bluuebunny/crossref_metadata_2025 huggingface dataset:
ПЕРВЫЕ СВЕДЕНИЯ О ВОДОРОСЛЯХ ОЗЕР ВИЛЬЕНТ И САМОТЛОР (ЗАПАДНАЯ СИБИРЬ, ХМАО-ЮГРА)
Authors: Skorobogatova Olga Nikolaevna , Usmanov Iskander Yusufovich
Published: August 2016

Приводится информация о водорослях, развивающихся в двух озерах Ханты-Мансийского автономного округа – Югры. Сбор и изучение фитопланктона и перифитона выполнены синхронно, в начале лета 2011 года. Целью работы является анализ таксономической структуры водорослей озер Самотлор и Вильент.Всего в водоемах отмечено 67 видовых и внутривидовых таксонов, относящихся к 28 родам, 19 семействам, 7 классам и 4 отделам: Chrysophyta – 9; Bacillariophyta – 19; Euglenophyta – 6; Chlorophyta – 33.Полученные вХанты-Мансийском автономном округе – Югре новые данные подтвердили распространение некоторых видов в экотопах с кислой средой и малыми концентрациями солей, то есть в ультрапресных, очень мягких водах. Так называемый «болотный комплекс» водорослей рассматриваемых озер составляет 26.9% от общего состава, представлен видами родов Pinnularia (2), Eunotia(2), Staurastrum (2), Cosmarium (3), Euastrum(1) и Closterium(8).Характер раннелетнего водорослевого комплекса имеет структуру диатомово – зелено – золотистого. К наиболее часто встречаемым водорослям относятся: Dinobryondivergens, Trachelomonashispida, Closteriumacicularis, Monoraphidiumarcuatium, Trachelomonasvolvocina, Nitzchiasublinearis, Tabellaria, Dinobryoncylindricum, D. elegans.По результатам эколого-географического анализа водорослей преобладают широко распространенные, олигогалобные и индифферентные по отношению к активной реакции среды виды.
О МОНОГРАФИИ «ТУБЕРКУЛЕЗ. ЭПИДЕМИОЛОГИЯ И ОРГАНИЗАЦИЯ БОРЬБЫ С ТУБЕРКУЛЕЗОМ В СОВРЕМЕННЫХ УСЛОВИЯХ КРАЙНЕГО СЕВЕРА (НА ПРИМЕРЕ РЕСПУБЛИКИ САХА (ЯКУТИЯ))»
Authors: Pavlova Ekaterina Sergeevna
Published: August 2016

Представлена рецензия на монографию коллектива авторов под редакцией заслуженного деятеля науки РФ, профессора Савилова Е.Д. Монография явилась первым совместным обобщающим трудом ГБУ РС (Я) Научно-практический центр «Фтизиатрия» (г. Якутск) и Научного центра здоровья семьи и репродукции человека (г. Иркутск) по проблеме организации борьбы с туберкулезом в регионе с низкой плотностью населения – Якутии, молекулярно-генетических особенностях микобактерий туберкулеза, циркулирующих в республике, лекарственной устойчивости возбудителя. Книга может быть интересна всем специалистам, занимающимся вопросами туберкулеза.
Automated Multilateral Negotiation on Multiple Issues with Private Information
Authors: Zheng Ronghuo , Dai Tinglong , Sycara Katia , Chakraborty Nilanjan
Published: August 2016

In this paper, we propose and analyze a distributed negotiation strategy for a multi-agent, multi-attribute negotiation in which the agents have no information about the utility functions of other agents. We analytically prove that, if the zone of agreement is nonempty and the agents concede up to their reservation utilities, agents generating offers using our offer-generation strategy, namely the sequential projection strategy, will converge to an agreement acceptable to all the agents; the convergence property does not depend on the specific concession strategy. In considering agents’ incentive to concede during the negotiation, we propose and analyze a reactive concession strategy. Through computational experiments, we demonstrate that our distributed negotiation strategy yields performance sufficiently close to the Nash bargaining solution and that our algorithms are robust to potential deviation strategies. Methodologically, our paper advances the state of the art of alternating projection algorithms, in that we establish the convergence for the case of multiple, moving sets (as opposed to two static sets in the current literature). Our paper introduces a new analytical foundation for a broad class of computational group decision and negotiation problems.
Stakeholder management strategies during construction project work
Authors: Collinge Bill
Published: August 2016

This article engages with stakeholder management practices from the building phase of hospital construction projects to analyse the methods employed by contractor and client in a construction project context. A series of vignettes illustrating stakeholder management practices in action are combined with the insights of a client relations manager with direct responsibility for stakeholder management affairs. The article provides practical guidance for practitioners and explores how stakeholder management issues revolve around the emerging event, with a supporting apparatus to facilitate communication and collaboration being critical to stakeholder interests and concerns being addressed. The insights are valuable for multiple health facility contexts where obtaining and maintaining stakeholder support is important.
Improving efficiency in the endoscopy unit
Authors: Mohamed Gaafar , Murphy Clodagh , McCarthy Jane , Buckley Martin
Published: August 2016

The demand for endoscopic services is increasing rapidly, and this necessitates optimal efficiency in the endoscopy unit.

