bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Interface Format, Feedback Style, and System lag on the Usability of Hand-Held Internet Controllers
Authors: Ergen Feyza F. , Beaton Robert J. , Deighan John 
Published: July 2017

The increasing popularity of the World Wide Web (WWW) has created a new market: Web access through television. One of the approaches for accessing the Web through television is the utilization of the existing cable system. Some unique characteristics of this browsing system are fast access to the Web, the use of nine buttons on a universal remote control, and a tree structure for navigating to Web sites. This study investigated potential user interface designs for this WWW browser and evaluated the usability of the nine-button interface. Sixteen volunteers navigated to 42 predetermined Web sites with two interface formats, five system lag times, and three feedback styles. Participants were prescreened for their experience with using computers and browsing the Web. The number of errors committed and task completion times were recorded. In addition, participants were asked to subjectively rate the WWW browser interface after each task as well as after the entire experiment. Participants preferred the 0.2 second system lag and the active feedback style. Overall, they committed fewer errors and took less time to complete the tasks with the tabbing interface than with the one-to-one mapping interface. Experienced participants committed more errors than did the inexperienced ones. Increasing system lag time was determined to have a greater adverse effect on the tabbing interface than on the one-to-one mapping interface.
The impact of barriers to providing high-quality care on nurses’ intentions to leave London hospitals
Authors: Reeves Rachel , West Elizabeth , Barron David 
Published: July 2017

Objectives Previous research on nurse retention has focused mainly on its relationship with employment conditions. This study aimed to include an examination of the impact of nurses’ perceived barriers to delivering high-quality patient-centred care on their intentions to leave their current employers. Methods An American employee questionnaire was adapted for use with British nurses. The questionnaire was mailed to 6160 nurses directly employed by 20 London hospitals. Up to two reminders were sent to non-responders. The questionnaire asked nurses to report on experiences in their working lives and to state their intentions to leave or stay with their current employer. Demographic and employment history information was also elicited. Results Responses were received from 2880 (47%). Nurses report that the care they are able to provide often falls short of recognised standards. Factor analysis combined 82 questions on nurses’ experiences into four patient-centred and four nurse-centred dimensions. Nurses who report more problems in both nurse-centred and patient-centred dimensions are more likely to intend to leave their current employers. Satisfaction with pay and the cleanliness of work areas are also important factors. Conclusions Standards of care are often perceived by nurses to be unacceptably poor. Furthermore, their experience of barriers to care has a demonstrable impact on their decision to leave or stay with their current employer. Nurse managers need to address the perceived barriers to providing high-quality care when considering nurse retention strategies.
Heart Rate Variability, Mortality, and Exercise in Patients with End-Stage Renal Disease
Authors: Cashion Ann K. , Cowan Patricia A. , Milstead E. Jean , Gaber A. Osama , Hathaway Donna K. 
Published: July 2017

Context Cardiac autonomic function has been associated with mortality in patients with end-stage renal disease. It is unknown whether end-stage renal disease patients who have succumbed to sudden cardiac death can be better identified by a newer test of heart rate variability that uses spectral analysis, rather than laboratory evoked measures. Objective This series of studies sought to characterize cardiac autonomic function in patients awaiting kidney transplantation, identify factors associated with heart rate variability, identify tests which distinguish patients at-risk for death, and compare evoked measures with 24-hour heart rate variability measures. Patients Data were collected on 184 nondiabetics, 60 type 1 diabetics, and 34 type 2 diabetics with end-stage renal disease, all of whom had been referred for kidney transplantation. Main Outcome Measures The 278 patients and 67 healthy control subjects underwent evoked tests (changes in heart rate with deep breathing and Valsalva maneuver) and 24-hour heart rate variability Holter monitoring (time and frequency domains). Five patients had sudden cardiac deaths during the study. Results Data showed that end-stage renal disease patients, particularly diabetics, had compromised autonomic function. The standard deviation of all R-to-R intervals for the electrocardiogram recording (<50 minutes in 60% of the deceased patients), a 24-hour heart rate variability time domain measure, holds the promise of identifying patients at increased risk for death. Exercise was identified as a factor associated with better autonomic function. Examining relationships between 24-hour heart rate variability and characteristics of patients who succumb to death could make quantification of the mortality risk for individual pretransplant end-stage renal disease patients possible, much as it has in other populations. The data from this study may also make it possible to design interventions, such as exercise, aimed at reducing mortality risk.
Benefit Analysis of Administrative and Clinical Computerization of a Large Transplant Center
Authors: Tietjen Andrea L. , Dowell-Cherry Rachel , Mulgaonkar Shamkant , Morgan Debbie 
Published: July 2017

