bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a thermal care bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia
Authors: Duff Jed , Walker Kim , Edward Karen‐Leigh , Ralph Nicholas , Giandinoto Jo‐Ann , Alexander Kimberley , Gow Jeff , Stephenson John 
Published: November 2017

Aims and objectivesTo improve the prevention, detection and treatment of perioperative inadvertent hypothermia in adult surgical patients by implementing a Thermal Care Bundle.BackgroundKeeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections and morbid cardiac events. The Thermal Care Bundle consists of three elements: (i) assess risk; (ii) record temperature; and (iii) actively warm.DesignA pre‐ and postimplementation study was conducted to determine the impact of the Thermal Care Bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia.MethodsThe Thermal Care Bundle was implemented using an adapted version of the Institute of Healthcare Improvement's Breakthrough Series Collaborative Model. Data were collected from auditing medical records.ResultsData from 729 patients (pre‐implementation: n = 351; postimplementation: n = 378) at four sites were collected between December 2014–January 2016. Improvements were recorded in the percentage of patients with a risk assessment; at least one documented temperature recording per perioperative stage; and appropriate active warming. Despite this, the overall incidence of perioperative inadvertent hypothermia increased postimplementation.ConclusionThe Thermal Care Bundle facilitated improved management of perioperative inadvertent hypothermia through increased risk assessment, temperature recording and active warming but did not impact on perioperative inadvertent hypothermia incidence. Increased temperature recording may have more accurately revealed the true extent of perioperative inadvertent hypothermia in this population.Relevance to clinical practiceThis study showed that a collaborative, context specific implementation method, such as the IHI Breakthrough Series Model, is effective at improving practices, which can improve thermal care.
Registered nurse and midwife experiences of using videoconferencing in practice: A systematic review of qualitative studies
Authors: Penny Robyn A , Bradford Natalie K , Langbecker Danette 
Published: November 2017

Aim and objectiveTo synthesise evidence of registered nurses’ and midwives’ experiences with videoconferencing and identify perceptions of the appropriateness, meaningfulness and feasibility of this technology in professional and clinical practice.BackgroundVideoconferencing is a form of telehealth that can facilitate access to high‐quality care to improve health outcomes for patients and enable clinicians working in isolation to access education, clinical supervision, peer support and case review. Yet use of videoconferencing has not translated smoothly into routine practice. Understanding the experiences of registered nurses and midwives may provide practitioners, service managers and policymakers with vital information to facilitate use of the technology.DesignA qualitative meta‐synthesis of primary qualitative studies undertaken according to Joanna Briggs Institute methodology.MethodA systematic search of 19 databases was used to identify qualitative studies that reported on registered nurses’ or midwives’ experiences with videoconferencing in clinical or professional practice. Two reviewers independently appraised studies, extracted data and synthesised findings to construct core concepts.ResultsNine studies met the criteria for inclusion. Five key synthesised findings were identified: useful on a continuum; broader range of information; implications for professional practice; barriers to videoconferencing; and technical support, training and encouragement.ConclusionsWhile videoconferencing offers benefits, it comes with personal, organisational and professional consequences for nurses and midwives. Understanding potential benefits and limitations, training and support required and addressing potential professional implications all influence adoption and ongoing use of videoconferencing.Relevance to clinical practiceRegistered nurses and midwives are well placed to drive innovations and efficiencies in practice such as videoconferencing. Nursing and midwifery practice must be reframed to adapt to the virtual environment while retaining valued aspects of professional practice. This includes ensuring professional standards keep pace with the development of knowledge in this area and addressing the findings highlighted in this meta‐synthesis.
The art of oral handovers: A participant observational study by undergraduate students in a hospital setting
Authors: Giske Tove , Melås Sunniva Nese , Einarsen Kari Anne 
Published: November 2017