Aim:

To assess the efficiency of an endoscopy unit, concentrating in the delay pre-and post-procedure.

Patients:

Outpatient/day ward procedures.

Methods:

We examined the delay in endoscopic procedures between 19 and 30 May 2014. The procedure process was examined at three different stages: stage 1 is from when the ‘patients arrives to pre-procedure ward’ to ‘ready for procedure’; stage 2 is from ‘where the patient is ready and waiting to be called’ to ‘when the endoscopy procedure commences’; and stage 3 is from ‘when the ward is contacted to collect patient post procedure’ to ‘when the patient is discharged from the ward’.

Results:

The pathways for 238 endoscopic procedures were assessed. In total, 249 episodes of delay were documented. Stage 1 accounts for 28% of the delays; there is 1.1–1.6 hours of a delay per patient at this stage. Stage 2 accounts for 53% of the delays; there is a delay of 2.5–2.75 hours per patient at this stage. Stage 3 accounts for 19% of the delays; there is a delay of 1.75 – 2 hours per patient at this stage.

Conclusion:

Delays were a major factor affecting optimal use of available day ward/endoscopy resources. Significant delay can occur pre-and post-procedure. Strategies to reduce peri-procedural delays could have a favourable impact on day ward capacity and the volume of procedures performed in the endoscopy unit.
Homeless medical respite in the UK: A needs assessment for South London
Authors: Dorney-Smith Samantha , Hewett Nigel , Burridge Stan
Published: August 2016

A needs assessment was undertaken to provide evidence to support a business case for enhanced homeless medical respite provision in South London. A literature review was undertaken, and existing homeless medical respite models were reviewed. Learning is summarised. A summary of the locality inpatient caseload analysis undertaken is presented, offering a new insight into the varied post-discharge needs of homeless patients. Service provider and service user perspectives are presented.
Patient perceptions of the professional attitudes of radiographers
Authors: Ochonma Ogbonnia , Eze Charles , Eze Bartholomew , Nwankwor Chikezie
Published: August 2016

Introduction:

In Nigeria radiographers practice in both public and private hospitals, yet there are lingering differences in perceptions among patients about the professional conduct of radiographers related to the type of hospital they work in. The purpose of this study was to investigate these differences and make policy recommendations.

Methods:

A cross-sectional study was undertaken in which 300 respondents (patients) who had received outpatient radiological services in a public and a private hospital answered a questionnaire.

Results:

The results showed that radiographers in the public facility excelled in five professional areas, including the principle of informed consent and the right of patients or their carers to refuse service or treatment, while radiographers in the private facility performed better in ten professional areas, including the observation of appropriate professional boundaries.

Conclusion:

Lack of enforcement of professional rules and regulations regarding the conduct of radiographers is a major problem. A monitoring body overseeing the professional conduct of radiographers is highly recommended to improve public trust and confidence in radiological services in public and private hospitals.
Blocked urinary catheters: can they be better managed?
Authors: Gibney Linda E
Published: August 2016

This article discusses one of the problems associated with urinary catheterisation. It focuses on catheter blockage and explains the effects of this on patients and the health service and aims to guide nurses in their management of this complex issue. The length of time a catheter remains functional is unique to the individual and imperative to good catheter care. Coupled with this the cause of the blockage needs to be identified before a treatment plan can be formulated. Encrustation is identified as a major problem and the reliability of using the pH value of urine to monitor is discussed. Adequate fluid intake is essential for catheter management and the benefits of citrate drinks are highlighted. The treatment regime of catheter maintenance solution is examined and while this may be an option for some patients the suggestion of proactive catheter changes would appear to be the most appropriate.
Reconstructing compassion: should it be taught as part of the curriculum?
Authors: Geraghty Sadie , Lauva Melanie , Oliver Kim
Published: August 2016

Currently, within the nursing and midwifery curriculum of Australia, the concepts of caring and compassion are not routinely taught. While these are thought of as integral components for nursing and midwifery students to develop during their theoretical and practical training, it is questionable whether they can actually be taught, or whether they are innate to the individual's own disposition. This article suggests that compassion is under threat, and examines whether it is possible to teach these concepts within the nursing and midwifery curriculum to address this possible deficit within the professions.
The aetiology of deep tissue injury: a literature review
Authors: Peart Joanna
Published: August 2016

Deep tissue injury affects patients of all ages in a variety of healthcare settings. It is therefore essential that nurses are aware of the underlying pathogenesis, in order to accurately assess the pressure ulcer risk of vulnerable patients, and to subsequently reduce patient harm. The majority of pressure ulcers are avoidable, however, a variety of intrinsic and extrinsic factors can contribute towards the development of deep tissue injury. Understanding the body's internal responses to external pressure will enable nurses to recognise that a visual assessment alone may not necessarily identify patients at risk of deep tissue damage. This article reviews the evidence for the internal causative mechanisms of deep tissue injury, while linking to clinical practice and pressure ulcer prevention.
Vitamin D deficiency in patients with inflammatory bowel disease
Authors: Fletcher Jane
Published: August 2016

