bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of nurse case managers within a central discharge planning role of collaboration between physicians, patients and other healthcare professionals: A sociocultural qualitative study
Authors: Thoma Jorun E , Waite Marion A 
Published: November 2017

Aims and objectivesTo gain knowledge of nurse case managers’ experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role; further to learn about patients’ assignment to the management of the nurse case managers; and explicitly to explore critical incidences of interactions between nurse case managers, patients and healthcare practitioner in discharge planning to understand the factor that contributes to effective collaboration.Background and purposeThe defined role of nurse case managers in many contexts is a patient‐centred responsibility for a central task of discharge management of patients with complex physical and social needs. Some studies have indicated that the general impact of the role reduces readmission rates. Given the necessity to work interprofessionally to achieve a safe discharge, little is known about how nurse case managers achieve this collaboratively.MethodsA qualitative case study within a German teaching hospital of nurse case managers (N = 8). Data were collected through semi‐structured interviews prompted by a critical incident technique and rigorously analysed through the lenses of sociocultural theory.ResultsConsistent object being worked upon was a safe and effective discharge from hospital with a focus on patient advocacy. Significant themes were a self‐value or recognition by others of professional expertise, reciprocal value on the capabilities of others thorough relational expertise and negotiation with patients and an identification of case trajectories.ConclusionMore continuity of nurse case managers’ care and management, clarity of role and transparency to peers, physicians and other professionals would be beneficial in ensuring appropriate referral of complex patients to nurse case managers responsibility.Relevance to clinical practiceClearer role description and benefit realisation of the nurse case managers could be achieved by interventions that are interprofessional and focus on the tasks that matter from a collaborative perspective. This could lead to refinement of available indicators and policy developments.
Positive effect on patient experience of video information given prior to cardiovascular magnetic resonance imaging: A clinical trial
Authors: Ahlander Britt‐Marie , Engvall Jan , Maret Eva , Ericsson Elisabeth 
Published: November 2017

Aims and objectivesTo evaluate the effect of video information given before cardiovascular magnetic resonance imaging on patient anxiety and to compare patient experiences of cardiovascular magnetic resonance imaging versus myocardial perfusion scintigraphy.To evaluate whether additional information has an impact on motion artefacts.BackgroundCardiovascular magnetic resonance imaging and myocardial perfusion scintigraphy are technically advanced methods for the evaluation of heart diseases. Although cardiovascular magnetic resonance imaging is considered to be painless, patients may experience anxiety due to the closed environment.DesignA prospective randomised intervention study, not registered.MethodsThe sample (n = 148) consisted of 97 patients referred for cardiovascular magnetic resonance imaging, randomised to receive either video information in addition to standard text‐information (CMR‐video/n = 49) or standard text‐information alone (CMR‐standard/n = 48). A third group undergoing myocardial perfusion scintigraphy (n = 51) was compared with the cardiovascular magnetic resonance imaging‐standard group. Anxiety was evaluated before, immediately after the procedure and 1 week later. Five questionnaires were used: Cardiac Anxiety Questionnaire, State‐Trait Anxiety Inventory, Hospital Anxiety and Depression scale, MRI Fear Survey Schedule and the MRI‐Anxiety Questionnaire. Motion artefacts were evaluated by three observers, blinded to the information given. Data were collected between April 2015–April 2016. The study followed the CONSORT guidelines.ResultThe CMR‐video group scored lower (better) than the cardiovascular magnetic resonance imaging‐standard group in the factor Relaxation (p = .039) but not in the factor Anxiety. Anxiety levels were lower during scintigraphic examinations compared to the CMR‐standard group (p < .001). No difference was found regarding motion artefacts between CMR‐video and CMR‐standard.ConclusionPatient ability to relax during cardiovascular magnetic resonance imaging increased by adding video information prior the exam, which is important in relation to perceived quality in nursing. No effect was seen on motion artefacts.Relevance to clinical practiceVideo information prior to examinations can be an easy and time effective method to help patients cooperate in imaging procedures.
Job strain in nursing homes—Exploring the impact of leadership
Authors: Backman Annica , Sjögren Karin , Lövheim Hugo , Edvardsson David 
Published: November 2017