Purpose To evaluate the implementation of a computer system that fully integrates all activities of a transplant center and coordinates secure, live data across the continuum of care. Methods Our center implemented a comprehensive patient tracking solution customized at each point of patient entry. Benefits were measured by provider, patient, and staff feedback; time study; and retrospective cost analysis. Results Computerization of each patient file maintained current clinical information, which facilitated patient monitoring, expeditious evaluations and listings, marketing, automated correspondence, and regulatory reporting. Enhanced data have allowed for clinical analysis, which has improved outcomes. Data availability has promoted consistency in negotiations with commercial insurers to ensure profitability. Research capacity has been increased through standardized budgets, time study, and cost analysis and has facilitated patient recruitment. Conclusion The need to integrate information is vital for data accuracy and integrity. Data integration has maximized performance, profitability, and accuracy while decreasing administrative time and costs.
Life Satisfaction among Kidney Transplant Recipients: Demographic and Biological Factors
Authors: Siegal Bonnie , Halbert R. J. , McGuire M. J. 
Published: July 2017

Purpose The Transplant Learning Center is a program providing education and support for solid-organ transplant recipients taking cyclosporine (Neoral or Sandimmune). One goal of the program is to improve patients' quality of life, which may be influenced by demographic and biological factors, and in turn influences adherence to prescribed medication regimens. We analyzed the results from the initial survey of enrollees to better understand life satisfaction and to test the validity and reliability of the satisfaction scale used in the program. Method Patients enter the program through self-selection: all enrollees who received a kidney transplant were included in this analysis. Satisfaction was measured using the Life Satisfaction Index, which includes 8 questions about aspects of satisfaction with the patient's life. Associations between the Life Satisfaction Index and demographic factors, comorbid medical conditions, adverse effects of immunosuppressants, and medication compliance were examined. Results All 3676 kidney transplant recipients who completed the initial survey were included. Mean satisfaction scores were highest in persons who were older than 64 years, men, and those who were married. Satsifaction scores were positively correlated with education and income. Mean satisfaction score was significantly lower among persons with medical comorbidities, persons who reported that adverse effects of medications were more frequent, and persons who reported noncompliance with their medication regimen. Conclusion The Life Satisfaction Index is a transplant-specific measure of health-related quality of life that can be used to help detect areas of potential concern in the clinical management of kidney transplant recipients.
Pain Experienced by Laparoscopic Donor Nephrectomy Patients in an Academic Medical Setting
Authors: Steinhauser Michele M. , Dawson Patricia B. , Barshick Rebecca M. , Janecek Jennifer L. 
Published: July 2017

