bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family members' experience of intensive care unit support group: qualitative analysis of intervention
Authors: Kirshbaum‐Moriah Dvora , Harel Chaya , Benbenishty Julie 
Published: December 2016

ABSTRACTBackgroundFamily members of intensive care unit patients develop anxiety, depression and/or symptoms suggestive of risk for post‐traumatic stress. Nurse‐led support groups have been recommended and used in a variety of settings as a mechanism to help meet family needs and overcome challenges. These groups have been reported to increase the members' understanding of complex medical issues involved in their situations and to be helpful in identifying practical coping mechanisms.AimTo investigate the experiences of family members participating in a nurse‐social worker led support group in the intensive care unit.MethodStudy design: prospective collection of family narratives during support group meetings. A qualitative analysis was done of the narratives of weekly routine nurse‐social worker led support group for family members of intensive care unit patients. The meeting contents are documented and related in the nursing notes.Setting: level 1 trauma centre, at a university hospital, with 13‐bed intensive care unit. During the past 3 years this family support group has been providing routine intervention with the purpose of calming the families of intensive care unit patients during crisis situations by utilizing nurse, social worker and group dynamics.ResultsA qualitative analysis was performed on the content of support group dynamics. The principal themes found were Behavioural, Perceptual, Emotional and Supportive.ConclusionsThe family support group provides the participants with a ‘tool box’ of coping mechanisms, which they can choose from in this current unfamiliar crisis event. The group provides a supportive environment, mutuality, a sense of belonging, needs of community, unconditional acceptance and information provision for the participants in the group.Relevance to clinical practiceIn order to provide support for several families, nurses can use the family support group intervention as an effective technique in reaching as many families as possible. Narratives from family members during group meetings may be a good information source providing insights for nursing guidance and patient/family education.
JAZ2 controls stomata dynamics during bacterial invasion
Authors: Gimenez‐Ibanez Selena , Boter Marta , Ortigosa Andrés , García‐Casado Gloria , Chini Andrea , Lewsey Mathew G. , Ecker Joseph R. , Ntoukakis Vardis , Solano Roberto 
Published: December 2016

Summary

Coronatine (COR) facilitates entry of bacteria into the plant apoplast by stimulating stomata opening. COR‐induced signaling events at stomata remain unclear. We found that the COR and jasmonate isoleucine (JA‐Ile) co‐receptor JAZ2 is constitutively expressed in guard cells and modulates stomatal dynamics during bacterial invasion

We analyzed tissue expression patterns of AtJAZ genes and measured stomata opening and pathogen resistance in loss‐ and gain‐of‐function mutants.

Arabidopsis jaz2 mutants are partially impaired in pathogen‐induced stomatal closing and more susceptible to Pseudomonas. Gain‐of‐function mutations in JAZ2 prevent stomatal reopening by COR and are highly resistant to bacterial penetration. The JAZ2 targets MYC2, MYC3 and MYC4 directly regulate the expression of ANAC19, ANAC55 and ANAC72 to modulate stomata aperture. Due to the antagonistic interactions between the salicylic acid (SA) and JA defense pathways, efforts to increase resistance to biotrophs result in enhanced susceptibility to necrotrophs, and vice versa. Remarkably, dominant jaz2Δjas mutants are resistant to Pseudomonas syringae but retain unaltered resistance against necrotrophs.

Our results demonstrate the existence of a COI1‐JAZ2‐MYC2,3,4‐ANAC19,55,72 module responsible for the regulation of stomatal aperture that is hijacked by bacterial COR to promote infection. They also provide novel strategies for crop protection against biotrophs without compromising resistance to necrotrophs.
Validation of an instrument to measure moral distress within the Australian residential and community care environments
Authors: Burston Adam , Eley Robert , Parker Deborah , Tuckett Anthony 
Published: December 2016

