bluuebunny/crossref_metadata_2025 huggingface dataset:
Pru p 3, a marker allergen for lipid transfer protein sensitization also in Central Europe
Authors: Mothes‐Luksch N. , Raith M. , Stingl G. , Focke‐Tejkl M. , Razzazi‐Fazeli E. , Zieglmayer R. , Wöhrl S. , Swoboda I.
Published: March 2017

In the Mediterranean area, lipid transfer proteins (LTPs) are important causes of plant‐food allergies often associated with severe allergic reactions. There, peach LTP (Pru p 3) seems to be the primary sensitizer, whereas in Central Europe, little is known about the importance of LTP sensitization. In this region, allergen extract‐based diagnosis is often complicated by co‐sensitization to Bet v 1, the major birch pollen allergen, its cross‐reactive food allergens, and profilins. We investigated the role of LTP sensitization in Central European patients displaying strong allergic reactions to plant‐derived food. Analysis of IgE reactivity revealed that ten of thirteen patients were sensitized to Pru p 3, nine to Bet v 1, and two to profilin. Our results showed that LTP sensitization represents a risk factor for severe allergic symptoms in Central Europe. Furthermore, the strong IgE reactivity detected in immunoblots of plant‐food extracts indicated that Pru p 3 can be used as a marker allergen for LTP sensitization also in Central European patients.
Head‐to‐head comparison of ranibizumab PRN versus single‐dose dexamethasone for branch retinal vein occlusion (COMRADE‐B)
Authors: Hattenbach Lars‐Olof , Feltgen Nicolas , Bertelmann Thomas , Schmitz‐Valckenberg Steffen , Berk Hüsnü , Eter Nicole , Lang Gabriele E. , Rehak Matus , Taylor Simon R. , Wolf Armin , Weiss Claudia , Paulus Eva‐Maria , Pielen Amelie , Hoerauf Hans ,   the COMRADE‐B Study Group
Published: March 2017

Purpose

To compare the efficacy and safety of ranibizumab 0.5 mg versus dexamethasone 0.7 mg according to their European labels in macular oedema secondary to branch retinal vein occlusion (BRVO) in a 6‐month, phase IIIb, randomized trial.

Methods

Patients received either monthly ranibizumab for 3 months followed by Pro re nata (PRN) treatment (n = 126) or a sustained‐release dexamethasone implant followed by PRN sham injections (n = 118). Main outcomes were mean average change in best‐corrected visual acuity (BCVA) from baseline to month 1 through month 6, mean changes in BCVA and foveal centre point thickness (FCPT), and adverse events (AEs).

Results

There was no difference in BCVA gains between the treatments prior to month 3. Best‐corrected visual acuity (BCVA) gain with dexamethasone declined thereafter. From month 3 to month 6, mean BCVA change from baseline was significantly higher with ranibizumab than with dexamethasone [raw means (standard deviation):+16.2 (±11) letters versus +9.3 (±10.1) letters]. At month 6, the difference in BCVA gains from baseline was +17.3 letters in the ranibizumab versus +9.2 letters in the dexamethasone group. Patients in the ranibizumab group received a mean of 2.94 loading injections and 1.74 PRN retreatment injections, while those in the dexamethasone group received a single loading injection. Elevated intraocular pressure (IOP) and AEs were more frequent with dexamethasone than ranibizumab treatment.

Conclusion

Ranibizumab PRN resulted in greater visual acuity (VA) gains in macular oedema following BRVO compared with single‐dose dexamethasone over a 6‐month study period, observed from month 3, when administered according to their European label. In clinical practice, retreatment with dexamethasone may be required prior to this point.
Prescribing patterns of analgesics and other medicines by dental practitioners in Australia from 2001 to 2012
Authors: Hollingworth Samantha A. , Chan Ryan , Pham Jenny , Shi Sonya , Ford Pauline J.
Published: March 2017

Objectives

Dental practitioners are able to prescribe a variety of medicines subsidized on the Pharmaceutical Benefits Schedule (PBS), the main categories of which are analgesics and antibiotics. We aimed to investigate the patterns of PBS prescribing of non‐antimicrobial medicines by dental practitioners in Australia from 2001 to 2012.

Methods

Data were collected from Medicare Australia on prescriptions from dental practitioners dispensed to concessional beneficiaries between 2001 and 2012. We examined patterns of use over time.

Results

There was an overall increase in number of prescriptions and in dispensed use (standardized by dose and population) of analgesic medicines for the concessional population over the 12‐years period. The use of dentally prescribed analgesics increased 15%, with use of nonsteroidal anti‐inflammatory drugs increasing by 41% and opioid analgesics by 12%. Prescribing of the oxycodone 5‐mg tablet increased 344% between 2005 and 2012, and dental prescription of the benzodiazepines diazepam and temazepam increased by 51% and 229%, respectively, over the observation period. Injectable corticosteroid use increased by 19%. Conversely, use of carbamazepine and anti‐emetics decreased by 39% and 10%, respectively.

