mantenerse tan activo/a como sea posible! Andar 30-45 minutos cada día. Otros ejercicios beneficiosos: el ciclismo, la natación, el baile y el uso de la escalera con más frecuencia que el ascensor /escalera mecánica. Atención: Para que sea efectivo, el ejercicio físico debe practicarse de forma regular. El ejercicio más práctico y barato es andar! a Comida Aumentar el consumo de verduras y frutas. Reducir la ingesta de grasas y alimentos fritos (Por ejemplo: carne con grasa, salchichas, embutidos, pollo con la piel y grasa, panceta y las comidas rápidas ). Atención: Los alimentos fritos contienen muchas calorías, su consumo frecuente puede conducir fácilmente a la obesidad. El proceso de freir resulta en alto contenido de grasa y material de óxido en los alimentos, causando así un alto nivel de colesterol en la sangre y, consecuentemente, la enfermedad coronaria. Se recomienda cocinar con aceite de oliva / girasol, o cocinar a la plancha. Reducir el consumo de sodio (la sal) y evitar los alimentos salados (Por ejemplo: aceitunas, conservas, salsas comerciales, frutos secos salados, quesos curados, embutidos y comidas precocinadas...etc.) Atención: Al cocinar, usar muy poca sal, eviatando también el uso de los poroductos potenciadores de sabor en el guisado y las sopas comerciales (en polvo o instantànea). Se recomienda el consumo de menos de 5g de sal por día (aproximadamente 2 cucharadita). Líquidos Beber por lo menos 1500ml de agua cada día (7 a 8 vasos). Si tiene problemas de corazón o riñon, seguir las instrucciones de su médico / enfermera. Café o té: no tomar más de 2 tazas al día. Vino y cerveza: no tomar más de 2 vasos al día. Atención: Limitar el consumo de refrescos carbonicos y bebidas alcohólicas! Evitar hábitos poco saludables Si fuma, debe dejar de fumar. Atención: Para su salud, podemos ayudarle a dejar de fumar, pero necesitamos su colaboración! Physical Activity Avoid a sedentary lifestyle: try to be as active as possible! Everyday walk for 30 to 45 minutes. Other beneficial exercises: cycling, swimming, dancing and using the staircase more often than the lift / elevator. Please note: To be effective, physical exercise should be done on a regular basis. The most practical and cheap exercise is walking! Food Increase consumption of vegetables and fruits. Reduce intake of fats and fried foods (For example: meat with fats, sausages, chicken skin and grease, bacon and fast foods ). Please note: Fried foods contain a lot of calories, frequent consumption can easily lead to obesity. The frying process increases higher oil content and oxide material in food, which can cause high cholesterol and coronary artery disease. It is recommended to use olive oil / sunflower seed oil for cooking, or grill food instead. Reduce sodium (salt) intake and avoid salty foods (For example: salted olives, tinned foods, commercialised sauces, salted nuts, cured cheese, cured pork products and commercialised precooked foods...etc.) Please note: Use very little salt, avoiding also the use of other salty products in cooking and commercialised soups (in powder or instant). Recommended daily salt intake is less than 5g (about 2 teaspoonful). Fluid Intake Drink at least 1500ml/ day (7 to 8 glasses). If you have heart or kidney problems, follow your doctor s / nurse s instructions. Coffee or tea: do not take more than 2 cups a day. Wine and beer: do not take more than 2 glasses a day. Please note: Limit intake of soft drinks and alcohol! Avoid unhealthy habits If you smoke, you should stop smoking. Please note: For your health, we can help you to stop smoking, but we need your collaboration! Hypertension