bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes- a significant contributor to complications in cardiac surgery: how and when to optimise glycaemic control
Authors: Penrose Melissa , Lee Geraldine
Published: June 2024

Objective: The aim is to present the literature on the association between pre-operative hyperglycaemia and post-operative complications and to review the current interventions (pre surgery, peri /intra- and post-operatively) in those with diabetes undergoing cardiac surgery.
Design: A literature review was undertaken to examine complications and interventions in those with diabetes undergoing cardiac surgery.
Setting: Acute care.
Subjects: Those with diabetes undergoing cardiac surgery.
Main outcome measures: Mortality and morbidity and improved glycaemic control.
Results: Pre-operative hyperglycaemia is associated with wound infections and prolonged length of hospital stay. Studies on intra- and post-operative medical interventions to control glycaemia in cardiac surgical patients demonstrate improved short-term medical outcomes, including decreased mortality and improved glycaemic control, reduction in infection rates and reduced length of stay. Some studies examined the roles of pre-operative glucose management (using glycosylated haemoglobin, HbA1c) prior to surgery and demonstrated that HbA1c can be decreased in short term post-educational interventions. Improvements in physical functioning and quality of life post-educational interventions have been reported. Although the primary outcome is often HbA1c, patient focused outcomes (such as empowerment and education) are equally as important in this chronic condition.
Conclusion: Diabetes is a chronic condition and patients need to be educated about the association between coronary artery disease and diabetes and the importance of glycaemic control. Interventions can improve glycaemic control in the short-term as well increasing patients’ empowerment and self-mastery. There is evidence supporting the benefits of educational interventions in those with diabetes undergoing cardiac surgery.
Introduction of a novel, mobile, nurse-led prostate cancer education and testing service
Authors: Crowe Helen , Bugeja Patricia , Wootten Addie , Howard Nicholas , Murphy Declan , Challacombe Ben , Costello Anthony
Published: June 2024

Testing for prostate cancer (PCa) remains a controversial issue with conflicting professional recommendations resulting in wide variation in general practitioner’s opinions, and advice to patients. As a result some men may not receive information about their risk of developing PCa, and are therefore unable to make a decision about undergoing testing. A nurse-led program was established for delivery of information about PCa, and providing convenient testing opportunities in the workplace. The program was evaluated and found to be an efficient and wellreceived model for delivery of this health related initiative.
Objective: The aim of this paper is to describe the development and evaluation of a mobile, nurse-led PCa education and testing service.
Setting: PCa information and testing in work-place environment.
Primary Argument: Controversy exists regarding the risks and benefits of PCa testing. Guidelines are conflicting, with one consistent premise being that men should be provided with enough information to make an informed decision. General practitioner’s uncertainty about appropriate advice, and men’s reluctance to engage in health seeking behaviours, make provision of information to men regarding the risks and benefits of PCa testing a challenge. This novel nurseled work-place service helps overcome some of the identified difficulties in men accessing information to enable them to make an informed decision regarding PCa testing and to undergo this testing.
Conclusion: The provision of work-place group education sessions and follow-up individual nurse-led consultation and testing sessions was well received and provided an opportunity for men to access information regarding PCa, and to undergo testing if appropriate, in a convenient, non-threatening environment.
Working with refugee young people: a nurse’s perspective
Authors: Garakasha Nyaradzai
Published: June 2024

Objective: To improve the health outcome of young people from a refugee background through sharing nursing experiences and processes that can be used to effectively address young people’s health related problems.
Setting: Primary Health Care.
Subjects: Newly arrived young people between the ages of 12-24 years from a refugee background.
Primary argument: There is evidence that a young person’s personal responses to history of torture and trauma, displacement, loss and interruption to family life; intertwined with adolescent uncertainty may lead to particular challenges. All young people require nurses and clinicians with the knowledge and skills to address their health problems. However this particularly vulnerable group also require health professionals that can approach these young people and their families in a manner that is culturally and professionally acceptable. This paper seeks to share some of the experiences gained while working with adolescents and youths from refugee backgrounds including common health issues raised by young people, their families and communities. In addition it will suggest some processes that are being used to address health issues. This includes setting up a health initiative that seeks to address health issues in a familiar supportive environment that is acceptable to the young people their families and communities.
Conclusion: Refugee young people are a special group of people with different needs when compared to adults from a refugee background. It is very important for nurses to identify these needs and know how to identify the problems young people from a refugee background face. As clinicians it is very important to be aware of the issues facing refugee young people and the best way to approach young people so they feel welcome. Working with refugee young people requires patience and relationship building. It is very important to treat refugee young people as individuals and to involve the young people and their families in the treatment and problem solving as much as possible in order to get the best result.
Urinary continence care in Australian nursing homes
Authors: Yu Ping , Hailey David , Traynor Victoria
Published: June 2024

