bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment of a Method for Describing stx Genes Expression of E. coli O157:H7 in Ground Beef Matrix during Refrigerated Storage
Authors: Mahmoudzadeh Maryam , Hosseini Hedayat , Hedayati Mehdi , Mousavi Khanghah Amin , Djalma Chaves Rafael , Azizkhani Maryam 
Published: September 2015

AbstractIngredients and complexity of food matrices are inhibitory factors for gene expression studies of bacterial pathogens directly from food matrix. The aim of this study was to develop a simple and fast method for RNA extraction from ground beef matrix as well as stx genes expression of Escherichia coli O157:H7 by relative quantitative real‐time reverse transcription‐polymerase chain reaction (RT‐PCR). Inoculated ground beef samples were kept 7 days in refrigerated storage (4 ± 1C) and bacterial RNA was extracted according to the described method at 0, 2, 5 and 7 days after storage. Results indicate that refrigerated storage temperature decreased gene expression of stx1A (−3.35 relative changes on day 7) and stx2A (−2.9 relative changes on day 7) in ground beef matrix. In the current study, a method requiring minimal equipment and limited interference for RNA extraction from bacteria associated with a meat matrix was evaluated (developed, invested, etc.). Results of the study suggest that the quantitative real‐time RT‐PCR method could be used as a reliable and sensitive method for gene expression studies.Practical ApplicationsPolymerase chain reaction (PCR), known as a sensitive and specific method, was extensively used for the detection of genes involved in stress and virulence of bacteria. In this way, real‐time PCR shows a good sensitivity and diversity for detection and gene expression studies of pathogens. This technique frequently has been used for the study of bacterial behavior in broth or food‐like broth models. Complexity of food matrix and presence of proteins, and also other PCR‐inhibiting factors, restricted gene expression studies in food matrix. There has been great interest in the survival and pathogenicity of Escherichia coli O157:H7 because it is a great concern of ground meat industry. Shiga toxins (Stx1 and Stx2) as manifest characteristics of E. coli O157:H7 are known as significant virulence factors in the pathogenicity of bacterium so its behavior and gene expression profile in meat matrix and during cold chain were evaluated.
Carbon dioxide insufflation during colonoscopy can significantly decrease post‐interventional abdominal discomfort in deeply sedated patients: A prospective, randomized, double‐blinded, controlled trial
Authors: Chen Shuo‐Wei , Hui Chung‐Kun , Chang Jia‐Jang , Lee Tsung‐Shih , Chan Siu‐Cheung , Chien Cheng‐Hung , Hu Ching‐Chih , Lin Chih‐Lang , Chen Li‐Wei , Liu Ching‐Jung , Yen Cho‐Li , Hsieh Po‐Jen , Liu Cheng‐Kun , Su Chih‐Sheng , Yu Chia‐Ying , Chien Rong‐Nan 
Published: September 2015

AbstractBackground and Aim:CO2 has been reported to be absorbed from the bowel more rapidly than air, resulting in a discomfort reduction after colonoscopy. Its role in deeply sedated patients is limited. This study was designed to investigate the efficacy and safety of CO2 insufflation during colonoscopy in patients deeply sedated with propofol.Methods:A total of 125 continuous patients were randomly assigned to receive either CO2 (n = 63) or air (n = 62) insufflation during propofol‐sedated colonoscopy. Postcolonoscopy abdominal pain, distention, and satisfaction were assessed at 1, 3, and 24 h after the procedure, and the proportions of pain‐free and distention‐free patients were compared. Residual bowel gas in the colon and small bowel was evaluated at 1 h after colonoscopy. End‐tidal CO2 and O2 saturation was measured for safety analysis.Results:There was a significant difference between the two groups regarding the postcolonoscopy abdominal pain, distention, and subjective satisfaction at 1 h (P < 0.001) and 3 h (P < 0.01) after the procedure. Patients' pain and distention at 1 and 3 h after the procedure were significantly lower in the CO2 group (P < 0.01). Residual bowel gas in the colon and small bowel was significantly less in the CO2 group (P < 0.001). There was no significant difference in end‐tidal CO2 levels between two groups before, during, and after the procedure.Conclusions:Compared with air, CO2 insufflation during colonoscopy reduced postcolonoscopy abdominal discomfort and improved patients' satisfaction. It was safe to use CO2 insufflation in deeply sedated colonoscopy.
Metabolism and Environmental Impacts of Household Consumption: A Review on the Assessment, Methodology, and Drivers
Authors: Di Donato Monica , Lomas Pedro L. , Carpintero Óscar 
Published: September 2015

