bluuebunny/crossref_metadata_2025 huggingface dataset:
In Situ Characterization of Spinel Nanoceramic Suspensions
Authors: Kadosh Tamar , Cohen Yachin , Talmon Yeshayahu , Kaplan Wayne D.
Published: July 2012

In this study, an approach to characterize ceramic colloidal suspensions has been developed, based on vitrification of aqueous ceramic suspensions and microstructural characterization using cryogenic‐temperature scanning electron microscopy (cryo‐SEM), augmented by conventional rheological measurements. The flocculation phenomenon in as‐milled and aged Mg‐spinel (MgAl2O4) aqueous suspensions was characterized. A microstructure based on hard particle agglomerates separated by long‐chain deflocculant molecules was directly observed, and correlated to the rheological properties of the suspension. Several levels of flocculation were detected as a function of suspension preparation conditions. Although suspensions at solid‐loading levels appropriate for ceramic processing cannot be characterized using conventional particle size measurement techniques, cryo‐SEM can be used to measure characteristic sizes, and to distinguish between agglomerated and flocculated particles, opening a new approach for optimizing solid‐loading conditions for slip casting in terms of viscosity and green density.
Crack Model for Toughness of Green Parts with Moisture or a Fluid Binder
Authors: Cannon W. Roger , Lessing Paul A. , Zuck Larry D.
Published: July 2012

A model is presented to predict the toughness, KIC, of green ceramics based on the binding forces of meniscuses formed between particles near the tip of the critical flaw. The model considers capillary pressure, surface tension, and the viscous flow of binders. Calculated toughness values were determined for moisture only, but the model can also be applied to binder meniscuses. Capillary pressure is highest at low moisture content. By using well‐established force–distance relationships for the meniscus between single particles, toughness was determined as a function of moisture content. For nonagglomerated particles, KIC increases with moisture content and decreases with contact angle. The particle‐size dependence, predicted at a constant humidity is approximately the same as the Kendall model and experimental results found in the literature. If particles are agglomerated and the meniscus is between agglomerates, the toughness peaks at low moisture content. This model assumes that the capillary pressure is transmitted through the agglomerate. The calculated values of KIC are approximately in agreement with the magnitude of the measured toughness values of binderless green parts having two different specific surface areas.
The Electronic Structures, Born Effective Charges, and Interatomic Force Constants in BaMO3 (M = Ti, Zr, Hf, Sn): A Comparative First‐Principles Study
Authors: Xie L. , Zhu J.
Published: July 2012

The electronic structures, Born effective charges (BEC), and interatomic force constants of BaMO3 (M = Ti, Zr, Hf, Sn) in the cubic perovskite structure are computed using first‐principles density functional theory. Comparison with the Maximally‐localized Wannier function description of the electronic structures for BaTiO3 shows that the change of a single constituent (Ti to Zr, Hf, and Sn) has pronounce effects on the orbital hybridizations with the oxygen, with significant implications for the nature of the BEC anomalous of the compounds. Examination of the real‐space interatomic force constants shows that the key interatomic interactions are strongly dependent on the constituent's dynamical effective charge and the very delicate compensation between the short‐range interactions and long‐range dipole–dipole interactions gives rise to the ferroelectric structural instabilities.
Detection of Latent Bloodstains Beneath Painted Surfaces Using Reflected Infrared Photography
Authors: Farrar Andrew , Porter Glenn , Renshaw Adrian
Published: July 2012

Bloodstain evidence is a highly valued form of physical evidence commonly found at scenes involving violent crimes. However, painting over bloodstains will often conceal this type of evidence. There is limited research in the scientific literature that describes methods of detecting painted‐over bloodstains. This project employed a modified digital single‐lens reflex camera to investigate the effectiveness of infrared (IR) photography in detecting latent bloodstain evidence beneath a layer or multiple layers of paint. A qualitative evaluation was completed by comparing images taken of a series of samples using both IR and standard (visible light) photography. Further quantitative image analysis was used to verify the findings. Results from this project indicate that bloodstain evidence can be detected beneath up to six layers of paint using reflected IR; however, the results vary depending on the characteristics of the paint. This technique provides crime scene specialists with a new field method to assist in locating, visualizing, and documenting painted‐over bloodstain evidence.
Criminal Behavior in Opioid‐Dependent Patients Before and During Maintenance Therapy: 6‐year Follow‐Up of a Nationally Representative Cohort Sample
Authors: Soyka Michael , Träder Anna , Klotsche Jens , Haberthür Annina , Bühringer Gerhard , Rehm Jürgen , Wittchen Hans‐Ulrich
Published: July 2012