There are over 300 000 people in the UK affected by inflammatory bowel disease (IBD). Though vitamin D deficiency is common in patients with IBD, National Institute for Health and Care Excellence (NICE) guidance regarding vitamin D supplementation does not address the needs of patients with chronic inflammatory diseases. However, there is growing evidence that vitamin D plays an important role in the management of IBD. Nurses caring for patients with IBD should have an understanding of the causes and consequences of vitamin D deficiency in this patient group. This article looks at the role vitamin D plays in the body and the challenges of treating deficiency. Consideration is given to diet, sun exposure and supplementation as possible treatments and acknowledges the limitations of treatments for patients with IBD. With a lack of clear national guidance, it is hoped that raising awareness of these issues will inform nursing practice and ensure a holistic approach to care.
Using health psychology to help patients: promoting wellbeing
Authors: Barley Elizabeth , Lawson Victoria
Published: August 2016

This article explores the construct of wellbeing. Research concerning the relationship between subjective wellbeing and health is discussed. Key components of wellbeing that are important to health include ‘sense of coherence’, ‘optimism’ and ‘benefit finding and post-traumatic growth’. A range of positive psychology interventions that aim to increase positive thoughts, feelings and emotions in order to improve wellbeing have been developed. Mindfulness-based approaches to improving wellbeing are especially popular and are evidence based. These focus on helping the individual to develop an awareness of the present with acceptance and attention. Instead of trying to change uncomfortable thoughts or feelings, the individual practices accepting these, without judgement. Nurses can draw on the information in this article to provide evidence-based advice and guidance to help improve their patients' and their own wellbeing.
Approaches to continuing professional development: putting theory into practice
Authors: Hayes Catherine
Published: August 2016

This article provides an overview of approaches to and models of education to assist nurses involved in the delivery of education and continuing professional development. A number of models will be summarised to look at how learning, teaching and assessment can be integrated to benefit the learner, and the benefits this may have in nursing education and continuing professional development courses. The author also considers different domains of learning: cognitive, psychomotor and affective. This article presents the case for considering the constructive alignment of educational content as one means of increasing the likelihood of it being translated into practice.
A survey of work engagement and psychological capital levels
Authors: Bonner Lynda
Published: August 2016

Aim:

To evaluate the relationship between work engagement and psychological capital (PsyCap) levels reported by registered nurses.

Background:

PsyCap is a developable human resource. Research on PsyCap as an antecedent to work engagement in nurses is needed.

Methods:

A convenience sample of 137 registered nurses participated in this quantitative cross-sectional survey. Questionnaires measured self-reported levels of work engagement and psychological capital. Descriptive and inferential statistics were used for data analysis.

Results:

There was a statistically significant correlation between work engagement and PsyCap scores (r=0.633, p<0.01). Nurses working at band 5 level reported statistically significantly lower PsyCap scores compared with nurses working at band 6 and 7 levels.

Conclusion:

Nurses reporting high levels of work engagement also reported high levels of PsyCap. Band 5 nurses might benefit most from interventions to increase their PsyCap. This study supports PsyCap as an antecedent to work engagement.
Can covert administration of medicines be in a patient's best interests?
Authors: Griffith Richard
Published: August 2016

In this article Richard Griffith considers whether it is ever in a patient's best interests to be given medicine by covert means, such as disguising it in food
Recognising and responding to the early signs of sepsis
Authors: Glasper Alan
Published: August 2016

Emeritus Professor Alan Glasper, from the University of Southampton, discusses new guidance on the recognition, diagnosis and early management of sepsis
Learning from mistakes in the NHS: a special PHSO report
Authors: Tingle John
Published: August 2016

John Tingle discusses a special report by the Parliamentary and Health Service Ombudsman (PHSO) into how the NHS failed to investigate properly the death of a 3-year-old child
Nursing education, the NHS and leaving the European Union
Authors: Rosser Elizabeth
Published: August 2016

Elizabeth Rosser, Deputy Dean (Education and Professional Practice) and Professor of Nursing at Bournemouth University considers how the nursing landscape may change from university and healthcare service perspectives
From staff nurse to nurse consultant
Authors: Fowler John
Published: August 2016

John Fowler, Independent education consultant, continues to explore the importance of leadership for clinically based nurses
Self-development and earning that staff nurse uniform
Authors: Stone Ruth
Published: August 2016

Ruth Stone, Second-year student at the University of East Anglia, reflects on her past 2 years as a nursing student and considers what she has ahead of her in her final year of study
Good customer service for patients
Authors: Foster Sam
Published: August 2016

Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, looks at what the NHS can learn about good customer service from the private sector, and how Always Events can improve patient care
Electronic SSKIN pathway: reducing device-related pressure ulcers
Authors: Campbell Natalie
Published: August 2016