Objective: Exploring urinary continence (UC) assessment and management practices in Australian nursing homes.
Design: Mixed method using a questionnaire and interviews.
Setting: Five nursing homes in Australian metropolitan cities.
Subjects: Participants 121 staff: mostly female (91%) with a range of roles including personal care assistants (PCAs) (63%), enrolled nurses (ENs) (11%), registered nurses (RNs) (20%) and managers (4%).
Main outcomes measure(s): Compliance with and perceptions about UC assessment and management.
Results: 77% (n=71) of care staff (PCAs, ENs and RNs) were compliant with the UC management protocol of checking for wetness every 2 to 2.5 hours. Toileting time and frequency of changing continence aids varied between nursing homes. Perceptions about the accuracy of UC assessments and knowledge of an older person following UC assessment also differed between nursing homes.
Conclusion: Areas where UC assessment and management in nursing homes could be improved include identifying the voiding times of older people, compliance with care plans in management practice, and caregiver ability to assess the capacity of continence aids to absorb urine. Training for effective continence care in nursing homes needs to be enhanced.
A Nurse Communication Manager reduces the number of non-relevant contacts
Authors: Wright Nana , Nielsen Nina , Lauersen Jannie , Rosenberg Jacob , Danielsen Anne
Published: June 2024

Objective: The aim of this study was to reduce interruptions in nursing practice by exploring the effects on the number of  nonrelevant contacts received by the nursing staff after implementation of a Nurse Communication Manager.
Design: The study was designed as a pre/post interventional study. All contacts to the nursing staff, either by telephone or in person, were registered 14 days before intervention and 14 days after intervention.
Setting: The study was set in a department of surgery.
Subjects: The subjects were contacts either in person or by telephone aimed at nurses and nurse assistants in the surgical department.
Interventions: During the daytime a Nurse Communication Manager handled all incoming contacts irrespective of whether they were in person or by telephone. When the Nurse Communication Manager was not available and during the evening, night and weekends, telephone contacts were managed by an electronic Call Centre guiding the call to the care teams.
Main outcome measure(s): The main outcome measures were the number of non-relevant contacts aimed at the nursing staff.
Results: Results showed a significant reduction in non-relevant contacts to the nursing staff from a mean of 80 contacts per day (SD 43) to a mean of 18 contacts per day (SD 7), p<0.01.
Conclusion: Implementation of a Nurse Communication Manager (NCM) reduced the number of non-relevant contacts. Reduction of non-relevant contacts is important for nurses in the clinical setting as non-relevant contacts may be perceived as interruptive. When nurses do not have to spend time responding to non-relevant contacts, they have more time to perform direct patient care.
Health literacy: how nurses can make a difference
Authors: Johnson Anne
Published: June 2024

Objective: To be a call to action to nurses and all health professionals to implement proven effective evidence based strategies that can decrease health literacy demands on health consumers, and improve health outcomes and the provision of safe person-centred health care.
Primary argument: Health professionals, specifically nurses, are important providers of health information to health consumers. They influence the health literacy demands placed on health consumers through the way they organise, present and communicate information (Australian Commission on Safety and Quality in Health Care, 2014). All health professionals need to be cognisant of the range of effective strategies they can implement to reduce the health literacy demands on health consumers through effective interpersonal communication, health materials in the written and visual formats and the creation of health literate environments to improve health outcomes and the provision of safe care. Population measurements of functional health literacy levels (Australian Bureau of Statistics 2008) indicate that 59 per cent of the Australian population aged 15 to 74 years did not achieve an adequate health literacy skill level to meet the complex demands of everyday life and work in a knowledge-based economy.
Objective:  To be a call to action to nurses and all health professionals to implement proven effective evidence based strategies that can decrease health literacy demands on health consumers, and improve health outcomes and the provision of safe person-centred health care.
Primary argument: Health professionals, specifically nurses, are important providers of health information to health consumers. They influence the health literacy demands placed on health consumers through the way they organise, present and communicate information (Australian Commission on Safety and Quality in Health Care, 2014). All health professionals need to be cognisant of the range of effective strategies they can implement to reduce the health literacy demands on health consumers through effective interpersonal communication, health materials in the written and visual formats and the creation of health literate environments to improve health outcomes and the provision of safe care.Population measurements of functional health literacy levels (Australian Bureau of Statistics 2008) indicate that 59 per cent of the Australian population aged 15 to 74 years did not achieve an adequate health literacy skill level to meet the complex demands of everyday life and work in a knowledge-based economy.
Conclusion: An understanding by all health professionals of the concept of health literacy, and the evidence based strategies they can implement to decrease health literacy demands on health consumers is imperative to enhancing the involvement of health consumers in their care, improving health outcomes and in the provision of safe health care.
A prospective comparison of the AUSDRISK and HbA1c for persons with spinal cord injury
Authors: Jannings Wendy , Fry Margaret , Gallagher Robyn
Published: June 2024

