bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyalinoecia artifex: Field notes on a charismatic and abundant epifaunal polychaete on the US Atlantic continental margin
Authors: Meyer Kirstin S. , Wagner Jamie K.S. , Ball Bernard , Turner Phillip J. , Young Craig M. , Van Dover Cindy L. 
Published: September 2016

AbstractHyalinoecia artifex is an abundant species on the US Atlantic margin, although little is known about its behavior, ecology, or reproduction. We provide field notes and high‐resolution in situ imagery of this species observed and collected in 2013 and 2015. Hyalinoecia artifex occurred primarily on soft sediment at a density of 10.9±0.95 individuals m−2 (mean±standard error). Although they were found adjacent to mussel beds associated with methane seeps, worms were negatively associated with authigenic carbonate and other epibenthic megafauna in the study area. Quill worms moved across the sediment by extending their heads from the tubes and dragging the tubes forward. Stable isotope analysis indicated that H. artifex is a secondary consumer. Most individuals collected in 2015 were ripe, with mature oocytes up to 400 μm. Oocytes were yolky, yellow in color and positively buoyant; no brooding was observed.
Frequent callers in primary health care – a qualitative study with a nursing perspective
Authors: Holmström Inger K. , Krantz Anna , Karacagil Lena , Sundler Annelie J. 
Published: September 2016

AbstractAimTo: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres.BackgroundTelephone nursing has been noted to be a cost‐effective method to enhance access to and use of health care. Some patients use these services extensively and are called ‘frequent callers’. Little is known about this group of callers, the reasons behind these calls and telephone nurses’ experiences and strategies to manage the calls.DesignDescriptive design with a qualitative inductive approach.MethodsInterviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted.ResultsA main theme was established, called ‘Balancing between the experienced and assessed needs’, which described the telephone nurses’ experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses’ definitions of frequent callers, telephone nurses’ views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers.ConclusionFrequent callers were commonly encountered by telephone nurses’ in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.
Patterns of behaviour in families of critically ill patients in the emergency room: a focused ethnography
Authors: Barreto Mayckel da Silva , Marcon Sonia Silva , Garcia‐Vivar Cristina 
Published: September 2016

AbstractAimThe aim of this study was to understand the patterns of behaviour from relatives of critically ill patients admitted to the emergency room.BackgroundAdmission of a critically ill family member to an accident and emergency department is often a sudden and unexpected experience for the family. This stressful event often creates feelings of instability and intense suffering in relatives. Understanding the experiences of these families is essential for the provision of comprehensive health care in the emergency room.DesignA focused ethnography design was applied to the study.MethodsPeripheral participant observation and informal conversations were conducted in an emergency room in southern Brazil during January 2015. Analysis of data was based on Leininger.FindingsSuffering was recurrent among family members of critically ill patients admitted to the emergency room. The environment, which was conditioned by the patient′s life‐threatening situation and professionals′ attitudes, resulted in relatives experiencing a range of feelings from suffering to calm. A distant approach and poor communication of professionals made relatives confused and silent. Factors that seemed to foster feelings of calm in families were the establishment of a continuous and close communication with professionals and the possibility to remain with the patient outside the established visiting hours.ConclusionThe findings of this study challenge emergency department providers and managers to promote comprehensive care in the emergency room by inviting family members to be with the patient and by engaging in family‐centred care.
Systematic literature review on effectiveness of self‐management support interventions in patients with chronic conditions and low socio‐economic status
Authors: Van Hecke Ann , Heinen Maud , Fernández‐Ortega Paz , Graue Marit , Hendriks Jeroen M.L. , Høy Bente , Köpke Sascha , Lithner Maria , Van Gaal Betsie G.I. 
Published: September 2016

AbstractAimTo assess the quality of evidence and determine the effect of patient‐related and economic outcomes of self‐management support interventions in chronically ill patients with a low socio‐economic status.BackgroundIntegrated evidence on self‐management support interventions in chronically ill people with low socio‐economic status is lacking.DesignSystematic literature review.Data sourcesCochrane database of trials, PubMed, CINAHL, Web of Science, PsycINFO and Joanna Briggs Institute Library were searched (2000–2013). Randomized controlled trials addressing self‐management support interventions for patients with cardiovascular disease, stroke, cancer, diabetes and/or chronic respiratory disease were included.Review methodsData extraction and quality assessment were performed by independent researchers using a data extraction form.ResultsStudies (n = 27) focused mainly on diabetes. Fourteen studies cited an underlying theoretical basis. Most frequently used self‐management support components were lifestyle advice, information provision and symptom management. Problem‐solving and goal‐setting strategies were frequently integrated. Eleven studies adapted interventions to the needs of patients with a low socio‐economic status. No differences were found for interventions developed based on health behaviour theoretical models.ConclusionLimited evidence was found for self‐management support interventions in chronically ill patients with low socio‐economic status. Essential characteristics and component(s) of effective self‐management support interventions for these patients could not be detected. Rigorous reporting on development and underlying theories in the intervention is recommended.
What matters in “multimorbidity”? Arguably resilience and personal health experience are central to quality of life and optimizing survival
Authors: Martin Carmel Mary 
Published: September 2016