Aim and objectivesThe aim of this study was to gain insight into the experience of moral distress within the aged care workforce. The objective of this study was to use and validate an existing instrument to measure moral distress within the aged care setting.BackgroundMoral distress, a phenomenon associated with worker satisfaction and retention, is common within nursing. Instruments to measure moral distress exist; however, there are no validated instruments to measure moral distress within an aged care setting.Design and methodAn existing instrument, the Moral Distress Scale (Revised) was identified and amended. Amendments were subject to expert review for face and content validity. Data were collected from aged care nurses working in residential and community aged care, in Australia. Reliability was assessed using Cronbach's alpha with exploratory factor analysis undertaken for construct validity.Results106 participants completed the survey, 93 (87.7%) identified as female and 13 (12.3%) male. Participants ranged in age from 21 to 73 years, with a mean time working in nursing of 20.6 years. The frequency component of the instrument demonstrated an alpha of 0.89, the intensity component 0.95 and the instrument as a whole 0.94. Three factors were identified and labelled as: Quality of Care, Capacity of Team and Professional Practice. Mean scores indicate a low occurrence of moral distress, but this distress, when experienced, was felt with a moderate level of intensity. Primary causes of moral distress were insufficient staff competency levels, poor quality care because of poor communication and delays in implementing palliation.ConclusionThe instrument demonstrates validity and reliability within the Australian aged care setting. Further analysis with larger populations is required to support these findings.Implications for practiceAustralian aged care workers do experience moral distress. They suffer adverse consequences of this distress and quality of care is negatively impacted. This newly validated instrument can be used to quantify the occurrence of moral distress and to inform targeted interventions to reduce the occurrence and intensity of the experience.
Predicting outcomes of restored Everglades high flow: a model system for scientifically managed floodplains
Authors: Choi Jay , Harvey Jud W. 
Published: December 2016

AbstractRestoration of higher flows through the Everglades is intended to reestablish sheetflow to rebuild a well‐functioning ridge and slough landscape that supports a productive and diverse ecosystem. Our objective of the study was to use hydrologic simulations and biophysical analysis to predict restoration outcomes for five major subbasins of the Everglades. Five different scenarios of restoration were examined, and for each we predicted an outcome based on metrics describing the present‐day condition of the landscape and additional metrics determined by modeling the hydrologic changes accompanying restoration. Restoration scenarios spanned from a baseline case with average annual flows of about 52% of the predrainage flow to the most aggressive scenario that permits 91% of the predrainage flow. Our predictions indicated that all restoration scenarios could benefit the functionality of the ridge‐slough ecosystem. However, the difference between any single restoration scenario and the “no restoration” baseline was far greater than was the difference between any two levels of restoration. Interestingly, our analysis suggested that the most extensive (and highest cost) restoration scenarios are not likely to improve ridge and slough function more than less extensive restoration options. However, the value of more aggressive restoration may lie in factors not considered directly in our analysis. For example, an important reason to implement the more aggressive restoration scenarios could be additional flexibility that permitting greater flow allows for adaptively managing the ecosystem while also serving water needs for southeastern Florida in what could be a drier Everglades in the coming decades.
Intraocular sarcoma associated with lens capsule rupture and persistent hyperplastic primary vitreous in a dog
Authors: Graham Kathleen L. , Krockenberger Mark B. , Billson F. Mark 
Published: December 2016

AbstractThis case report describes the clinical findings and ocular pathology in an adult Golden Retriever diagnosed with an intraocular sarcoma. Nineteen s prior to diagnosis with a lens capsule rupture and intraocular sarcoma, the dog was diagnosed with persistent hyperplastic primary vitreous and uveitis based on clinical signs and the ultrasonographic appearance of the eye. Two years after enucleation, there was no evidence of metastatic spread of the sarcoma. The immunohistochemical characteristics of the tumor as well as the limitations and supportive evidence used in attempting to identify the histogenesis of the tumor are outlined.
Activities of Omadacycline and Comparator Agents against Staphylococcus aureus Isolates from a Surveillance Program Conducted in North America and Europe
Authors: Pfaller Michael A. , Rhomberg Paul R. , Huband Michael D. , Flamm Robert K. 
Published: December 2016