Aims and objectivesTo explore the association between nursing home managers' leadership, job strain and social support as perceived by direct care staff in nursing homes.BackgroundIt is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Leadership styles have been associated with job strain in the literature; however, the impact of perceived leadership on staff job strain and social support has not been clarified within nursing home contexts.DesignThis study had a cross‐sectional design.MethodsParticipating staff (n = 3,605) completed surveys which included questions about staff characteristics, valid and reliable measures of nursing home managers' leadership, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted.ResultsNursing home managers' leadership were significantly associated with lower level of job strain and higher level of social support among direct care staff. A multiple regression analysis including an interaction term indicated individual and joint effects of nursing home managers' leadership and social support on job strain.ConclusionsNursing home managers' leadership and social support were both individually and in combination associated with staff perception of lesser job strain. Thus, nursing home managers' leadership are beneficial for the working situation and strain of staff.Relevance to clinical practicePromoting a supporting work environment through leadership is an important implication for nursing home managers as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers can buffer adverse health effects among staff.
The impact of a prolonged stay in the ICU on patients’ fundamental care needs
Authors: Minton Claire , Batten Lesley , Huntington Annette 
Published: November 2017

Aims and objectivesTo explore patients’, families’ and health professionals’ experiences of a long‐stay patient in an intensive care unit.BackgroundThe fast‐paced technologically driven intensive care unit environment, designed for a short patient stay, supports the provision of complex physiologically focused care for those with life‐threatening illnesses. Long‐stay patients with pronounced fundamental care needs fall outside predicted patient pathways, and nurses can find caring for these patients challenging.Design and methodsA longitudinal, qualitative, multicase study of six cases from four New Zealand units. Case participants were patients, family members, nurses and other health professionals. Data collection methods included observation, conversations, interviews and document review. Data were analysed using thematic analysis, vignette development and trajectory mapping.ResultsChallenges and successes of providing fundamental care for long‐stay ICU patients are attributed to two interlinked factors. First, the biomedical model influences ICU nursing practices, resulting in prioritising tasks and technology for patient survival while simultaneously devaluing relational and comfort work. Fundamental psychosocial needs such as family presence, comfort, relationships and communication may be unmet. Second, the unit environment and culture have a significant impact on long‐stay patients’ ICU experiences and form physical and psychological barriers to families being present and involved. Some nurses negotiated these challenges to provide fundamental, patient‐ and family‐centred care by adopting an approach of knowing the patient and these nurses reported satisfaction when seeing patients’ positive responses.ConclusionThe care environment and culture provide challenges to the provision of patient‐ and family‐centred care for long‐stay patients; however, when nurses prioritise knowing their patient these challenges can be overcome and patient and family distress reduced with the potential to improve patient outcomes.Relevance to clinical practiceRecognition that patients have fundamental care needs irrespective of the setting where they receive care. Intensive care environments and cultures create challenges for nurses when there is such a heavy burden of physiological needs to be met and technological tasks to be undertaken, with a focus on acuity; however, improving provision fundamental care can result in positive patient outcomes.
Vascular complications after percutaneous mitral valve repair and venous access closure using suture or closure device
Authors: Steppich Birgit , Stegmüller Felix , Rumpf Philipp Moritz , Pache Jürgen , Sonne Carolin , Lesevic Hasema , Braun Daniel , Hausleiter Jörg , Kasel Albert Markus , Ott Ilka 
Published: November 2017