Lifetime prevalence of opioid dependence is about 0.4% in western countries. Opioid‐dependent patients have high morbidity and mortality and a high risk of criminal behavior. Few studies have addressed the long‐term impact of opioid maintenance therapy on convictions and criminal behavior. The PREMOS study is a prospective, longitudinal, naturalistic clinical study of a nationally representative sample of 2694 opioid‐dependent patients to investigate convictions and criminal behavior at baseline and after 6 years of maintenance treatment. At follow‐up, 2284 patients still were eligible (84.7%). A comprehensive assessment including a patient and doctor questionnaire, and the EuropASI was completed at baseline and follow‐up. Data on criminality at follow‐up had been received for 1147 (70.6%) patients. A large number (84.5%) of them had been charged or convicted at any time before baseline assessment, most frequently with drug‐related offenses (66.8%), acquisitive crime (49.1%), or acts of violence (22.0%). Reported charges and convictions had declined to 17.9% for the last 12 months before follow‐up, which was also reflected by a significant decrease in the EuropASI subscore “legal problems” from 1.52 at baseline to 0.98 after 6 years. These data indicate a significant and clinically relevant reduction in criminal behavior in opioid‐dependent patients in long‐term maintenance treatment. Maintenance therapy is effective in the reduction in both narcotics‐related and acquisition crime.
A constrained optimization model based on generalized maximum entropy to assess the impact of reforming agricultural policy on the sustainability of irrigated areas
Authors: Cortignani Raffaele , Severini Simone
Published: July 2012

This article presents an optimization model for agricultural supply analysis in which the relevant parameters were obtained using a generalized maximum entropy approach that includes exogenous information. This latter feature is very important for cases in which the dataset is relatively poor, but for which a priori information on land allocation elasticities is available. The model includes a description of the use of water resources, and is supplemented with indicators addressing various dimensions of sustainability in agricultural production. This is consistent with the need to assess the likely impact of agricultural policies on the environmental and social dimensions of sustainability.

The model was applied to a specific study area to explore the likely consequences of a recently proposed reform of the Common Agricultural Policy of the European Union. This enabled testing of the applicability of the proposed model to policy analysis, assessment of whether it can be used to explore sustainability issues, and evaluation of its strengths and weaknesses.
Activin A and its Regulatory Molecules in Placenta and Fetal Membranes of Women with Preterm Premature Rupture of the Membranes Associated with Acute Chorioamnionitis
Authors: Torricelli Michela , Voltolini Chiara , Novembri Romina , Bocchi Caterina , Di Tommaso Mariarosaria , Severi Filiberto M. , Petraglia Felice
Published: July 2012

Labeled Problem

To investigate regulation of activin A and related molecules in placenta/fetal membranes from preterm premature rupture of membranes (pPROM) associated with acute chorioamnionitis (ACA).

Method of Study

Tissues were obtained from women with spontaneous preterm deliveries (PTD), pPROM without ACA, pPROM with ACA. Activin A, follistatin, and nodal and cripto mRNA were measured by RT‐PCR.

Results

Activin A mRNA was up‐regulated in tissues from pPROM, in presence or absence of HCA, respect to PTD and in pPROM with ACA respect to pPROM without ACA. Follistatin mRNA expression did not differ between the groups. In placenta, nodal mRNA showed the same trend of activin A, while cripto was down‐regulated in pPROM with ACA than other groups. Nodal and cripto were not expressed by fetal membranes.

Conclusion

The study shows the involvement of activin A pathway in pPROM with ACA. Further studies will focus on its role in placental immune functions.
The preterm gut microbiota: changes associated with necrotizing enterocolitis and infection
Authors: Stewart CJ , Marrs ECL , Magorrian S , Nelson A , Lanyon C , Perry JD , Embleton ND , Cummings SP , Berrington JE
Published: July 2012

Aim:  To describe gut colonization in preterm infants using standard culture and 16S gene rRNA profiling, exploring differences in healthy infants and those who developed NEC/late onset sepsis (LOS).

Methods:  Ninety‐nine stools from 38 infants of median 27‐week gestation were cultured; 44 stools from 27 infants had their microbial profiles determined by 16S. Ordination analyses explored effects of patient variables on gut communities.

Results:  Standard microbiological culture identified a mean of two organisms (range 0–7), DGGE 12 (range 3–18) per patient. Enterococcus faecalis and coagulase negative staphylococci (CONS) were most common by culture (40% and 39% of specimens). Meconium was not sterile. No fungi were cultured. Bacterial community structures in infants with NEC and LOS differed from healthy infants. Infants who developed NEC carried more CONS (45% vs 30%) and less Enterococcus faecalis (31% vs 57%). 16S identified Enterobacter and Staphylococcus presence associated with NEC/LOS, respectively.

Conclusions:  Important differences were found in the gut microbiota of preterm infants who develop NEC/LOS. The relationship of these changes to current practices in neonatal intensive care requires further exploration.
Sexual Arousal in Women with Provoked Vestibulodynia: The Application of Laser Doppler Imaging to Sexual Pain
Authors: Boyer Stéphanie C. , Pukall Caroline F. , Chamberlain Susan M.
Published: July 2012

Introduction

Women with provoked vestibulodynia (PVD) report lower sexual arousal than nonaffected women, however, laboratory studies of arousal have reported contradictory results about whether group differences exist in genital and subjective arousal.

Aim

To examine genital and subjective sexual arousal in women with and without PVD.

Methods

Eligible women with and without PVD (N = 42) attended a laboratory session that included an interview, questionnaire completion, and genital imaging. A direct measure of superficial blood flow—laser Doppler imaging—was used to assess vulvar blood flow levels while participants watched three films, including an erotic film. Participants answered questions about their level of sexual arousal before, during, and after the erotic film.

