bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomised trial of nursing interventions supporting recovery of the postmastectomy patient
Authors: Cho Ho Soon Michelle , Davis Gail C , Paek Jae Eun , Rao Roshni , Zhao Hong , Xie Xian‐Jin , Yousef Mary G , Fedric Tara , Euhus David H , Leitch Marilyn 
Published: July 2012

Aims and objectives.  This ABC to recovery study evaluated the combined and separate components of preoperative education and the effectiveness of wearing the Papilla Gown.Background.  Surgical removal of the breast may lead to activity limitation, self‐image issues, discomfort and later complication of lymphoedema.Design.  This study used experimental and longitudinal design.Methods.  One hundred and forty‐five women undergoing mastectomies for stages two and three breast cancer were randomised into four groups: education and Papilla Gown, education only, gown only and control. The outcomes of activity (A), body image (B), comfort (C), knowledge and lymphoedema were assessed at baseline and/or 1 week and 6 months using three measures. All 145 participants completed the study questionnaires at first two measures, and forty‐six of these participants completed the questionnaires at 6 months postoperatively. The setting for the study included two clinics and hospitals. To examine statistical significance at each time point after surgery, 2‐way anovas were performed on ABC, knowledge and tape measurement to see whether there were any statistically significant differences between the four groups. All reported p‐values are two sided. All statistical analyses were performed using sas 9.2 for Windows.Results.  The mean age of the sample was 55 years. The study revealed that women who received the combined intervention demonstrated greater activity. Women who wore the gown only had a greater comfort level and decreased lymphoedema. Women that received preoperative education experienced increased knowledge.Conclusions.  Outcomes suggest that the combined intervention (ABCs to recovery) can improve recovery following mastectomy.Relevance to clinical practice.  The results will be used to further modify the intervention and to increase awareness of nurse practitioners and other healthcare professionals of the specific needs of postmastectomy patients.
Evaluation of the effectiveness of hospital discharge planning and follow‐up in the primary care of patients with chronic obstructive pulmonary disease
Authors: Abad‐Corpa Eva , Royo‐Morales Tania , Iniesta‐Sánchez Javier , Carrillo‐Alcaraz Andrés , Rodríguez‐Mondejar Juan José , Saez‐Soto Ángeles Rosario , Vivo‐Molina Mª Carmen 
Published: July 2012

Aims and objectives:  To evaluate the effectiveness of protocolised intervention for hospital discharge and follow‐up in the primary care of patients with chronic obstructive pulmonary disease (COPD).Background:  Chronic obstructive pulmonary disease is one of the main causes of morbidity and mortality internationally.Design:  A quasi‐experimental design was adopted, with a control group and it was pseudorandomised by services.Methods:  Patients with COPD admitted to two tertiary‐level public hospitals in Spain were recruited (2007–2008). The outcome variables included: readmission rate, patient satisfaction (LOPSS12), quality of life (St. George′s Respiratory Questionnaire) and level of knowledge about COPD. 48 hours after admission, both groups were evaluated by specialist coordinating nurses. At the hospital, a coordinating nurse visited each patient in the experimental group every 24 hours to identify the main caregiver, provide information about the disease, explain treatment, identify care problems and needs and facilitate communication between professionals. 24 hours after discharge, the coordinating nurses informed the primary care nurses about patient discharge. The two nurses made the first home visit together. There were follow‐up phone calls at 2, 6, 12 and 24 weeks after discharge. A total of 143 patients were recruited (Intervention group=56; Control group=87).Results:  The results showed a significant improvement in the evolution of quality of life, at 12 and 24 weeks after discharge; the level of knowledge about COPD revealed significant differences between the groups. There were no differences according to satisfaction or readmission rate. Multivariate analysis (non‐conditional logistic regression) showed the intervention to be ineffective in reducing the readmission rate.Conclusions:  The planning of discharge for patients with COPD is effective in terms of improving the patients’ quality of life and level of knowledge about the disease.Relevance to clinical practice:  The characteristics of patients with COPD make it necessary to include them in hospital discharge planning programmes.
‘He did what? Well that wasn't handed over!’ Communicating risk in mental health
Authors: MILLAR R. , SANDS N. 
Published: July 2012