ObjectiveThe aim of this study was to assess the impact of different access‐site closure strategies, suture or closure device (Proglide, Abbott Vascular), on vascular and bleeding complications after percutaneous mitral valve repair (MitraClip, Abbott Vascular).BackgroundConsidering the high‐risk profile in patients receiving percutaneous mitral valve repair, complications related to the large 24 Fr access sheath and its relation to the closure technique have not been evaluated so far.Methods and ResultsBetween 2009 and 2015, 277 consecutive high‐risk patients with severe mitral valve regurgitation (MR) underwent percutaneous mitral valve repair at our institution using Z‐suture (n = 150) or closure device (n = 127) to close the access‐site. Duplex sonography was performed in all patients. The primary endpoint was access‐site related complications according to the Valve Academic Research Consortium (VARC) criteria. Secondary outcomes were the incidence of bleeding complications and mortality. Access‐site related VARC2 major and minor complications were comparable after closure with Z‐suture or closure device (2,7% vs 3.1%, P = 0.81 and 15,3% vs 15.7%, P = 0.92). Three patients (2%) in the suture and four patients (3.1%) in the closure device group experienced unplanned endovascular intervention at the access site. Access‐site related major bleeding was observed in 4 (2.7%) suture and 4 (3.1%) closure device treated patients (P = 0.81). No access site related mortality occurred.ConclusionBoth Z‐suture and closure device use after percutaneous mitral valve repair are feasible and safe. However, there is no benefit of one strategy over the other according to VARC2 major and minor complications.
Ear, nose and throat surgery: All you need to know about the surgical approach to the management of middle‐ear effusions in Australian Indigenous and non‐Indigenous children
Authors: Kong Kelvin , Lannigan Francis J , Morris Peter S , Leach Amanda J , O'Leary Stephen J 
Published: November 2017

AbstractOtitis media (OM) is a common condition in Australia. It represents a spectrum of diseases from otitis media with effusion (OME) to chronic suppurative otitis media. For all the OM diagnoses, Australian Indigenous children have higher rates of early onset, severe and persistent disease. OME is the most common form of OM and often occurs after an upper respiratory tract infection. It can be difficult to diagnose (and often goes unrecognised). Hearing loss is the most important complication. The middle‐ear effusion impedes the movement of the tympanic membrane and causes a conductive hearing loss of around 25 dB. Around 20% will have a hearing loss exceeding 35 dB. Children with early onset, persistent, bilateral OME and hearing loss (or speech delay) are most likely to benefit from interventions. However, the impact of all the effective treatment options is modest. Giving advice about effective communication strategies for young children is always appropriate. The best evidence from randomised trials supports not using antihistamines and/or decongestants, considering a trial of antibiotics and referral for tympanostomy tubes. Despite the availability of evidence‐based guidelines, giving advice about treatment is a challenge because recommendations vary according to condition, age, risk of complications and parental preference. While most children with OME can be effectively managed in primary care, we need to get children who meet the criteria for simple ear, nose and throat procedures that improve hearing on to ear, nose and throat surgery waiting lists. Long delays in hearing support may contribute to life‐long social and economic disadvantage.
Gastrodin protects myocardial cells against hypoxia/reoxygenation injury in neonatal rats by inhibiting cell autophagy through the activation of mTOR signals in PI3K-Akt pathway
Authors: Li Xiang , Zhu Qinhui , Liu Yuanyuan , Yang Zhiyong , Li Bin 
Published: November 2017

Abstract

Objectives
This study aimed to investigate the protective effect of gastrodin (GAS) on myocardial cells with hypoxia/reoxygenation (H/R) injury in neonatal rats and explore the underlying mechanism.

Methods
Myocardial cells were extracted from neonatal rats and divided into six groups: control, H/R, H/R + Low-Concentration GAS, H/R + Middle-Concentration GAS, H/R + High-Concentration GAS and H/R + High-Concentration GAS + AKT Inhibitor groups. After 48-h treatment, cell viability, autophagosome quantity and the expression levels of LC3-II, p62, Akt, pAkt, mammalian target of rapamycin (mTOR) and uncoordinated 51-like kinase 1 (ULK1) in myocardial cells were made comparisons among each group.

Key findings
Gastrodin improved the proliferation activity of myocardial cells under H/R injury in a dose-dependent manner and inhibited the level of cell autophagy. However, when AKT inhibitor was added, the effect of GAS was partly inhibited (P &lt; 0.05). Gene and protein expressions showed that GAS made no significant effect on the expression quantity of Akt and mTOR genes (P &gt; 0.05) but could significantly promote the phosphorylation of Akt and mTOR (P &lt; 0.05). GAS had significant inhibiting effect on the expression of ULK1 (P &lt; 0.05).