This article describes how an interprofessional project in a London NHS Foundation Trust was undertaken to develop an intranet—based medical device-related pressure ulcer prevention and management pathway for clinical staff working across an adult critical care directorate, where life-threatening events require interventions using medical devices. The aim of this project was to improve working policies and processes to define key prevention strategies and provide clinicians with a clear, standardised approach to risk and skin assessment, equipment use, documentation and reporting clinical data using the Trust's CareVue (electronic medical records), Datix (incident reporting and risk-management tool) and eTRACE (online clinical protocol ordering) systems. The process included the development, trial and local implementation of the pathway using collaborative teamwork and the SSKIN care bundle tool. The experience of identifying issues, overcoming challenges, defining best practice and cascading SSKIN awareness training is shared.
Management of diabetic foot ulcers: evaluation of case studies
Authors: Torkington-Stokes Rachel , Metcalf Daniel , Bowler Philip
Published: August 2016

This article explores local barriers to diabetic foot ulcer healing, and describes the use of a dressing designed to manage exudate, infection and biofilm (AQUACEL® Ag+ dressing (AQAg+)) on recalcitrant diabetic foot ulcers. The authors consider four case studies that demonstrate how managing local barriers to wound healing with antimicrobial and anti-biofilm dressings in protocols of care can improve outcomes for patients.
Self-care and postoperative dressing management
Authors: Dawn Hunt Sharon
Published: August 2016

As the increasing burden on healthcare costs continues to rise, posing clinical and financial challenges for all healthcare providers attempting to provide optimal, evidence-based wound care, the situation appears to be reaching the tipping point with regard to reduced resources, increasing patient groups with complex wounds and financial restraints. It is clearly time for action and new ways of working that include empowering patients and carers to take appropriate ownership within their personal wound-care journey. This observational evaluation explores 10 community-based patients presenting with postoperative acute surgical wounds; it examines and evaluates the patients' experience with regard to self-care satisfaction, Leukomed Control product satisfaction and actual traditional/personal costs incurred up to a 4-week period. The evaluation highlights not only an overall positive improvement within patient satisfaction and experience, alongside optimised wound progression and related cost savings, but also offers a valuable insight into the promotion and success of patients taking ownership of their wound-care journey.
The role of dressings in the prevention of pressure ulcers
Authors: Brown Julie
Published: August 2016

Pressure ulceration is a significant global healthcare problem and represents a considerable burden on healthcare resources. Within the literature an increasing number of studies have examined the role prophylactic dressings play in redistributing pressure and helping to protect the skin from the effects of friction and shear. The use of dressings to prevent pressure ulcers may be considered a controversial issue, as previous opinion has been that dressings do not reduce the effects of pressure. This article will critically evaluate the literature to examine the role dressings play in the prevention of pressure ulceration.
Antiseptic with modern wound dressings in the treatment of venous leg ulcers: clinical and microbiological aspects
Authors: Sopata M. , Kucharzewski M. , Tomaszewska E.
Published: August 2016

Objective:

To assess the impact of a two-period treatment on the clinical condition, bacteriological changes and results of treatment of venous leg ulcers (VLU) using octenidine dihydrochloride.

Method:

Patients with a VLU were recruited and treated with octenidine dihydrochloride for one month, after which they were randomised and treated with hydrocolloids or foam dressings. The wounds were clinically assessed for the amount of necrotic tissue, granulation tissue, epithelialisation, amount of exudate and pain level. During the first period, bacterial colonisation and antimicrobial efficacy of octenidine dihydrochloride were also evaluated. In the second period the efficacy of treatment, time of treatment and healing rate were investigated.

Results:

In the group of 50 VLU patients, all wounds (100%) improved after the first treatment period. No clinical signs of infection were observed. Statistically significant changes were observed in all the clinical parameters studied in the treated groups of VLU patients, including reduction of necrotic tissue, the amount of exudate and of pain, as well as increased granulation and epithelialisation. In the second period including treatment with the two dressings, no differences were observed in treatment efficacy, time of treatment or healing rate.

Conclusion:

As used in this study, octenidine dihydrochloride proved to be effective and useful, changing the clinical condition of VLU, preparing the wound for future treatment with modern dressings. High microbicidal activity of octenidine was observed, both against Gram-negative and Gram-positive bacteria isolated from the ulcers. Octenidine dihydrochloride caused an eradication of multiresistant strains (88%) as well as of bacteria qualified as alert-pathogens (100%) in the treated wounds after four weeks. However, no differences in the effects, time or rate of healing of VLU with two dressings were found in the second period. No side effects or significant local intolerance reactions used for treatment were observed
Quality of wound dressings: a first step in establishing shared criteria and objective procedures to evaluate their performance
Authors: Mennini N. , Greco A. , Bellingeri A. , De Vita F. , Petrella F.
Published: August 2016

Objective:

There are no well-defined criteria for assessing the efficacy and quality of wound dressings, and evaluation is often simplistic and based on the subjective opinion of the health-care professional. The aim of this study was to identify specific parameters suitable for measuring dressings' performance, and to recommend laboratory tests able to evaluate these specific criteria in an objective manner.

