bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a home care mobile app on the outcomes of discharged patients with a stoma: A randomised controlled trial
Authors: Wang Qing‐Qing , Zhao Jing , Huo Xiao‐Rong , Wu Ling , Yang Li‐Fang , Li Ju‐Yun , Wang Jie 
Published: May 2018

Aims and objectivesTo explore the effects of a home care mobile app on the outcomes of stoma patients who discharged from hospital.BackgroundPatients with a newly formed stoma experience many difficulties after surgery. Mobile application (app) has the potential to help patients self‐manage their diseases and adjust to the changes in their lives and is a convenient way to ensure the continuity of care. However, there is a lack of studies about the effects of a mobile app on the transitional care for improving discharged stoma‐related health outcomes.DesignA randomised controlled trial.MethodsA total of 203 patients with a permanent stoma in tertiary hospitals in China were randomly assigned into two groups. Patients in the control group (n = 103) received routine discharge care. Patients in the intervention group (n = 100) received home care via a mobile app besides routine care. The psychosocial adjustment level, self‐efficacy scale and stoma complications incidence were measured in the follow‐up period and compared between the two groups. Data were collected at four time points: before intervention (baseline), at 1, 3 and 6 months after discharge.ResultsThe psychosocial adjustment level and stoma self‐efficacy score of the intervention group were significantly higher than those of the control group, respectively, at 1‐, 3‐ and 6‐month follow‐up (all p < 0.05). The incidence of stoma complications in the intervention group was tending to reduce at 1, 3 and 6 months after discharge.ConclusionThe findings indicated that follow‐up care at home via a mobile app can effectively improve the psychosocial adjustment level, self‐efficacy scale and other related outcomes of stoma patients.Relevance to clinical practiceThe home care mobile app is an effective intervention to support the psychosocial adjustment and self‐efficacy of stoma patients after discharge. It ensures the continuity of care and provides nursing guidance for the patients timely.
Conflicting priorities: Observation of medicine administration
Authors: Alteren Johanne , Hermstad Marit , White Jo , Jordan Susan 
Published: May 2018

Aims and objectivesTo identify sources of interruptions and distractions to medicine administration rounds in hospitals.BackgroundNurses are frequently interrupted during medicine administration. There is no systematic description of nurses' behaviours and interruptions during administration of medicines to patients.DesignExploratory nonparticipant observational study.MethodsThree hundred and fifty‐one episodes of medicine administration with 32 nurses from three hospitals in Norway were observed using paper‐based observation grids between December 2013 and March 2014.ResultsNurses were frequently interrupted and distracted, mainly by nurses and other healthcare professionals. One‐third of the nurses interrupted their medicine administration: They prioritised helping patients with direct patient care. When the nurses were interrupted, they left the round and re‐entered the procedure. Even so, they managed to refocus and continue to administer the medicines: Interruptions and disturbances made little difference to most behaviours and actions, possibly because nurses double‐checked more frequently. Some differences were seen in behaviours potentially affecting the safety of the medicine administration, such as leaving medicines at the bedside and not helping patients take their medicines. Some interruptions were avoidable, such as those by other nurses and professionals.ConclusionsThis study offers insights into nurses' behaviours and actions when they are interrupted and distracted during medicine administration. The findings highlight a conflict for nurses administering medicines. Nurses are forced to prioritise between two important activities: direct patient care and medicine administration. Management and education providers need to recognise that nurse interrupting each other is a potential threat to patient safety.Relevance to clinical practiceOur data indicate that nurses and other healthcare professionals should be warned not to interrupt colleague administering medicines and managers should ensure other staff are available to respond to patients' immediate needs during medicine rounds.
Association of objectively measured physical activity with brain structure: UK Biobank study
Authors: Hamer M. , Sharma N. , Batty G. D. 
Published: May 2018