Accessible summary
This paper reports on a study that was conducted in an acute psychiatric unit investigating how and what information is communicated at nursing handovers that relates to a patients risk status.
Nursing handovers are conducted in an ad hoc manner and may not effectively communicate information required for management of patient risks.
A consistent and evidenced‐based approach to mental health nursing handovers is required, in order to promote best nursing practice.
AbstractMental health inpatient units are dynamic, complex environments that provide care for patients with heterogeneous ages, diagnoses and levels of acuity. These environments commonly expose clinicians and patients to many potential risks. Despite extensive research into risk assessment, prediction and management, no study has investigated how risk information is communicated at handover in acute mental health settings. Given the pivotal role handover plays in informing risk management, this evidence gap is significant. This paper reports on a study that investigated the practices of communicating risk at handover in an Australian acute mental health inpatient unit. The aim of this research was to identify the frequency and type of risk information communicated between nursing shifts, and the methods by which this communication was performed. A secondary aim was to identify effective and ineffective risk communication practices. This study involved an observational design method using a 14‐item Clinical Audit Tool derived from handover principles outlined by World Health Organization. Five hundred occasions of patient handover were observed. Few risk information items were observed to be communicated in any method. Risk communication practice was inconsistent, and a key recommendation from the study is the use of standardized handover tools that ensures risk information is adequately reported.
Integrating an evidence‐based intervention into clinical practice: ‘transitional relationship model’
Authors: FORCHUK C. , MARTIN M.‐L. , JENSEN E. , OUSELEY S. , SEALY P. , BEAL G. , REYNOLDS W. , SHARKEY S. 
Published: July 2012

Accessible summary

The transitional relationship model (TRM) facilitates the discharge of psychiatric clients from hospital to community by providing hospital staff involvement until a therapeutic relationship has been established with a community care provider as well as peer support.

Psychiatric wards at six hospital sites implemented the TRM in three waves. Monthly summaries, progress reports, meeting minutes and focus group discussions were reviewed in order to uncover facilitators and barriers to TRM implementation.

Factors that facilitated TRM implementation included: educational modules for staff and peer training, the presence of on‐site champions, and supportive documentation systems. Barriers included: feeling swamped/overwhelmed, death by process, team dynamics and changes in champions.

Implementation strategies suggested by the initial hospital wards were used to enhance implementation on subsequent wards, leading to positive outcomes. This study highlights the need to address work environment issues when implementing healthcare interventions, particularly for interprofessional teams.

AbstractThe transitional relationship model (TRM) facilitates the discharge process by providing peer support and hospital staff involvement until a therapeutic relationship has been established with a community care provider. A quasi‐experimental, action‐oriented research design was employed in which psychiatric wards at six hospital sites implemented the model in three waves. Helpful strategies were identified by each wave of wards for consideration by subsequent wards. Using an ethnographic approach, qualitative data were examined to uncover experiences and perceptions of TRM implementation and to help identify key issues that were supporting or hampering implementation. Specific strategies that facilitate the implementation of TRM include: (1) the use of educational modules for on‐ward hospital staff training and peer training; (2) presence of on‐site champions; and (3) supportive documentation systems. Issues identified as barriers to implementation included: (1) feeling drowned, swamped and overwhelmed; (2) death by process; (3) team dynamics; and (4) changes in champions. Staged large‐scale implementation of the TRM allowed for iterative improvements to the model leading to positive outcomes. This study highlights the need to address work environment issues, particularly interprofessional teams.
Metabolic profiling of the methylerythritol phosphate pathway reveals the source of post‐illumination isoprene burst from leaves
Authors: LI ZIRU , SHARKEY THOMAS D. 
Published: July 2012