Aims and objectivesTo explore the conditions for oral handovers between shifts in a hospital setting, and how these impact patient safety and quality of care.BackgroundOral handovers transfer patient information and nursing responsibilities between shifts. Short written summaries of patients can complement an oral handover. How to find the balance between a standardised protocol for handovers and tailoring variations to specific patients and situations is debated in the literature. Oral handovers provide time for discussion, debriefing and problem solving, which can lead to increased team cohesiveness.DesignThis study used a participant observation design.MethodFifty‐two undergraduate nursing students conducted 1100 hr of participant observation in seven different units in a hospital in Western Norway from 2014–2015. Field notes were analysed using qualitative content analysis.ResultsSix themes emerged from the data: (i) content and structure of the handover, (ii) awareness of nurses’ attitudes during oral handover, (iii) verbal and nonverbal communication, (iv) distractions, (v) relaying key information accurately, (vi) ensuring quality through oral handovers.ConclusionDeveloping a familiar structure for oral handovers and minimising the use of abbreviations and unfamiliar medical terms promote clarity and understanding. Limiting disturbances during handovers helps nurses focus on the content of the report. Awareness of one's attitudes and the use of verbal and nonverbal communication can enhance the quality of a handover. Time allocated for an oral handover should allow for professional discussions and student supervision. Involving nurse leaders in promoting the quality of oral handovers can impact the quality of care.Clinical implicationsOral handovers serve many purposes, such as the safe transfer of patient information between shifts and staff education and debriefing, which enhance team cohesiveness.
Promoting person‐centred care in the perioperative setting through patient advocacy: An observational study
Authors: Sundqvist Ann‐Sofie , Nilsson Ulrica , Holmefur Marie , Anderzén‐Carlsson Agneta 
Published: November 2017

Aims and objectivesTo examine the extent to which the findings from an integrative review regarding perioperative patient advocacy could be empirically supported, and to describe Swedish registered nurse anaesthetists’ patient advocacy actions and interactions during the perioperative period.BackgroundPatient advocacy is practiced by various healthcare professionals in promoting the well‐being of patients. It is complex, and in a general healthcare context, it has been described as supporting the patients both physiologically and psychologically. During general anaesthesia, the patient enters an unconscious state, and the registered nurse anaesthetist safeguards patient privacy and autonomy.DesignQualitative descriptive.MethodsIndividual, nonparticipant observations (n = 16) with eight registered nurse anaesthetists. The observer followed the nurses unobtrusively by shadowing them during the perioperative phase on two separate occasions. The analysis was conducted with a directed content analysis in the light of four predetermined categories, identified in a previous integrative review of patient advocacy in the perioperative setting: protecting, value preserving, supporting and informing.ResultsThe predetermined categories were empirically supported. They were further refined by identifying 11 new subcategories leading to a conceptual extension of the theoretical frame. The registered nurse anaesthetists interacted with the patient and all members of the surgical team when practicing perioperative patient advocacy and the actions were mostly initiated by the registered nurse anaesthetists themselves.ConclusionsThe findings offer a new insight into the registered nurse anaesthetist's professional role. The observations deepen the understanding of the registered nurse anaesthetists’ perioperative patient advocacy actions and can contribute to a more reflective and theory‐oriented view of practice.Relevance to clinical practiceThe results from this study could be used to help registered nurse anaesthetists and their students understand practice in a more complete and insightful way.
Factors influencing the delivery of the fundamentals of care: Perceptions of nurses, nursing leaders and healthcare consumers
Authors: Conroy Tiffany 
Published: November 2017