AbstractBackgroundPhysical activity may be beneficial for cognition but mechanisms are unclear. We examined the association between objectively assessed physical activity and brain volume, with a focus on the hippocampus region.MethodsWe used data from UK Biobank (n = 5272; aged 55.4 ± 7.5 years; 45.6% men) collected through 2013–2016. Participants wore the Axivity AX3 wrist‐worn triaxial accelerometer for 7 days to assess habitual physical activity. Structural magnetic resonance imaging was performed using a standard Siemens Skyra 3T running VD13A SP4 to obtain images of the brain.ResultsThere was an association between physical activity (per SD increase) and grey matter volume after adjustment for a range of covariates, although this association was only detected in older adults (>60 years old). We also observed associations of physical activity with both left (B = 0.52, 95% CI, 0.01, 1.03; P = 0.046) and right hippocampal volume (B = 0.59, 95% CI, 0.08, 1.10; P = 0.024) in covariate‐adjusted models.ConclusionIn summary, physical activity may play a role in the prevention of neurodegenerative diseases.
How task instructions affect performance on the unspecified tetrad test
Authors: Castura J. C. , King S. K. , Phipps K. 
Published: May 2018

AbstractThis parallel‐groups study (n = 1,857) investigates compliance of untrained assessors with tetrad instructions. Stimuli are four unique color swatches that differ only in their green chromaticities. Results confirm that the swatches used in this study were generally perceived as nonconfusable visual stimuli ordered A, B, C, D, and that AB and CD were more different than BC. These stimuli thus modeled the scenario in which following the tetrad decision strategy (grouping samples into two groups of two by similarity) gives a correct response, whereas following the select‐two decision strategy (selecting the two most similar samples) gives an incorrect response. Four of the five variants of tetrad task instructions, including the tetrad instructions that are usually recommended, were understood by roughly 90–95% of the assessors. Neither perceptual variance nor guessing provided adequate explanations for the incorrect groupings observed. Results indicate that the optimal cognitive decision strategy is not always followed because some assessors misinterpret instructions systematically. Results imply that d′ estimates from the conventional tetrad test method with untrained assessors may slightly underestimate δ. As a safeguard, it is suggested that any written task instructions be supplemented with verbal instructions and/or visual demonstrations, with the aim of increasing task understanding.Practical applicationsThis paper uses empirical evidence from untrained assessors to investigate their performance on various tetrad instructions. Conclusions from this study are relevant to both researchers and practitioners: (i) observed results confirm that the best‐practices tetrad instructions performs well against the other candidate tetrad instructions that were tested; (ii) the use of dissimilar samples revealed that some incorrect tetrad responses are due to task misunderstanding, rather than perceptual variance, as would be assumed by a Thurstonian model; (iii) discriminal distance (d′) estimates from the conventional tetrad test method with untrained assessors may slightly underestimate the true population parameter (δ); and (iv) practitioners are advised to communicate task instructions to untrained assessors using multiple modes (verbal, visual) with the aim of increasing task understanding.
Practical approach to the gastrointestinal manifestations of cystic fibrosis
Authors: Bolia Rishi , Ooi Chee Y , Lewindon Peter , Bishop Jonathan , Ranganathan Sarath , Harrison Jo , Ford Kristyn , van der Haak Natalie , Oliver Mark R 
Published: May 2018

AbstractCystic fibrosis (CF) is the most common, life‐shortening, genetic illness affecting children in Australia and New Zealand. The genetic abnormality results in abnormal anion transport across the apical membrane of epithelial cells in a number of organs, including the lungs, gastrointestinal tract, liver and genito‐urinary tract. Thus, CF is a multi‐system disorder that requires a multi‐disciplinary approach. Respiratory disease is the predominant cause of both morbidity and mortality in patients with CF. However, there are significant and clinically relevant gastrointestinal, liver, pancreatic and nutritional manifestations that must be detected and managed in a timely and structured manner. The aim of this review is to provide evidence‐based information and clinical algorithms to guide the nutritional and gastrointestinal management of patients with CF.
Assessment of nursing workload in adult psychiatric inpatient units: A scoping review
Authors: Sousa Carla , Seabra Paulo 
Published: May 2018

Accessible summaryWhat is known on the subject?