Method:

After reviewing all tests currently used in Italy and examining the criteria for evaluating the quality of dressings, the authors selected 12 clinically significant parameters. These parameters were measured using standard and non-standard tests, and in some cases, these tests were modified and improved to simulate real-life conditions more accurately.

Results:

Most of the tests used were able to discriminate well between dressings belonging to different brands, with some tests being more suitable than others for the assessment of specific dressings.

Conclusion:

These results highlighted some issues in the standard testing procedures, such as the need of a suitable fluid that mimics the real exudate, and the importance of standard temperature and humidity conditions during testing. Our study paves the way for a larger project aimed at a systematic evaluation of dressing quality able to assess every wound dressing on the market.
Exploring nurses' and patients' feelings of disgust associated with malodorous wounds: a rapid review
Authors: Ousey K. , Roberts D.
Published: August 2016

Objective:

To identify primary empirical research related specifically to feelings of disgust associated with malodorous chronic cutaneous wounds.

Method:

A rapid review of the literature using the key words disgust; wounds; malodour and psychosocial.

Results:

A total of 163 papers were retrieved with seven being included for the final review. Themes emanating from the review were malodour, health-care professionals coping with malodour and disgust. Malodour is a concern to patients, which can sometimes go unreported by nursing staff; although the reasons for this remain unclear. The coping mechanisms developed by nurses in response to ‘disgusting’ wounds requires further exploration in order for a fuller understanding of these mechanisms to be achieved. This review has identified that both health-care professionals and patients can become distressed at wound odours, yet there is little evidence that is available to guide people as to how to manage these feelings.

Conclusion:

Hard-to-heal or chronic cutaneous wounds, such as leg ulcers and diabetic foot ulcers, are an increasing global health-care issue. While some research has been undertaken to explore the psychological impact of living with a fungating carcinoma; much less has been written about the management and mitigation of feelings of disgust for patients and families living with a malodorous wound or how health-care professionals can effectively provide psychosocial care.
The management of chronic ulcers with an acidoxidising solution
Authors: Ricci E.
Published: August 2016

Objective:

Chronic ulcers are an intractable problem in many patients and are associated with impaired quality of life and high health-care costs. In an attempt to improve outcome, our centre began cleansing wounds with a novel spray acidoxidising solution (Nexodyn) with unique physicochemical features, pH <3.0; oxidation reduction potential >1000mV; and free chlorine content (>95% HClO).

Method:

A retrospective analysis was conducted in patients with numerous comorbidities and an unsatisfactory response to standard therapy. The solution was administered for six weeks and the patients' clinical course evaluated using standard measures of wound healing, pain and bioburden.

Results:

We assessed 20 patients with a mean time since ulcer onset of 23.7 months. Complete resolution of the lesion was achieved in 25% of cases (p=0.005). In the group as a whole, wound size decreased significantly (11% mean reduction versus baseline; p=0.039). In the relatively short six-week observation period, significant reductions versus baseline were also observed in control of wound bioburden (p=0.005) and ulcer-related pain score (p<0.001). Furthermore, the wound bed preparation score suggests an improved wound microenvironment with better wound bed cleansing and the presence of granulation tissue. There were no adverse systemic effects of treatment nor adverse local effects in the wound bed or on healthy periwound skin.

Conclusion:

Encouraging initial results in a population refractory to standard management provide evidence that this new product may make a helpful contribution to the care of chronic ulcers. The integration of this cleansing solution into standard care contributes to the modulation of local microenvironmental responses that inhibit physiological healing processes while also contributing to the reduction of bacterial load.
Comparative evaluation of the functional properties of superabsorbent dressings and their effect on exudate management
Authors: Browning P. , White R. J. , Rowell T.
Published: August 2016

A range of wound dressings currently available in the UK and elsewhere, each claiming to possess different performance characteristics, can make dressing selection difficult. This report concentrates on the superabsorbent polymer dressings (SAPs) – which are designed to absorb medium to high levels of exudate and to maintain an ‘ideal moist wound healing environment’. What do these dressings achieve, what are they suitable/not suitable for, and are all super-absorbent dressings equal in terms of performance and quality? When assessing the key performance characteristics of absorbency, moisture vapour transmission rate (MVTR), strikethrough and structural integrity, results show that SAPs are not all the same—in fact each of them varies considerably and may lend themselves to different wound aetiologies and usage conditions. While performance data is often presented from non-standard tests or modifications, it is proposed that to provide clarity over dressing selection, all SAPs were measured using International Standards for the key performance characteristics. This will aid clinical staff in selecting the most appropriate dressing for each wound.
Clinical acceptability of a dressing with matrix technology: a multisite evaluation of acute and chronic wounds
Authors: Guthrie J. , Potter R.
Published: August 2016

Objective:

This article will describe the findings of an evaluation on the performance and clinical acceptability of Urgotul Absorb Border (Urgo Medical), a silicone border adhesive foam dressing containing technology lipidocolloid (TLC) healing matrix technology, as either a primary or secondary dressing in the management of acute and chronic wounds in a multisite evaluation. The purpose of the evaluation was to establish the effectiveness of the silicone border dressing for managing exudate, ease of use, patient comfort and acceptability of the clinician for the dressing to meet with treatment objectives

Method:

The patient experiences given through verbal or written feedback were also documented. Local Health Board evaluation forms were used to capture data and the authors of this article created a data evaluation tool to collate and subsequently report all study findings.