ABSTRACT

Omadacycline is a new broad-spectrum aminomethylcycline in late-stage clinical development for acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia as a once-daily formulation taken orally or intravenously. In this study, omadacycline and comparator agents were tested against 502 isolates of
Staphylococcus aureus
selected from a 2014 global surveillance program, and the results were compared with those for 7,740 isolates from a 2010 surveillance program. For the 2014 isolates, testing was completed on 252 isolates from Europe and 250 isolates from North America. Each set of isolates was composed of ∼100 hospital-acquired methicillin-resistant
Staphylococcus aureus
(HA-MRSA) isolates (isolated >48 h after hospital admission), 100 community-acquired MRSA (CA-MRSA) isolates (isolated <48 h after hospital admission), and 50 methicillin-susceptible
S. aureus
(MSSA) isolates. The omadacycline MIC
50
and MIC
90
for all
S. aureus
collected during 2014 was 0.12 and 0.12 μg/ml, respectively. The MIC
90
values were identical for MRSA, HA-MRSA, and CA-MRSA (0.12 μg/ml). The MIC
90
values for isolates from 2010 for
S. aureus
, MRSA, and CA-MRSA were 0.25 μg/ml (0.5 μg/ml for HA-MRSA; 87.8% were at ≤0.25 μg/ml). All 2014 and 2010 MRSA isolates were susceptible to vancomycin, and ≥99.8% were susceptible to daptomycin, linezolid, and tigecycline. The activity of omadacycline was similar for North American and European isolates, including MRSA (CA-MRSA or HA-MRSA). There was no evidence for emerging resistance to omadacycline between 2010 and 2014. The potent activity of omadacycline against
S. aureus
indicates that omadacycline merits further study in serious infections where multidrug resistance may be a concern.
Imaging of Borrelia turicatae Producing the Green Fluorescent Protein Reveals Persistent Colonization of the Ornithodoros turicata Midgut and Salivary Glands from Nymphal Acquisition through Transmission
Authors: Krishnavajhala Aparna , Wilder Hannah K. , Boyle William K. , Damania Ashish , Thornton Justin A. , Pérez de León Adalberto A. , Teel Pete D. , Lopez Job E. 
Published: December 2016

ABSTRACT

Relapsing fever (RF) spirochetes colonize and are transmitted to mammals primarily by
Ornithodoros
ticks, and little is known regarding the pathogen's life cycle in the vector. To further understand vector colonization and transmission of RF spirochetes,
Borrelia turicatae
expressing a green fluorescent protein (GFP) marker (
B. turicatae-gfp
) was generated. The transformants were evaluated during the tick-mammal infectious cycle, from the third nymphal instar to adult stage.
B. turicatae-gfp
remained viable for at least 18 months in starved fourth-stage nymphal ticks, and the studies indicated that spirochete populations persistently colonized the tick midgut and salivary glands. Our generation of
B. turicatae-gfp
also revealed that within the salivary glands, spirochetes are localized in the ducts and lumen of acini, and after tick feeding, the tissues remained populated with spirochetes. The
B. turicatae-gfp
generated in this study is an important tool to further understand and define the mechanisms of vector colonization and transmission.

IMPORTANCE
In order to interrupt the infectious cycle of tick-borne relapsing fever spirochetes, it is important to enhance our understanding of vector colonization and transmission. Toward this, we generated a strain of
Borrelia turicatae
that constitutively produced the green fluorescent protein, and we evaluated fluorescing spirochetes during the entire infectious cycle. We determined that the midgut and salivary glands of
Ornithodoros turicata
ticks maintain the pathogens throughout the vector's life cycle and remain colonized with the spirochetes for at least 18 months. We also determined that the tick's salivary glands were not depleted after a transmission blood feeding. These findings set the framework to further understand the mechanisms of midgut and salivary gland colonization.
Novel Observations in 11 Heteroresistant Vancomycin-Intermediate Methicillin-Resistant Staphylococcus aureus Strains from South India
Authors: Bakthavatchalam Yamuna Devi , Veeraraghavan Balaji , Peter John Victor , Rajinikanth Janakiraman , Inbanathan Francis Yesurajan , Devanga Ragupathi Naveen Kumar , Rajamani Sekar Suresh Kumar 
Published: December 2016