Conclusions

Dental prescribing of analgesics, anti‐inflammatories and benzodiazepines in the concessional population has increased significantly over the past decade. These data can form the baseline to further examine appropriate medicine use in the management of dental conditions.
Leaving the door open for “tune ups”: Challenging notions of ending working relationships in family work
Authors: Reimer Elizabeth Claire
Published: March 2017

The working relationship is considered a central feature of direct practice with human services clients. There are many challenges when it comes time to end a working relationship, yet limited guidance for workers on successful relationship ending. This paper aims to increase understanding of the process of the ending phase of the working relationship for parents and workers working with families where child neglect is an issue. The paper draws on data from a small‐scale qualitative Australian study of perceptions of parents, family workers, and supervisors involved in eight parent‐worker relationships. Using semistructured interviews, participants were asked to explore how they experienced the relationship. The findings illuminate important aspects about the ending phase of the relationship; in particular, challenging the idea that parents' returning to services for support is a sign that the service has not provided a successful intervention. The paper challenges social workers to consider recurring parent–worker relationships similar to other professional relationships where there are episodes of service but the relationship is there to be reactivated where needed.
Risk factors for anastomotic leakage after colorectal resection: a retrospective analysis of 17 518 patients
Authors: Parthasarathy M. , Greensmith M. , Bowers D. , Groot‐Wassink T.
Published: March 2017

Aim

A large, prospectively collected, clinical database was analysed to determine the various pre‐ and intra‐operative factors affecting anastomotic leakage (AL) in colorectal surgery.

Method

Data on 17 518 patients having a colorectal resection with anastomosis, taken from the 2013 American College of Surgeons National Surgical Quality Improvement Program database, were included in the study. Multivariable logistic regression analysis was carried out to identify risk‐adjusted predictive factors for AL. Statistical significance was set at P < 0.05 and confidence intervals were reported at the 95% level.

Results

The AL rate was 3.9% (687/17 518). Younger patients, male gender and an American Society of Anesthesiology (ASA) score of ≥ 3 (P < 0.001), smoking (P = 0.001), diabetes (P = 0.035), a preoperative serum albumin level of < 4 g/dl (P = 0.030), elective rectal cancer surgery (P = 0.024), emergency colectomy for bleeding (P = 0.013) and splenic flexure mobilization (P = 0.043) were associated with an increased risk of AL. Preoperative oral antibiotics (P < 0.001), right hemicolectomy (open or laparoscopic) and laparoscopic partial colectomy were associated with a reduced risk of AL compared with the entire group. Body mass index, preoperative chemotherapy, emergency surgery and mechanical bowel preparation were not related to AL.

Conclusion

In contrast to most studies, younger age was found to be an independent risk factor for AL. The risk for AL was lower with laparoscopic partial colectomy and open or laparoscopic right hemicolectomy. Preoperative oral antibiotic preparation significantly reduces the risk of AL and should be incorporated as a standard protocol.
Pathogenese von Wundheilungsstörungen bei älteren Patienten
Authors: Makrantonaki Evgenia , Wlaschek Meinhard , Scharffetter‐Kochanek Karin
Published: March 2017

Ältere Menschen sind für Wundheilungsstörungen und chronische Wunden am anfälligsten, insbesondere für venöse Beinulzera, Dekubitalulzera und diabetische Fußulzera. Jedoch sollten bei der diagnostischen Abklärung chronischer Wunden weitere altersassoziierte Krankheiten in Betracht gezogen werden. Ein besseres Verständnis der an Wundheilungsstörungen beteiligten Pathomechanismen ist wichtig für die Bewältigung der Schwierigkeiten bei der Behandlung chronischer Wunden. In den letzten Jahrzehnten wurden beachtliche Fortschritte bei zukunftsweisenden Therapien chronischer Wunden erzielt. In diesem Zusammenhang haben sich Wachstumsfaktoren und Zytokine, Gewebeanzucht (Tissue Engineering) und Zelltherapie – auch mit Stammzellen – als sehr vielversprechend erwiesen. Vor Einführung in die klinische Praxis muss jedoch die Sicherheit dieser Techniken durch umfangreiche klinische Studien nachgewiesen werden.
Cutaneous side effects of TNF‐alpha inhibitors
Authors: Lindhaus Claudia , Tittelbach Jörg , Elsner Peter
Published: March 2017

Since the early 1990s, tumor necrosis factor alpha (TNF‐alpha) inhibitors have been successfully used in the treatment of various immune‐mediated inflammatory diseases. By now, comprehensive safety data has been compiled. While adverse reactions do occur, they are – in relation to the frequent use of these agents – rare and usually not serious. Cutaneous side effects include local injection site reactions, infections, immune‐mediated reactions, and neoplasms. The most common serious adverse events are of an infectious nature. Mycobacteria but also non‐mycobacterial pathogens, such as viruses and fungi, may cause serious, even lethal, systemic infections. The present article is meant to review current knowledge with respect to cutaneous side effects of TNF‐alpha inhibitors.
Nebenwirkungen von TNF‐alpha‐Inhibitoren am Hautorgan
Authors: Lindhaus Claudia , Tittelbach Jörg , Elsner Peter
Published: March 2017