Objective: The primary object of this study was to determine the validity of the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) for predicting the development of type 2 diabetes in persons with spinal cord injury (SCI).
Design and setting: The prospective comparative study (December 2013-March 2014) collected data on AUSDRISK and haemoglobin A1c (HbA1c) in participants’ homes.
Participants: Participation rate was 67% (n=79). Study criteria: over 18 years of age, a SCI for more than 12 months, living at home, wheelchair dependant and no diabetes diagnosis.
Main outcome measures: AUSDRISK sensitivity and specificity in predicting incident type 2 diabetes in persons with SCI.
Results: Of the 79 participants, 81% were male, mean age was 53 years (SD 14.14) with 23.2years (median 23; SD +/- 13.2yrs) since injury. There was a positive correlation between length of time since SCI and risk score (AUSDRISK) (r = .242, p = .032). Participants with high AUSDRISK scores had higher HbA1c% (5.38 versus 5.2, p = .026) level. The high risk classification explained a moderate amount of HbA1c % (area under curve = .651; 95% CI .53 - .77). The level of HbA1c which had the highest sensitivity (.59) and specificity (.73) for risk classification was 5.25%. Waist circumference and physical activity items require further powered studies to determine if appropriately weighted.
Conclusion: Comparing the AUSDRISK with HbA1c assays, the AUSDRISK can predict type 2 diabetes risk in a person with S
Being a fellow patient to a critically ill patient leads to feelings of anxiety – an interview study
Authors: Laursen Jannie , Bonnevie Lundby Trine , Kjaergaard Danielsen Anne , Rosenberg Jacob
Published: June 2024

Objectives: To explore in-patients’ experiences being a fellow patient to patients who become critically ill.
Design: The study was designed as a qualitative phenomenological study.
Setting: The study was conducted in a surgical ward of a hospital in Denmark.
Subjects: Fifteen fellow patients to patients, who became critically ill.
Results: Three key themes emerged from the analysis of the data: patients’ interaction, anxiety, and professional support. These findings demonstrated the importance of understanding how patients experienced being a fellow patient to patients, who become critically ill, their views on interacting with such a patient, how the patients who become critically ill influenced them, and what kind of support they needed from the health professionals.
Conclusion: The findings highlighted the different emotions and feelings experienced by fellow patients. It showed how the impact of the situation can lead to anxiety, a feeling of being forced into patient inter-action and the lack of professional support. Health professionals should have a central role in supporting the fellow patients and communicating with them about their experiences and this does not seem to be fulfilled sufficiently in daily clinical practice.
Rotating shift work and colorectal cancer among nurses and midwives: a cross-sectional study
Authors: Wickremaratne Kalana , Strand Haakan , Zhao Isabella
Published: June 2024

Objective: The main aim of this study was to explore any association between colorectal cancer (CRC) and rotating shift work in nurses and midwives. The secondary aim of this study was to identify risk factors for CRC in nurses and midwives who are rotating shift workers.
Design: Cross-sectional study.
Setting: Electronic survey of participants from Australia, New Zealand and the United Kingdom.
Subjects: A sample of 8,199 male and female nurses and midwives from Australia, New Zealand and the United Kingdom invited through their registration papers or newsletter advertisement.
Main outcome measure: Prevalence of CRC in participants who have worked rotating shifts for 1-14 years or ≥15 years compared to participants who have never worked rotating shifts. In addition, risk factors for CRC in the rotating shift work population were analysed in a multivariate logistic regression model in order to obtain odds ratio of CRC.
Results: No statistically significant difference was found in the prevalence of CRC between those who have never worked rotating shift work, worked 1-14 years and worked 15 or more years.Among rotating shift workers, diabetes was associated with a 123-fold (95% CI 39-392; p<0.001) increased odds of CRC, while Inflammatory Bowel Disease (IBD) was associated with a 190-fold (95%CI 68-526; p<0.001) increased odds of CRC. Screening colonoscopy or sigmoidoscopy for CRC was associated with a 10-fold (95% CI 3-35; p<0.001) increased odds of being diagnosed with CRC.
Conclusion: No significant association was found between rotating shift work and colorectal cancer in nurses and midwives. In nurses and midwives who are rotating shift workers, diabetes, IBD and CRC screening significantly increased the odds of CRC.
Designing simulation learning experiences to reduce technological burden on nursing academics: a discussion paper
Authors: Ryan Colleen , Roy Sherre , O'Neill Barbara , Simes Tracey , Lapkin Samuel , Riva Elizabeth
Published: June 2024

Objective: The literature reports nursing academics avoid manikin-based simulation because they feel intimidated by the technology. With that in mind, we sought to design a manikin-based simulation learning experience for nursing students, with low technological burden for those nursing academics expected to work with the technology.
Setting: A multi-campus Australian regional university school of nursing.
Subjects: Nursing academics with little or no experience in manikin-based simulation.
Primary argument: Nursing academics are encouraged to use manikins in their clinical teaching but little has been done to address their fears and concerns around the technology. We argue that taking simple steps to decrease the technological burden will help to encourage nursing academics uptake of manikin-based simulations, as a favoured pedagogy in clinical teaching.
Conclusion: The technological burden around manikin-based simulation was reduced by: (1) choosing medium level fidelity simulations, (2) designing simulations where students operate the equipment, (3) preparing participants for the SLE with a pre-brief video and instruction handouts, (4) offering academics roles as observers, and (5) providing on-site technological support. Nursing academics were encouraged by the process and more inclined to engage with manikin simulations. Designing simulations that address nursing academics’ fears and concerns around simulation technology encourages simulation uptake.
Is it time to re-examine the doctor-nurse relationship since the introduction of the independent nurse prescriber?
Authors: Pritchard Michael John
Published: June 2024