Conclusions
Gastrodin could protect against H/R injury of myocardial cells in neonatal rats by reducing the level of autophagy through the activation of mTOR signals in PI3K-Akt pathway.
Melatonin alleviates low PS I‐limited carbon assimilation under elevated CO2 and enhances the cold tolerance of offspring in chlorophyll b‐deficient mutant wheat
Authors: Li Xiangnan , Brestic Marian , Tan Dun‐Xian , Zivcak Marek , Zhu Xiancan , Liu Shengqun , Song Fengbin , Reiter Russel J. , Liu Fulai 
Published: November 2017

AbstractMelatonin is involved in the regulation of carbohydrate metabolism and induction of cold tolerance in plants. The objective of this study was to investigate the roles of melatonin in modulation of carbon assimilation of wild‐type wheat and the Chl b‐deficient mutant ANK32B in response to elevated CO2 concentration ([CO2]) and the transgenerational effects of application of exogenous melatonin (hereafter identified as melatonin priming) on the cold tolerance in offspring. The results showed that the melatonin priming enhanced the carbon assimilation in ANK32B under elevated [CO2], via boosting the activities of ATPase and sucrose synthesis and maintaining a relatively higher level of total chlorophyll concentration in leaves. In addition, melatonin priming in maternal plants at grain filling promoted the seed germination in offspring by accelerating the starch degradation and improved the cold tolerance of seedlings through activating the antioxidant enzymes and enhancing the photosynthetic electron transport efficiency. These findings suggest the important roles of melatonin in plant response to future climate change, indicating that the melatonin priming at grain filling in maternal plants could be an effective approach to improve cold tolerance of wheat offspring at seedling stage.
Effects of dietary tryptophan levels on performance and biochemical variables of plasma and intestinal mucosa in yellow‐feathered broiler breeders
Authors: Jiang S. Q. , Gou Z. Y. , Lin X. J. , Li L. 
Published: November 2017

SummaryThe effects of dietary tryptophan (Trp) levels on performance and biochemical variables of plasma and intestinal mucosa in broiler breeder hens were investigated in this study. A total of 780 Lingnan yellow‐feathered broiler breeder hens were randomly assigned in one of five dietary treatments with six replicates per treatment (26 birds per replicate). The breeder hens were fed either the basal diet (0.11% Trp) or the basal diet supplemented to 0.15%, 0.19%, 0.23% and 0.27% Trp, from 197 to 259 days of age. Graded levels of Trp from 0.11% to 0.27% in the diet produced quadratic (p < .05) responses in laying rate, average daily egg production, and feed conversion ratio, and quadratic (p < .01) responses in total large follicle weight and average large follicle weight. An increase in fertilization rate of total eggs was observed in breeders fed 0.27% Trp, and hatchability was higher in breeders fed 0.23% and 0.27% Trp than with 0.19% Trp (p < .05). The content of uric acid N decreased with 0.15% and 0.23% dietary Trp (p < .05). The content of GSH and the GSH‐to‐GSSG ratio in plasma were reduced by 0.15%, 0.19% and 0.27% Trp diets (p < .05). A higher activity of GST in plasma was observed with 0.15% Trp in relation to 0.23% and 0.27% Trp (p < .05). The activity of Na+‐K+‐ATPase of plasma in birds fed 0.27% Trp was lower than in those fed 0.15% Trp and the control birds (p < .05). There were significant influences of dietary Trp levels on S6K1, B0AT1, Nrf2, TLR4, TNF‐α and IL‐6 transcripts of ileal mucosa (p < .05). The optimal dietary Trp level was 0.203% or 254 mg per hen per day, for Chinese yellow‐feathered broiler breeder hens aged from 197 to 259 days.
Effectiveness of a virtual reality intervention to minimize pediatric stress and pain intensity during venipuncture
Authors: Piskorz Joanna , Czub Marcin 
Published: November 2017