AbstractRationaleMuch is written about “multimorbidity” as it is a difficult problem for health systems, as it reflects a complex phenomenon unique to each individual health journey and health service context. This paper proposes the adoption of 2 constructs or knowledge streams into mainstream “multimorbidity” care which are arguably most important to person‐centered care—personal health perceptions and resilience.Analysis“Multimorbidity” is the manifestation of multiple nonlinear physical, psychosocial, and environmental phenomena in an individual health journey. Multimorbidity encompasses very stable states for the most part together with highly unstable phases that are difficult to manage. Averting or controlling the underlying loss of resilience in instability can be challenging without early warning signals pointing towards tipping points. Monitoring resilience and early warning signals for tipping points is new to health care. Yet what should we monitor in the complexity of multimorbidity? There are multiple and competing health service features and biometrics that can be measured. However, an expanding of literature endorses importance of simply asking a person about their self‐rated health in order to provide predictions of their resilience and survival. Interoception, exemplified as self‐rated health, arises from internal neurocognitive self‐monitoring functions of different internal and external phenomena. Interoception is being to be recognized as predictors and barometers of resilience and survival.ConclusionsTwo phenomena of human systems—interoception and resilience—can guide care in the complex nature of multimorbidity in unstable health journeys and should be incorporated into clinical practice.
A Simple Tool to Predict Development of Delirium After Elective Surgery
Authors: Dworkin Andy , Lee David S.H. , An Amber R. , Goodlin Sarah J. 
Published: September 2016

ObjectivesTo identify a quick clinical tool to assess the risk of delirium after elective surgery.DesignProspective observational study.SettingPreoperative assessment clinic at the Veterans Affairs Portland Health Care System.ParticipantsCommunity‐living veterans aged 65 and older scheduled for elective surgery requiring general or major anesthesia.MeasurementsConfusion Assessment Method (CAM) or Family Confusion Assessment Method (FAM‐CAM). Data on education, medications, substance use, Patient Health Questionnaire (PHQ‐9), Study of Osteoporotic Fractures Frailty, Mini‐Cog, and Charlson‐Deyo score were collected preoperatively.ResultsOf 114 veterans who agreed to participate, 76 completed the final delirium assessment. Ten of the 76 (13%) developed delirium in the 72 hours after surgery as assessed using the CAM or FAM‐CAM. In bivariate analysis, factors that increased the odds of delirium at least three times were low education; poor PHQ‐9, clock draw, word recall, Mini‐Cog, and poor preoperative orientation scores; alcohol use; and higher comorbidities as measured using Charlson‐Deyo index. Scoring the Mini‐Cog from 0 to 5 had a higher predictive power (area under the receiving operating characteristic curve = 0.77) than other approaches to scoring the Mini‐Cog. Other models did not significantly improve prediction of postoperative delirium risk and would be complicated to use in a clinical setting.ConclusionIn this sample of veterans who had elective surgery with major anesthesia, Mini‐Cog score predicted likelihood of postoperative delirium.
Periodic fevers and autoinflammatory syndromes in childhood
Authors: Ostring Genevieve T , Singh‐Grewal Davinder 
Published: September 2016

AbstractRecurrent fever is a common presentation in paediatric practice and can be caused by a wide variety of diseases including autoinflammatory conditions. The innate immune system plays an essential role in the ‘first line’ response to infection through mediation of inflammatory responses. Inflammasomes are part of the regulatory process for this system and result in the production of the powerful pro‐inflammatory cytokine interleukin‐1B. Dysregulation of inflammasomes, and Interleukin 1 production, contributes to the pathogenesis of autoinflammatory diseases. This review focuses on described periodic fever syndromes (PFS) which are now collectively referred to as autoinflammatory syndromes. Conditions discussed include periodic fever aphthous stomatitis pharyngitis and cervical adenopathy, familial Mediterranean fever, tumour necrosis factor receptor‐associated periodic syndromes, hyperimmunoglobulinaemia D and the cryopyrin‐associated periodic syndromes. Presenting features, complications, diagnostic and treatment approaches for these conditions are discussed. Nonetheless, as most of these conditions are rare and may have significant long‐term complications, it is recommended that they be managed in consultations with a physician experienced in managing PFS.
Comparison of the pharmacokinetics of two formulations of hydroxyethyl starch in healthy horses
Authors: Epstein K. L. , Bergren A. , Nie B. , Arnold R. D. , Brainard B. M. 
Published: September 2016