Context Since 1996, 414 laparoscopic live donor nephrectomy procedures have been completed at our institution. Although this procedure has gained acceptance within the past 5 years, little is known about its nursing implications. Objective The purpose of this performance improvement project was to identify pain management practices, satisfaction levels, and clinical outcomes among patients undergoing laparoscopic live donor nephrectomy. Patients Data were collected for a convenience sample of 70 patients for 18 months. Intervention Several pain management methods were used, including patient-controlled analgesia and intramuscular and oral medications. Results Pain ratings ranged from 3.2 to 3.8 for the first 36 hours postoperatively. The mean pain level did not differ significantly between pain regimes. At discharge, patients perceived a mean overall pain level of 5.0 but anticipated a pain level of 6.1. A significant negative correlation between satisfaction and pain rating also was noted. Conclusions Opportunities exist to standardize current regimens of pain medications and address pain level and treatment 24 hours postoperatively.
Establishing a Transplant Coordinator-Led Living Kidney Donor Follow-up Clinic
Authors: Lumsdaine Jennifer A. , Wigmore Stephen J. , Wooton Donna , Stewart Casey , Akyol Murat , Forsythe John L. R. 
Published: July 2017

Background The long-term risks of renal failure and hypertension are statistically low for living kidney donors as a group, but can have serious consequences for the individual. Objectives To describe the experience with a transplant coordinator-led living donor follow-up clinic. Method Living kidney donors are reviewed on an annual basis by a designated coordinator (registered nurse). A 24-hour urine collection estimates renal function. Blood pressure and blood chemistry are measured and urinalysis performed. Current health status and wound discomfort are assessed. Any medical problems identified are referred to a specialist hospital department or to the donor's family practitioner. Results Fifty-nine appointments were booked and 12 (20%) donors did not attend. Renal function was within acceptable limits for all attending donors. Three donors had raised blood glucose levels and 8 donors were hypertensive; all were referred to family practitioners. Forty-seven donors (35 new, 12 return) completed a questionnaire on the follow-up provided. Thirty-eight (81%) were satisfied with the follow-up, and 47 (100%) agreed this clinic provided adequate follow-up. Thirty-three (70%) donors stated they preferred that the transplant coordinator performed the follow-up, 3 (6%) preferred the family practitioner, and 11 (23%) had no preference. Conclusions There are many possible solutions to the provision of lifelong care of living kidney donors. The model of a transplant coordinator-led clinic appears to have a high degree of patient acceptance, perhaps because of the continuity of care provided by a known member of the transplant team. Further work is required to identify reasons for nonattendance.
Exploring Donors' and Recipients' Attitudes about Living Donor Kidney Transplantation
Authors: Pradel Françoise G. , Mullins C. Daniel , Bartlett Stephen T. 
Published: July 2017

Context There is a growing interest in living donor kidney transplantation because of its potential to reduce the current kidney shortage. Objective To explore the experience of potential recipients, recipients, potential donors, and donors with regard to living donor kidney transplantation and laparoscopic living donor nephrectomy. Method Twenty-five patients participated in a series of focus group interviews. The interviews were tape-recorded and a content analysis was performed. Results All participants had a positive attitude toward living donor kidney transplantation and laparoscopic living donor nephrectomy, though this procedure was not a factor that influenced potential donors' decision to donate a kidney. None of the potential donors and donors felt coerced into giving a kidney; they were motivated by a desire to help a loved one who was suffering. The main perceived impediment to donate a kidney was the potential recipients' reluctance to accept the offer. Potential recipients and recipients found it difficult to ask for a kidney and worried about the consequences of a kidney removal on their donor's health. A potential barrier to living donor kidney transplantation was that recipients would never have accepted a kidney if their donor had to pay for the kidney removal. In addition, recipients believed that a kidney from a non–blood-related donor was not as a good a match as a kidney from a blood-related donor. Conclusion This exploratory study reveals that donors, potential donors, recipients, and potential recipients had an overall positive attitude toward living donor kidney transplantation and laparoscopic living donor nephrectomy. This study also sheds light on a number of barriers that have not been previously reported.
Unintended Consequences: The Impact of Protocol Change on Critical Care Nurses' Perceptions of Stress
Authors: Dodd-McCue Diane , Tartaglia Alexander , Myer Kevin , Kuthy Susan , Faulkner Ken 
Published: July 2017