Aims and objectivesTo explore the factors described by nurses and consumer representatives influencing the delivery of the fundamentals of care.BackgroundAn ongoing challenge facing nursing is ensuring the “basics” or fundamentals of care are delivered optimally. The way nurses and patients perceive the delivery of the fundamentals of care had not been explored. Once identified, the factors that promote the delivery of the fundamentals of care may be facilitated.DesignInductive content analysis of scenario based focus groups.MethodsA qualitative approach was taken using three stages, including direct observation, focus groups and interviews. This paper reports the second stage. Focus groups discussed four patient care scenarios derived from the observational data. Focus groups were conducted separately for registered nurses, nurses in leadership roles and consumer representatives. Content analysis was used.ResultsThe analysis of the focus group data resulted in three themes: Organisational factors; Individual nurse or patient factors; and Interpersonal factors. Organisational factors include nursing leadership, the context of care delivery and the availability of time. Individual nurse and patient factors include the specific care needs of the patient and the individual nurse and patient characteristics. Interpersonal factors include the nurse–patient relationship; involving the patient in their care, ensuring understanding and respecting choices; communication; and setting care priorities.ConclusionsSeeking the perspective of the people involved in delivering and receiving the fundamentals of care showed a shared understanding of the factors influencing the delivery of the fundamentals of care. The influence of nursing leadership and the quality of the nurse–patient relationship were perceived as important factors.Relevance to clinical practiceNurses and consumers share a common perspective of the factors influencing the delivery of the fundamentals of care and both value a therapeutic nurse–patient relationship. Clinical nursing leaders must understand the impact of their role in shaping the delivery of the fundamentals of care.
Outcomes of primary percutaneous coronary intervention in acute myocardial infarction due to unprotected left main thrombosis: The Asia‐Pacific Left Main ST‐Elevation Registry (ASTER)
Authors: Yap Jonathan , Singh Gagan D. , Kim Jung‐Sun , Soni Krishan , Chua Kelvin , Neo Alvin , Koh Choong Hou , Armstrong Ehrin J. , Waldo Stephen W. , Shunk Kendrick A. , Low Reginald I. , Hong Myeong‐Ki , Jang Yangsoo , Yeo Khung Keong 
Published: November 2017

IntroductionPrior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST‐elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).MethodsThe Asia‐pacific left main ST‐Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States. The registry included patients presenting with STEMI due to an ULM coronary artery culprit lesion who underwent emergency PCI. The primary outcome was in‐hospital mortality. Secondary outcomes included major adverse cardiovascular events.ResultsA total of 67 patients (mean age 64.2 ± 12.8 years, 53 [79.1%] males) were included. The distal left main bifurcation was most commonly involved (85%, n = 57). Fifty one (76%) patients had TIMI 3 flow post‐PCI. The in‐hospital mortality rate was 47.8% (n = 32); 61% (n = 41) had cardiac failure, 4% (n = 3) had emergency coronary artery bypass grafting, 1% (n = 1) had a re‐infarction, 3% (n = 2) had stroke and 55% (n = 37) had malignant ventricular arrhythmias. On multivariate analysis, predictors of in‐hospital mortality included older age (odds ratio (OR) 1.085 (95% confidence interval (CI) 1.002‐1.175), P = 0.044), diabetes mellitus (OR 10.882 (95%CI 11.074‐110.287), P = 0.043) and absence of post‐PCI TIMI 3 flow (OR 71.429 (95%CI 2.985‐1000), P = 0.008).ConclusionsSTEMI from culprit unprotected left main coronary artery stenosis is associated with significant mortality and morbidity. Emergency PCI provides an important treatment option in this high‐risk group, but in‐hospital mortality remains high.
Association between a single‐nucleotide polymorphism in the GREM1 gene and non‐syndromic orofacial cleft in the Chinese population
Authors: Wang Xiaotong , Song Hongquan , Jiao Xiaohui , Hao Yanru , Zhang Wei , Gao Yuwei , Li Yong , Mi Na , Yan Jiaqun 
Published: November 2017