ABSTRACTThe methylerythritol phosphate (MEP) pathway in plants produces the prenyl precursors for all plastidic isoprenoids, including carotenoids and quinones. The MEP pathway is also responsible for synthesis of approximately 600 Tg of isoprene per year, the largest non‐methane hydrocarbon flux into the atmosphere. There have been few studies of the regulation of the MEP pathway in plants under physiological conditions. In this study, we combined gas exchange techniques and high‐performance liquid chromatography–tandem mass spectrometry (HPLC‐MS‐MS) and measured the profile of MEP pathway metabolites under different conditions. We report that in the MEP pathway, metabolites immediately preceding steps requiring reducing power were in high concentration. Inhibition of the MEP pathway by fosmidomycin caused deoxyxylulose phosphate accumulation in leaves as expected. Evidence is presented that accumulation of MEP pathway intermediates, primarily methylerythritol cyclodiphosphate, is responsible for the post‐illumination isoprene burst phenomenon. Pools of intermediate metabolites stayed at approximately the same level 10 min after light was turned off, but declined eventually under prolonged darkness. In contrast, a strong inhibition of the second‐to‐last step of the MEP pathway caused suppression of isoprene emission in pure N2. Our study suggests that reducing equivalents may be a key regulator of the MEP pathway and therefore isoprene emission from leaves.
Screening of patients with tuberculosis for diabetes mellitus in China
Authors: Li Liang , Lin Yan , Mi Fengling , Tan Shouyong , Liang Bing , Guo Chaojun , Shi Lian , Liu Li , Gong Fang , Li Yuanyuan , Chi Jingyu , Zachariah Rony , Kapur Anil , Lönnroth Knut , Harries Anthony D. 
Published: July 2012

AbstractObjective  There is a high burden of both diabetes (DM) and tuberculosis (TB) in China, and this study aimed to assess feasibility and results of screening patients with TB for DM within the routine healthcare setting of six health facilities.Method  Agreement on how to screen, monitor and record was reached in May 2011 at a stakeholders’ meeting, and training was carried out for staff in the six facilities in July 2011. Implementation started in September 2011, and we report on 7 months of activities up to 31 March 2012.Results  There were 8886 registered patients with TB. They were first asked whether they had DM. If the answer was no, they were screened with a random blood glucose (RBG) followed by fasting blood glucose (FBG) in those with RBG ≥ 6.1 mm (one facility) or with an initial FBG (five facilities). Those with FBG ≥ 7.0 mm were referred to DM clinics for diagnostic confirmation with a second FBG. Altogether, 1090 (12.4%) patients with DM were identified, of whom 863 (9.7%) had a known diagnosis of DM. Of 8023 patients who needed screening for DM, 7947 (99%) were screened. This resulted in a new diagnosis of DM in 227 patients (2.9% of screened patients), and of these, 226 were enrolled to DM care. In addition, 575 (7.8%) persons had impaired fasting glucose (FBG 6.1 to <7.0 mm). Prevalence of DM was significantly higher in patients in health facilities serving urban populations (14.0%) than rural populations (10.6%) and higher in hospital patients (13.5%) than those attending TB clinics (8.5%).Conclusion  This pilot project shows that it is feasible to screen patients with TB for DM in the routine setting, resulting in a high yield of patients with known and newly diagnosed disease. Free blood tests for glucose measurement and integration of TB and DM services may improve the diagnosis and management of dually affected patients.
Effects of Exposure to Environmental Chemicals During Pregnancy on the Development of the Male and Female Reproductive Axes
Authors: Bellingham M , Fiandanese N , Byers A , Cotinot C , Evans NP , Pocar P , Amezaga MR , Lea RG , Sinclair KD , Rhind SM , Fowler PA 
Published: July 2012