Management: Lifestyle Interventions - Patient Handout (Hebrew) Co-author: Nurit Cohen RN, MHA. Nephrology dept, Soroka University Medical Center, Beer-Sheva, Israel Recommendations on Lifestyle Interventions adapted from the ESH/ESC 2007 Guidelines for the Management of Arterial Hypertension (To maintain a healthy lifestyle) (Hypertension and cardiovascular disease are closely related) ןיב קודה רשק ונשי םד ץחל רתי ה ילכו בל תולחמל םד To prevent cardiovascular disease complications it is necessary to control high blood pressure) טולשל ךרוצ שי םד ילכו בל תולחמ תעינמל ב הובג םד ץחל Therefore, it is very important that your blood pressure is well controlled) ןכל ךמד ץחלב בטיה טולשל דאמ בושח (The management of hypertension consists of) םד ץחלב לופיטה לוכ : A healthy lifestyle) רוא אירב םייח ח Medication) תופורת (This document contains recommendations for a healthy lifestyle) מסמ אירב םייח חרואל תוצלמה ללוכ הז ך,םידוהיה ואב ןהמ תונוש תויוברתמ םילכאמ וכותב בלשמ ילארשי/ידוהי לושיב,ןוכיתה חרזממ ואבש לושיב תונונגס ללוכ,דרפס,ןוכיתה םי.תיחרזמ הפוריאו הינמרג.לוביתב ןהו םילכאמה גוסב ןה איה העפשהה,לושיבב תומיוסמ תולבגה םירידגמש תורשכ יקוחמ םג םינשה ךלהמב ועפשוה ולא לכ תליכא יא,בלחו רשב לש הדרפה :ןוגכ.הרשכ הטיחש,םי ילכאמו ריזח רשב,םדה תאצוהל חלמומ הרשכהה ךילהתב רשב לכ,בטיה ףטשנ.לושיבל סנכנ ןכמ רחאל קרו,תורשכ לע םירמוש םידוהיה לכ אל םויכ.םייתרוסמו םייתד רקיעב אלא,ןחלושה ביבס םה תילארשיו תידוהיה תוברתב םיגחה לכ חוריאה תוברת םגו.םיחרואו החפשמ -אתווצב הליכאה תא תללוכ.ףדוע לקשמ ףסוותהל יושע םיגחה רחאלש ךכ,. " Jewish/Israeli cooking combines foods from different cultures Jews came from, including cooking styles from Middle East, Mediterranean, Spain, Germany and Eastern Europe. The effect is both on the type of food and its seasoning. All of these were influenced over the years by the rules of kosher cooking with certain restrictions, such as separation of meat and milk, not eating pork, seafood, and kosher slaughter. During meat preparation it is salted for removal of blood, washed well, and only than is cooked. Today, not all Jews keep kosher, but mostly those who are the religious and traditional Jews. family and guests. So, after the holidays All Jewish culture and Israeli holidays are around the table, and also the hosting culture includes eating together - you may be gain extra weight so be careful at holiday time Should you be overweight, try to lose weight effectively by doing physical exercise and eating a healthy diet.! : דע 30 לש תימוי םוי הכילה תוקד 45 :תפסונ תינפוג תוליעפ,תולמעתה,הייחש,םיינפוא תביכר,םידוקיר.תילעמב םוקמב תוגרדמב היילע :,ליעוהל ידכ תוליעפה.עובק סיסב לע עצבתהל הכירצ תינפוג תוליעפ!הכילה איה רתויב השיגנה.ךרובע הנהמ היהת תוליעפהש יוצר תוקריו תוריפ תליכאב הברת :אמגודל).םינגוטמו םינמש םילכאמ תחפה,שבכו ןמש רקב רשב,םינפ יקלח,ףוע לש רוע בבק -םינכומ רשב ילכאמ,םיקינקנ,.(ריהמ ןוזמ ;םינמש בלח ירצומ ;רגרובמה םיזר בלח ירצומו רשב לוכא,היגרנא יריתע םה םיליכמ םינגוטמ םילכאמ : םהלש תרבגומ הכירצ.הנמשהל ליבוהל הלולע,ךכמ הרתי רצונ םגו ןמש גפוס לכואה ןוגיטה ךילהתב.תואירבל קיזמה ןצמחמ רמוח םורגלו לורטסלוכ תולעהל םייושע הלא לכ.בל תלחמלו םיקרוע תשרטל תיז ןמש ןוגכ םינמשב ןוגיטל שמתשהל יוצר.הלונקו ענמיה ;לושיב חלמ יביכרממ דחא אוהש,ןרתנה תכירצ תא לבגה םיחולמ םילכאמ תליכאמ,תוחולמ תוניבג :אמגודל),םיחולמ םיגד,קרמ תוקבא,םיקינקנ ומכ םידבועמ תונוזמ,םיבטר םישובכ תוקרי,חלמב.(םיחולמ םיפיטחו םיחוציפ םירמושמ לע םיפידע םיאופק וא םיירט ןוזמ ירצומ,לושיבה ךילהתב חלמ דאמ טעמב שמתשת : םירשב לושיבב דוחייב 5-.םירשכומ ( 2-),םויל ל"מ 1500 תוחפל התש תוסוכ 7-8-כ הצלמהל םאתהב) (תיאופר :הת וא הפק םויל תוסוכ 2-מ רתוי אל :הריבו ןיי.םויל תוסוכ 2-ל רבעמ אל!םיילוהוכלאו םילק תואקשמ תכירצ לבגה :בל םיש!!