bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing overnight hospital admissions: an audit and literature review
Authors: Rose Pat , Gardner Sandra 
Published: May 2014

This paper presents the findings of an audit of children staying overnight in a District General Hospital, and examines them in the light of current research. The aim was to establish whether it was possible to reduce overnight stays by identifying the characteristics of the children, and their patterns of medical attention and nursing intervention. An audit of 45 sets of case notes was undertaken by a single investigator. The findings indicated that the majority of children were under three years, and were more likely to attend after mid-day. Initial medical assessment and treatment tended to be by a junior doctor and discharge was more likely to be by a consultant. The number of nursing interventions ranged between two and eight, with 90% (n=45) of the sample receiving five or less. Some inconsistencies were noted between the audit findings and current research, for example in relation to admitting doctor. However, both the audit and related research indicate that overnight stays could be reduced if children are reviewed more frequently, and particularly in the late evening, by a consultant. Neither the audit nor related research identified predictors of which children were likely to stay only one night. The characteristics of the child, including age and medical diagnosis, were not found to be predictors of which children were likely to stay only one night, and which were likely to become more seriously ill. In addition, non-medical factors, such as social circumstances, do not appear to be predictors of length of stay. Recommendations for practice include the establishment of a 24–hour assessment unit for children, and consultant attendance in the late evening. Further research is needed into the precise nature and number of nursing interventions needed by children, and whether these could be delivered at home. Finally, a model for prediction of length of stay needs to be developed.
Can laboratory investigations help us to decide when to discontinue larval therapy?
Authors: Steenvoorde P. , Jukema G.N. 
Published: May 2014

Objective: This study investigated retrospectively whether three laboratory investigations — testing for leucocyte levels, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) — can be used to guide the decision of when to discontinue larval therapy. Method: Between 1999 and 2002 we administered larval therapy to 16 inpatients. In all cases the decision to discontinue therapy was a clinical one made by the surgeon who headed the trauma department. We retrospectively analysed laboratory investigations, testing for leucocyte levels, CRP and ESR, on the first and last days of therapy to ascertain if the results could have guided this decision. Results: The median leucocyte count on the first day of larval therapy was 10.5 (x 10e9/L) compared with 8.4 (x 10e9/L) on the last day (Friedman test: p<0.05). CRP and ESR showed a non-significant tendency towards lower values. Conclusion: Although the methodological limitations of this open-label non-comparative cohort study preclude a definite conclusion, we believe that laboratory investigations, particularly leucocyte count, can guide the decision of when to discontinue larval therapy. However, this objective parameter cannot replace clinical judgement. Declaration of interest: None.
A prospective observational study of the efficacy of a novel hydroactive impregnated dressing
Authors: Meuleneire F. , Zoellner P. , Swerev M. , Holfeld O. , Effing J. , Bapt S. , Tholon N. , Felder E. , Streit B. , Kapp H. , Smola H. 
Published: May 2014

Objective: To assess the clinical efficacy, tolerance and acceptance of a novel, hydroactive-impregnated dressing (Hydrotul) in the local treatment of acute and chronic wounds. Method: In a prospective observational study 24 centres in France, Belgium, Germany and Austria recruited 74 patients. At each dressing change the investigators evaluated the condition of the wound, perilesional skin and patient-reported pain. Overall, five dressing changes were documented, or until complete healing occurred. The hydroactive properties of the dressing were assessed in laboratory tests by measuring fluid absorption capacity and kinetics. Results: Patients were treated for an average of 17 days. The wound condition improved markedly during the observation period. The wound area covered with fibrinous slough decreased from 29% to 14%, epithelialisation increased from 19% to 54% and 22 wounds were completely healed by the end of the study. The number of patients reporting severe and moderate wound pain decreased from 35% to 19% and the proportion of patients without wound pain doubled from 27% to 60%. In laboratory tests, Hydrotul absorbed two to three times the amount of fluid compared with other impregnated wound dressings and the kinetics of absorption was much faster. Conclusion: The novel hydroactive impregnated dressing supports the healing process in patients with acute and chronic wounds and reduces wound pain. The dressing absorbs excess wound exudate while keeping the wound surface moist and protecting perilesional skin. Declaration of interest: This study was sponsored by Paul Hartmann AG, Heidenheim, Germany.
Effect of activated charcoal dressings on healing outcomes of chronic wounds
Authors: Kerihuel J.C. 
Published: May 2014