TNF‐alpha‐Inhibitoren werden seit Anfang der 1990er Jahre erfolgreich zur Behandlung diverser immunvermittelter entzündlicher Erkrankungen eingesetzt. Inzwischen gibt es eine umfangreiche Datenlage bezüglich ihrer Sicherheit. Nebenwirkungen sind bezogen auf die Häufigkeit der Anwendung selten und meist nicht schwerwiegend. Zu den Nebenwirkungen am Hautorgan zählen lokale injektionsassoziierte Reaktionen, Infektionen, immunvermittelte Reaktionen sowie Neoplasien. Die häufigsten schwerwiegenden Nebenwirkungen sind infektiöser Natur. Mykobakterielle Infektionen, aber auch non‐mykobakterielle Erreger, Viren und Pilze können potenziell letale, systemische Infektionen auslösen.

Im Folgenden wird eine Übersicht über das gegenwärtige Wissen bezüglich der Nebenwirkungen von TNFα‐Inhibitoren am Hautorgan gegeben.
Accessory nictitating membrane in a Lipizzaner colt
Authors: Moyer C. T. , Ball E. E. , Brown J. A.
Published: March 2017

A 2‐year‐old Lipizzaner colt presented for removal of a mass over the left eye. The colt had no blepharospasm or significant ocular discharge, but the cornea underlying the mass was mildly oedematous. The mass protruded from the conjunctiva at the dorsotemporal aspect of the globe and was covered in normal conjunctiva. It had a gross appearance similar to the cartilaginous flap of a nictitating membrane, but in an aberrant location. It was moveable to cover the dorsal aspect of the cornea when the globe was retropulsed. Excision of the mass under general anaesthesia was elected. Histopathology supported a diagnosis of an accessory nictitating membrane, consisting of a cartilaginous band surrounded by glandular epithelium. The colt recovered from surgery without complication and no problems were reported by the owner at 8.5 months post‐operatively. To the author's knowledge, there have not been previous reports of accessory or ectopic nictitating membranes in equine or other species.
Assessing Students’ Perceived Success in Attainment of Course Objectives in a Retail Merchandising Class
Authors: Sadachar Amrut , Jablon Sara , Niehm Linda , Hurst Jessica
Published: March 2017

This study assesses student perceptions of the effectiveness of educational approaches and assessment techniques for an introductory retail merchandising course designed using the Biggs model (1999) of constructive alignment for curriculum development. Data were collected using an online survey that was developed to evaluate students’ attitudes toward educational approaches and assessment techniques and their perceived success in attainment of course objectives. Regression results showed those students’ attitudes toward assessment techniques and educational approaches were significant in predicting their perceived success in attaining course objectives.
Effect of addition of Agaricus blazei mushroom residue to milk enriched with Omega‐3 on the prevention of lipid oxidation and bioavailability of bioactive compounds after in vitro gastrointestinal digestion
Authors: Vital Ana Carolina P. , Croge Camila , Gomes‐da‐Costa Sandra Maria , Matumoto‐Pintro Paula T.
Published: March 2017

The residue from a hydroalcoholic extract of the mushroom Agaricus blazei (MAR) was evaluated for phenolic compounds, flavonoids and antioxidant activity. The ability of MAR to slow the oxidation of Omega‐3 resulting from light exposure in milk matrix, and its bioavailability after in vitro digestion was investigated. MAR presented phenolic compounds and flavonoids and showed antioxidant activity. At each concentration, addition of MAR to Omega‐3‐supplemented milk inhibited the production of conjugated dienes and malonaldehyde compared with samples without MAR. The bioavailability assay showed that polyphenols were still present after in vitro digestion and had antioxidant activity.
Assessment of phytochemicals, enzymatic and antioxidant activities in germinated mung bean (Vigna radiata L. Wilezek)
Authors: Wang Junhong , Ye Yutong , Li Quan , Abbasi Arshad Mehmood , Guo Xinbo
Published: March 2017

Vitamin C, phenolic and flavonoid contents along with enzymatic and antioxidant activities were determined in germinated mung bean (Vigna radiate). Elevated levels of vitamin C 72.31 ± 0.62 mg/100 g FW and flavonoid content 85.57 ± 0.59 mg CE/100 g FW were estimated for euphylla after 6 days of germination. Moreover, maximum peroxyl radical scavenging activity 645.4 ± 28.5 μmol ASA equiv./100 g FW was also determined in euphylla. However, seed coat has the highest content of phenolic content (568.4 ± 8.8 mg GAE/100 g FW), whereas cotyledon depicted the highest ascorbate oxidase and peroxidase activities (396.5 ± 4.0 and 548.4 ± 2.8 min−1 g−1 FW, respectively). These findings revealed that euphylla in mung bean sprouts is the most bioactive part with significant level of phytochemicals. Therefore, after germination of 6 days, euphylla is the main source of nutrition in mung bean sprouts.
Model Uncertainty Effect on Asset Prices
Authors: Jiang Junya , Tian Weidong
Published: March 2017