There is a shortage of empirical research in the field of psychiatric and mental health nursing regarding how to calculate a safe staffing level in psychiatry inpatient units. Furthermore, the tools to assess nursing workload in this specialty are limited. No systematic reviews on measurement tools in adult psychiatric inpatient settings were found.

What does this paper add to existing knowledge?

This study confirms the scarcity and heterogeneity of instruments with which to evaluate nursing workload in this specific context. Likewise, the instruments identified do not capture the complexity of the psychiatric nursing setting, namely, the relational and psychotherapeutic strategies that must be implemented in the patient care approach. The findings of the study suggest that evidence‐based tools for adult psychiatric inpatient settings require further development.

What are the implications for practice?

This review shows the need to continue to develop tools that assess workload in psychiatric inpatient units that embrace activities related to patient (direct and indirect) and nonpatient activities. The great challenge is providing a sensitive understanding of the workload resulting from psychotherapeutic interventions, the primary treatment that many patients need. This review reinforces the need to add patient outcomes to workload assessment processes.

AbstractIntroductionNo systematic reviews on measurement tools in adult psychiatric inpatient settings exist in the literature, and thus, further research is required on ways to identify approaches to calculate safe nurse staffing levels based on patients’ care needs in adult psychiatric inpatient units.AimTo identify instruments that enable an assessment of nursing workload in psychiatric settings.MethodA scoping review was conducted.ResultsFour studies were identified, with five instruments used to support the calculation of staff needs and workload. All four studies present methodological limitations. Two instruments have already been adapted to this specific context, but validation studies are lacking.DiscussionThe findings indicate that the tools used to evaluate nursing workload in these settings require further development, with the concomitant need for more research to clarify the definition of nursing workload as well as to identify factors with the greatest impact on nursing workload.Implications for practiceThis review highlights the need to develop tools to assess workload in psychiatric inpatient units that embrace patient‐related and non‐patient‐related activities. The great challenge is to enable a sensitive perception of workload resulting from nurses’ psychotherapeutic interventions, an important component of treatment for many patients.
Lignin composition is related to xylem embolism resistance and leaf life span in trees in a tropical semiarid climate
Authors: Lima Taysla R. A. , Carvalho Ellen C. D. , Martins Fernando R. , Oliveira Rafael S. , Miranda Rafael S. , Müller Caroline S. , Pereira Luciano , Bittencourt Paulo R. L. , Sobczak Jullyana C. M. S. M. , Gomes‐Filho Enéas , Costa Rafael C. , Araújo Francisca S. 
Published: May 2018

Summary

Wood properties influence the leaf life span (LL) of tree crowns. As lignin is an important component of wood and the water transport system, we investigated its relationship with embolism resistance and the LL of several tree species in a seasonally dry tropical ecosystem.

We determined total lignin and the monomer contents of guaiacyl (G) and syringyl (S) and related them to wood traits and xylem vulnerability to embolism (Ψ50) for the most common species of the Brazilian semiarid, locally known as Caatinga.

Leaf life span was negatively related to Ψ50 and positively related to S : G, which was negatively related to Ψ50. This means that greater S : G increases LL by reducing Ψ50. Lignin content was not correlated with any variable.

We found two apparently unrelated axes of drought resistance. One axis, associated with lignin monomeric composition, increases LL in the dry season as a result of lower xylem embolism vulnerability. The other, associated with wood density and stem water content, helps leafless trees to withstand drought and allows them to resprout at the end of the dry season. The monomeric composition of lignin (S : G) is therefore an important functional wood attribute affecting several key functional aspects of tropical tree species in a semiarid climate.
Esophageal multimodal stimulation and sensation
Authors: Hoff Dag Arne Lihaug , McMahon Barry , Gregersen Hans 
Published: May 2018