ןשעמ ךניה םא,ןושיע קספה ונא,ךתואירב ןעמל ךא,ןושיע תקספהב ךל עייסל לוכי יאופר תווצ :!ךלש הלועפה ףותישל םיקוקז Physical Activity Avoid a sedentary lifestyle: be as active as possible! Everyday walk for 30 to 45 minutes. Other beneficial exercises: training, cycling, swimming, dancing and using the staircase more often than the lift / elevator. Please note: To be effective, physical exercise should be done on a regular basis. The most practical and cheap exercise is walking! Physical activity should be fun for you. Food Increase consumption of vegetables and fruits. Reduce intake of fats and fried foods (For example: fat beef and lamb meat, chicken skin, sausages, prepared meat dishes hamburger, kebab; fat diary products, and fast foods) Eat lean meat and diary products Please note: Fried foods contain high energy density; frequent consumption can easily lead to obesity. Moreover, the frying process increases higher oil content and oxide material in food, which can cause high cholesterol and coronary artery disease. It is better to use olive or canola oil for cooking or grill food instead. Reduce sodium (salt) intake; avoid salty foods (For example: salted cheese, fish; processed food as sausages, soup, sauces, salt-pickled vegetables, salted nuts, seeds and snacks). Fresh or frozen products are better than canned Please note: Use very little salt in cooking, especially of kosher meat. Recommended daily salt intake is less than 5g (about 2 teaspoonfuls). Fluid Intake Drink at least 1500 ml/ day; about 7 to 8 glasses. If you have heart or kidney problems, follow your doctor s /nurse s instructions. Coffee or tea: do not take more than 2 cups a day. Wine and beer: do not take more than 2 glasses a day. Please note: Limit intake of soft drinks and alcohol! Avoid unhealthy habits If you smoke, you should stop smoking. Please note: For your health, medical staff can help you to stop smoking, but we need your collaboration! Hypertension Management: Lifestyle Interventions - Patient Handout (Simplified Chinese) Author: T. M. Ho, RN, RM. Unitat d Hipertensió i Risc Vascular, Servei de Nefrologia, Hospital del Mar (Parc de Salut MAR), Barcelona, Catalunya (Spain) Recommendations on Lifestyle Interventions adapted from the ESH/ESC 2007 Guidelines for the Management of Arterial Hypertension (To maintain a healthy lifestyle) (Hypertension and cardiovascular disease are closely related) To prevent cardiovascular disease complications it is necessary to control high blood pressure) Therefore, it is very important that your blood pressure is well controlled) The management of hypertension consists of): A healthy lifestyle)medication) (This document contains recommendations for a healthy lifestyle). The traditional Chinese diet is usually low in fat and high in fibre, as it contains more vegetables and less meat intake. However, people living abroad sometimes also eat local food besides their own traditional diet. Some of this food may contain high fat and sugar content. Therefore, they can lead to obesity, thus affecting health. Choose low-saturated-fat products. Restrict the consumption of meat products. Eat small portion of lean meat. Select soybean, fish or poultry as an alternative to beef and pork. Before cooking meat, trim off all visible fat.eat roast or barbecue foods, instead of fried foods. Regarding pre-cooked foods or eating in restaurants, choose low-fat dishes with vegetables, grains and beans and fruits. Should you be overweight, try to lose weight effectively by doing physical exercise and eating a healthy diet. 30 45 5 2 ). 