We develop a weighted‐average approach of pricing under model uncertainty, where several plausible models are considered instead of a perfect one. The model uncertainty effect from this weighted‐average approach is significantly different from the conventional wisdom, in which the true price must be bounded by prices in all plausible models. We identify under what circumstances the model uncertainty effect is significant and reveal serious risk management challenges for researchers, regulators, and market participants.
Length of surgery and pressure ulcers risk in cardiovascular surgical patients: a dose–response meta‐analysis
Authors: Chen Hong‐Lin , Shen Wang‐Qin , Liu Peng , Liu Kun
Published: March 2017

The aim of this study was to assess the relationship between length of surgery (LOS) and pressure ulcer (PU) risk in cardiovascular surgery patients. PubMed and Web of Science were systematically searched. We compared LOS difference between PU (+) group and PU (‐) group. We also examined the dose–response effect of this relationship. The mean LOS in the PU(+) groups ranged from 252·5 to 335·7 minutes, compared with 233·0 to 298·3 minutes in PU(−) groups. The LOS was higher in PU(+) groups compared with PU(−) groups [weighted mean difference (WMD) = 36·081 minutes; 95% CI: 21·640–50·522 minutes; Z = 4·90, P = 0·000]. The funnel plot showed no publication bias. A significant dose–response association was also found between the LOS and the risk of surgery‐related pressure ulcers (SRPU, model χ2 = 9·29, P = 0·000). In the linear model, the PU OR was 1·296 (95% CI 1·097–1·531) for a 60‐minute increase in the LOS intervals and 13·344 (95% CI 2·521–70·636) for a 600‐minute increase. In a spline model, the OR of PU increased almost linearly along with the LOS. Our meta‐analysis indicated that LOS was an important risk factor for pressure ulcers in cardiovascular surgical patients.
A comprehensive sintering mechanism for TBCs‐Part I: An overall evolution with two‐stage kinetics
Authors: Li Guangrong , Xie Hua , Yang Guanjun , Liu Gang , Li Chengxin , Li Changjiu
Published: March 2017

A comprehensive sintering mechanism for lamellar thermal barrier coatings was reported experimentally and theoretically in this study. To begin with, an overall property evolution with two‐stage kinetics was presented during thermal exposure. The increase in mechanical property at initial thermal exposure duration (stage‐I) was much faster with respect to that in the following longer duration (stage‐II). At the stage‐I, the in situ pore healing behavior revealed that the significant faster sintering kinetics was attributed to the rapid healing induced by multipoint connection at the intersplat pore tips, as well as a small quantity of the narrow intrasplat cracks. At the following stage‐II, the residual wide intersplat pore parts and the wide intrasplat cracks decreased the possibility of multiconnection at their counter‐surfaces, resulting in a much lower sintering kinetic. Moreover, a structural model based on the microstructure of plasma sprayed YSZ coatings was developed to correlate the microstructural evolution with mechanical property. Consequently, the model predicted a two‐stage evolutionary trend of mechanical property, which is well consistent with experiments. In brief, by revealing the pore healing behavior, this comprehensive sintering mechanism shed light to the structure tailoring toward the advanced TBCs with both higher thermal‐insulating effect and longer life time.
Measuring hospital staff nurses perception on quality of the professional practice environment
Authors: De Brouwer Brigitte Johanna Maria , Fingal Cheryl , Schoonhoven Lisette , Kaljouw Marian J. , Van Achterberg Theo
Published: March 2017

Aim

The purpose of this study was to determine construct validity of the Dutch Essentials of Magnetism II © instrument, designed to assess nursing practice environments, using hypotheses testing.

Background

Reduction in hospital length of stay and the number of inpatient beds increases care intensity. Educational levels and numbers of nursing staff in hospitals, however, do not match this increase, resulting in a strain on quality of care and patient safety. A possible answer to existing concerns about quality of care may be the creation of a productive and healthy practice environment, as this has an impact on the quality of care. Therefore, areas requiring improvement of the practice environment have to be defined.

Design

A cross‐sectional, correlational study design.

Method

We determined construct validity with hypotheses testing by relating the Dutch Essentials of Magnetism II to the Dutch Practice Environment Scale of the Nursing Work Index. We formulated 15 hypotheses prior to data‐analysis; 10 related to convergent validity and five related to discriminant validity. Data were collected from qualified nurses (N = 259) on nine randomly selected hospital wards from March to April 2012.

Results

Response rate was 47% (n = 121). Total scores of both instruments are strongly correlated (r = 0·88). In total, 12 of 15 hypotheses (80%) were confirmed and three were rejected.