Main Outcome Measures

Average vulvar blood flow levels during the baseline and erotic films, numerical ratings of subjective sexual arousal and anxiety, as well as questionnaire measures of arousal.

Results

There was a significant group difference in genital arousal, whereby the PVD group showed a lower genital response to the erotic film, as well as a significant interaction between baseline blood flow and group membership. Separate group regression analyses demonstrated that baseline blood flow explained a substantial amount of the variance in erotic film blood flow in the control group (70%), while only 27% was explained by this variable in the PVD group. There were no differences in subjective sexual arousal or anxiety between the groups. Across questionnaire measures, women with PVD reported lower sexual arousal than the control group.

Conclusions

The results suggest that women with PVD show lower genital responsiveness than nonaffected women to sexual stimuli in a laboratory setting and that their genital arousal is likely impacted by a number of biopsychosocial factors.
Viscous versus nonviscous soluble fiber supplements: Mechanisms and evidence for fiber‐specific health benefits
Authors: Chutkan Robynne , Fahey George , Wright Wendy L. , McRorie Johnson
Published: July 2012

Purpose: This review focuses on the health benefits of viscous versus nonviscous soluble fibers, why symptoms can occur with increased fiber consumption, and how to avoid symptoms to improve adherence with a high‐fiber diet.

Data sources: Review of scientific literature as well as evidence‐based guidelines and resources.

Conclusions: While it is generally known that “fiber is good for you,” it is less well known that specific health benefits are associated with specific fiber characteristics. Many of the health benefits of fiber can be directly correlated with the viscosity of soluble fibers when hydrated (i.e., gel‐forming). A reduction in viscosity of a given fiber will attenuate these health benefits, and a nonviscous fiber does not exhibit these health benefits.

Implications for practice: Increasing the viscosity of chyme with a viscous soluble fiber has been shown clinically to lower cholesterol for cardiovascular health, improve glycemic control in type 2 diabetes, normalize stool form in both constipation (softens hard stool) and diarrhea (firms loose/liquid stool), and improve the objective clinical measures of metabolic syndrome (glycemic control, lipoprotein profile, body mass index/weight loss, and blood pressure).

Disclosures:  Johnson McRorie is a Clinical Scientist with Procter & Gamble, which markets two fiber products. George Fahey is a paid consultant for Procter & Gamble involved with several activities related to fiber. Funding was provided by Procter & Gamble for assistance of a medical writer in preparing this manuscript.
Lingual osteoma in a dog
Authors: Fernandez M. , Grau‐Roma L. , Roura X. , Majó N.
Published: July 2012

An 11‐year‐old male Belgian shepherd dog was evaluated for a one‐week history of progressive lethargy, decreased appetite and excessive panting. On physical examination, a pedunculated mass protruding from the right side of the tongue base was observed. The mass was solid, irregular and multi‐lobulated, and it measured approximately 4×2 cm. The mass was surgically excised. The histological examination was consistent with a lingual osteoma and the margins were free of neoplastic cells. The dog was euthanased eight months after the diagnosis because of an unrelated problem and no evidence of recurrence at the surgical site was appreciated at that time. To the author's knowledge, this is the first report of a lingual osteoma in a dog, and, therefore, it should be included in the differential diagnosis of masses on the tongue, especially pedunculated masses located at the base of the tongue.
The cutaneous trunci reflex for localising and grading thoracolumbar spinal cord injuries in dogs
Authors: Gutierrez‐Quintana R. , Edgar J. , Wessmann A. , Cherubini G. B. , Penderis J.
Published: July 2012

Objectives

To evaluate the accuracy of the cutaneous trunci reflex to localise thoracolumbar spinal cord injuries and to assess the correlation between focal loss (cut‐off) of the reflex and clinical severity of thoracolumbar spinal cord injury.

Methods

Prospective study of 41 dogs with thoracolumbar spinal cord injuries investigated by magnetic resonance imaging. Linear regression analysis was performed to determine the relationship between the vertebral level of the cutaneous trunci reflex cut‐off and the maximal and cranial lesion extent. The association between cutaneous trunci reflex cut‐off and spinal cord injury severity was tested using a Mann–Whitney U test.

Results

Cutaneous trunci reflex cut‐off was evident in 33 (80%) of dogs. The cut‐off level was 0 to 4 vertebrae caudal to the maximal spinal cord lesion in all dogs. In 16 (48·5%) dogs the cut‐off was either 2 or 3 vertebrae caudal to the lesion. The presence of a cut‐off significantly correlated with increasing severity (P=0·0001). Loss of the reflex occurred at less severe grades than loss of ambulation and in dogs with ambulatory paresis it was significantly (P=0·0084) associated with increasing severity.

Clinical Significance

The cutaneous trunci reflex allows localisation of thoracolumbar spinal cord lesions within four vertebrae and facilitates clinical segregation of dogs with ambulatory paresis into mild and severe categories.
2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement
Authors: Lee Ing‐Kit , Liu Jien‐Wei , Wang Lin , Yang Kuender D. , Li Chung‐Chen , Eng Hock‐Liew
Published: July 2012

Please cite this paper as: Lee and Liu et al. (2012) 2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement. Influenza and Other Respiratory Viruses 6(601), e152–e161.