ObjectiveTo compare the ability of activated charcoal dressings with that of a hydrocolloid dressing to reduce the wound area of chronic wounds.MethodTwo separate randomised controlled trials (RCTs) were undertaken; both used the same hydrocolloid as the control. One RCT compared Actisorb (without silver) with the control on chronic pressure ulcers and the other RCT compared Actisorb Silver 220 with the control on chronic venous leg ulcers. Patients were followed for four weeks. Baseline patient demographic and wound characteristics were comparable between the treatment and control groups. Wounds were assessed at weekly intervals. Ulcers were photographed and then traced by an experienced, independent investigator. Both the reduction in ulcer area and the percentage reduction were calculated.ResultsSixty patients were enrolled into each study, although data for one patient were not available in the pressure ulcer study. There were differences in results at week 1 in favour of the treatment group in both studies, although the results for the two groups in each study were comparable at week 4. Activated charcoal dressing was better tolerated than the control.ConclusionThese clinical data indicate the potential usefulness of using activated charcoal impregnated with silver in the management of chronic wounds, even at the debridement stage. This dressing may help remove fluids and toxins that impair the healing process.Declaration of interestThese studies were sponsored by Systagenix Wound Management.
Clinimetrics of tristimulus colourimeters in scar assessment: a review of evidence
Authors: Jones H.G. 
Published: May 2014

Objective: To review the evidence regarding the use of tristimulus colourimeters (TC) in scar assessment. Method: A literature search was performed using ovid and the Cochrane database with the search terms ‘scar assessment’, ‘clinimetrics’, ‘tristimulus colourimeter’, ‘microcolour’, ‘chromameter’ and ‘colour spectrometer’. Results: Wound colour is usually assessed with a visual analogue scale, such as VSS or POSAS. Research on objectifying the assessment by using an assessment tool has so far been encouraging, but has failed to show a benefit over the visual analogue scales in terms of validity, accuracy and reproducibility. Studies vary in methodological quality. Conclusion: Research on TC clinimetrics has shown moderate to high concurrent validity, reliability and reproducibility of these products in terms of assessing vascularity, but less correlation in terms of pigmentation, when compared with the visual scoring systems. The evidence for using TC is based on a relatively small number of studies, and more research is needed before widespread implementation of TC for assessing scar maturation is recommended. Declaration of interest: The authors have no conflicts of interest to declare. There were no external sources of funding for this report.
Total contact casting combined with human fibroblast-derived dermal tissue in 15 DFU patients
Authors: Kashefsky H , Marston W. 
Published: May 2014

Objective: To investigate the use of a cryopreserved human fibroblast-derived dermal substitute (Dermagraft; DG) in combination with total contact casting (TCC) in patients with diabetic foot ulcers, compared with previously published rates of healing with TCC alone. Method: Fifteen consecutive diabetic foot ulcer patients were referred to a multi-speciality clinic to be managed with a combination of DG and TCC, after showing no progress toward healing following at least 4 weeks of standard, conservative therapy. Follow-up visits were scheduled every 7 days, for a period of 12 weeks, or until fully healed. At each visit, DG and TCC were applied by the investigating clinician, and ulcer size and depth were recorded. Photographs were taken once a month, or when healed. If indicated, debridement was done to remove fibrotic tissue, callus and slough. Results: The results demonstrated an average healing rate of 23.7 ± 16.3 days. The average number of DG applications was 2.1. There was no correlation observed between ulcer duration, or ulcer location (forefoot or mid-foot), and time to healing; however, a correlation was found between wound size and healing time. Conclusion: The findings may suggest combining advanced healing modalities, such as DG with TCC, can be done and that they may have a benefit of limiting the time spent in TCC, as well as a reduction in time to heal. The study size was small and further studies into combining modalities are warranted to validate these findings. Declaration of interest: Both authors have been paid consultants for Advanced Biohealing, the producers of Dermagraft (DG). There are no financial disclosures for Med Efficiency, Inc. (MedE-Kast Ultra; TCC), or any other conflicts of interest to declare.
Retinervus luffae fructus (RLF): a novel material for use in negative pressure wound therapy
Authors: Zuo H.Y. , Chen Y. 
Published: May 2014