Objective: The aim of this paper is to stimulate a debate and discussion into how the nurse‑doctor relationship needs to change.
Setting: The National Health Service, United Kingdom.
Primary argument: The nurse‑doctor relationship needs to be re‑evaluated in light of the expanding role of nurses into areas that traditionally had been considered a doctor’s role. While the medical profession has been willing to relinquish some control to nurses in areas such as wound or incontinence care because these aspects do not threaten their authority, position or power. The issue of non‑medical prescribing remains for some in the medical profession a topic of concern. Despite non‑medical prescribing being discussed widely in the literature, very little has been mentioned about how the introduction of the nurse prescriber has impacted the professional relationship between the nurse and the doctor.
Conclusion: The blurring of the roles between nurses and doctors requires a re‑evaluation of this relationship. As nurses take on more responsibility such as prescribing medication the old traditional view of this relationship is no‑longer viable, if we are to maximise patient health care in the 21st century.
Nurses plastering and splinting in the emergency department: an integrative review
Authors: Stevens Leahanna , Thompson Susie , Stoddart Emma , Bost Nerolie , Johnston Amy
Published: June 2024

Objective: Increasing numbers of presentations, high acuity of patients and a decreased access to hospital beds contribute to lengthy waiting times in Emergency Departments (EDs). Implementing models of care to improve patient flow through EDs is imperative. This integrative review was undertaken to evaluate existing evidence regarding the impact of nurses’ plastering and splinting in EDs.
Setting: Data included in the review was drawn from five International databases that include publications exploring acute care interventions using PRISMA guidelines. An unbiased search and then application of exclusion criteria by three independent researchers delineated 11 papers for inclusion. Full-text analysis using a predefined framework enabled development of the primary outcomes.
Primary argument: The research question guiding this integrative review is: What is the impact on patient and staff satisfaction, cost, ED length of stay, ED re-presentation rates when ED nurses apply plasters and splints to patients who present to ED with a fractured or sprained limb?While no literature focused specifically on outcomes from nurses applying plasters or splints, studies indicated that plastering, as part of a suite of nursing skills, had positive effects on patient outcomes such as reduced waiting times to treatment.
Conclusions: There is insufficient evidence to inform protocols for nurses to perform plastering and splinting. Further research evaluating the impact of nurses using this skill in their practice is required to support evidence-based practice.
Glycaemic response to three main meals or five smaller meals for patients on rapid-acting insulin
Authors: Meng Zhaolin , Overland Jane , Shen Xingping , Wu Xiaobin , Wang Yuanyuan , Liu Yunyun
Published: June 2024

Objective: To compare seven-point blood glucose profiles of patients with type 2 diabetes mellitus using rapid-acting insulin, when daily calories were provided as three main meals versus five smaller meals (three main meals + two snacks), while maintaining the same total daily calorie intake and composition of carbohydrates, fats and protein.
Design: A cross-over study.
Setting: Xiamen University Zhongshan Hospital, China.
Subjects: Over a four week period, 22 patients with type 2 diabetes mellitus using fixed doses of rapid-acting insulin were recruited into the study. Two patients failed to complete the study and data from the remaining 20 subjects were analysed.
Intervention: The subjects using fixed doses of rapid-acting insulin were randomised to five smaller meals versus three main meals treatment periods. Glycaemic response to each meal pattern was measured by seven-point blood glucose profiles.
Main Outcome Measures: The mean seven-point blood glucose levels and the risk of hypoglycaemia.
Results: The mean seven-point blood glucose levels with the pattern of eating five smaller meals was lower than that with three main meals (9.1mmol/L vs. 9.5mmol/L), however the difference was not statistically significant (F=0.524, P=0.474). There were no differences in mean blood glucose levels across the seven-point profile. The risk of hypoglycaemia was also not statistically significant.
Conclusions: This suggests that it may be unnecessary for patients using rapid-acting insulin to have five smaller meals.
Pilot study: how Sydney community nurses identified food security, and student nurse focus group perceptions
Authors: Saville Lynette
Published: June 2024

Objectives: This paper aims to discuss and explore food security in the context of community health nursing, to provide insight about how frontline workers may identify whether their client is food secure.
Design: A qualitative descriptive design pilot study, using questionnaire and unstructured interviews.
Setting: Community health services across Sydney.
Subject: How community health nurses identify whether their client is food secure.
Method: Three community health nurses were interviewed and their responses recorded. Two student nurses participated ina focus group during professional work experience in community health.
Findings/Results: Although community health nurses claim they can identify whether their clients are food (in)secure, it remains unclear how they operationalise this claim, and indeed if they do, what the outcome may be for their clients’ health determinants.
Primary argument: To raise awareness and stimulate discussion about food security as a social determinant of health, and whether community nurses have a role identifying client food security.
Conclusion: Food (in)security is increasingly recognised as a social determinant of health, with evidence that the prevalence of food insecurity is increasing in Australia. It is acknowledged that community health nurses have established professional relationships with their clients, and that food insecurity may be identified though formal and informal means.A more open discussion is required about food (in)security and potential ways in which it may be discussed in nonjudgmental, sensitive ways. Further investigation is required to interview community health nurses, in the context of their relationships with clients, how they establish whether food security is occurring and being maintained.
Osteoporosis treatment preferences and satisfaction in postmenopausal women: Denosumab compared with oral bisphosphonates
Authors: Bajger Boguslawa
Published: June 2024