Background  To better understand clinical and laboratory characteristics in children, adults, and patients with lung involvement suffering 2009 pandemic influenza A (H1N1).

Methods  A total of 442 patients with 2009 pandemic influenza A (H1N1) were retrospectively analyzed.

Results  Comparing to their adult counterpart (n = 55), pediatric patients (n = 387) had significantly higher frequencies of fever, rhinorrhea, cough, sore throat, nausea/vomiting, and longer length of fever; lower frequencies of chest pain and dyspnea; higher incidence of lymphopenia; and lower incidence of elevated serum C‐reactive protein. Among the 227 patients with radiographs available, lung involvement was found in 19 (8·4%) (52·6% consolidation and 47·4% interstitial infiltrations), including 18 children and one adult. One child with lung consolidation died of multiorgan failure. Significant findings in patients with lung involvement included predominant young age (≤10 years), prolonged fever, and delayed oseltamivir therapy (≥48 hours after onset of illness); higher frequencies of dyspnea, nausea/vomiting, and altered consciousness; and higher incidences of leukopenia, elevated serum creative kinase, and lactic dehydrogenase.

Conclusions  Among patients with 2009 pandemic influenza A (H1N1), we found significant difference in clinical manifestations between children and adults, and significant differences in clinical and laboratory manifestations between patients with lung involvement and those without. On the basis of data from this study and the existing literature, early treatment with oseltamivir is recommended for patients with 2009 pandemic influenza A (H1N1), regardless of age.
Future developments in renal care, the patient's perspective
Authors: Erben K.
Published: July 2012

This paper explores from a patients perspective, how collaboration between staff and patients enhances the quality of care for patients with ends stage renal disease. The role of patient associations and professional associations are discussed.
Informing the UK's South Asian communities on organ donation and transplantation
Authors: Khan Z. , Randhawa G.
Published: July 2012

There is a growing demand for human organs for transplantation, particularly of the kidney among the UK's South Asian population which, due to problems with histocompatibility can only be met with a significant increase in the number of Asian donors. Specific attempts have only recently been made to attract donors from South Asian communities using ‘ethnically‐targeted mass media’. A recent pilot study sought to evaluate the effectiveness of these initiatives in providing information with regards to organ donation for the South Asian population. The findings show that detailed information related to transplantation activity had been learned only through the experience of people undergoing transplants within the community and has been transmitted through various informal networks rather than through the resources provided by the Department of Health. This paper provides an overview of who the South Asians are and how these community networks were established.
The evolution of kidney transplantation in Spain. Role of the nurse
Authors: Gaya A. Rochera
Published: July 2012

This paper provides an overview of the role of the nurse in kidney transplantation with a particular emphasis on Spanish units. The evolution of the care of kidney transplant patients has tended towards a holistic approach, with the nurse being responsible for the integral care of the patient during the entire hospitalisation period. Nursing care covers the full range of functions, including education, outpatient clinic, continuous care, evaluation of care, and preparation for discharge. At the present time, the Spanish patient with serious kidney disease has a better chances of receiving an organ than in any of the countries in our geographical setting, thanks to the excellent health care professionals working in the setting of the Spanish health care system, and to the support of the entire Spanish society in favour of donation and transplantation, Clearly, personal and collective attitudes are not improvised, and the infrastructure required for this type of treatment is not a question of chance.
Management of anaemia in renal failure
Authors: Macdougall I.
Published: July 2012

The management of renal anaemia has been transformed over the last decade by the advent of recombinant human erythropoietin (EPO) therapy. In relation to the use of erythropoietin, three major topics have emerged which have stimulated the most discussion and controversy. This article explores these three areas: the use of EPO in pre‐dialysis patients, iron management in patients receiving EPO therapy, and target haemoglobin.
Why do renal nurses focus on issues of compliance when working in the rehabilitative HD setting?
Authors: Woodcock S.
Published: July 2012

Renal nurses are aware that a process of rehabilitation and adaptation must be facilitated for ESRF patients to acquire adjustments in health behaviours and lifestyle. These philosophies advocate the use of holistic nursing approaches, however, it has been observed that renal nurses frequently adopt a compliance approach for their client group, an approach which impedes rather than enhances the rehabilitative process. The author researched the question of why renal nurses focus on issues of compliance when working in the rehabilitative HD setting using modified grounded theory principles. Tentative findings suggest renal nurses are cogniscent of rehabilitation/adaptive philosophies, but are constrained in their use by stressful working environments and limited resources. Recommendations to enhance practice and suggestions for further study are made.
Outcome measurements in dialysis: the consensus and the conflicts
Authors: Boag J. T.
Published: July 2012

There are several published sources of guidelines and studies measuring dialysis parameters. The practical aspects of measuring and improving these parameters in a typical clinical setting are discussed in this paper and the paper concludes with recommendations for actions that can be taken at the current time.
Ultrafiltration controller failing: a case report. Problem investigation and solution
Authors: Stragier A. , Maes T.
Published: July 2012