BackgroundNon‐syndromic orofacial cleft (NSOC) is a common craniofacial deformity among newborns. The GREM1 gene is correlated with orofacial development. The aim of our study was to investigate the association between a single‐nucleotide polymorphism in the GREM1 gene and this malformation in the Chinese population.MethodsThe SNaPshot mini‐sequencing technique was used to genotype the locus rs1258763 of the GREM1 gene in 331 patients with NSOC and 271 individuals in a control group.ResultsFor GREM1 rs1258763, there was a significant difference between the NSOC case group and control group (P = .022). Children carrying GA and GA/AA genotypes had an increased risk of NSOC (OR=1.62, 95%CI: 1.15‐2.30; OR=1.52, 95%CI: 1.09‐2.12). In the cleft subgroup, we found that the GREM1 rs1258763 GA genotype might contribute to the elevated risk of the cleft lip with or without cleft palate (CL/P) (P = .029). Non‐significant differences were found between the cleft palate only (CPO) and control groups (P = .077).ConclusionOur findings revealed that the GREM1 polymorphism was significantly associated with the risk of NSOC in the Chinese population.
Position Accuracy of Implant Analogs on 3D Printed Polymer versus Conventional Dental Stone Casts Measured Using a Coordinate Measuring Machine
Authors: Revilla‐León Marta , Gonzalez‐Martín Óscar , Pérez López Javier , Sánchez‐Rubio José Luis , Özcan Mutlu 
Published: November 2017

AbstractPurposeTo compare the accuracy of implant analog positions on complete edentulous maxillary casts made of either dental stone or additive manufactured polymers using a coordinate measuring machine (CMM).Material and MethodsA completely edentulous maxillary model of a patient with 7 implant analogs was obtained. From this model, two types of casts were duplicated, namely conventional dental stone (CDS) using a custom tray impression technique after splinting (N = 5) and polymer cast using additive manufacturing based on the STL file generated. Polymer casts (N = 20; n = 5 per group) were fabricated using 4 different additive manufacturing technologies (multijet printing‐MJP1, direct light processing‐DLP, stereolithography‐SLA, multijet printing‐MJP2). CMM was used to measure the correct position of each implant, and distortion was calculated for each system at x‐, y‐, and z‐axes. Measurements were repeated 3 times per specimen in each axis yielding a total of 546 measurements. Data were analyzed using ANOVA, Sheffé tests, and Bonferroni correction (α = 0.05).ResultsCompared to CMM, the mean distortion (μm) ranged from 22.7 to 74.9, 23.4 to 49.1, and 11.0 to 85.8 in the x‐, y‐, and z‐axes, respectively. CDS method (x‐axis: 37.1; z‐axis: 27.62) showed a significant difference compared to DLP on the x‐axis (22.7) (p = 0.037) and to MJP1 on the z‐axis (11.0) (p = 0.003). Regardless of the cast system, x‐axes showed more distortion (42.6) compared to y‐ (34.6) and z‐axes (35.97). Among additive manufacturing technologies, MJP2 presented the highest (64.3 ± 83.6), and MJP1 (21.57 ± 16.3) and DLP (27.07 ± 20.23) the lowest distortion, which was not significantly different from CDS (32.3 ± 22.73) (p > 0.05).ConclusionFor the fabrication of the definitive casts for implant prostheses, one of the multijet printing systems and direct light processing additive manufacturing technologies showed similar results to conventional dental stone. Clinical significance: Conventional dental stone casts could be accurately duplicated using some of the additive manufacturing technologies tested.
DIRECTIONAND INTENSITYOF RISK PREFERENCEATTHE THIRD ORDER
Authors: Keenan Donald C. , Snow Arthur 
Published: November 2017

ABSTRACTIn expected utility theory, aversion to risk, greater aversion, and the desire to substitute away from risk are each characterized by properties of the Arrow–Pratt index of absolute risk aversion, with comparative statics implications for such decisions as saving. At the third order, however, no single index suffices. We contrast alternative indices of third‐order risk preference and show that the substitution effect of downside risk is governed by the Schwarzian, and that where the degree of prudence governs the magnitude of precautionary saving, the Schwarzian governs the effect of background risk on the marginal rate of time preference.
The treatment of pyloric stenosis: Evolution in practice
Authors: Taghavi Kiarash , Powell Emma , Patel Bhaveshkumar , McBride Craig A 
Published: November 2017