ContentsThere is a large body of literature describing effects of environmental chemicals (ECs), many of them anthropogenic with endocrine‐disrupting properties, on development in rodent laboratory species, some of which lead to impaired reproduction and adverse health. This literature joins extensive human epidemiological data and opportunistic wildlife findings on health effects of ECs. In contrast, the effect of endocrine disruption on foetal development and reproductive performance in domestic species is less extensively documented. This applies both to domestic farm and to companion species even though the former is critical to food production and the latter share our homes and many aspects of the modern developed human lifestyle. In domestic species, the nature of chemicals exposure in utero and their consequences for animal health and production are poorly understood. A complication in our understanding is that the pace of development, ontogeny and efficiency of foetal and maternal hepatic and placental activity differs between domestic species. In many ways, this reflects the difficulties in understanding human exposure and consequences of that exposure for the foetus and subsequent adult from epidemiological and largely rodent‐based data. It is important that domestic species are included in research into endocrine disruption because of their (i) wide variety of exposure to such chemicals, (ii) greater similarity of many developmental processes to the human, (iii) economic importance and (iv) close similarities to developed world human lifestyle in companion species.
Effects of Maternal Diet and Exposure to Bisphenol A on Sexually Dimorphic Responses in Conceptuses and Offspring
Authors: Rosenfeld CS 
Published: July 2012

ContentsWhereas sexual differentiation is considered as the onset of differentiation of the male or female gonads, mounting evidence indicates that sex differences in developmental programming are established as early as the zygotic stage. Genetic and epigenetic differences between the sexes might govern how each responds to shifts in their early environment, including in the uterus or culture dish, as in the case of in vitro cultured pre‐implantational embryos. Even if no differences are evident between the sexes at birth, divergent conceptus responses to surrounding changes, such as maternal diet and exposure to endocrine disrupting compounds (EDC), such as bisphenol A (BPA), might predispose one sex over the other to later adult‐onset diseases, otherwise termed developmental origin of health and disease (DOHaD). Overall, males subjected to less than optimal in utero conditions tend to be at greater risk for various diseases, including neurobehavioural disorders. As the placenta is the primary nutrient acquisition and communication organ between the dam and foetus, its ability to adapt rapidly to environmental shifts might buffer the conceptus against environmental insults. The placenta of one sex over the other might possess greater ability to respond to environmental fluctuations. In utero environmental changes, including maternal nutrient excess or reduction or exposure to the EDC, BPA, might govern sex‐dependent behavioural alterations. In sum, this review examines the evidence to date that male and female zygotes and conceptuses diverge in their responses to shifting environmental conditions and whether these contrasting sexually dimorphic responses underpin later DOHaD outcomes, namely neurobehavioural changes.
Domestic Animal Models for Biomedical Research
Authors: Bähr A , Wolf E 
Published: July 2012

ContentsExperimental animals in biomedical research provide insights into disease mechanisms and models for determining the efficacy and safety of new therapies and for discovery of corresponding biomarkers. Although mouse and rat models are most widely used, observations in these species cannot always be faithfully extrapolated to human patients. Thus, a number of domestic species are additionally used in specific disease areas. This review summarizes the most important applications of domestic animal models and emphasizes the new possibilities genetic tailoring of disease models, specifically in pigs, provides.
Livestock Induced Pluripotent Stem Cells
Authors: Lu Y , Mumaw JL , West FD , Stice SL 
Published: July 2012

ContentsChimeric animals generated from livestock‐induced pluripotent stem cells (iPSCs) have opened the door of opportunity to genetically manipulate species for the production of biomedical models, improving traits of agricultural importance and potentially providing a system to test novel iPSC therapies. The potential of pluripotent stem cells in livestock has long been recognized, with many attempts being chronicled to isolate, culture and characterize pluripotent cells from embryos. However, in most cases, livestock stem cells derived from embryonic sources have failed to reach a pluripotent state marked by the inability to form chimeric animals. The in‐depth understanding of core pluripotency factors and the realization of how these factors can be harnessed to reprogram adult cells into an induced pluripotent state has changed the paradigm of livestock stem cells. In this review, we will examine the advancements in iPSC technology in mammalian and avian livestock species.
Induced Pluripotent Stem Cells from Pigs and Other Ungulate Species: An Alternative to Embryonic Stem Cells?
Authors: Ezashi T , Telugu BPVL , Roberts RM 
Published: July 2012