A lower molecular weight and molar substitution formulation (130/0.4) of hydroxyethyl starch solution has been shown to have a more sustained effect on COP and similar hemodynamic effects as a higher molecular weight and molar substitution formulation (600/0.75) in healthy horses. In humans, these pharmacodynamic characteristics are coupled with more rapid clearance and decreased adverse coagulation effects and accumulation. The objective of this study was to determine and compare the pharmacokinetics of these two formulations in horses. Eight healthy horses were given a 10 mL/kg bolus of each formulation (600/0.75 and 130/0.4) of hydroxyethyl starch solution in a randomized crossover design. Blood was collected, and plasma was harvested for plasma levels over 24 h. Pharmacokinetic parameters for each horse were estimated from a noncompartmental analysis. Treatment with 600/0.75 resulted in a higher initial plasma concentration (C0), systemic half‐life (t1/2), and overall drug exposure (AUC0–inf) in addition to decreased elimination rate (β), volume of distribution (Vd), and clearance (CL), compared to treatment with 130/0.4 (P < 0.001). The pharmacokinetic findings combined with previous pharmacodynamics findings suggest that 130/0.4 can provide similar benefits to 600/0.75 with a lower risk of accumulation in the circulation.
Does serelaxin treatment alter passive mechanical wall properties in small resistance arteries?
Authors: Jelinic Maria , Kahlberg Nicola , Parry Laura J. , Tare Marianne 
Published: September 2016

AbstractThe peptide hormone relaxin is recognized for its connective tissue remodeling actions in the reproductive tract during pregnancy and parturition, but it also has vascular remodeling actions independent of pregnancy. Recombinant human relaxin (serelaxin) treatment in male and non‐pregnant female rodents enhances passive arterial compliance in the renal vasculature. This review focuses on serelaxin's actions on passive mechanical wall properties in small arteries and highlights the diversity of responses to serelaxin treatment in rodents. Different experimental approaches (duration of serelaxin treatment, rat strain, age) and animal models of disease (obesity, hypertension) will be considered. Most studies in young rodents demonstrate that serelaxin treatment fails to alter passive compliance in resistance‐size arteries (mesenteric and femoral arteries and cerebral parenchymal arterioles), suggesting that serelaxin's beneficial effects are minimal in healthy animals. Short‐term serelaxin treatment (5d) in aged, obese, and spontaneously hypertensive rats (SHRs) is largely without effect on passive mechanical wall properties. However, a longer duration of serelaxin treatment in SHRs (14d) enhances passive compliance in large muscular arteries as well as resistance‐size arteries. In conclusion, serelaxin is capable of vascular remodeling. Its actions are vascular bed‐dependent, more prominent in disease, and likely requires a longer duration of treatment to be effective.
Extent and application of patient diaries in Austria: process of continuing adaptation
Authors: Heindl Patrik , Bachlechner Adelbert , Nydahl Peter , Egerod Ingrid 
Published: September 2016

ABSTRACTBackgroundDiaries written for patients in the intensive care unit (ICU) are offered in many European countries. In Austria, ICU diaries have been relatively unknown, but since 2012, they have started to emerge.AimThe aim of this study was to explore the extent and application of ICU diaries in Austria in 2015.MethodThe study had a prospective multiple methods design of survey and interviews. All ICUs in Austria were surveyed in 2015 to identify which ICUs used diaries. ICUs using diaries were selected for semi‐structured key‐informant telephone interviews on the application of ICU diaries. Interviews were analysed by content analysis.ResultsOf the 178 ICUs contacted, 13 had implemented ICU diaries. In all ICUs, diaries were sporadically introduced by a few dedicated nurses. Experiences of participating nurses can be summarized in two main themes: (a) the process of innovation and (b) the process of practice. Sub‐themes were: (i) inspiration, creativity and innovation and (ii) purpose, indications, responsibility, authorship, experience, negative reception, and post‐ICU practice. Individual nurses at each ICU found ways to organize and format ICU diaries while dealing with ambivalence and legal implications.ConclusionThe implementation of a new nursing intervention is an ongoing process. Being innovative and responsible can be challenging, especially in hierarchical team structures. We recommend that nurses work towards national standards for the diary concept in order to enable future research into the process and outcome of ICU diaries.Relevance to Clinical PracticeThe implementation of ICU diaries in routine care requires an ongoing adaptive, reflective process. Nurses may experience innovation, leading to the development of their own, feasible adaptions and structures.
Assessing changes in a patient's condition – perspectives of intensive care nurses
Authors: Kvande Monica , Delmar Charlotte , Lykkeslet Else , Storli Sissel Lisa 
Published: September 2016