We reported in a recent EDTNA/ERCA Journal (1) the unexpected failure of an ultrafiltration controller leading to a 3.1 kg weight gain instead of a programmed 4.5 kg weight loss in one of our patients on a Monitral‐S machine from Hospal. Upon technical investigation, it appeared that the priming valve of this ultrafiltration controller was not tight, due to small particles of calcium carbonate, that had stuck inside it. These small particles of calcium carbonate originated from the preparation tank for reasons that were unclear at that time.
Residual renal function and post dialysis urea rebound
Authors: Carofei O. , Taratufolo A. , Atti S. , Fringuello F. , Alaimo M.
Published: July 2012

Kt/v is used to estimate haemodialysis prescription and treatment adequacy and usually does not include evaluation of urea rebound. In addition urea clearance provided by the presence of residual renal function (RRF) is additive to dialytic urea clearance. Rebound is a phenomenon involving other molecules such as creatinine and phosphorus. The aim of this study was to investigate the role of RRF on post dialysis urea, creatinine and phosphorus rebounds. We investigated 7 patients with RRF (group 1) and 7 uraemic anuric patients (group 2). Urea rebound was lower in group 1 than group 2: 9.5±4% vs 18±7% (p=0.04). Creatinine rebound and phosphorus rebound were similar in both groups 15.2±9% group 1 vs 14.6±5% group 2 (p=NS) and 16.7±7% group 1 vs 20±7% group 2 (p=NS) respectively. Our data suggest Kt/v calculated without considering rebound overestimates haemodialysis efficacy.
Blood pressure measurement in haemodialysis patients
Authors: Cerrai T. , Benedetti I. , Scala F. Della , Gori M. , Nicolini S. , Pampaloni S. , Paolini R. , Piccioli G.C. , Righi M. , Romoli R. , Torricelli S.
Published: July 2012

Several studies suggest that the 24 hour ambulatory blood pressure monitoring (ABPM) predicts left ventricular hypertrophy more accurately than conventional blood pressure measurement (CBPM) with mercury sphygmomanometer. We estimated the left ventricular mass by M‐mode echocardiography in 58 patients on regular haemodialysis treatment during the midweek haemodialysis (HD) interval. ABPM was recorded during the 24 hours preceding the dialysis session and the average of values were compared with the average of the 13 pre HD CBPM recorded by nurses during the month preceding the echocardiography study. The two types of BP measurements correlated significantly with each other, (systolic BP r=0.62; p < 0.001 and diastolic BP r=0.74; p < 0.001). The correlation of left ventricular mass with pre‐HD systolic BP was stronger (r=0.54; p < 0.001) than with 24h‐systolic BP (r=0.33; p<0.01). The overall accuracy of prediction was also similar (68% for pre HD‐CBPM; 67% for 24h‐ABPM). Measurements of diastolic BP did not correlate significantly with LVM. Our data suggest that 24h‐ABPM does not offer any advantage over pre HD‐CBPM in predicting left ventricular hypertrophy in HD patients
Intraperitoneal hydrostatic pressure and volume in peritoneal dialysis patients
Authors: Di Lauro V. , Luccio F. , Colaluca M. , De Francesco F. , Pintauro A.
Published: July 2012

Dialysate Intraperitoneal Volume (IPV) represents one of the major determinants of Peritoneal Dialysis (PD) efficiency, but most adult patients are currently treated with the same standard IPV, regardless of body size. In order to evaluate the tolerability of different IPV, we adapted the current connection in use at our Institution to produce a simple method to directly measure Intraperitoneal Hydrostatic Pressure (IPP). We studied the relationship between IPV and IPP in 30 adult (age 19–77 years) patients (19 males) of various body sizes, on PD between 17±17 months. Mean end‐inspiratory and end‐expiratory IPP with different IPV were measured in each patient in the IPV range of clinical interest. A total of 210 individual measurements showed a statistically significant positive relationship between BSA‐normalised IPV and IPP (r=0.355, p<0.001). Interpatient variability was high, thus suggesting that individualisation of IPV according to body size is not accurate, IPP being often higher in larger body size. Direct IPP measurement with different IPV in the single patient is a simple, safe and reproducible procedure, allowing an individually tailored IPV prescription which should optimise PD efficiency while monitoring for IPP related complications.
Pre‐dialysis education. A change in clinical practice. How effective is it?
Authors: O'Donnell A. , Tucker L.
Published: July 2012

The last decade has seen a great expansion in the provision of pre‐dialysis education within the UK, with our programme in operation since 1996. In order to evaluate its impact on patient care, two methodologies were employed: the first used a satisfaction survey with which to examine patient perception of the programme; the second approach examined resource utilisation, in particular length of stay, as an outcome measure. Difficulties have arisen in discerning the impact of the programme amongst the other education interventions to which the patient is exposed. Comparative length of stay data was used as an alternative means of assessment. The results of the audit led us to question the effectiveness of the methodology that we employed and has led us to propose the development of a standard. It is hoped that the adoption of a more structured approach will not only aid the effectiveness of the programme itself but also facilitate the evaluation process.
EDTNA/ERCA Technicians' SIG Journal Club 1/99 Summary of paper discussion
Authors: Stragier André
Published: July 2012