ContentsRobust embryonic stem cell (ESC) lines from livestock species have been difficult to derive and maintain, and unlike mouse ESC, have not contributed to our ability to understand directed differentiation in vitro. Nor have such cells yet provided a simpler means than pronuclear injection to manipulate the genomes of agriculturally important species, such as cattle, sheep and pigs. Induced pluripotent stem cells (iPSC) generated by reprogramming somatic cells, such as fibroblasts, with a set of stemness genes, most usually but not exclusively POU5F1, SOX2, KLF4 and c‐MYC, offer an alternative to ESC in these regards, as they exhibit a pluripotent phenotype resembling that of ESC, yet are readily generated in the laboratory. Accordingly, such cells, in association with cloning technologies, may be useful for introducing complex genetic changes into livestock, although this potential has yet to be demonstrated. Porcine iPSC may be especially valuable because the pig is a prime biomedical model for tissue transplantation. In general, iPSC from livestock, like those from humans, are of the epiblast type and depend upon FGF2 and activin/nodal signalling systems to maintain their pluripotency and growth. Recent experiments, in which newly reprogrammed porcine and bovine cells were selected on a LIF‐based medium in presence of specific protein kinase inhibitors, have allowed iPSC cells of the naïve type, resembling the more amenable blastocyst‐derived mouse ESC and iPSC to be isolated. However, hurdles still remain if such cells are to achieve their biotechnological promise.
Recent Advances in Stem and Germ Cell Research: Implications for the Derivation of Pig Pluripotent Cells
Authors: Alberio R , Perez AR 
Published: July 2012

ContentsPluripotent stem cells have the unique capacity to contribute to all the tissues of an adult animal after transfer into a host embryo. How pluripotency is acquired during early development and how it is maintained in stem cells have attracted the interest of many scientists for over three decades. Much progress in our understanding of how stem cells arise in culture and the signals required for homoeostasis has enabled the derivation of pluripotent cells in multiple species. Here, we discuss recent developments in stem cell biology that will impact the generation of pluripotent cells from different embryonic origins and will contribute to increase our capacity for generating transgenic animals.
Gonadotropin‐Releasing Hormone Targeting for Gonadotroph Ablation: An Approach to Non‐surgical Sterilization
Authors: Struthers RS 
Published: July 2012

ContentsSurgical sterilization is the mainstay of dog and cat population control, but its use is still often limited by the costs and effort involved, especially in developing countries. An ideal non‐surgical sterilant that is safe, effective, permanent, administered as a single injection and capable of being manufactured inexpensively could have a significant impact on the world‐wide dog and cat overpopulation problem. One approach towards developing such an agent is the targeting of pituitary gonadotrophic cells with cytotoxic agents using gonadotropin‐releasing hormone (GnRH). GnRH is a peptide that binds to high‐affinity receptors selectively expressed on gonadotrophs and some types of cancers. Both small molecules and proteins have been conjugated to GnRH analogues to generate targeted cytotoxic and imaging agents. Although most of these efforts have focused on development of human cancer therapeutics, available reproductive studies in rats and dogs suggest that current compounds do not have sufficient therapeutic windows for complete gonadotroph ablation, in part owing to poor stability of peptide targeting sequences. The only reported longer‐term study of gonadotroph ablation in dogs reported suppression of serum testosterone for 8 months, but endocrine function then recovered, raising important questions about the mechanism of reproductive suppression and its recovery. Although studies to date suggest that this is a potentially attractive approach to non‐surgical sterilization, ideal agents are yet to be developed, and important mechanistic questions remain to be answered.