Conclusion

The D‐EOMII has satisfactory construct validity for measuring the nursing practice environment in hospitals and can be used by nurses, managers, health policy makers, hospitals and governments to assess and identify processes and relationships that are in need of improvement.
The BP Oil Spill: Shareholder Wealth Effects and Environmental Disclosures
Authors: Heflin Frank , Wallace Dana
Published: March 2017

We use the BP oil spill to provide new evidence regarding the consequences of, and motivations for, environmental disclosures. We find that among oil and gas firms drilling in US waters, those with greater environmental disclosure suffered smaller negative shareholder wealth effects following the spill. This suggests that shareholders believed firms with more environmental disclosures were better prepared to address future environmental regulations and less likely to experience similar environmental incidents. We also document an increase in environmental disclosure, specifically disclosures of disaster readiness plans, in the year following the spill. Firms with poorer past environmental performance were more likely to increase disaster readiness plan disclosures. The increased disclosure by the poor pre‐spill environmental performers is not entirely window dressing, as their post‐spill environmental performance improved. The totality of our evidence is most consistent with the voluntary disclosure theory of environmental disclosure.
Disaster Resilience Through Public–Private Short‐Term Collaboration
Authors: Gabler Colin B. , Richey Robert Glenn , Stewart Geoffrey T.
Published: March 2017

While contingency planning may provide a perspective for anticipating critical incidents, supply chain managers must develop competencies to address the long‐term disruptions that stem from both natural and man‐made disasters. The broad‐reaching nature of disasters brings public and private entities together and often requires collaboration to revitalize disrupted supply chains. Leveraging supply chain governance logic through the dual lenses of resource management and competing values, a research framework is introduced to address the nature of public–private short‐term collaboration and its influence on supply chain resilience. The largely unstudied concept of short‐term collaboration is at the heart of a model focusing on the alignment and adjustment of potentially disparate organizational values (public/private) to establish collective responsiveness while facilitating the fulfillment of mutual goals for a single event and/or discrete repeat events. We offer research propositions pertaining to the model and conclude with a discussion of managerial implications and the dire need for future research.
Effects of mobile devices on K–12 students' achievement: a meta‐analysis
Authors: Tingir S. , Cavlazoglu B. , Caliskan O. , Koklu O. , Intepe‐Tingir S.
Published: March 2017

In this meta‐analytic study, we investigated the effects of mobile devices on student achievement in science, mathematics and reading in grades K–12. Based on our inclusion criteria, we searched the ERIC and PsycINFO databases and identified 14 peer‐reviewed research articles published between 2010 and 2014. We identified the device type, subject area, intervention language, grade level, study design and implementer (i.e., of the intervention) as potential moderator variables that may influence student achievement in the targeted content areas. We followed a three‐level meta‐analytic procedure to estimate the overall effect of these variables and explain the variation in outcomes. The results suggest that use of mobile devices in teaching yielded higher achievement scores than traditional teaching in all subject areas. With regard to the analysis of moderator variables, the results suggest that using mobile devices in reading is significantly more effective than doing so in mathematics.
Life history, immunity, Peto's paradox and tumours in birds
Authors: Møller A. P. , Erritzøe J. , Soler J. J.
Published: March 2017

Cancer and tumours may evolve in response to life‐history trade‐offs between growth and duration of development on one hand, and between growth and maintenance of immune function on the other. Here, we tested whether (i) bird species with slow developmental rates for their body size experience low incidence of tumours because slow development allows for detection of rapid proliferation of cell lineages. We also test whether (ii) species with stronger immune response during development are more efficient at detecting tumour cells and hence suffer lower incidence of tumours. Finally, we tested Peto's paradox, that there is a positive relationship between tumour incidence and body mass. We used information on developmental rates and body mass from the literature and of tumour incidence (8468 birds) and size of the bursa of Fabricius for 7659 birds brought to a taxidermist in Denmark. We found evidence of the expected negative relationship between incidence of tumours and developmental rates and immunity after controlling for the positive association between tumour incidence and body size. These results suggest that evolution has modified the incidence of tumours in response to life history and that Peto's paradox may be explained by covariation between body mass, developmental rates and immunity.
Diabetes care: Comparison of patients' and healthcare professionals' assessment using the PACIC instrument
Authors: Gijs E. , Zuercher E. , Henry V. , Morin D. , Bize R. , Peytremann‐Bridevaux I.
Published: March 2017

Rationale, aims and objective

Whereas the Patient Assessment of Chronic Illness Care (PACIC) instrument measures the extent to which care received by patients is congruent with the Chronic Care Model, the 5As model emphasizes self‐management and community resources, 2 key components of the Chronic Care Model. We aimed at comparing evaluation of diabetes care, as reported by patients with diabetes and healthcare professionals (HCPs), using these instruments.

Methods

Two independent samples, patients with diabetes (n = 395) and HCPs (including primary and secondary care physicians and nurses; n = 287), responded to the 20‐item PACIC and the six 5As model questions. The PACIC‐5A (questions scored on a 5‐point scale, 1 = never to 5 = always) was adapted for HCPs (modified‐PACIC‐5A). In both samples, means and standard deviations for each question as well as proportions of responses to each response modality were computed, and an overall score was calculated for the 20‐item PACIC.

Results

Patients' and HCPs' overall scores were 2.6 (SD 0.9) and 3.6 (SD 0.5), respectively, with HCPs reporting higher scores for all questions except 1. Patients' education and self‐management, referral/follow‐up and participation in community programs were rated as low by patients and HCPs.