Aim: This paper aims to investigate whether Denosumab is more effective in promoting adherence and satisfaction than oral bisphosphonates in the treatment of osteoporosis in postmenopausal women.
Methods: Electronic database - MEDLINE, PubMed, CINAHL, Wiley online Library, ProQuest Nursing and Allied Health), free text engines Google Scholar and Findit@Flinders and reference lists of retrieved papers were searched according to the inclusion and exclusion criteria. Twelve studies were ultimately selected.
Primary argument: The author analyses and critically appraises literature comparing two common osteoporotic medications: oral bisphosphonates and subcutaneous Denosumab in view of patients’ preferences and satisfaction. Findings from this review could provide suggestions for developing frameworks in clinical practice, identify strategies to improve patient adherence to treatment and develop policies promoting active patient involvement in treatment decisionmaking.
Results: Following thematic organisation of the studies, four major themes emerged: patient’s view on attributes on osteoporotic medications; patient satisfaction and preferences in oral bisphosphonates compared to Denosumab; adherence to treatment with oral bisphosphonates compared to Denosumab; and practice implications.
Conclusion: Findings from reviewed studies favor Denosumab over oral bisphosphonates as the preferred long-term treatment in postmenopausal women. Patients have a greater satisfaction with less frequent dosing, mode of administration and side effects of Denosumab.
Emergency management of patients with Supratherapeutic INRs on Warfarin: a multidisciplinary education study
Authors: Safatly Inaam , Singleton Hugh , Decker Kelly , Roman Cristina , Bystrzycki Adam , Mitra Biswadev
Published: June 2024

Objective: Supratherapeutic INRs exceeding 4.5 are associated with increased risk of haemorrhage. The aim of this study was to evaluate the efficacy of an educational program focused at improving emergency clinician compliance with the Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ) guidelines.
Design: A pre and post-intervention study was undertaken. Retrospective data from 1 July 2014 to 30 June 2015 andprospective data 1 January 2016 to 31 December 2016 were collected.
Setting: This study was conducted in a large tertiary care hospital in Melbourne, Victoria, Australia.
Subjects: Included were all consecutive patients in the study periods that presented to the emergency department with an initial INR result of >4.5 on warfarin only.
Interventions: Development and delivery of an educational program in accordance with the current THANZ guidelines was implemented.
Main outcome measures: To improve education regarding the correct management of emergency patients on warfarin with a supratherapeutic INR.
Results: Data on 158 patients with an INR >4.5 were collected. Data on 46 patients were excluded. Management in 31patients did not follow recommended guidelines. There was no difference detected between groups with 17 compliant with guidelines pre-intervention and 14 post intervention; p=0.87.
Exploring the experiences of internationally and locally qualified nurses working in a culturally diverse environment
Authors: O’Callaghan Cathy , Loukas Patty , Brady Michelle , Perry Astrid
Published: June 2024

Objective: This article explores the support needs, attitudes and experiences of both internationally and locally qualified nurses working within a culturally diverse environment.
Design: Open and closed survey questions.
Setting: Hospital in Sydney, Australia.
Subjects: 108 nurses were surveyed, representing 14% of the nursing staff at the hospital.
Main outcome measure(s): The research project measured the experiences encountered by internationally qualified nurses (IQNs) in relation to language use, discrimination, culture and differing health systems. It provided a forum to discuss how their cultural background, professional background and linguistic skills affect interactions with patients and other staff. It also explored suggestions for improvement in cross-cultural relations between staff, and support for IQNs and their peers in a diverse staff environment.
Results: Although IQNs feel they are adjusting well to their role, locally qualified nurses largely disagree. Staff were aware of discrimination from patients towards staff, and from other staff towards staff. The research revealed that IQNs are unsure when to use their language skills, have different approaches to nursing and expectations of the staffpatient/family relationship.
Conclusion: Adjustment to the Australian healthcare system for IQNs is challenging. There are a number of strategies that can support both IQNs in their integration, as well as all nurses to work more effectively together in a cross-cultural work environment.
Analysis of interviews to uncover the effects of nurse prescribing on the doctor-nurse relationship
Authors: Pritchard Michael
Published: June 2024