ABSTRACTAimTo explore the phenomenon of assessing changes in patients' conditions in intensive care units from the perspectives of experienced intensive care nurses.BackgroundProviding safe care for patients in intensive care units requires an awareness and perception of the signs that indicate changes in a patient's condition. Nurses in intensive care units play an essential role in preventing the deterioration of a patient's condition and in improving patient outcomes.Design and methodsThis hermeneutic phenomenological study conducted close observations and in‐depth interviews with 11 intensive care nurses. The nurses' experience ranged from 7 to 28 years in the intensive care unit. Data were collected at two intensive care units in two Norwegian university hospitals. The analysis was performed using the reflective methods of van Manen.FindingsAn overarching theme of ‘sensitive situational attention’ was identified, in which the nurses were sensitive in relation to a patient and understood the significance of a given situation. This theme was further unfolded in four subthemes: (1) being sensitive and emotionally present, (2) being systematic and concentrating, (3) being physically close to the bedside and (4) being trained and familiar with the routines.ConclusionsNurses understand each patient's situation and foresee clinical eventualities through a sensitive and attentive way of thinking and working. This requires nurses to be present at the bedside with both their senses (sight, hearing, smell and touch) and emotions and to work in a concentrated and systematic manner. Knowledge about the unique patient exists in interplay with past experiences and medical knowledge, which are essential for nurses to understand the situation.Relevance to clinical practiceClinical practice should develop routines that enable nurses to be present at the bedside and to work in a concentrated and systematic manner. Furthermore, providing safe care requires nurses to be sensitive and attentive to each patient's unique situation.
An international survey: the role of specialist nurses in adult respiratory extracorporeal membrane oxygenation
Authors: Daly Kathleen JR , Camporota Luigi , Barrett Nicholas A 
Published: September 2016

ABSTRACTBACKGROUNDThe last decade has seen an increase in the number of centres able to provide venovenous extracorporeal membrane oxygenation (VV‐ECMO) internationally across different health care systems. To support this growth, a variety of staffing arrangements have been adopted depending on local need and availability of resources, both in terms of manpower and finances to safely meet the complex needs of the patient and circuit management.AIMThe aim of the survey was to describe current staffing arrangements of care provision for adult patients on VV‐ECMO, with a focus on understanding the professional roles and responsibilities of staff managing the circuit in order to inform further discussion around different approaches to staffing.METHODSWe conducted a cross‐sectional international survey using an electronic questionnaire emailed to 177 worldwide ECMO centres treating adult patients with acute respiratory failure. The survey questions were generated through an internal and external iterative process and assessed for clarity, content and face validity.RESULTSThe response rate was 82%. Respondents managed extracorporeal oxygenation for adult respiratory alone (75%) or in combination with adult cardiac (67%), paediatric respiratory (62%) and paediatric cardiac (58%). The specialist nurse to patient ratio was 1:1 in 59% of centres, with 24‐h/day presence in 74%. Overall, the specialist nurse provided the 24‐h/day management of the circuit, including interventions. Perfusionists were responsible for the technical aspects of circuit management.CONCLUSIONSA specialist nurse with perfusion backup is the staffing arrangement implemented by most centres and likely reflects the most efficient use of the professional competences available.RELEVANCE TO CLINICAL PRACTICEStaffing for adult respiratory extracorporeal support has important implications for the planning of workforce, training and education, quality of service and the number of ECMO beds available.
Simple tests for the diagnosis of childhood obesity: a systematic review and meta‐analysis
Authors: Simmonds M. , Llewellyn A. , Owen C. G. , Woolacott N. 
Published: September 2016

SummaryThere is a need to accurately quantify levels of adiposity in order to identify overweight and obesity in children. This systematic review aimed to identify all diagnostic accuracy studies evaluating simple tests for obesity and adiposity, including body mass index (BMI), skin‐fold thickness and waist circumference, compared against high‐quality reference tests. Twenty‐four cohort studies including 25,807 children were included. BMI had good performance when diagnosing obesity: a sensitivity of 81.9% (95% confidence interval [CI]: 73.0 to 93.8) for a specificity of 96.0% (95% CI: 93.8 to 98.1). It was less effective at diagnosing overweight (sensitivity: 76.3%, 95% CI: 70.2 to 82.4; specificity: 92.1% 95% CI: 90.0 to 94.3). When diagnosing obesity, waist circumference had similar performance (sensitivity: 83.8%; specificity: 96.5%). Skin‐fold thickness had slightly poorer performance (sensitivity: 72.5%; specificity: 93.7%). Few studies considered any other tests. There was no conclusive evidence that any test was generally superior to the others. BMI is a good simple diagnostic test for identifying childhood adiposity. It identifies most genuinely obese and adipose children while misclassifying only a small number as obese. There was no conclusive evidence that any test should be preferred to BMI, and the extra complexity of skin‐fold thickness tests does not appear to improve diagnostic accuracy.