Conclusion

Healthcare professionals, particularly diabetes specialists, tended to report better PACIC scores than patients, suggesting that care was not reported similarly when received or provided. Evaluation differences might be reduced by a closer collaboration between patients and HCPs, as well as the implementation of community‐based interventions considering more patients' perspectives such as patients' education and self‐management.
Meeting patient needs trumps adherence. A cross‐sectional study of adherence and adaptations when national guidelines are used in practice
Authors: Kakeeto Mikael , Lundmark Robert , Hasson Henna , von Thiele Schwarz Ulrica
Published: March 2017

Rationale, aims and objectives

In the evidence‐to‐practice pathway, guidelines are developed to provide a practical summary of evidence and stimulate change. However, when guidelines are used in practice, adherence to the recommendations in guidelines is limited, and adaptations are common. Thus, we need more detailed knowledge about adherence and adaptations when guidelines are used in practice to understand the end of the evidence‐to‐practice pathway. Subsequently, the aim is to examine adherence to and adaptations of recommendations in the Swedish National Guidelines for Methods of Preventing Disease.

Material and methods

A questionnaire was sent to healthcare professionals and managers in Stockholm between January and March 2014. Adherence to the recommendations was compared between practice settings, and the frequency of different adaptations and reasons for adaptations was analysed.

Results

Partial adherence to the guidelines was found. The adherence was significantly greater within primary care than at the hospitals (P < .001). Modifications formed the most common category of adaptations (55%) and included mainly prioritization of specific patient groups and increased patient customization. The most common reason for adaptations (25%) was to meet the patients' specific needs and capabilities.

Conclusions

This study provides insight into adherence and adaptation when guidelines are used in practice. Work with lifestyle habits was partially done in accordance with the guidelines. Lack of time and lack of resources were not the most common reasons for adaptations. Rather, the findings suggest that when patient needs and capabilities contrast with guideline recommendations, patient needs trump adherence to guidelines.
Current knowledge of metabolomic approach in infectious fish disease studies
Authors: Low C‐F , Rozaini M Z H , Musa N , Syarul Nataqain B
Published: March 2017

The approaches of transcriptomic and proteomic have been widely used to study host–pathogen interactions in fish diseases, and this is comparable to the recently emerging application of metabolomic in elucidating disease‐resistant mechanisms in fish that gives new insight into potential therapeutic strategies to improve fish health. Metabolomic is defined as the large‐scale study of all metabolites within an organism and represents the frontline in the ‘omics’ approaches, providing direct information on the metabolic responses and perturbations in metabolic pathways. In this review, the current research in infectious fish diseases using metabolomic approach will be summarized. The metabolomic approach in economically important fish infected with viruses, bacteria and nematodes will also be discussed. The potential of the metabolomic approach for management of these infectious diseases as well as the challenges and the limitations of metabolomic in fish disease studies will be explored. Current review highlights the impacts of metabolomic studies in infectious fish diseases, which proposed the potential of new therapeutic strategies to enhance disease resistance in fish.
Influence of age at diagnosis on the clinical characteristics of Crohn's disease in Korea: Results from the CONNECT study
Authors: Hwang Sung Wook , Kim Jee Hyun , Im Jong Pil , Ye Byong Duk , Koo Hoon Sup , Huh Kyu Chan , Cheon Jae Hee , Kim You Sun , Kim Young Ho , Han Dong Soo , Kim Won Ho , Kim Joo Sung ,   The Crohn's disease clinical network and cohort (CONNECT) study
Published: March 2017

Background and Aim

The present study evaluated the clinical characteristics of Korean patients with Crohn's disease (CD) according to their age at diagnosis in a nationwide multicenter cohort study.

Methods

A total of 1224 patients diagnosed with CD between 1982 and 2008 in 32 hospitals were included, and age at diagnosis was categorized as ≤ 16 (G1), 17–40 (G2), 41–59 (G3) and ≥ 60 (G4) years old. The baseline characteristics, medication, and intestinal resection were compared according to the age at diagnosis.

Results

The number of patients in each age group was 155 (G1; 12.7%), 919 (G2; 75.1%), 120 (G3; 9.8%), and 30 (G4; 2.5%). The frequencies of ileocolonic disease in the late adult onset and elderly onset groups were lower than those in the other groups (P < 0.001). The cumulative probabilities of thiopurine and anti‐tumor necrosis factor use in late adult onset and elderly onset groups were significantly reduced compared with those of the other groups (P < 0.01). However, the risk of the first intestinal resection was not different among the age groups. The ileal location (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.11–2.27), complicated behavior (HR: 3.35; 95% CI: 2.63–4.27), and early thiopurine use (HR: 0.27; 95% CI: 0.17–0.43) were associated with the first intestinal resection, whereas the age at diagnosis was not a risk factor.