SummaryThe focus when analyzing the environmental requirements and impacts of the economic system is usually placed on production activities. But all production is associated with final consumption, and recently many studies have also been dedicated to final consumption. This article comprehensively reviews the biophysical assessment of households from the point of view of materials and energy required and emissions and wastes resulting from household consumption patterns. Although the aggregation bias and methodological variability make comparisons difficult, some patterns can be recognized. Results show that for many Organization for Economic Cooperation and Development (OECD) and a few developing countries, household metabolism has been mainly assessed from the energetic perspective, stressing household responsibility for emissions of greenhouse effect gases and climate change. Few studies deal with other emissions and wastes. There is a lack of information about material requirements, too. Environmental input‐output (I‐O) analysis and life cycle assessment are the methods usually employed, together with the use of economic, environmental, and expenditure information. Information about direct inputs and outputs is complemented with data on the environmental requirements associated with the consumption of goods and services. Multiregional I‐O techniques have been used to capture upstream requirements in an attempt to avoid errors owing to truncation and domestic technology assumptions. Housing, food, and mobility are the most important consumption categories, but the shares of these categories in the requirements are different according to environmental, socioeconomic, and demographic factors. Finally, challenges for further research are discussed based on the need for new methodological developments, as well as the potential of the metabolic narrative to elaborate information relevant to sustainable consumption policies.
‘Watching an artist at work’: aesthetic leadership in clinical nursing workplaces
Authors: Mannix Judy , Wilkes Lesley , Daly John 
Published: September 2015

Aims and objectivesTo explore how clinical leaders enact aesthetic leadership in clinical nursing workplaces.BackgroundClinical leadership is heralded as vital for safe and effective nursing. Different leadership styles have been applied to the clinical nursing workplace over recent years. Many of these styles lack an explicit moral dimension, instead focusing on leader qualities and developing leader competence around team building, quality and safety. Aesthetic leadership, with its explicit moral dimension, could enhance clinical leadership effectiveness and improve nursing workplaces. How aesthetic leadership is enacted in clinical nursing settings requires exploration.DesignA qualitative design, employing conversation‐style interviews with experienced registered nurses and written responses gathered from an online descriptive survey.MethodsNarrative data were gathered from interviews with 12 registered nurses and written accounts from 31 nurses who responded to an online survey. Together, transcribed interview data and the written accounts were subject to thematic analysis.ResultsThree main themes emerged: Leading by example: ‘be seen in the clinical area’; Leading with composure: ‘a sense of calm in a hideous shift’; and Leading through nursing values: ‘create an environment just by your being’.ConclusionsAesthetic leadership was shown to enhance clinical leadership activities in the nursing workplace. The capacity for clinical leaders to be self‐reflective can positively influence the nursing workplace. It was apparent that clinical leader effectiveness can be enhanced with nursing values underpinning leadership activities and by being a visible, composed role model in the clinical workplace.Relevance to clinical practiceAesthetic leadership can enhance clinical nursing workplaces with its explicit moral purpose and strong link to nursing values. Clinical leaders who incorporate these attributes with being a visible, composed role model have the capacity to improve the working lives of nurses across a range of clinical settings.
Effects of therapeutic positioning on vital parameters in patients with central neurological disorders: a randomised controlled trial
Authors: Pickenbrock Heidrun M. , Zapf Antonia , Dressler Dirk 
Published: September 2015