The selected paper focused on 29 cases of bloodstream infections that occurred in 2 haemodialysis centres. Culture studies revealed that the same pathogens were present in the Waste Handling Option (WHO) of the machines used. The WHO is a device of Centry Cobe machines, for disposal of spent saline. The pathogens could enter directly or indirectly into the blood line tubing from this WHO. These incidents were halted by measures directed at the WHO attachment.
The dark side of the moon: how clients face dialysis
Authors: Bruno E.
Published: July 2012

Patients requiring haemodialysis experience various problems, some of which are caused by the medical treatment. We explored various aspects of a haemodialysis patients life, to focus on the effects that their treatment had on their daily life. The aim of this study was “to know the life of the respondent, in order to improve the quality of the assistance.” This pilot study allowed the staff to plan arrangements in order that the patient could pursue a “normal life”.
The psychosocial implications of live‐related kidney donation
Authors: Eggeling C.
Published: July 2012

The aim of the study was to explore the donor's experience of the live related transplantation process whilst seeking to identify the external and internal resources and ethical considerations which were reflected in the decision‐making process. The outcome would indicate that altruism and a sense of moral obligation were the prime motivational influences with the spontaneity of decision‐making casting doubt on the ability to give informed consent. These findings are also discussed in relation to implications for professional practice and would suggest that potential donors benefit from having access to a counsellor during the donor‐search and throughout the transplant work up programme.
Increasing the safety of volumetric ultrafiltration control
Authors: Peter H.
Published: July 2012

Deviations in ultrafiltration volume can cause various problems for patients undergoing a haemodialysis treatment. With the introduction of high flux dialysers, closed systems with volumetric fluid balancing became the systems of choice, because control of transmembrane pressure used previously is too inaccurate and unsafe to be used with such filters. In this article, a reliable and cost effective test method is described to increase the safety of a closed system. The test is carried out by simply analysing the dialysate pressure while the dialyser is isolated from the system for typically 7.2 seconds. No additional sensors and components other then a valve combination used to isolate the dialyser are required.
Haemodialysis in acute renal failure
Authors: Taratufolo A. , Manzi M. , Pedulla F. , De Bernardini F. , Carofei O. , Alaimo M.R. , Ugolini N. , Galeotti P.
Published: July 2012

Haemodialysis in acute renal failure differs from chronic uraemia. We describe our clinical experience comparing tolerance to dialysis and dialysis efficacy of bicarbonate haemodialysis in comparison to haemofiltration. Both provide adequate treatment for ARF, Kt/v 0.6±0.1, URR 56% in bicarbonate haemodialysis compared to Kt/v 0.4±0.06, URR 60% in haemofiltration. Clinical outcome was the same in both groups, in particular the overall survival was satisfactory at about 70%. These results are likely to reflect close control of these patients by nursing staff committed to haemodialysis in acute renal failure.
Renal nursing education: an innovative difference
Authors: Bonner A.
Published: July 2012

The purpose of this paper is to describe the Master of Nursing (Renal) course that is offered to internal and distance education nephrology nurses in Australia. The challenging demand of offering this innovative curriculum will be discussed, and analysis of the first cohort of students will be made. Finally, future directions for renal nursing education will be discussed.
Total quality improvement assessment of the EPO co‐ordinator role
Authors: Morrison E.A.
Published: July 2012

Total quality management or total quality improvement has developed and grown from the process of quality assurance. Its main features are, quality is a management led approach, top management participation is essential, it is a concept for preventing mistakes, not finding fault and correcting it. A client centred approach and teamwork are seen as key components. This paper explores the role of the Epo co‐ordinator and identified what changes were required to improve the quality of the service.
Preparing for the challenges of the millennium
Authors: Polpitiye M. , Fairchild V.
Published: July 2012

This paper describes a retrospective view of the challenges the two authors were faced with as Nurse managers when the haemodialysis unit was expanded from ten dialysis stations to thirty‐one within a period of three years. This expansion involved changes to the environment and management strategies. There were four issues identified that helped to face these challenges and they are described in depth. The authors claim the skill of communication within the team and the proactive approach to change was the key to their success.
Exit‐site infection prevention and treatment protocol
Authors: Rivetti M. , Galliano F. , Cotto M. , Benotto S. , Bosio A.
Published: July 2012

Infections are universally known as one of the main causes of drop‐out in peritoneal dialysis. Exit‐site infections are often a problem, as they are difficult to treat, tend to become chronic and may lead to the development of continuity peritonitis, resulting in the need for removal of the peritoneal catheter. The purpose of this paper is to describe the application of an exit‐site infection prevention and treatment protocol.
The patient with diabetic nephropathy in the hospital
Authors: Thanasa G. , Afthentopoulos I. E.
Published: July 2012

Diabetic nephropathy leads to chronic renal failure in 30–40% of diabetic patients. By offering primary health care and teaching patients with diabetic nephropathy about factors which influence their renal function, we can delay the renal deterioration and therefore the start of the renal replacement therapy. By learning to control their blood pressure, blood glucose and diet they will be fully aware of their health problem, avoid possible complications and last but not least they will possibly achieve more time. The nephrology nurse is capable of making a difference by offering advanced nursing care and being the patient's teacher and supporter.
Treatment decisions in paediatric dialysis: children's versus parental rights
Authors: Gabbai N. , Rauch‐Elnekave H. , Spitz M. , Weissman I.
Published: July 2012