Conclusions

Elderly onset CD may be related to favorable outcomes in Korea. Thus, the heterogeneity of this disease should be considered when developing a tailored strategy for the treatment of CD.
Combining Eco‐Efficiency and Eco‐Effectiveness for Continuous Loop Beverage Packaging Systems: Lessons from the Carlsberg Circular Community
Authors: Niero Monia , Hauschild Michael Z. , Hoffmeyer Simon B. , Olsen Stig I.
Published: March 2017

Eco‐efficiency (i.e., increasing value while reducing resource use and pollution) can with advantage be combined with eco‐effectiveness (i.e., maximizing the benefits to ecological and economical systems) to address the challenges posed by the circular economy in the design of circular industrial systems. We present a framework combining life cycle assessment (LCA) and the Cradle to Cradle® (C2C) certification program for the development of continuous loop packaging systems, which was conceived for aluminum cans in the context of the Carlsberg Circular Community. As a first step, the environmentally optimal beverage packaging life cycle scenario is identified, both in terms of defined use and reuse. Second, the limiting factors are identified for the continuous use of materials in multiple loops, meeting the two requirements in the C2C certification process that address the material level (i.e., “material health” and “material reutilization” criteria) and the “renewable energy” criterion. Then, alternative scenarios are built to meet C2C certification criteria, and LCA is used to quantify the environmental impacts of the resulting improvement strategies, for example, change in material composition, in order to guide the identification of the optimal scenario from an eco‐efficiency point of view. Finally, the business perspective is addressed by assessing the potential for a green value network business model for a closed‐loop supply. The outcome is a list of prioritized actions needed to implement the most efficient and effective “upcycling” strategy for the beverage packaging, both from an environmental and an economic point of view. In the case of the aluminum cans, the main recommendation from both the LCA and C2C perspective is to ensure a system that enables can‐to‐can recycling.
New graduate registered nurses’ knowledge of patient safety and practice: A literature review
Authors: Murray Melanie , Sundin Deborah , Cope Vicki
Published: March 2017

Aims and objectives

To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses.

Background

Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety.

Design

A focused review of research literature.

Methods

The review used key terms and Boolean operators across a 5‐year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty‐four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review.

Results

This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory‐practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse.

Conclusions

Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety.

Relevance to clinical practice

Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition.
Effect of the cooling suit method applied to individuals with multiple sclerosis on fatigue and activities of daily living
Authors: Özkan Tuncay Fatma , Mollaoğlu Mukadder
Published: March 2017

Aims and objectives

To determine the effects of cooling suit on fatigue and activities of daily living of individuals with multiple sclerosis.

Background

Fatigue is one of the most common symptoms in people with multiple sclerosis and adversely affects their activities of daily living. Studies evaluating fatigue associated with multiple sclerosis have reported that most of the fatigue cases are related to the increase in body temperature and that cooling therapy is effective in coping with fatigue.

Design

This study used a two sample, control group design.

Methods

The study sample comprised 75 individuals who met the inclusion criteria. Data were collected with study forms. After the study data were collected, cooling suit treatment was administered to the experimental group. During home visits paid at the fourth and eighth weeks after the intervention, the aforementioned scales were re‐administered to the participants in the experimental and control groups.

Results

The analyses performed demonstrated that the severity levels of fatigue experienced by the participants in the experimental group wearing cooling suit decreased. The experimental group also exhibited a significant improvement in the participants’ levels of independence in activities of daily living.

Conclusions

The cooling suit worn by individuals with multiple sclerosis was determined to significantly improve the participants’ levels of fatigue and independence in activities of daily living.

Relevance to clinical practice

The cooling suit therapy was found to be an effective intervention for the debilitating fatigue suffered by many multiple sclerosis patients, thus significantly improving their level of independence in activities of daily living.
Effective pain management in recently discharged adult trauma patients: Identifying patient and system barriers, a prospective exploratory study
Authors: Goldsmith Helen , Curtis Kate , McCloughen Andrea
Published: March 2017

Aims and objectives

To identify barriers to adherence with prescribed analgesic regimens in recently discharged trauma patients.

Background

Trauma pain severely interferes with the life of healthy and often working individuals with intense and enduring pain experienced at home following discharge. The reasons for this are unclear considering discharge information (including discharge referral letters and nursing discharge checklists) and analgesics (scripts and/or medication) are routinely provided to patients at hospital discharge.

Design

A prospective exploratory study.

Methods

Between July–December 2014, 82 recently discharged adult trauma patients completed a questionnaire about their injury‐related pain and pain management experiences posthospital discharge from a level one trauma centre. For 77 of these participants, medical records were reviewed for documentation regarding pain, analgesic consumption and hospital discharge processes.

Results

Sixty‐five participants (84%) consumed opioids prior to discharge, with two‐thirds (65%) of these participants given a script for and/or opioid medication at hospital discharge. Of the 77 participants who took analgesics following discharge, 26 (34%) indicated they had experienced side effects and 16 (21%) used pain medication not prescribed by a doctor. Whilst it was documented that discharge letters were given to 25 participants (32%) at discharge and 13 participants (17%) had completed nursing discharge checklists, these participants reported the lowest pain severity and interference scores postdischarge.