Aims and objectivesTo investigate the effects of positioning on heart rate, breathing frequency and blood pressure in postacute, severely disabled patients with central neurological disorders.BackgroundPositioning patients is part of the regular nursing routine in the care for severely disabled patients. Positioning can be done in a conventional way or in Lagerung in Neutralstellung (Engl.: positioning in neutral), which has recently been shown to have better effects on the passive range of motion and comfort than conventional positioning. While it is thought that positioning influences vital parameters, so far no study has investigated this for a clinically relevant observation period, and no study has compared different positioning concepts in this respect.DesignA multicentre, randomised, controlled, single‐blind clinical trial.MethodsTwo hundred and eighteen patients were randomly assigned to positioning in neutral or conventional positioning. For two hours, they were lying in one of five positions (supine, 30° and 90° side lying on the right or left side) according to the respective positioning concept. Heart rate, breathing frequency and blood pressure were measured before and after positioning in a supine lying position (i.e. not positioned according to any concept). It was investigated if the interventions influence vital parameters and whether there are differences between positioning in neutral and conventional positioning, or between the different positions.ResultsIn neither of the groups did heart rate, breathing frequency and blood pressure change significantly after the intervention compared to before (p ≤ 0·01).ConclusionPositioning does not influence heart rate, breathing frequency and blood pressure when patients are lying for a clinically feasible length of two hours.Relevance to clinical practiceThis study shows that nurses can apply both positioning concepts according to their patients' preferences or to address problems like pressure sore prevention. There is no risk of influencing basic vital parameters.
Reliability and validity of the Nurse Practitioners' Roles and Competencies Scale
Authors: Lin Li‐Chun , Lee Sheuan , Ueng Steve Wen‐Neng , Tang Woung‐Ru 
Published: September 2015

Aims and objectivesThe objective of this study was to test the reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale.BackgroundThe role of nurse practitioners has attracted international attention. The advanced nursing role played by nurse practitioners varies with national conditions and medical environments. To date, no suitable measurement tool has been available for assessing the roles and competencies of nurse practitioners in Asian countries.DesignSecondary analysis of data from three studies related to nurse practitioners' role competencies.MethodsWe analysed data from 563 valid questionnaires completed in three studies to identify the factor structure of the Nurse Practitioners' Roles and Competencies Scale. To this end, we performed exploratory factor analysis using principal component analysis extraction with varimax orthogonal rotation. The internal consistency reliabilities of the overall scale and its subscales were examined using Cronbach's alpha coefficient.ResultsThe scale had six factors: professionalism, direct care, clinical research, practical guidance, medical assistance, as well as leadership and reform. These factors explained 67·5% of the total variance in nurse practitioners' role competencies. Cronbach's alpha coefficient for the overall scale was 0·98, and those of its subscales ranged from 0·83–0·97.ConclusionThe internal consistency reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale were good. The high internal consistency reliabilities suggest item redundancy, which should be minimised by using item response theory to enhance the applicability of this questionnaire for future academic and clinical studies.Relevance to clinical practiceThe Nurse Practitioners' Roles and Competencies Scale can be used as a tool for assessing the roles and competencies of nurse practitioners in Taiwan. Our findings can also serve as a reference for other Asian countries to develop the nurse practitioner role.
Treatment of older people with dementia in surgical wards from the viewpoints of the patients and close relatives
Authors: Hynninen Nina , Saarnio Reetta , Isola Arja 
Published: September 2015

Aims and objectivesThe aim of this study was to describe the treatment of older people with dementia in surgical wards from the viewpoints of the patients and their close relatives.BackgroundLittle is known about the impact of the increasing number of older people with dementia on the treatment of patients in acute care.DesignA qualitative, descriptive design was used.MethodThe data were collected using unstructured interviews, which were then subjected to inductive content analysis.ResultsSupport from close relatives was significant for the mental and social wellbeing of older dementia patients during their hospital stay. People with dementia felt insecure in their relatives’ absence, and missed them. For the relatives, the patients’ hospital stay was emotionally heavy. The relatives desired more emotional support from the nursing staff. The participating patients hoped that the nursing staff would spend more time discussing their cases with them. One of the factors that hindered good care of an older person with dementia was use of restraint. Relatives felt that use of restraints violated patients’ dignity.ConclusionsTo improve the treatment of the people with dementia, the close relatives need to participate in planning the nature of care for the patients.Relevance to clinical practiceThe results are applicable for efforts to improve the abilities of nursing staff, physicians and close relatives in the treatment of older people with dementia in acute care settings.
Nurses' documentation of physiological observations in three acute care settings
Authors: Considine Julie , Trotter Carissa , Currey Judy 
Published: September 2015