Context The Family Communication Coordinator protocol was implemented to facilitate effective communications during potential organ donation cases. Previous research records its effectiveness relative to donor outcome measures. By redefining and clarifying role responsibilities, the protocol may be associated with reduced job stress for those caring for potential donors. Objectives To determine the relationship of the Family Communication Coordinator protocol on the role stress of critical care nurses. To examine role stress in terms of role ambiguity, role conflict, and role overload within the context of potential organ donation cases. Design Retrospective nonexperimental descriptive design. Setting Critical care units of an academic teaching hospital. Participants Nineteen critical care nurses with experience before and after implementation of the Family Communication Coordinator protocol. Main Outcome Measures Job dimensions, role stress, job satisfaction, and commitment, measured using surveys. These data were supplemented with interviews and hospital records. Results The findings demonstrate that the Family Communication Coordinator protocol is associated with reduced role stress. More specifically, the nurses perceived significant reductions in role ambiguity and role conflict, and some reduction in role overload. The findings highlight high satisfaction with the protocol, as well as improved job satisfaction, and professional and organizational commitment. Conclusions The results suggest that reduced role stress among critical care nurses is associated with implementation of a protocol already associated with improved organ donation outcomes. The findings suggest positive outcomes also may impact other staff, multidisciplinary functions, and the organization. Similar protocols may be appropriate in other end-of-life situations to reduce uncertainty and stress among critical care professionals.
Treating Gout in Kidney Transplant Recipients
Authors: Baroletti Steven , Bencivenga Gina Ann , Gabardi Steven 
Published: July 2017

Objective To review the etiology, treatment, and preventive strategies of hyperuricemia and gout in kidney transplant recipients. Data Sources Primary literature was obtained via Medline (1966-June 2003). Study Selection and Data Extraction Studies evaluating treatment and prevention of hyperuricemia and gout in kidney transplantation were considered for evaluation. English-language studies were selected for inclusion. Data Synthesis Approximately 14000 kidney transplantations were performed in the United States in 2003, and of those transplant recipients, nearly 13% will experience a new onset of gout. The prevalence of hyperuricemia is even greater. There are several mechanisms by which hyperuricemia and gout develop in kidney transplant recipients. Medication-induced hyperuricemia and renal dysfunction are 2 of the more common mechanisms. Prophylactic and treatment options include allopurinol, colchi cine, corticosteroids, and, if absolutely necessary, nonsteroidal anti-inflammatory drugs. Conclusion It is generally recommended to decide whether the risks of prophylactic therapy and treatment outweigh the benefits. Often, the risk of adverse events associated with agents to treat these ailments tends to outweigh the benefits; therefore, treatment is usually reserved for symptomatic episodes of acute gout. Practitioners must also decide if changes in immunosuppressive regimens may be of benefit on a patient-by-patient basis.
Appraisal and Coping as Predictors of Psychological Distress and Self-Reported Physical Disability before Lung Transplantation
Authors: Burker Eileen J. , Evon Donna M. , Sedway Jan A. , Egan Thomas 
Published: July 2017

Context Certain appraisals and coping strategies have been associated with increased levels of psychological distress and disability in other medical populations, but no study has examined this relationship with patients who are awaiting lung transplantation. Objective To describe the cognitive appraisal and coping strategies used by patients who are pursuing lung transplantation and to evaluate the extent to which these processes are associated with depression, anxiety, and disability. Methods This is a cross-sectional design with 160 participants (42.5% men) who have end-stage lung disease and were evaluated for lung transplantation at a large medical center. Measures The outcome variables of depression, anxiety, and physical disability were assessed using the Beck Depression Inventory, Spielberger Trait Anxiety Inventory, and the Sickness Impact Profile, respectively. The predictor variables, coping and appraisal styles, were measured using the COPE and the Stress Threat Questionnaire, respectively. Demographic variables were also assessed. Results Patients used a variety of adaptive problem- and emotion-focused coping strategies. Hierarchical multiple regressions demonstrated that harm appraisals and the use of particular types of coping styles; namely, disengagement, avoidance, ruminating and venting emotions, low solicitation of emotional support, and suppressing other activities are maladaptive and were uniquely related to psychological distress and disability. Conclusions Maladaptive appraisal and coping styles can serve as markers of emotional distress and disability that may help the transplant team identify patients who may benefit from counseling and psychological interventions.
Potential Living Kidney Donors' Health Education Use and Comfort with Donation
Authors: Waterman Amy D. , Covelli Tonie , Caisley Laura , Zerega Wendy , Schnitzler Mark , Adams David , Hong Barry A. 
Published: July 2017