AbstractPurposeVirtual reality (VR) technology is an effective tool in treatment of acute pain. Numerous studies show the effectiveness of this method both in a clinical context and in the laboratory. However, research results on the effectiveness of VR in pediatric venipuncture pain is not conclusive—not all studies report the analgesic effect of VR. In addition to testing effectiveness of VR, we also assess the usability of a novel hands‐free interface.Design and MethodsPatients of paediatric nephrology clinic (N = 38; mean age 11 years, range 7–17) participated in a posttest only between group quasi‐experimental study. Participants in the treatment group received the venipuncture procedure with VR distraction. They were wearing a head‐mounted Oculus DK2 HMD, and playing a game designed by the authors of the study. The game was based on Multiple Object Tracking (MOT) task, where players have to remember and simultaneously track several moving targets. MOT has been used in many studies on attention and working memory. Participants rated their pain and stress intensity on visual analogue scales (VAS) on a scale of 0 to 100 and answered a short questionnaire.ResultsThe VR group reported significantly lower pain intensity than the controls (mean = 15.16 ± 20.51 vs. 37.05 ± 30.66; t = 2.59, df = 36, p < .02, d = 0.863). Similar results were obtained for stress level (11.16 ±18.58 vs 41.89 ± 40.89; t = 2.98, df = 36, p < .01, d = 0.993). There were no correlations with age.Practice ImplicationsVR can be as an effective tool to minimize pediatric pain and stress due to venipuncture. The MOT‐based VR game was suitable for children at the studied age range. This solution can be easily applied by nurses in their clinical practice.
Phenylbutazone induces equine glandular gastric disease without decreasing prostaglandin E2concentrations
Authors: Pedersen S. K. , Cribb A. E. , Read E. K. , French D. , Banse H. E. 
Published: November 2017

In equids, phenylbutazone at high doses induces gastric disease, primarily in the glandular portion of the stomach. However, the mechanism of nonsteroidal anti‐inflammatory drug (NSAID)‐induced gastric disease in horses has yet to be determined. While phenylbutazone‐associated ulceration is often attributed to a decrease in basal gastric prostaglandins, this has not been demonstrated in the horse. Twelve horses were randomly assigned to treatment (n = 6; 4.4 mg/kg phenylbutazone PO in 20 ml molasses q 12 hr for 7 days) or placebo (n = 6; 20 ml molasses PO q 12 hr for 7 days) groups. Before treatment and 3 and 7 days after initiation of treatment, gastroscopy was performed and glandular gastric biopsies were collected and frozen at −80°C. Glandular disease was assessed on a scale of 0–4. Prostaglandin E2concentrations in biopsies were measured using a commercially available enzyme‐linked immunosorbent assay. All phenylbutazone‐treated horses developed grade ≥2 glandular disease. Prostaglandin concentrations increased over time (p = .0017), but there was no effect of treatment (p = .49). These findings indicate that despite induction of glandular disease grade ≥2, phenylbutazone did not decrease basal glandular gastric prostaglandin E2concentration.
Ichthyosaurian palaeopathology: evidence of injury and disease in fossil ‘fish lizards’
Authors: Pardo‐Pérez J. M. , Kear B. P. , Gómez M. , Moroni M. , Maxwell E. E. 
Published: November 2017

AbstractThe documented record of ichthyosaurian paleopathologies reveals an array of injury‐related bone modifications and instances of disease evidenced through multiple clades, skeletal regions and body‐size classes from the Middle Triassic to middle Cretaceous. Examples include traumatic injuries, as well as a high incidence of articular diseases, including avascular necrosis. Forelimb pathologies are particularly abundant (65% of total reported), and the glenoid region seems to have been especially prone to articular disease. In contrast, pathologies affecting the vertebral column are comparatively underrepresented (6% of reported pathologies). Also notable is the disproportionate commonality of osteopathologies in ichthyosaurian taxa between 2 and 6 m in length (54%), as opposed to demonstrably larger (31%) or smaller bodied (15%) species. Furthermore, osteopathologies are almost exclusively described from skeletally mature individuals, and are best known from taxa of Jurassic age (78%), versus those from the Triassic (15%) or Cretaceous (7%); this likely reflects biases in the ichthyosaurian fossil record through time. Ichthyosaurs evince remarkable similarities in the types of observed skeletal damage relative to other ecologically similar marine amniotes – especially cetaceans and mosasaurid squamates, all of which potentially exhibited equivalent palaeoecological and/or behavioural adaptations for life in aqueous environments. Notably, however, the unusually low frequency of vertebral pathologies in ichthyosaurs is peculiar, and requires further investigation to establish significance.