Aims and objectivesTo explore nurses' documentation of physiological observations in acute care; emergency department, medical and surgical units.BackgroundIn Australia, physiological observations include respiratory rate, oxygen saturation, heart rate, blood pressure, temperature and level of consciousness. There is a clear relationship between abnormal physiological observations and adverse events. Nurses have highest level of responsibility for accurate measurement, interpretation and documentation of physiological observations.DesignA descriptive exploratory design was used and the study data were collected using a prospective point prevalence approach between 25 July 2012–22 August 2012.MethodsThe study was conducted in the emergency department, two 30‐bed medical units and one 30‐bed surgical unit of a 578 bed public health service in Melbourne, Australia. All adult patients aged ≥18 years present during data collection periods were eligible for inclusion. Patients in the emergency department resuscitation area were excluded. Patient characteristics and physiological observations for the preceding 24 hours in ward patients or eight hours in emergency department patients were collected.ResultsOne hundred and seventy‐eight patients were included; 38 emergency department patients, 84 medical patients and 56 surgical patients. The median age was 72·5 years and 43·8% were males. The most frequently documented physiological observations were respiratory rate, oxygen saturation, heart rate and systolic blood pressure. The least frequently recorded physiological observations were temperature and conscious state. One or more abnormal physiological parameters was documented in 79·8% (n = 142) patients; evidence of reporting abnormalities was documented in 19·7% of patients (n = 28/142). When controlled for length of stay, physiological observations were more frequently documented in the emergency department.ConclusionsThere was variability in the number of parameters documented and frequency of physiological observations documented by nurses.Relevance to clinical practicePhysiological abnormalities that do not necessarily fulfil rapid response team activation criteria are common in acute care patients and provide nurses with an opportunity for early recognition of deteriorating patients.
Effects of a feeding intervention in patients with Alzheimer's disease and dysphagia
Authors: Chen Li‐Li , Li Hong , Lin Rong , Zheng Jian‐Huang , Wei Yan‐Ping , Li Jing , Chen Ping , Chen Hui‐Ying 
Published: September 2015

Aims and objectivesThis study aimed to investigate the effects of a feeding intervention in patients with Alzheimer's disease with dysphagia.BackgroundIn patients with Alzheimer's disease, inadequate food and fluid intake can result in malnutrition, dehydration and increased morbidity and mortality. Patients may lose self‐care abilities such as self‐feeding.DesignA prospective cohort study.MethodsA three‐month self‐control feeding intervention was conducted prospectively in 30 nursing home residents with Alzheimer's disease with dysphagia. Pre‐ and post‐intervention measures included the Kubota water swallow test, type and amount of food intake and assessment of nutritional status by triceps skinfold thickness, upper arm circumference, serum albumin and haemoglobin. We used the Edinburgh Feeding Evaluation in Dementia scale to evaluate eating compliance and the Mini‐ Mental State Examination to evaluate cognitive function. Pre‐ and post‐intervention results were compared to evaluate the effects of nursing intervention.ResultsPatients’ eating/feeding abilities improved overall, including significantly increased food intake (p < 0·001), decreased levels on the Kubota water swallow test (p < 0·001) and significant differences in skinfold thickness, arm circumference, serum albumin and haemoglobin (all p < 0·01), indicating improved nutritional status. Edinburgh Feeding Evaluation in Dementia scale scores decreased significantly, showing improved eating compliance. No changes were noted in cognition post‐intervention. Among 22 patients who initially required feeding, five patients resumed self‐feeding after the intervention (p = 0·06).ConclusionsResults of this study show that a feeding intervention can improve food intake, eating compliance and nutritional status in patients with Alzheimer's disease with dysphagia and prevent further decline in swallowing function.Relevance to clinical practiceThe significant improvement in eating/feeding measures suggest that this feeding intervention model could be developed as a feeding skills programme to improve both the eating/feeding care by nursing staff and the eating/feeding abilities and nutritional status of Alzheimer's disease patients.
Effect of birth ball on labor pain relief: A systematic review and meta‐analysis
Authors: Makvandi Somayeh , Latifnejad Roudsari Robab , Sadeghi Ramin , Karimi Leila 
Published: September 2015