Objective: The introduction of nurse prescribing has had a profound effect on how patients obtain a prescription. Yet very little has been researched about the effects of nurse prescribing on the professional relationship between nurses and doctors since its introduction. It was this lack of enquiry that led to this research study to see if this relationship has changed since the introduction of the nurse prescriber.
Design methods: A purposeful sample approach was chosen, interviews were undertaken using a semi-structured method and interpretative phenomenological analysis was used to analyse the data.
Setting: A large teaching hospital in the north west of England.
Subjects: Four nurse prescribers and four doctors working in orthopaedics, breast surgery or urology looking after adult elective surgery patients.
Main outcomes: What emerged from this study is a complex pattern of readjustment within this relationship. The power once enjoyed by the medical profession is now challenged by the introduction of the nurse prescriber. A number of themes emerged around the topics of prescribing, relationship, educational and communication. Each help to focus how this change manifests itself in the relationship and how it needs to evolve if the maximum benefit from nurse prescribing is to be achieved.
Conclusions: What has emerged from this research is how complex the relationship between the nurse prescriber and doctor really is. The power to prescribe medication that was once the sole preserve of the medical profession is now shared with the nurse prescriber. But this shared authority remains unequal; the medical profession remains at least unwilling to give up its position of control just yet, but the dialogue has begun.
Aspergillus niger prolyl endopeptidase in celiac disease
Authors: Colella Marica , Cafiero Concetta , Palmirotta Raffaele
Published: June 2024

We comment here on the article by Stefanolo et al entitled “Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet”, published in the World Journal of Gastroenterology . Celiac disease is a well-recognized systemic autoimmune disorder. In genetically susceptible people, the most evident damage is located in the small intestine, and is caused and worsened by the ingestion of gluten. For that reason, celiac patients adopt a gluten-free diet (GFD), but it has some limitations, and it does not prevent re-exposure to gluten. Research aims to develop adjuvant therapies, and one of the most studied alternatives is supplementation with Aspergillus niger prolyl endopeptidase protease (AN-PEP), which is able to degrade gluten in the stomach, reducing its concentration in the small intestine. The study found a high adherence to the GFD, but did not address AN-PEP as a gluten immunogenic peptide reducer, as it was only tested in patients following a GFD and not in gluten-exposing conditions. This study opens up new research perspectives in this area and shows that further study is needed to clarify the points that are still in doubt.
Konsep Sistem Informasi Manajemen Organisasi dalam Pelayanan Kesehatan
Authors: Maharani Ridha
Published: June 2024

The purpose of the research is to find the Concept of Organizational Management Information Systems in Health Services. Research method is a research that reviews literature using a number of sources selected based on standards of inclusion and exclusion of researchers. This research is a review of literature by doing searches and searches of libraries to produce articles on a particular research topic or problem. Research results One important component in the provision of medical services in the clinic is the health information system. Patient documentation becomes easier, operational efficiency increases, and decision-making becomes more accurate with integrated health information systems. Some of the other benefits of implementing a health information system include centralized patient data storage, inter-departmental integration, performance monitoring, and improved patient service. However, the use of SIK also faces issues such as costs, adjustment of procedures, data security, and user acceptance. Clinics can improve the efficiency and quality of services by understanding the advantages and disadvantages of Health Information Systems.
A study on the mnemotropic and antidepressant-like effects of the low-molecular-weight mimetic of nerve growth factor, dipeptide GK-2, in experimental ischemic stroke
Authors: Povarnina P. Yu. , Sazonova N. M. , Nikiforov D. M. , Gudasheva T. A. , Dorofeev V. L.
Published: June 2024

Relevance. The nerve growth factor (NGF), possessing neuroprotective and neuroregenerative properties, holds promise for the development of medications for the treatment of post-stroke conditions. At the Federal Research Center for Innovator and Emerging Biomedical and Pharmaceutical Technologies, a dimeric dipeptide mimic of NGF with the laboratory code GK-2 was designed and synthesized. Under conditions of experimental cerebral ischemia, it significantly reduced the volume of brain infarction and stimulated neuro- and synaptogenesis.

Objective. The aim of this study was to investigate the effects of GK-2 on experimental post-stroke dementia and depression.

Methods. Ischemic stroke was induced by occlusion of the middle cerebral artery (MCAO) in Wistar rats. GK-2 was administered intraperitoneally at a dose of 0.5 mg/kg for 21 days post MCAO. Short-term and long-term memory of the animals were assessed 30–40 days post MCAO using the novel object recognition test. Depressive-like state was evaluated through the forced swimming test and sucrose preference test.

Results. In animals subjected to MCAO, both short-term and long-term memory exhibited a statistically significant decline of 80 %, along with a depressive-like state characterized by a 50 % increase in total immobility time and a 30 % reduction in sucrose preference, when compared to the sham-lesioned group. Dipeptide GK-2 completely averted the onset of these impairments.