ABSTRACT

We report here the draft genome sequences of 11 heteroresistant vancomycin-intermediate
Staphylococcus aureus
(hVISA) strains from bloodstream infection. All strains harbor mutations in
vraSR
,
graSR
,
walKR
, and/or
tcaRAB
and are often implicated as the frequently mutated candidate genes in hVISA phenotypes.
Conserved ABC Transport System Regulated by the General Stress Response Pathways of Alpha- and Gammaproteobacteria
Authors: Herrou Julien , Willett Jonathan W. , Czyż Daniel M. , Babnigg Gyorgy , Kim Youngchang , Crosson Sean 
Published: December 2016

ABSTRACT

Brucella abortus
σ
E1
is an EcfG family sigma factor that regulates the transcription of dozens of genes in response to diverse stress conditions and is required for maintenance of chronic infection in a mouse model. A putative ATP-binding cassette transporter operon,
bab1_0223-bab1_0226
, is among the most highly activated gene sets in the σ
E1
regulon. The proteins encoded by the operon resemble quaternary ammonium-compatible solute importers but are most similar in sequence to the broadly conserved YehZYXW system, which remains largely uncharacterized. Transcription of
yehZYXW
is activated by the general stress sigma factor σ
S
in
Enterobacteriaceae
, which suggests a functional role for this transport system in bacterial stress response across the classes
Alphaproteobacteria
and
Gammaproteobacteria
. We present evidence that
B. abortus
YehZYXW does not function as an importer of known compatible solutes under physiological conditions and does not contribute to the virulence defect of a σ
E1
-null strain. The sole
in vitro
phenotype associated with genetic disruption of this putative transport system is reduced growth in the presence of high Li
+
ion concentrations. A crystal structure of
B. abortus
YehZ revealed a class II periplasmic binding protein fold with significant structural homology to
Archaeoglobus fulgidus
ProX, which binds glycine betaine. However, the structure of the YehZ ligand-binding pocket is incompatible with high-affinity binding to glycine betaine. This is consistent with weak measured binding of YehZ to glycine betaine and related compatible solutes. We conclude that YehZYXW is a conserved, stress-regulated transport system that is phylogenetically and functionally distinct from quaternary ammonium-compatible solute importers.

IMPORTANCE
Brucella abortus
σ
E1
regulates transcription in response to stressors encountered in its mammalian host and is necessary for maintenance of chronic infection in a mouse model. The functions of the majority of genes regulated by σ
E1
remain undefined. We present a functional/structural analysis of a conserved putative membrane transport system (YehZYXW) whose expression is strongly activated by σ
E1
. Though annotated as a quaternary ammonium osmolyte uptake system, experimental physiological studies and measured ligand-binding properties of the periplasmic binding protein (PBP), YehZ, are inconsistent with this function. A crystal structure of
B. abortus
YehZ provides molecular insight into differences between bona fide quaternary ammonium osmolyte importers and YehZ-related proteins, which form a distinct phylogenetic and functional group of PBPs.
Does increased duration of consultant presence affect length of hospital stay for unplanned admissions in acute paediatrics?: an observational before-and-after analysis using administrative healthcare data
Authors: Cromb Daniel , Carter Chris , Lemer Claire , Cheung C Ronny 
Published: December 2016