AbstractAimTo critically evaluate the available evidence related to the impact of using a birth ball on labor pain relief.MethodsThe Cochrane library, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE/PubMed and Scopus were searched from their inception to January 2015 using keywords: (Birth* OR Swiss OR Swedish OR balance OR fitness OR gym* OR Pezzi OR sport* OR stability) AND (ball*) AND (labor OR labour OR Obstetric). All available randomized controlled trials involving women using a birth ball for pain relief during labor were considered. The search resulted in 341 titles and abstracts, which were narrowed down to eight potentially relevant articles. Of these, four studies met the inclusion criteria. Pain intensity on a 10 cm visual analogue scale was used as the main outcome measure. Risk of bias was assessed using the Cochrane Risk of Bias tool. Comprehensive Meta‐Analysis Version 2 was used for statistical analysis.ResultsFour RCTs involving 220 women were included in the systematic review. One study was excluded from the meta‐analysis because of heterogeneous interventions and a lack of mean and standard deviation results of labor pain score. The meta‐analysis showed that birth ball exercises provided statistically significant improvements to labor pain (pooled mean difference ‐0.921; 95% confidence interval ‐1.28, ‐0.56; P = 0.0000005; I2 = 33.7%).ConclusionThe clinical implementation of a birth ball exercise could be an effective tool for parturient women to reduce labor pain. However, rigorous RCTs are needed to evaluate the effect of the birth ball on labor pain relief.
Decreased baseline variability on fetal heart rate pattern in a fetus with heterotaxy syndrome
Authors: Yamada Ryutaro , Takei Kohta , Kaneshi Yosuke , Morikawa Mamoru , Cho Kazutoshi , Minakami Hisanori 
Published: September 2015

AbstractIn a fetus with suspected heterotaxy syndrome, a decreased/absent baseline variability of fetal heart rate pattern developed at gestational week 36+5 and continued for 5 days until birth at gestational week 37+2, while repeat biophysical profile scorings with ultrasound were consistently unremarkable. This neonate weighing 2404 g with Apgar scores of 7 (1‐min) and 8 (5‐min) and umbilical arterial cord blood pH of 7.28 with base deficit of 3.9 mmol/L, showed a heart rate of 120 b.p.m. for 3 h after birth, but subsequently developed sinus bradycardia (84 b.p.m.) unresponsive to crying. Isoproterenol initiated 9 h after birth was effective in the increase of heart rate to 120 b.p.m. in this neonate. Brain magnetic resonance imaging at 16 days of age was unremarkable. The decreased/absent baseline variability of fetal heart rate pattern was speculated to have been caused by sinus node dysfunction, and not by reduced fetal oxygenation in this case.
Sarcoid‐like reaction mimicking vaginal cancer recurrence
Authors: Mayama Michinori , Yoshihara Masato , Ukai Mayu , Kondo Shinya , Kishigami Yasuyuki , Oguchi Hidenori 
Published: September 2015

AbstractA sarcoid‐like reaction is a development of non‐caseating granuloma in patients with underlying malignancy and represents a false positive finding on positron emission tomography/computed tomography (PET/CT). A sarcoid‐like reaction is a benign condition; therefore, differentiating a sarcoid‐like reaction from cancer recurrence is necessary. Only uterine and ovarian cancer related cases have been reported in the gynecological field and to the best of our knowledge, this is the first case of a sarcoid‐like reaction in vaginal cancer. A 59‐year‐old vaginal cancer patient received concurrent chemoradiotherapy and achieved complete remission. Recurrence of vaginal cancer was suspected because of the elevation of serum squamous cell carcinoma antigen level. PET/CT revealed abnormal uptake at the bilateral mediastinal and hilar lymph nodes. A non‐caseating granuloma was detected from the biopsy of the swollen lymph nodes. No evidence of cancer recurrence was observed. A sarcoid‐like reaction should be considered when evaluating PET/CT in cancer patients to prevent unnecessary treatments.