Objective: To describe a modified negative pressure wound therapy (NPWT) apparatus, made mainly of an environmentally-friendly material derived from the retinervus luffae fructus (RLF; or loofah) plant. Method: We retrospectively reviewed the charts of patients with skin defects on their limbs who underwent treatment with the RLF-NPWT device from September 2012 to October 2012. The endpoint of the study was healing by secondary intention; the time (days) to endpoint was evaluated. Results: The RLF-NPWT device was used in 16 patients. The age of the patients ranged from 15–82 years, with a mean age of 43±17 years. Six patients sustained crush injuries, nine patients had open limb injuries from motor vehicle accidents and a further patient had a diabetic foot ulcer. The mean time to healing was 8.5±2.4 days. Following RLF-NPWT, fresh granulation tissue was observed in all wound beds, with no evidence of macroscopical necrosis. All 16 patients in the study achieved secondary healing. Conclusion: The environmentally friendly RLF-NPWT apparatus is easy to use and able to provide continual negative pressure for optimal preparation of the wound bed. The cost-effectiveness of RLF-NPWT compared to standard NPWT requires further investigation. Declaration of interest: There were no external sources of funding for this study. The authors have no conflicts of interest to declare.
Qualitative interview study of clinicians’ opinions of which intubation aids to use following a CBRN incident
Authors: Castle Nick 
Published: May 2014

Aim: to ascertain what intubation aids clinicians believed should be consideredfor further evaluation for use while wearing CBRN-PPE Introduction: Intubation remains a key treatment option for the managementof casualties with respiratory failure following a chemical biological radiationnuclear (CBRN) incident. However, CBRN personnel protective equipment (CBRN-PPE) adversely affects intubation performance. To date, only the IntubatingLaryngeal Mask airway has been evaluated as an intubation aid for use whilewearing CBRN-PPE within a randomized control study. Methods: This is a qualitative, interview based study involving 25 clinicians fromvarious backgrounds. All interviewees had previously been involved in a numberof manikin based CBRN-PPE research studies involving airway managementincluding intubation. Results: Five different intubation aids were identified by the interviewees, including the gum elastic bougie, Airtraq™, stylet, Intubating Laryngeal MaskAirway and the McCoy laryngoscope as well as non intubation aids such aspractising intubation techniques while wearing CBRN-PPE, training with regardsto optimal techniques for intubation/airway management while wearing CBRN-PPE, correct/optimal patient position as well as the availability of a skilledassistant. Conclusion: This interviewed opinion based study involving UK clinicianswith experience of performing intubation and other related resuscitationtechniques while wearing CBRN-PPE has identified a number of intubation aidsthat clinicians believe may assist with intubation performance by potentiallyimproving speed and/or intubation success within the CBRN environment.However, the loss of fine motor movement and tactile sensation has beenidentified as a possible limitation of the devices and therefore these intubationaids warrant further evaluation. The role of training in skill performance andsimulation based practise, while wearing CBRN-PPE, also requires furtherinvestigation.
Co-codamol: safely using an effective analgesic
Authors: Greener Mark 
Published: May 2014