AbstractOver the last hundred years, idiopathic hypertrophic pyloric stenosis has undergone an evolution in treatment, with subsequent improvements in outcome. Initially, it was treated by physicians with antispasmodics and various alternative feeding and resuscitation modalities. The evolution of surgical approaches led to a revolution in outcome, from almost certain death to complete cure. The progression of surgical and medical treatments is reviewed in this article until, ultimately, Ramstedt's pyloromyotomy is reached. This distilled operation has remained the gold‐standard procedure for over a century.
Five lessons in uncomplicated appendicitis: Can we remove the surgery?
Authors: Read Andrew , Xu Jane , Adams Susan , Karpelowsky Jonathan 
Published: November 2017

AbstractAppendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in uncomplicated appendicitis, with early paediatric trials demonstrating that antibiotic‐only therapy can be safe and effective. Further rigorously designed and appropriately powered studies are necessarily to establish the place of non‐operative management of uncomplicated appendicitis in the future.
Undescended testis: What paediatricians need to know
Authors: Hutson John M , Vikraman Jaya , Li Ruili , Thorup Joergen 
Published: November 2017

AbstractUndescended testis (UDT) occurs when something goes wrong with testicular descent from high in the abdominal cavity to the scrotum. Normal descent occurs in two steps, with the transabdominal phase controlled by a new testicular hormone, insulin‐like hormone 3, and the inguinoscrotal phase controlled by androgens. The latter phase requires a complex process of migration from the inguinal abdominal wall to the scrotum and is commonly defective, leading to the high incidence (2–4%) of UDT at birth. The clinical examination of babies and infants aims to confirm the persistence of congenital UDT by 3–6 months, so surgery can be optimally timed at 6–12 months. For those boys who develop acquired UDT later in childhood, the ‘ascending’ testis often needs surgery between 5 years and 10 years, so all boys should be screened again for UDT at school entry.
Common paediatric conditions of the lower limb
Authors: Dobbe Ashlee M , Gibbons Paul J 
Published: November 2017

AbstractGrowing children are susceptible to a number of disorders to their lower extremities of varying degrees of severity. The diagnosis and management of these conditions can be challenging. With musculoskeletal symptoms being one of the leading reasons for visits to general practitioners, a working knowledge of the basics of these disorders can help in the appropriate diagnosis, treatment, counselling, and specialist referral. This review covers common disorders affecting the hip, the knee and the foot. The aim is to assist general practitioners in recognising developmental norms and differentiating physiological from pathological conditions and to identify when a specialist referral is necessary.
Endocannabinoids modulate Gq/11 protein-coupled receptor agonist-induced vasoconstriction via a negative feedback mechanism
Authors: Karpińska Olga , Baranowska-Kuczko Marta , Kloza Monika , Kozłowska Hanna 
Published: November 2017

Abstract

Objectives
The endocannabinoid (eCB) system centrally and peripherally regulates cardiovascular parameters, including blood pressure, in health and disease. The relationship between Gq/11 protein-coupled receptor activation, regulation of eCBs release (mainly 2-arachidonoylglycerol) and subsequent CB1 receptor activation was initially observed in the central nervous system. Here, we review the latest findings from systemic physiological studies which include for the first time data from pulmonary arteries. We present evidence for direct CB1-dependent cannabinoid ligand-induced vasorelaxation, vascular expression of eCBs along with their degradation enzymes, and indicate the location of the described interaction.

Key findings
Endocannabinoids (mainly 2-arachidonoylglycerol), acting via CB1 receptors, evoke vasodilatory effects and may modulate responses of vasoconstrictors for Gq/11 protein-coupled receptors including angiotensin II, thromboxane A2, phenylephrine, noradrenaline in systemic or pulmonary arteries. However, the role of the endothelium in this interaction is not well-established, and the precise vascular location of eCB system components remains unclear, which contributes to discrepancies in the interpretation of results when describing the above-mentioned relationship.

Summary
Endocannabinoid's negative feedback is responsible for diminishing agonist-induced vasoconstriction, which may be clinically important in the treatment of arterial and pulmonary hypertension. Further research is required to establish the importance of the eCB system and its downstream signalling pathways.