Results:

A total of 100 patients with wounds considered suitable for the application of the dressing were selected to take part in the study. In less than a four week period, 38 patients achieved wound healing with a further 36 patients demonstrating wound improvements within the same time period.

Conclusion:

The dressing was found to have met both the clinicians and patients aims when used as either a primary or secondary dressing and was considered suitable for use in both acute and chronic wounds of varying duration.
Peripheral nerve crushing to relieve chronic pain in diabetic and ischaemic foot ulcers
Authors: Nagasaki K. , Obara H. , Tanaka K. , Koyano K. , Asamia A. , Kitagawa Y.
Published: August 2016

Objective:

We retrospectively assessed the effectiveness of peripheral nerve crushing (Smithwick operation) in relieving intractable chronic pain associated with foot ulcers caused by diabetes mellitus (DM) or atherosclerosis.

Method:

From April 2009 to April 2012, patients underwent peripheral nerve crushing in the leg affected by foot ulceration. The cause of ulceration was either DM alone, atherosclerosis alone, or both DM and atherosclerosis. Because sensation in the foot is associated with five nerves: the tibial, deep peroneal, superficial peroneal, sural, and saphenous, one or more of these nerves were crushed over a length of 1.5cm by using a ‘pean’ in the distal third of leg the where there are no major motor nerves.

Results:

There were 36 patients recruited with ulcers grade 3–5 according to the Wagner ulcer classification system that affected the toes, dorsum pedis, or any part of the plantar surface or the heel. The mean duration of foot ulcerations before the nerve crushing was 22.3±9.7 weeks. In all 36 patients, the nerve crushing was performed successfully without any perioperative surgical complication. Of the 36 patients, 34 (94.4%) had substantial pain relief immediately after nerve crushing. While the mean pain level before the procedure was 86.6±0.51mm on visual analogue scale (VAS), pain level dropped significantly after the operation to 18.6 ± 5.4mm at one week, 14.8±4.8mm at one month, 13.7±4.1mm at two months, 9.8±4.1mm at three months, 11.8±5.7mm at four months, 10.1±4.7mm at five months and 8.8±3.3mm at six months. The time to regeneration of the sensory nerves was 121±6.5 days (range: 80–181 days). The surgical complications were wound infection (6 patients) and temporary toe paralysis (three patients). The foot ulcers in 20 of the 36 patients (55.6%) were resolved by debridement or minor amputation. In seven patients (19.4%), a major amputation (five below and two above the knee) was required because of ischemia or infection. No patient died within 30 days of the operation, while nine patients died during the observation period because of comorbid conditions.

Conclusion:

Peripheral nerve crushing could be the alternative procedure for achieving analgesia in patients with intractable chronic pain from foot ulcers caused by DM or atherosclerosis.
A comparative study of negative pressure wound therapy with and without instillation of saline on wound healing
Authors: Omar M. , Gathen M. , Liodakis E. , Suero E.M. , Krettek C. , Zeckey C. , Petri M.
Published: August 2016

Objective:

Negative pressure wound therapy (NPWT) has become an established treatment of traumatic and infected wounds. Negative pressure wound therapy with instillation (NPWTi) is a further development that combines the conventional NPWT with instillation of different fluids which continuously administer therapeutic reagents to the wound. The aim of this study was to compare the impact of additional saline instillation in NPWTi to NPWT alone.

Method:

Between January and July 2014, consecutive patients with acute wounds of the lower limb were treated with NPWTi with saline instillation. The number of revision surgeries, length of hospital stay, and duration of treatment until final healing were recorded and compared with matched patients undergoing NPWT without instillation.

Results:

There were 10 patients recruited with 10 matched controls examined restrospectivley. Patients who received NPWTi were found to have decreased time of hospitalisation (21.5 versus 26.5 days, p=0.43), and accelerated wound healing (9.0 versus 12.5 days, p=0.36) than patients who received NPWT. However, the difference in the outcomes of the patients who received NPWTi and patients who received NPWT was not found to be statisticallly significant.

Conclusion:

NPWTi with instillation of saline is a promising method and its effectiveness needs to be tested in a randomised controlled trial compared with NPWT alone.

Declaration of interest:

This study obtained support by KCI (Wiebsaden, Germany) for the surgical material.
Antimicrobial resistance among aerobic biofilm producing bacteria isolated from chronic wounds in the tertiary care hospitals of Peshawar, Pakistan
Authors: Rahim K. , Qasim M. , Rahman H. , Khan T. A. , Ahmad I. , Khan N. , Ullah A. , Basit A. , Saleha S.
Published: August 2016

Objective:

Chronic wound infections impose major medical and economic costs on health-care systems, cause significant morbidity, mortality and prolonged hospitalisation. The presence of biofilm producing bacteria in these wounds is considered as an important virulence factor that leads to chronic implications including ulceration. The undertaken study aimed to isolate and identify the biofilm aerobic bacterial pathogens from patients with chronic wound infections, and determine their antibiotics resistance profiles

Method:

During this study, swab specimens were collected from patients with chronic wounds at teaching hospitals of Peshawar, Pakistan between May 2013 and June 2014. The isolated aerobic bacterial pathogens were identified on the basis of standard cultural characteristics and biochemical tests. Antibiotics resistance profiles of biofilm producing bacteria against selected antibiotics were then determined.