Conclusion. The dipeptide mimic of NGF, GK-2, mitigates the development of cognitive and psychomotional impairments in the setting of experimental stroke.
The possibility of calculating optimal doses in combined medicinal product (Working hypothesis)
Authors: Tsorin I. B. , Kryzhanovskii S. A.
Published: June 2024

The purpose of the study is a theoretical justification (working hypothesis) of a possible approach to calculating doses in a combined medicinal product containing 2 pharmaceutical substances. A mathematical model is proposed, which is a multiple regression equation from two variables, which is a square polynomial. The proposed model makes it possible to calculate the optimal doses of pharmaceutical substances in a combined drug by further differentiating the regression equation in partial derivatives. Two examples of dose calculation are presented.
Experimental pharmacokinetics of a new antiparkinsonian drug ADK-1113
Authors: Kravtsova O. Yu. , Dvoryaninov D. A. , Kolyvanov G. B. , Litvin A. A. , Gribakina O. G. , Zherdev V. P.
Published: June 2024

The pharmacokinetics of a new antiparkinsonian drug ADK-1113 after single intravenous and intragastric administrations in mice at doses of 10 and 20 mg/kg was studied. The absolute bioavailability was 10.1–16.3 % that indicates on potential possibility of preparing a dosage form for oral administration.
Assessment of the influence of demographic and anthropometric indicators on the variability of pharmacokinetic parameters
Authors: Vasilyuk V. B. , Verveda A. B. , Faraponova M. V. , Syraeva G. I.
Published: June 2024

Relevance. Planning the design of bioequivalence clinical studies of generic highly variable drugs requires non-standard approaches – the use of replicative (repeated) or adaptive design. However, both approaches entail an increase in organizational, time, and financial costs. Therefore, it becomes relevant to search for ways to pre-select volunteers with a lower initial level of variability in pharmacokinetic parameters to reduce the number of subjects.

Objective. The aim of this study was to determine the potential subjects in clinical trials with a low initial level of variability in pharmacokinetic parameters using methods for assessing initial gender – age and anthropometric and clinical laboratory parameters.

Material and methods. Data from clinical studies of the bioequivalence of drugs (valganciclovir, carebastine and raltegravir) with different levels of variability conducted in the period 2020–2022 in Russia were used for analysis. To achieve this goal, a model for grouping pharmacokinetic parameters (PhK) with known demographic and clinical laboratory parameters was developed using discriminant analysis. Discrimination was performed between optimal pharmacokinetics (OPhK) and variable pharmacokinetics (VPhK). Mathematical and statistical analyses of the results were performed using Microsoft Excel 2013 and Statistica 10.0.

Results. During the study, the variability of the maximum concentration of the drug in plasma (Cmax), including its logarithmic values, was used as a basis. The levels of intra-individual variability (CVintra), which is the main characteristic of drug variability, in the OPhK group were several times lower than those in the VPhK group for all studied drugs, but for the highly variable drug raltegravir, they differed by almost 10 times.

Conclusion. Therefore, the obtained results indicated that using traditional gender – age and anthropometric indicators alone is impossible to separate the OPhK and VPhK groups for the analyzed drugs with high PhK variability.
Centrinis necukrinis diabetas ir nėštumas. Klinikinis atvejis ir literatūros apžvalga
Authors: Baliukevičiūtė Gabija , Naskauskienė Gintarė , Ramašauskaitė Diana
Published: June 2024

Necukrinis diabetas – tai retas endokrininės sistemos sutrikimas, nulemtas antidiuretinio hormono nepakankamumo ir pažeidžiantis vandens bei elektrolitų pusiausvyrą organizme. Straipsnyje pateikiamas centrinio necukrinio diabeto nėštumo laikotarpiu klinikinis atvejis, rodantis galimą nėštumo įtaką minėtam sutrikimui ir taikomą gydymą. Taip pat, remiantis literatūros duomenimis, vertinami centrinio necukrinio diabeto pasireiš- kimo nėštumo laikotarpiu savitumai, pacienčių gydymo bei jo veiksmingumo stebėsenos galimybės. Centrinio necukrinio diabeto diagnozė gali būti pirmą kartą nustatoma nėštumo laikotarpiu, visgi dažniau susiduriama su nėščiosiomis, patiriančiomis pregestacinio centrinio necukrinio diabeto paūmėjimą. Gydyti skiriamas sintetinis vazopresino analogas desmopresinas, teikiant pirmenybę jo poliežuvinei formai. Gydymo veiksmingumui vertinti svarbūs tokie klinikiniai požymiai, kaip padažnėjęs šlapinimasis, pakitusi šlapimo spalva, suintensyvėjęs troškulys, hipernatremijos sukeltas sąmonės sutrikimas, silpnumas arba traukuliai bei laboratoriniai rodikliai, vertinantys kraujo ir šlapimo osmoliališkumą, šlapimo santykinį tankį, natrio kiekį kraujo plazmoje. Klinikinėje praktikoje itin svarbi nėščiųjų stebėsena ir šios ligos diagnostika, nes gydymas yra labai paprastas, veiksmingas bei padedantis išvengti galimų komplikacijų tiek motinai, tiek vaisiui.
Granuliomatozinis mastitas. Literatūros apžvalga ir klinikinio atvejo analizė
Authors: Samuilytė Ana Liza , Ceslevičienė Ieva
Published: June 2024

Idiopatinis granuliomatozinis mastitas – tai reta gerybinė lėtinė nežinomos etiologijos krūtų uždegiminė liga. Šios ligos diagnozę patvirtina tik histopatologinis tyrimas. Idiopatinio granuliomatozinio mastito gydymas iki šiol nėra standartizuotas.
Herlyn-Werner-Wunderlich sindromas. Klinikinis atvejis
Authors: Jarienė Kristina , Jukna Povilas , Šiaudikytė Gintarė
Published: June 2024