1500ml 7-8, Physical Activity Avoid a sedentary lifestyle: try to be as active as possible! Everyday walk for 30 to 45 minutes. Other beneficial exercises: practising taijiquan, cycling, swimming, dancing and using the staircase more often than the lift / elevator. Please note: To be effective, physical exercise should be done on a regular basis. The most practical and cheap exercise is walking! Food Increase consumption of vegetables and fruits. Reduce intake of fats and fried foods (For example: Chinese sausages, chicken and duck skin or grease, fried pork rind, deep fried noodles and fast foods). Please note: Fried foods contain high energy density, frequent consumption can easily lead to obesity. Moreover, the frying process increases higher oil content and oxide material in food, which can cause high cholesterol and coronary artery disease. It is better to use peanut oil / sunflower seed oil for cooking. Coconut and palm oils are not recommended. Reduce sodium intake; avoid salty foods (For example: instant noodles, salted duck eggs, pickled vegetables, dried and salted seafood snacks, tinned fish in black bean sauce...) Please note: Use very little salt, monosodium glutamate, soy sauce, shrimp paste and the like in cooking. Recommended daily salt intake is 5g (about 2 teaspoonful). Fluid Intake Drink at least 1500 ml/ day; about 7 to 8 glasses. (If you have kidney problems, follow your doctor s / nurse s instructions). Coffee or tea: do not take more than 2 cups a day. Wine and beer: do not take more than 2 glasses a day. Please note: Limit intake of soft drinks and alcohol! Avoid unhealthy habits If you smoke, you should stop smoking. Please note: For your health, we can help you to stop smoking, but we need your collaboration! Hipertansiyon, kardiyovasküler ve böbrek hastalıkları için bir risk faktörüdür. Tahminlere göre, yoğun ve etkin önlemler uygulanmadığı sürece hipertansiyon görülme sıklığı artacaktır. Sağlıklı bir yaşam tarzını benimsemek için hastalarda bakım müdahaleleri etkili iletişim gerektirir. Ancak, insanların göçü nedeni ile sağlık profesyonellerinin çoğu farklı kültüre sahip hastalar ile karşılaşırlar. Böylece, yeterli kan basıncı kontrolü gerektiren bu hastaları tedavi etmek birçok vakada iletişimleri zor hale getirir. Literatür değerlendirmeleri şunu gösterir: kültürel olarak ayrı bağlamda karşılaşılan dil ve kültürel engeller, hastalar ve sağlık ekibi için istenmeyen sonuçlara yol açabilir. Bu çalıştayın amacı: 1. Avrupa Hipertansiyon Topluluğu ve Avrupa Kardiyoloji Topluluğu nun Arteryel Hipertansiyonun yönetimi için 2007 kılavuzuna göre ayrı kültürel geçmişlerden hastaların, terapötik yaşam tarzı değişiklikleri ile ilgili sorunları ele almak. 2. Yaşam tarzı değişikliklerinde bakım müdahalelerini kolaylaştırmak için farklı kültürel geçmişli hipertansif hastalarda Bildirilerin üretimini sunmak. Bu Bildiriler Çince, Yunanca, İbranice ve İspanyolca kullanılabilir olacaktır. 3. Çalıştaya katılanlara kendi dilleri ve kültürlerinde benzer bildirileri özenle hazırlama fırsatı vermek. Amaç, ilgili kültürel bilgiler ile farklı dillerde mümkün olduğunca çok belge üretmektir. Bakımını üstlendiğimiz tüm hastalarda optimal kan basıncı kontrolü elde etmek için görevimizde yardımcı olacak bu dokümanlar daha sonra, Avrupa daki hemşireler ile paylaşmak için EDTNA/ERCA web sitesine yüklenecektir. KBY Projesi KBY Çalışma Grubu 18 21 Eylül 2010 da Dublin, İrlanda da gerçekleşecek olan 39. Uluslararası EDTNA/ERCA Konferansında bir çalıştay düzenlemeyi planlamaktadır. Bu çalıştay hipertansif hastalarda trans-kültürel yaşam tarzı müdahaleleri üzerine odaklanacaktır. KLinik uygulamalara yönelik dokümanları elde etme şansını kaçırmayın!!!