Results:

Among the chronic wound infections, diabetic foot ulcers were most common 37 (37%), followed by surgical ulcers 27 (27%). Chronic wounds were common in male patients older than 40 years. Among the total 163 isolated bacterial pathogens the most prevalent bacterial species were Pseudomonas aeruginosa 44 (27%), Klebsiella pneumoniae 26 (16%), Staphylococcus species 22 (14%) and Streptococcus spp. 21 (13%). The isolation rate of bacterial pathogens was high among patients with diabetic foot ulcers 83 (50.9%). Among bacterial isolates, 108 (66.2%) were observed as biofilm producers while 55 (33.8%) did not form biofilm in our model. The investigated biofilm producing bacterial isolates showed comparatively high resistance against tested antibiotics compared to non-biofilm producing bacterial isolates. The most effective antibiotics were amikacine and cefepime against all isolates.

Conclusion:

Increased multidrug resistance in biofilm producing bacteria associated with chronic wounds was observed in this study. Judicious use of antibiotics is needed to control the wound associated biofilm associated pathogens.
The effect of chitosan-based gel on second degree burn wounds
Authors: Honardar S. , Kordestani S. S. , Daliri M. , NayebHabib F.
Published: August 2016

Objective:

Chitosan has been widely used in wound healing, including burn wounds. ChitoHeal gel, a novel chitosan-based gel, is studied to assess the effectiveness and rate of wound healing in second degree burns compared with traditional wound dressings.

Method:

New Zealand rabbits were divided into two groups, control and treatment. Second degree burn wounds were created using a hot round aluminium stamp. It was heated up to 80°C and applied 14 seconds without additional pressure. Morphological, histological, and molecular parameters were used to evaluate the effects of the chitosan-based gel on burn healing.

Results:

The study exhibited that in the control group with an increase in the number of keratinocytes due to the papillary growth of the epidermis, melanocyte pigmentation increased, and some melanin was observed in the dermis. In the treatment group, however, there was no hyper pigmentation nor overgrowth of the epidermis. Transmission electron microscopy micrographs of healed epidermis in treatment group showed melanocyte with normal morphology.

Conclusion:

The result of the present study is likely to be important for the development of novel strategies for wound healing using chitosan gel.
Research roundup: August 2016
Authors: Greener Mark
Published: August 2016

In brief

Children born to women who take paracetamol during pregnancy are more likely to develop autism spectrum symptoms and show poor attention Oral antibiotics are routinely prescribed for acne for longer than the National Institute for Health and Care Excellence recommends, which increases the risk of resistance. People with acne also seem to experience delays accessing specialist care Zinc acetate lozenges could reduce the duration of the common cold by more than a third Recurrent diabetic ketoacidosis carries ‘a substantially elevated risk of death’
Prescribing intermittent self-catherisation: An update
Authors: Nazarko Linda
Published: August 2016

Each year, around one million urinary catheters are inserted in NHS hospitals ( Nazarko, 2010 ). Around 25% of these procedures are not clinically indicated ( Fakih et al, 2010 ; Rothfeld and Stickley, 2010 ; Bhatia et al, 2010 ), and in cases where bladder drainage is necessary, it may have been possible to manage bladder dysfunction using intermittent catheterisation ( Bardsley, 2015 ; Karason and Olafsson, 2013 ; Halleberg et al, 2013 ). Around 450 000 people in the UK have a long-term indwelling urinary catheter ( Prinjha and Chapple, 2013 ). Indwelling urinary catheters can increase the risk of infection, affect bladder health and affect quality of life. Guidance from the National Institute for Health and Care Excellence ( 2012a ; 2012b ) recommends that whenever possible, intermittent catheterisation should be considered. This article outlines indications for intermittent catheterisation and provides guidance for its use.
Assessment and prescribing decisions in contraception
Authors: Robinson Gina
Published: August 2016

This article describes the contraceptive methods available for women across the age groups, and supports prescribers in safely assessing and reviewing women who require contraception; advising women on the choices available; advising on the emergency contraception available; and determining whether or not Fraser guidelines must be applied for girls younger than 16 years of age.
‘No action today means no cure tomorrow’: The threat of antimicrobial resistance
Authors: While Alison
Published: August 2016

Antimicrobial resistance is a major concern for British health professionals, and there is growing evidence of multi-resistant pathogens. Poor prescribing practices, partly driven by patient demand and poor patient adherence to prescribed regimens are two causes of growing antimicrobial resistance. Improved infection prevention and control practices will not only reduce healthcare-acquired infections, but also reduce the necessity for antimicrobials.
Prescribing safely: Top 10 tips for non-medical prescribers
Authors: Petty Duncan
Published: August 2016