Context Much living kidney donation research focuses on actual donors rather than all donors who are evaluated by the transplant center. Objective To determine (1) what concerns and benefits potential donors saw possible from donation, (2) how they educated themselves before contacting the transplant center, and (3) who were the most comfortable donors. Design A telephone survey of 91 potential donors before transplant evaluation. Setting Barnes-Jewish Hospital Transplant Center in St Louis, Mo. Main Outcome Measures Willingness and comfort donating, key concerns and perceived benefits to donation, hours of transplant-related education. Results On a 7-point scale, potential donors were very willing (mean=6.65, SD=0.95) and comfortable (mean=6.31, SD=1.12) donating. They were most concerned that their recipients would die if they could not donate, the evaluation and surgery would be anxiety provoking or painful, and they did not understand what donation would require. Donors previously spent an average of 6 hours reading health resources and 32 hours discussing donation. Using logistic regression, those donors with 0 to 4 concerns (odds ratio=7.1, 95% confidence interval [CI], 2.2–23.16), more than 5 benefits (odds ratio=3.7, 95% CI, 1.2–11.0), and who were family members (odds ratio=4.7, 95% CI, 1.4–15.8) were more likely to be extremely comfortable donating compared to others. Conclusions Before evaluation, most potential donors are willing to donate because they think that it is important to improve the health of a loved one. Their knowledge of donation varies and they need clear information about medical testing and support coping with any negative donation outcomes.
Influenza Vaccine Antibody Responses in Lung Transplant Recipients
Authors: Hayney Mary S. , Welter Deborah L. , Francois Mary , Reynolds Ann Marie , Love Robert B. 
Published: July 2017

Context Lung transplant recipients are at high risk of morbidity and mortality from influenza infection because of altered lung physiology and immunosuppression. Annual influenza immunization is recommended, but the ability to mount an antibody response may be limited by immunosuppressant medications. Objective To compare the antibody response rate to influenza vaccine in lung transplant recipients to healthy controls. Design Open label study Setting Lung transplant clinic and General Clinical Research Center at a university hospital. Subjects Sixty-eight single and bilateral lung transplant recipients and 35 healthy controls were enrolled in October and November 2002. Methods Each individual underwent blood sampling before receiving the 2002–2003 influenza vaccine and 4 weeks later. Influenza antibody concentrations were measured by hemagglutination inhibition assay. Vaccine response rates (antibody concentration >40 hemagglutination units and at least 4-fold increase in antibody concentration) were compared using χ2. The influence of specific immunosuppressants on vaccine response was compared. Results The influenza vaccine response rate for lung transplant recipients was 29/68 (43%) and 22/35 (63%) for the healthy individuals ( Pž < .05; χ2). Among the recipients, mycophenolate mofetil was associated with poorer influenza vaccine antibody response (> 40 hemagglutination units) (62% vs 91%; Pž = .01), whereas sirolimus (91% vs 63%; Pž = .02) was associated with better influenza antibody response compared to those not taking mycophenolate mofetil or sirolimus, respectively. Conclusion Lung transplant recipients had lower influenza vaccine response rates than healthy individuals. Influenza vaccine antibody response is influenced by concomitant administration of mycophenolate mofetil or sirolimus. Future studies should measure protection from influenza infection conferred by immunization and alternative vaccination strategies.