AbstractEsophageal mechanosensation describes the relationship between a mechanical stimulation of the esophageal wall, such as bag distension, and the reaction to the stimulation perceived or unperceived. When studying mechanosensation in esophageal disease, it is important to recognize that symptoms might be due to alterations at different levels of the neuromuscular system, such as alterations at the mechanoreceptor level or in the afferent mechanosensory pathways, or irregularities in the homeostatic state. One might ask if it is possible to provoke, record, and describe the multidimensional responses behind a mechanosensory experience? It is a complex system and, at a minimum, a multidisciplinary approach is needed to avoid erroneous conclusions. The multimodal study design, taking the mode, location, and parameters of stimulation into consideration, together with controlled recording of assessment parameters, is an approach that seems rational and valid. Gastrointestinal (GI) physicians of the 21th century need to have knowledge of advances in the evaluation of GI mechanical function and what provokes symptoms. Hereby, it is possible to fully appreciate the slowly emerging awareness of how GI pain symptoms should be explored and explained to patients.
Combined effect of parathyroid hormone and strontium ranelate on bone healing in ovariectomized rats
Authors: Göker Funda , Ersanlı Selim , Arısan Volkan , Cevher Erdal , Güzel Emine Elif , İşsever Halim , Ömer Beyhan , Durmuş Altun Gülay , Morina Deniz , Ekiz Yılmaz Tuğba , Dervişoğlu Elmire , Del Fabbro Massimo 
Published: May 2018

AbstractObjectiveParathyroid hormone (PTH) enhances bone healing. Strontium ranelate (SR) is an antiresorptive agent that increases bone formation. Reports about combined effects of PTH and SR on local bone regeneration in osteoporotic subjects are limited. We aimed at investigating the efficacy of PTH and SR for promoting new bone formation in critical‐sized defects of ovariectomized rats.Materials and MethodsParathyroid hormone‐ and/or SR‐containing poloxamer implant tablets with/without chitosan microparticles were delivered locally to calvarial defects of 90 Wistar rats. Biopsies were analyzed histologically and histomorphometrically at 4 and 8 weeks of healing.ResultsHistomorphometry revealed that PTH alone promoted new bone formation at 4 weeks but the efficiency declined in 8 weeks. There was no positive effect of SR alone on bone formation at 4 or 8 weeks. Calvarial defects treated with PTH+SR combinations showed statistically significant greater new bone formation than either treatment alone at both time intervals. Tissue responses were modest and supported the good biocompatibility of the biomaterials used.ConclusionParathyroid hormone and SR combinations can be effective for calvarial bone regeneration of ovariectomized rats. PTH plus SR may have potential use as bone graft material in orthopedic and dental surgery to enhance bone healing and osseointegration.
Hand‐foot‐skin reaction related to use of the multikinase inhibitor sorafenib and hard orthotics
Authors: Kusari Ayan , Borok Jenna , Han Allison M. , Valderrama Alix Jessika , Friedlander Sheila Fallon 
Published: May 2018

AbstractHand‐foot‐skin reaction is a distinct clinical condition arising in association with the use of multikinase inhibitors, including sorafenib. Because multikinase inhibitors are increasingly being used in children with cancer, recognition of this previously unfamiliar condition is of importance to pediatric dermatologists. We describe the diagnosis and successful treatment of a case of hand‐foot‐skin reaction in a child taking sorafenib for an unresectable desmoid tumor.
Erythema nodosum arising during everolimus therapy for tuberous sclerosis complex
Authors: Galligan Eloise R. , Fix Lindsey , Levin Laura E. , Imundo Lisa , Yamashiro Darrell J. , Garzon Maria C. 
Published: May 2018

AbstractIndications for everolimus and other drugs within the mammalian target of rapamycin inhibitor class have recently expanded to include tuberous sclerosis complex. Everolimus is generally well tolerated, but it is important for physicians to identify and manage associated cutaneous adverse effects. We report the first case of a child developing erythema nodosum while undergoing everolimus therapy.
A Dose Finding Design for Seizure Reduction in Neonates
Authors: Ursino Moreno , Yuan Ying , Alberti Corinne , Comets Emmanuelle , Favrais Geraldine , Friede Tim , Lentz Frederike , Stallard Nigel , Zohar Sarah 
Published: May 2018