Conclusions

Insufficient information and analgesics given to trauma patients at hospital discharge and inconsistent and incomplete discharge processes fail to equip trauma patients to effectively manage their pain at home.

Relevance to clinical practice

It is crucial that nurses and other healthcare professionals are aware of and actively contribute to correct and complete discharge processes. Effective patient and hospital facilitators can contribute to good pain management practices amongst recently discharged trauma patients, which will thereby improve the functional outcomes of this patient population.
Patient experiences and predictors in an acute geriatric ward: A cross‐sectional study
Authors: Leonardsen Ann‐Chatrin Linqvist , Jelsness‐Jørgensen Lars‐Petter
Published: March 2017

Aims and objectives

To investigate older peoples’ experiences with acute hospital treatment and care, and variables that may influence these experiences.

Background

In the Nordic countries, research on older peoples’ experiences with hospital care is sparse.

Methods

Participants were recruited from an acute geriatric ward in a hospital in Norway during a 1‐year period (n = 189). Patient experience was assessed using the Picker Patient Experience Questionnaire, self‐rated health by Euro‐QoL 5‐dimension, three‐level version and comorbidity by Charlson comorbidity index.

Results

Responders’ median age was 79 years, 48.7% male. Most of the problems were related to continuity and transition, while fewest problems were related to respect for patient preferences. Charlson comorbidity index score and the variables “still working,” “in a relationship” and “living alone” negatively influenced patient experience.

Conclusions

A high amount of problems were identified among patients hospitalised in an acute geriatric ward. Findings from this study may provide important information about issues that need focus to increase the care experiences of older people.

Relevance to clinical practice

Results from this study adds to existing knowledge, and emphasize the need for increased focus on discharge and continuity of care processes.
Liberating burdensomeness of suicide survivorship loss: A Critical Interpretive Synthesis
Authors: Talseth Anne‐Grethe , Gilje Fredricka L
Published: March 2017

Aims and objectives

What is an interpreted and synthesised understanding of responses of survivors to a suicide death of a close person?

Background

It is well known that survivors of suicide loss who are in a close relationship with the deceased are at high risk for suicidality and health conditions. Nurses in various settings need evidenced‐informed approaches to encounter these vulnerable persons and support their healing journey from postvention to prevention.

Design

The design is reflexive and iterative.

Method

A Critical Interpretive Synthesis comprised of six phases: formulating the review question; searching literature; sampling; determining quality; extracting data; interpretive synthesis. Qualitative content analysis was also.

Results

Based on a sample of 15 published full‐text qualitative and quantitative nursing research studies published between 1990 and 2016, an aggregated, interpreted and synthesised understanding of responses of survivors of suicide loss to the suicide death of a close person emerged. Four synthesised concepts were: dreading burden of suicide risk and stigma; facing burdensomeness in the aftermath of suicide death; enduring being burdened‐unburdened, striving to invest in living; and liberating burdensomeness, journeying toward healing.

Conclusions

Contextually, geo‐cultural gaps exist in published nursing studies. Most studies were from North American and a few from Asia. The reported suicide deaths occurred over a wide range of time. Conceptually, four synthesised concepts can be viewed as a process of moving from burdensomeness to liberating burdensomeness. Methodologically, a small body of knowledge that met quality appraisal was interpreted and synthesised into an understanding of an evidenced‐informed approach to guide nurses' encounters with survivors of suicide loss.

Relevance to clinical practice

The results contribute to an evidenced‐informed approach for nurses in practice to support survivors of suicide loss journeying from burdensomeness to liberating burdensomeness. Results also serve as a foundation for further research.
Taste‐related sensations in old age
Authors: Ogawa T. , Annear M. J. , Ikebe K. , Maeda Y.
Published: March 2017

The sense of taste is important as it allows for assessment of nutritional value, safety and quality of foods as well as for food enjoyment and quality of life. Several factors are suggested to be associated with taste sensitivity, and higher prevalence of taste disorder has been reported among older adults. This review focused on the reported causes and correlates of taste decline in older adults, with the aim to consolidating existing evidence and identifying gaps and limitations. Using a scoping review methodology, we sought relevant literature from the last 20 years. Search terms included taste, gustatory sense, older adults and geriatric. Considered research was limited to reports that involved research participants over 60 years old, papers written in English, and manuscripts published after 1995. We have consolidated available evidences on the influences on taste‐related sensations among international cohorts of older adults. Influences can be reflected under the topics of physiological changes in the sensory organs, physiological and behavioural variables related to taste sensation. This review identified three areas of historic and current research endeavour related to studies of taste sensation in older subjects: physiological changes in the sensory organs, factors related to the ageing of the individual and behavioural variables affecting taste‐related sensation. Key limitations and gaps in the current literature include notable lack of consideration of potential confounding, mediating and moderating effects, while future research is indicated in the areas of measuring the quality of health and life. As global population ageing accelerates in the coming decades, maintaining taste sensations and sensitivity in older adults will be a key measure to ensuring quality of health and life.