Co-codamol (codeine and paracetamol)—which is available in several formulations, including Codipar—is one of the most popular choices for pain management. Co-codamol begins to alleviate pain after 20–30 minutes and analgesia persists for about 4 hours. Adding codeine to paracetamol increases the proportion of patients that report a reduction in pain of at least 50% over 4–6 hours by 10–15%, increases the time to use rescue medication by about 1 hour and reduces the proportion of participants that need rescue medication by about 15% compared with paracetamol alone (Toms et al, 2009). Co-codamol is contraindicated in some groups of patients, causes a variety of adverse events, and misuse can lead to analgesic-related headaches and codeine addiction.Thus, prescribers should remind patients to not ingest more than 4 g paracetamol in 24 hours and not to take over the counter co-codamol for more than 3 days or, in the case of prescription-only formulations, for longer than directed by the prescriber. Despite these caveats, Codipar and other co-codamol formulations are generally well-tolerated and effective members of the analgesic armamentarium. This article aims to help nurse prescribers use Codipar and other co-codamol formulations safely and effectively.
NVQs 30years on: Have we got it right?
Authors: Pooley Pam 
Published: May 2014

Madam, The NVQ in Care was introduced in the 1980s to improve practice in care homes. It was an excellent initiative, enhancing not only practice, but also self-worth for carers. Bell (2004) states that ‘many hoped the introduction of the NVQ in Care would make it easier for home carers to obtain a nationally recognized qualification’ and O'Neill (2004) believes that ‘all staff are eligible for full NVQ training leading to a formal qualification’.
Feline lower urinary tract disease:predisposition, causes and nursing care
Authors: Woolf Karen 
Published: May 2014

Feline lower urinary tract disease (FLUTD) is a common problem in veterinary practice. The causes of and predispositions to FLUTD are often misunderstood and this can lead to recurrence within patients. Sex, weight, diet and stress have all been suggested as factors that increase the risk of a cat developing FLUTD. Males would appear to be more predisposed to FLUTD than females and are regularly over represented in studies of FLUTD cats. Obesity also seems to be a predisposing factor with larger cats more likely to experience FLUTD. However cats that are fed a dry diet do not appear to be significantly more likely to develop FLUTD when compared to those fed a wet diet. Stress would seem to be the most significant inciting factor in the recurrence of FLUTD with much research conducted in this area.
R2 and Idiosyncratic Risk Are Not Interchangeable
Authors: Li Bin , Rajgopal Shivaram , Venkatachalam Mohan 
Published: May 2014

ABSTRACT
A growing literature investigates the association between stock return variation and several aspects of information and governance structures, in both a cross-country setting and a cross-firm setting within the U.S. Papers use either idiosyncratic stock return volatility or R2 as interchangeable measures of firm-specific return variation but report inconsistent results. An important reason for the differing interpretations is the assumption about whether lower R2 (or higher ) captures firm-specific news or noise. We document that higher (or equivalently, lower R2) resembles noise. In addition, we show, analytically and empirically, that different results obtain when using R2 or because the systematic risk inherent in the R2 metric is also correlated with the independent variable of interest. Therefore, we recommend that when assessing the association between R2 (or ) and some independent variable, researchers (1) control for elements of systematic risk and (2) triangulate their findings with other measures of information environment.
Data Availability: The data in this study are available from commercial providers, e.g., WRDS, Compustat, CRSP, I/B/E/S.
Comparing Survey and Sampling Methods for Reaching Sexual Minority Individuals in Flanders
Authors: Dewaele Alexis , Caen Maya , Buysse Ann 
Published: May 2014

Abstract
As part of a large sexual health study, we used two different approaches to target Sexual Minority Individuals (SMIs). Firstly, we drew on a probability sample (1,832 respondents aged 14-80) of the Flemish population in Belgium. Secondly, we set up a targeted sampling design followed by an Internet survey. Our focus was to explore how two different sampling procedures and survey designs could lead to differences in sample characteristics. Results showed that for female SMIs (we excluded male SMIs from the analyses due to their low numbers) the population sample differed from the Internet sample in terms of sociodemographic characteristics (the latter included younger and more highly educated respondents) and scores on sexual orientation dimensions (the population sample included more respondents who didn’t identify as lesbian or bisexual but reported same-sex sexual experiences and desire). Respondents’ scores on sexual health indicators differed between the samples for two of the seven variables. We discuss implications for improving the quality and validity of nonrandom samples.
WACCM climate chemistry sensitivity to sprite perturbations
Authors: Arnone E. , Smith A. K. , Enell C.‐F. , Kero A. , Dinelli B. M. 
Published: May 2014