ObjectivesThis study aims to review whether implementation of increased duration of consultant presence is associated with reduction in length of hospital stay (LoS) in children with an unplanned admission to hospital.Method (design/setting/participants/interventions/outcome measures)An observational before-and-after study of all unplanned general paediatric admissions to a UK hospital between 1 September 2012 and 31 August 2015, comparing LoS and readmission rates before and after implementation of a policy mandating consultant review within 12 hours of unplanned hospital admission.Results5367 inpatient admissions were analysed: 3386 prior to implementation of the policy and 1981 afterwards. There was no significant difference in median LoS between the two groups or in readmission rates at 24 hours, 48 hours or 7 days. However, among children who stayed in hospital for under 24 hours, and those who were discharged with a diagnosis of acute gastroenteritis, consultant review within 12 hours of admission was associated with a shorter LoS—respectively, 16 hours 23 min versus 15 hours 45 min (p=0.01) and 28 hours 46 min versus 19 hours 41 m (p<0.01).ConclusionsIncreased duration of consultant presence was not associated with significant impact on LoS, other than in admissions of brief duration and in gastroenteritis, where diagnosis is based on clinical judgement in the absence of objective diagnostic thresholds. Future studies should focus on whether these results are generalisable across other settings, and other measures of cost-effectiveness of early consultant review, given the major implications on resource and workforce planning of such policies.
Shape of the association between income and mortality: a cohort study of Denmark, Finland, Norway and Sweden in 1995 and 2003
Authors: Mortensen Laust H , Rehnberg Johan , Dahl Espen , Diderichsen Finn , Elstad Jon Ivar , Martikainen Pekka , Rehkopf David , Tarkiainen Lasse , Fritzell Johan 
Published: December 2016

ObjectivesPrior work has examined the shape of the income–mortality association, but work has not compared gradients between countries. In this study, we focus on changes over time in the shape of income–mortality gradients for 4 Nordic countries during a period of rising income inequality. Context and time differentials in shape imply that the relationship between income and mortality is not fixed.SettingPopulation-based cohort study of Denmark, Finland, Norway and Sweden.ParticipantsWe collected data on individuals aged 25 or more in 1995 (n=12.98 million individuals, 0.84 million deaths) and 2003 (n=13.08 million individuals, 0.90 million deaths). We then examined the household size equivalised disposable income at the baseline year in relation to the rate of mortality in the following 5 years.ResultsA steep income gradient in mortality in men and women across all age groups except the oldest old in Denmark, Finland, Norway and Sweden. From the 1990s to 2000s mortality dropped, but generally more so in the upper part of the income distribution than in the lower part. As a consequence, the shape of the income gradient in mortality changed. The shift in the shape of the association was similar in all 4 countries.ConclusionsA non-linear gradient exists between income and mortality in most cases and because of a more rapid mortality decline among those with high income the income gradient has become steeper over time.
Introduction of standard measles vaccination in an urban African community in 1979 and overall child survival: a reanalysis of data from a cohort study
Authors: Mogensen Søren Wengel , Aaby Peter , Smedman Lars , Martins Cesário L , Rodrigues Amabelia , Benn Christine S , Ravn Henrik 
Published: December 2016

ObjectiveTo examine the effect of the first introduction of measles vaccine (MV) in Guinea-Bissau in 1979.SettingUrban community study of the anthropometric status of all children under 6 years of age.ParticipantsThe study cohort included 1451 children in December 1978; 82% took part in the anthropometric survey. The cohort was followed for 2 years.InterventionIn December 1979, the children were re-examined anthropometrically. The participating children, aged 6 months to 6 years, were offered MV if they did not have a history of measles infection. There were no routine vaccinations in 1979–1980.Primary and secondary outcome measuresAge-adjusted mortality rate ratios (MRRs) for measles vaccinated and not vaccinated children; changes in nutritional status.ResultsThe nutritional status deteriorated significantly from 1978 to 1979. Nonetheless, children who received MV at the December 1979 examination had significantly lower mortality in the following year (1980) compared with the children who had been present in the December 1978 examination but were not measles vaccinated. Among children still living in the community in December 1979, measles-vaccinated children aged 6–71 months had a mortality rate of 18/1000 person-years during the following year compared with 51/1000 person-years for absent children who were not measles vaccinated (MRR=0.30 (0.12–0.73)). The effect of MV was not explained by prevention of measles infection as the unvaccinated children did not die of measles infection.ConclusionsMV may have beneficial non-specific effects on child survival not related to the prevention of measles infection.