SummaryClinical trials in vulnerable populations are extremely difficult to conduct. A sequential phase I–II trial aimed at finding the appropriate dose of levetiracetam for treating neonatal seizures was planned with a maximum sample size of 50 newborns. Three primary outcomes are considered: efficacy and two types of toxicity that occur at the same time but are measured at different time points. In the case of failure, physicians could add a second agent as a rescue medication. The primary outcomes were modelled via a logistic model for efficacy and a weighted likelihood with pseudo-outcomes for the two toxicities taking into account the dependences under Bayesian inference. Simulations were conducted to assess the design properties.
Suicidal Behavior and Personality Traits Contribute to Disability in First‐episode Psychosis: A 1‐Year Follow‐up Study
Authors: Canal‐Rivero Manuel , Lopez‐Moriñigo Javier‐David , Barrigón Maria‐Luisa , Ayesa‐Arriola Rosa , Crespo‐Facorro Benedicto , Ruiz‐Veguilla Miguel , Obiols‐Llandrich Jordi E. 
Published: May 2018

BackgroundDisability encompasses impairments, activity limitations, and restrictions on participation. Improvement in functioning has therefore become a crucial outcome of treatment in psychosis.ObjectiveThe main aim of this study was to analyze the potential relationship between suicidal behavior after first episode of psychosis (FEP) and family disability. The second aim was to find out whether personality traits are associated with disability dimensions.MethodThe study sample was composed of 65 FEP patients. The personal care, occupational, family, and social dimensions of disability were evaluated at 12 months after FEP. Bivariate and multivariate analyses were performed to explore any putative outcome factors associated with dimensions of disability.ResultsPersonal care during the 1‐year follow‐up was significantly impaired in suicide attempters and significantly associated with sociopathic personality traits. A decline in occupational functioning was significantly associated with schizotypy traits. On the other hand, deterioration in family, social, and global functioning at 1 year after FEP was related to poor premorbid adjustment during late adolescence.ConclusionsSuicidal behavior prevention could improve psychosocial functioning, particularly personal care, in FEP. In addition, sociopathic and schizotypy personality traits as well as poor premorbid adjustment during late adolescence appear to be useful early markers of future disability.
Incidences of Pseudomonas aeruginosa-Associated Ventilator-Associated Pneumonia within Studies of Respiratory Tract Applications of Polymyxin: Testing the Stoutenbeek Concurrency Postulates
Authors: Hurley James C. 
Published: May 2018

ABSTRACT

Regimens containing topical polymyxin appear highly effective at preventing ventilator-associated pneumonia (VAP) overall and, more so, VAP caused by Gram-negative bacteria. However, Stoutenbeek's postulates that VAP incidences within studies of topical antibiotics depend on the context of whether the component (control and intervention) groups of each study were concurrent versus nonconcurrent remain untested. The literature was searched for concurrent control (CC) versus nonconcurrent control (NCC) designed studies of respiratory tract applications of topical polymyxin to mechanically ventilated (MV) patients that reported incidences of
Pseudomonas
-associated ventilator-associated pneumonia (PsVAP). Studies of various interventions other than topical polymyxin (nonpolymyxin studies) served to provide additional points of reference. The PsVAP incidences within the component groups of all studies were benchmarked against groups from observational studies. This was undertaken by meta-regression using generalized estimating equation methods. Dot plots, caterpillar plots, and funnel plots enable visual benchmarking. The PsVAP benchmark (and 95% confidence interval [CI]) derived from 102 observational groups is 4.6% (4.0 to 5.3%). In contrast, the mean PsVAP within NCC polymyxin intervention groups (1.6%; CI, 1.0 to 4.5%) is lower than that of all other component group categories. The mean PsVAP within CC polymyxin control groups (9.9%; CI, 7.6 to 12.8%) is higher than that of all other component group categories. The PsVAP incidences of control and intervention groups of studies of respiratory tract applications of polymyxin are dependent on whether the groups were within a concurrent versus nonconcurrent study. Stoutenbeek's concurrency postulates are validated.