Non-medical prescribers should know these 10 ways to prescribe more safely. Personal vigilance and care is required when prescribing to avoid errors resulting from poor prescribing decisions, which may be related to the wrong drug, dose, route, frequency and/or quantity being prescribed. Errors can also occur because of other reasons, including poor patient communication, lack of monitoring, and poor interface communication. Systems for reviewing and monitoring will help to reduce errors, and the non-medical prescriber must work with other prescribers to ensure these systems are in place. These tips are not exhaustive, but, if practised, will go a long way to improving patient safety.
Pop Quiz Makeover: Rethinking How and When Unannounced Quizzes Occur to Maximize Their Effectiveness and Increase Student Engagement
Authors: Youmans Robert
Published: August 2016

Surprise quizzes are useful in higher education for motivating and assessing student preparation, but disliked by students. This session describes the use of random quizzing procedure whereby a chance event set in motion by a student from the class determines whether a quiz is administered. The session will explore why students may both prefer, and benefit more, from the enhanced quiz method, and examples of the technique's effectiveness in the classroom will be provided. Session participants will be shown alternate forms of the procedure that might work in a variety of higher education settings, and data will be presented with theoretical and practical discussions about the effectiveness of the technique.
Not Just About Avoiding Plagiarism: Utilizing Research on the Development of Disciplinary Expertise to Teach Source Integration for Graduate & Undergraduate Writers
Authors: Mallett Karyn , Habib Anna , Rogers Paul
Published: August 2016

Throughout coursework and research, graduate and undergraduate student writers must demonstrate an ability to successfully integrate sources in their writing. Further, faculty across the curriculum expect graduate and undergraduate students to develop and deliver both discipline-specific content/technical knowledge and the academic skills needed in order to effectively communicate emerging disciplinary expertise. What, however, is the relationship between disciplinary knowledge and academic writing? At what point(s) in the writing project should source integration be discussed? And how?The purpose of this interactive workshop is to present four approaches to the teaching and learning of disciplinary expertise, with a focus on the role of writing and—specifically—source integration. Utilizing a theoretical framework (Tardy, 2009) for the development of disciplinary expertise, the intersectional nature of four domains "process knowledge, rhetorical knowledge, formal knowledge, and content knowledge" is presented as a tool for the teaching and learning of source integration in the context of authentic graduate writing projects. While these strategies are presented using a graduate context, many of these are also beneficial for undergraduates. The workshop aims to provide faculty with practical tools for helping students (international and otherwise) not only avoid plagiarism but—moreover—understand common academic goals and strategies for utilizing outside sources in disciplinary writing.
Creating Experiential Learning Opportunities for Undergraduate Students through Federal Work Study
Authors: Nazaire Denise
Published: August 2016

The Students as Scholars initiative at George Mason University provides opportunities for undergraduate students to participate in research and creative activities. This initiative is designed to be inclusive, encouraging students from all disciplines and all academic levels to participate. In order to increase opportunities to participate in research for all Mason undergraduate students, we collaborated with the Office of Financial Aid in spring 2013 to pilot a program using Federal Work Study funds to support undergraduate research assistant positions. This program offered experiential learning opportunities to undergraduate students by introducing them to the concept of scholarship and the research or scholarly methods in their field. Faculty were given "free" research assistance, with the understanding that they would involve students in research discussions and regularly evaluate them. Using institutional and program data, this poster will highlight the diversity of disciplines and students, demonstrate the process of establishing a program such as this, and define what students learn in these introductory roles.
Investigating students’ use of lecture videos: Learning analytics vs. self-evaluation surveys
Authors: Kuo Ying-Ying , Luo Judy , Brielmaier Jennifer
Published: August 2016

This presentation examines students’ use of lecture videos through two approaches -- (1) students’ real usages of lecture videos as collected from Blackboard, a learning management system which can track students’ activities and store every click in its backend database or in the web server log file, and (2) a self-evaluation of students’ study strategies in the course survey at the end of the semester.   This study was conducted in a fully online psychology course taught in Fall 2014, Summer 2015, and Fall 2015. The course included 76 streaming lecture videos ranging from 3.5 to 30 minutes. A comparison between these two sets of data was examined and discussed in this presentation.The preliminary analysis revealed that most students’ study strategies reported on the survey were consistent with their real usages on the Blackboard course site.  However, survey data could not explain which lecture videos students had watched and how frequently students watched videos. Learning analytics can support instructors in understanding how students used videos, when they watched, and which videos were watched most.  The data also implied that students’ final grades and learning satisfaction associated with their usage of lecture videos.  As compared to survey data, the evidence indicated that learning analytics can give more detailed and accurate descriptions about students’ learning behaviors. This presentation will share the limitations of either method. This presentation will benefit both undergraduate and graduate courses whose instructors plan to use surveys or learning analytics to understand their students’ learning behaviors and study strategies.