Treatment decisions in Paediatric Dialysis are often fraught with ethical questions about how to serve the best interests of children on dialysis, especially when parents refuse recommended treatments and opt for non‐optimal interventions. This paper reviews the issues of children's rights, as guaranteed in the United Nations Covenant on Children's Rights and the Israel's Patients' Rights Law, and presents several case vignettes where conflict between children's rights for optimal treatment and parental desires arose. The paper concludes with policy recommendations to assure that children's expressed desires and medical needs are met, including the establishment of multidisciplinary committees to address the needs of children on dialysis and their families.
An educational programme for persistent life‐style changes in patients with chronic renal disease
Authors: Bergström K. , Bárány P. , Holm I.
Published: July 2012

The aim of this study was to produce positive life‐style changes in patients with chronic renal disease through a residential education programme about the medical aspects of chronic renal failure and the various treatment options in order to increase their physical capacity, emotional stability and general well‐being. The programme was available to all categories of patients with chronic renal disease irrespective of treatment modality. Comparison of data pre and post course demonstrated improvements in physical activity, mental well‐being and nutritional awareness.
Review of arteriovenous fistula care
Authors: Yang R. , Humphrey S.
Published: July 2012

The patient with End Stage Renal Failure is largely dependent upon haemodialysis for survival. Vascular access is the vital lifeline. This paper provides a review of the literature and aims to advocate the advantages of arteriovenous fistulae compared with other vascular access. It will discuss the main causes of thrombosis in arteriovenous fistula failure, measurements of early detection of venous stenosis and the care of an arteriovenous fistula to ensure its patency. The responsibility of the dialysis nurse is also considered.
Influence of post haemodialysis sampling on Kt/V result
Authors: Gago C. , Marco B. , Fernández J. , Piña M.D. , Gálvez C. , González A. , Martínez S. , Hernando P. , Gruss E.
Published: July 2012

The recommended Kt/V is 1.2. Unfortunately there is no written policy for nurses on the procedure for taking blood urea nitrogen samples post haemodialysis. The aim of this study was to establish the Kt/V variability of haemodialysis patients depending on the method of collection of post‐haemodialysis blood urea nitrogen. Twenty‐two patients were analysed. A Kt/V was performed every 15 days during a period of 2 months. It was taken five times on each patient: 30 minutes before the end of a haemodialysis session (Kt/V30), at the end of haemodialysis (Kt/V1), after slowing flows (50 ml/min) for 2 minutes (Kt/V2) and after the blood circuit had been returned to the patient at 5 and 15 minutes respectively. (Kt/V5, Kt/V15). The Kt/V results were: Kt/V1 1.23+/‐0.2 Vs Kt/V2 1.14+/‐0.19 (p< 0.003); Kt/V5‐ 1.05+/‐0.19 (p<0.002 Vs Kt/V2); Kt/V15 1+/‐0.16 (p<0.05 Vs Kt/V5); Kt/V30 1.12+/‐0.21 (pNS Vs Kt/V2). In conclusion, there was a large variability in the Kt/V depending on the method of collection of the blood urea nitrogen sample post‐haemodialysis.
Nutritional education of CAPD patients and media influence
Authors: Bordin G. , Zuccherato N. , Toniato E.
Published: July 2012

The aim of our paper was to investigate the short period of training offered to peritoneal dialysis patients. We focused our attention on the nutritional knowledge of patients who often gather information, and advice from external factors such as their family and the media. We organized group meetings on nutrition for 22 patients and 17 relatives. Questionnaires were completed before and after the education programme. The group meetings improved knowledge on nutrition and highlighted the influence of the media. The important role of the nurse at these meetings has also been recognised.
Complications of complicated grief in renal failure
Authors: Harvey B.
Published: July 2012

This paper sets out to bring together recurrent themes in the understanding and care of patients with Chronic/End Stage Renal Failure centring on the key issue of loss. A multi‐disciplinary conceptual framework is proposed based on three perspectives ‐ Systemic, Existential and Narrative. The integrated framework for understanding the complexity of grief issues for dialysis and pre‐dialysis patients focuses on the perception of self and the inter‐relationship with others directly involved in their care.
Quality of life and exercise in renal disease
Authors: Moltó C. Iborra , Vicent L. Picó , Castillo A. Montiel , Ramón F. Clemente
Published: July 2012

Many publications describe the advantages of physical exercise in improving quality of life. The aim of this study was to highlight the need for physical activity when patients commence haemodialysis. A correlation was found between muscular deterioration and the years on haemodialysis and it was accentuated in men. From our study we recommend adequate physical activity at the beginning of, and during the lifetime of haemodialysis to enhance the physical and psychological well being of patients.
Factors Leading to Increased Mortality in ESRF
Authors: Khan I.H.
Published: July 2012

End‐stage renal disease is a condition, which can only be treated with renal replacement therapy, in the form of dialysis and transplantation. Despite great technological advances in the field of renal replacement therapy, mortality among patients remains very high. A variety of factors are responsible for the increased mortality in end‐stage renal disease despite treatment. These have been classified in this review into those that are patient related and those, which can be modified by treatment. Age, comorbidity, malnutrition and pattern of referral of patients with end‐stage renal disease are the major associations of adverse survival in renal replacement therapy.
Management of temporary haemodialysis catheters in paediatrics
Authors: Muñoz E. Tornay , Moreno C. Xérès
Published: July 2012