Herlyn-Werner-Wunderlich sindromas (HWWS) yra reta Miulerio latakų anomalija, kuriai būdinga dvi gimdos, vienos makšties obstrukcija ir ipsilateralinė inkstų agenezė. 13 metų amžiaus pacientei HWWS diagnozuotas remiantis skundais ir instrumentiniais tyrimais (ultragarsiniu tyrimu, kompiuterine tomografija bei magnetinio rezonanso tomografija), chirurgiškai atverta užakusi makštis.
Integration of a Comprehensive Ultrasound Assessment in the Prognostic Modeling of benign and Malignant Ovarian Tumors
Authors: Tairova Madina Ilkhom Qizi  , Xayitboyeva Mukhayyo Ravshanovna  , Kalash Dwivedi
Published: June 2024

Ovarian tumors can be challenging to diagnose and treat, especially in areas with limited access to advanced medical care. During routine prenatal ultrasounds, abnormal growths in the ovaries can be unexpectedly discovered. In clinical practice, it is essential to accurately differentiate between benign and malignant ovarian tumors in order  to develop appropriate treatment plans. Ultrasound imaging has become the preferred diagnostic tool. The aim of  this article is to examine the ultrasound characteristics of ovarian and adnexal growths and to explore how these  characteristics, along with other clinical factors, can aid in predicting the likelihood of ovarian cancer.
Analisis Pengaruh Pengalaman dan Karakter Sumber Daya Manusia Terhadap Kualitaskerjaan Proyek Konstruksi (Studi Kasus: Kecamatan Kuta Alam dan Syiah Kuala)
Authors: Bunyamin  , Heru Pramanda  , Wahyu Diara  , David Sarana
Published: June 2024

Kualitas kerja merupakan suatu hasil yang dapat diukur dengan efektifitas dan efisiensi suatu pekerjaan yang dilakukan oleh sumber daya manusia. Terdapat banyak faktor yang dapat mempengaruhi kualitas pekerjaan, salah satunya dari pengalaman dan karakter. Rumusan masalah dari penelitian ini adalah bagaimana hubungan antara variabel bebas dengan variabel terikat. Dalam penelitian ini, variabel bebas terdiri dari variabel Pengalaman (X1), dan Karakter (X2), sedangkan variabel terikatnya adalah Kualitas Pekerjaan (Y). Tujuan penelitian ini adalah untuk mengetahui pengaruh dan karakter sumber daya manusia terhadap kualitas pekerjaan proyek konstruksii Kabupaten Aceh Tengah. Pengolahan data menggunakan metode analisis data statistik deskriptiflalui aplikasi SPSS. Hasil penelitian yang didapat dari uji validitas setiap item pertanyaan dinyatakan bahwa semuanya valid. Pengaruh dariengalaman dan karakter jika dilihat dari nilai tertinggi frekuensi berjumlah 50,0% yaitu berdampak sangat berpengaruh. Sedangkan nilai frekuensi tertinggi terhadap kualitas pekerjaan sejumlah 36,7%.  Uji hipotesis dari uji f variabel bebas memiliki pengaruh secara (simultan) terhadap variabel terikat. Uji koefisien determinasi ganda (R2) diperoleh nilai R2 = 0,782, berarti pengalaman dan karakter konsultan manajemen konstruksi secara bersama-sama berpengaruh terhadap kualitas pekerjaan. Untuk uji koefisien determinasi parsial diketahui besarnya sumbangan efektif variabel karakter sebesar 31,9%, variabel karakter lebih berpengaruh terhadap kualitas pekerjaan pada pekerjaan proyek di Kabupaten Aceh Tengah daripada variabel pengalaman.
Integrating Mathematics and Computer Science in the classroom
Authors: Morge Shelby , Gordon Christopher
Published: June 2024

Effective mathematics instruction engages students in making connections among representations. When integrating mathematics and computer science, teachers may address standards in both subjects while supporting students in making connections, thus deepening understanding. Teachers participating in a professional development workshop on strategies for meaningful and authentic computer science and mathematics integration were asked to share examples of how they integrate other subjects in mathematics. In this paper, we will share the teachers’ thinking about such integration before and after participating in the workshop. Additionally, we provide an overview of workshop activities that supported teachers’ thinking about integration. Finally, we will discuss the challenges and opportunities related to integrating computer science in the mathematics classroom.
The Guided Reinvention in the Teaching of Linear Algebra
Authors: Safuanov Ildar
Published: June 2024

The paper describes how “the guided reinvention” (a technique introduced by G. Freudenthal and close to the genetic approach) can be applied in the teaching of linear algebra. The principles of constructing the course, the sequence of the study, as well as the design of the process of the teaching of linear dependence are considered. This paper is about the use of “the guided reinvention” in the teaching of some topics of linear algebra. We consider the designing the process of studying educational material using the example of studying a linear dependence. The experience of implementation of the described approach in the teaching of first year mathematic majors demonstrated the increased interest in the subject, the successful mastering of the meaning and applications of the concept of linear dependence.