AbstractTransient luminous events affect Earth's atmosphere between thunderstorm tops and the lower ionosphere through ion‐neutral chemistry reactions. Particular emphasis has been given to sprites, with models and observations suggesting a capability of perturbing atmospheric nitrogen oxides at a local level, as it is known to occur for tropospheric lightning and laboratory air discharges. However, it is as yet unknown whether sprites can be a relevant source of nitrogen oxides for the upper atmosphere. In this paper, we study the sensitivity of the Whole Atmosphere Community Climate Model (WACCM) to sprite‐like nitrogen oxide perturbations. We take a top‐down approach to estimate what magnitude sprite perturbations should have to become significant as compared to other relevant atmospheric processes and study the sensitivity of the model response within the given uncertainties. We show that, based on current predictions by sprite streamer chemistry models, sprites can perturb Tropical NOx at 70 km altitude between 0.015 ppbv (buried in the background variability) and 0.15 ppbv (about 20%), adopting a local NOx production per sprite of 1.5·1023 and 1.5·1024 molecules respectively at this altitude. Below the lowest of the adopted values, sprites are irrelevant at global scales. Sprite NOx may build up to significantly larger amounts locally above active thunderstorms, further aided by other transient luminous events and possibly terrestrial gamma ray flashes. We also use model results to interpret the available observational studies and give recommendations for future campaigns.
Phosphine‐ and Hydrogen‐Free: Highly Regioselective Ruthenium‐Catalyzed Hydroaminomethylation of Olefins
Authors: Gülak Samet , Wu Lipeng , Liu Qiang , Franke Robert , Jackstell Ralf , Beller Matthias 
Published: May 2014

AbstractA highly regioselective ruthenium‐catalyzed hydroaminomethylation of olefins is reported. Using easily available trirutheniumdodecacarbonyl an efficient sequence consisting of a water‐gas shift reaction, hydroformylation of olefins, with subsequent imine or enamine formation and final reduction is realized. This novel procedure is highly practical (ligand‐free, one pot) and economic (low catalyst loading and inexpensive metal). Bulk industrial as well as functionalized olefins react with various amines to give the corresponding tertiary amines generally in high yields (up to 92 %), excellent regioselectivities (n/iso>99:1), and full chemoselectivity in favor of terminal olefins.
Synthesis of Imidazole Derivatives and Study of the ON‐Based Different Memory Performances
Authors: Liu Haifeng , Zhuang Hao , Li Hua , Lu Jianmei 
Published: May 2014

AbstractWe report the synthesis of two imidazole‐based small molecules with different planarity of terminal aromatic rings and their application in memory devices with a sandwich configuration. The optical, electric, and the on‐based device performances were systematically investigated. Surprisingly, the device based on BT‐PMZ exhibited volatile static random access memory (SRAM) behavior, whereas that based on BT‐BMZ showed nonvolatile write‐once‐read‐many‐times (WORM) behavior. Further studies on the film morphology and the molecular electronic structure were carried out to investigate the underlying mechanism for the large difference in their performance. Moreover, the performance of the device that incorporates a LiF buffer layer (5 nm) embedded at the interface between the BT‐BMZ active layer and the Al top electrode as well as that of the device with a cold‐deposited top electrode of mercury droplet was further investigated. At that point a dramatic change in memory performance of the devices from the WORM to SRAM type was observed. The intrinsic volatile SRAM performance for the two molecules results from the moderate electron‐withdrawing strength of the acceptor moieties and thus weak trapping of the charge carriers.