Children with haemodialysis catheters can suffer serious complications related to activity, cognitive level, and hospitalisation. The objective of this study was to improve our patients' quality of life by studying catheter fixation and preservation of skin integrity. In this descriptive‐prospective study we used a hydrocolloid dressing to fix the catheter and an elastic tubular mesh to complete the immobilisation. We studied 21 catheters in 6 children, aged 3 to 11 years, from December 95 to April 98. Of the 21 catheters, 13 were changed and 6 were removed. The incidence of local infection was 38% and general infection 28%. The mean duration was 42 days.
Disinfectant rebound release from adequately rinsed, reused dialysers: Is the potting resin the main source?
Authors: Stragier A. , Wenderickx D. , Maes T. , Struyven J.
Published: July 2012

Disinfectant Rebound Release (DRR) from adequately rinsed, reused dialysers is usually considered to originate from the potting resin and thus unavoidable. We measured DRR of 3 disinfecting agents from 8 dialysers groups, with (capillaries) and without (plates) potting resin. Our results demonstrate that in current dialysers the main determinants of DRR are the type of disinfecting agent and dialysis membrane. DRR is similar for plate and capillary dialysers, proving thus that the presence of potting resin is currently not responsible for DRR from chemically disinfected reused dialysers.
What choices have renal patients with learning disabilities?
Authors: Duffield K.
Published: July 2012

This paper will look at how our haemodialysis unit educates selected patients with their self‐care regimen. Each patient has their own level of understanding and compliance in maintaining their own lifestyle. This provides renal nurses with challenges when pursuing patient education. This paper will highlight some of the problems encountered when teaching patients with learning difficulties.
Assessing Quality of Life in routine clinical practice: A pilot study
Authors: Keogh A.M. , Carfray A. , Andrews S. , Jenkins J. , Longmate R. , Nichols N. , Farina C. , Wilde D.
Published: July 2012

To assess the feasibility and usefulness of administering a quality of life (QoL) questionnaire in routine clinical practice, we performed a 5‐centre UK study with nurses administering a disease‐specific questionnaire, the Renal Quality of Life Profile (RQLP), to 140 patients. The completed questionnaires were reviewed by the nurse who felt that there were issues requiring discussion in 46% of patients. These issues were either discussed with the nurse immediately in person (65%), or the patient was contacted by telephone (28%) or post (7%) and appropriate referrals and interventions were actioned. We conclude that measurement of QoL is feasible and useful in routine clinical nursing practice.
Is it surprising they omit their tablets?
Authors: Valentine A.
Published: July 2012

Non‐compliance is a significant contributory factor to graft loss. In these days of organ shortage and ever growing transplant waiting lists it is important that we maximize graft survival by addressing this issue. A study was conducted of eighty‐three patients consecutively attending the annual health review clinic. A series of structured questions were asked to ascertain, the patients' knowledge about medications, feelings about taking them, level of compliance and reasons for non‐compliance. Results showed that 90% of the patients fully understood what all their tablets were for, 74% said they never missed taking any of their tablets, whilst 22% forgot occasionally. Three patients admitted to stopping one or all of their immunosuppressive medications completely and one patient was enjoying a ‘holiday’ from his medications. Reasons given for non‐compliance included; adverse effects of the drugs, the number of tablets to be taken, life crises and forgetfulness.
Improving Nutritional Intake in Dialysis Patients
Authors: Russell Lesley
Published: July 2012

The developments in the field of renal replacement therapy have created a challenge for all those who are involved in the nutritional elements of patient care. We can expect to look after our patients for longer, see all ages and a full range of Coexisting morbidity. To support this there have been some advances in nutritional care, which can be offered, but for the vast majority of patients it is normal food, which provides the means to meeting these needs.
Psychosocial implications for live‐related donors
Authors: Eggeling C.
Published: July 2012

Two studies were carried out which explored the experiences of potential live‐related donors and the transplantation process. The studies concluded that adequate physical and psychosocial screening and assessment facilitates inform decision‐making and lead to successful live related transplantation.
Technical basis for immunoadsorption
Authors: di Nicuolo A. , Braun N. , Risler T.
Published: July 2012

Immunoadsorption is a new extracorporeal treatment for immunologicaly‐mediated diseases. This review deals with the primary plasma separation for immunoadsorption, the various immunoadsorbers and the technique of immunoadsorption itself. Primary plasma separation can be performed either by plasma membrane filtration or by centrifugation depending on the quantity of processed plasma. Currently, there are non‐selective, semi‐selective and highly selective adsorbers commercially available. Adsorbers can be subdivided into single‐use and reusable devices. The choice of the adsorber is dependent on the clinical situation of the patient. An adapted anticoagulant regimen must be used to avoid complications in the patient and to obtain optimal adsorber performance. Thus, immunoadsorption is an effective and safe extracorporal treatment in severely ill patients suffering from autoimmune diseases.