bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurturing and nourishing: the nurses’ role in nutritional care
Authors: Jefferies Diana , Johnson Maree , Ravens Jennifer 
Published: January 2011

Aims.  Researchers collaborated with clinicians, consumers and dietitians to develop a policy defining how nurses could support their patients’ nutritional care.Background.  A high prevalence of hospital malnutrition has been reported in Australia, Europe and the UK. A patient’s nutritional status can deteriorate during admission. Malnutrition can increase complications, length of stay, mortality rates and health care costs. As the nursing role has become increasingly complex, traditional nurturing activities such as serving the patients’ meals have devolved to other categories of staff leaving the role of nurses in their patients’ nutritional care ill‐defined.Design.  The research team systematically reviewed relevant research literature using the principles of qualitative metasynthesis to identify appropriate nursing strategies that would assist in reducing the prevalence of hospital malnutrition.Method.  The policy was developed using a systematic review approach: devising a clinical question, searching the literature, appraising research evidence, analysing existing policy documents, synthesising evidence into dominant themes and once the policy was drafted, initiating a wide ranging consultation and ratification process.Results.  A literature search located 147 articles. Forty articles were identified as being within the scope of the clinical question. Most were reports of audits or observation studies. The dominant themes were developed into standards that assisted nurses in supporting the oral nutrition of their patients. These included the following: a focussed mealtime, management of mealtime environments, management of staff mealtimes and a designated nutrition support nurse in each clinical area to monitor and evaluate the implementation of the policy.Conclusions.  There is a distinct role for nurses that will assist in reducing the prevalence of hospital malnutrition but successful implementation can only occur with the support of the multidisciplinary team.Relevance to clinical practice.  This policy provides a framework to define and invigorate nursing’s role in supporting the patient’s nutrition care.
Mental health nursing in emergency departments: the case for a nurse practitioner role
Authors: Nicholls Daniel , Gaynor Nick , Shafiei Touran , Bosanac Peter , Farrell Gerald 
Published: January 2011

Aims and objectives.  This paper aims to explore the effectiveness of the mental health nurse practitioner role in the emergency department in the context of the growing use of special units or segregated areas to manage particular kinds of mental health presentations, often complicated by substance use.Background.  In recent years, there has been a significant increase in mental health presentations to emergency departments, often complicated by substance abuse. Emergency departments have introduced a variety of mechanisms to address this growing problem. With the introduction of mental health nurse practitioners, opportunities arise to reconsider these mechanisms.Design.  Discursive paper.Methods.  In this discursive paper, contemporary practices are described in relation to ‘special care areas’, ‘psychiatric emergency centres’ and ‘short‐stay units’. The mental health nurse practitioner role in training and capacity building is also explored and the notion of ‘locational processes’ described. Rather than being presented as an alternative to short‐stay units, the mental health nurse practitioner role is explored in its potential to enhance mental health nursing practice in a sometimes difficult clinical environment.Results.  The paper provides evidence from literature and practice that the clinical outcome for consumers is enhanced through the mental health nurse practitioner role.Conclusions.  It is argued that the introduction of the mental health nurse practitioner role in the emergency department leads to increased staff competence and confidence in interacting with those presenting with mental health issues. The mental health nurse practitioner role also addresses the serious problem of stigma associated with those with a mental health issue.Relevance to clinical practice.  It is expected that those presenting with mental health issues to the emergency department will benefit through the increased assessment and management skills of staff.
Nurse and allied health professional consultants: perceptions and experiences of the role
Authors: Stevenson Kay , Ryan Sarah , Masterson Abigail 
Published: January 2011

Aims and objectives.  To explore the perceptions and experiences of nurse and allied health professional consultants and key stakeholders.Background.  Nurse and allied health professional consultants’ roles were introduced in the United Kingdom in 1999 with defined role criteria and a remit to improve patient outcomes. Although these roles have now existed for over a decade, there is a lack of research as to whether these roles have achieved their intended impact on clinical care. Through an exploration of the experiences of consultant nurses and allied health professionals and key stakeholders who work with these practitioners, a greater understanding of the consultant role can be achieved.Design.  Qualitative.Methods.  A purposive sample of seven non‐medical consultants (five nurses, one physiotherapist and a pharmacist) and eight stakeholders took part in focus group interviews. Each focus group was audio‐taped and lasted between 1·5–2 hours. Content analysis was used to interpret the data.Results.  Four main themes were identified: (1) Role interpretation – core features include clinical practice, leadership, education and research. Debate surrounded the need to incorporate managerial responsibilities into the role. (2) Role implementation required political skills and emotional intelligence. (3) Role impact especially on clinical practice was a major priority for both groups. (4) Challenges included lack of organisational and administrative support.Conclusion.  There was consensus amongst the two groups regarding the value of the role, key role functions and skills and the emerging impact on clinical practice.Relevance to clinical practice.  Both groups were able to identify the clinical impact of the role including helping patients manage chronic pain, reducing the need for follow‐up appointments and managing emergency admissions. To capture the clinical diversity of the roles, a variety of evaluation strategies should be implemented.
Creating an agreed discharge: discharge planning for clients with high care needs
Authors: Tomura Hikari , Yamamoto‐Mitani Noriko , Nagata Satoko , Murashima Sachiyo , Suzuki Shigemi 
Published: January 2011

Aims. The purpose of this study was to develop a conceptual model of discharge planning by discharge planning nurses for clients returning home with high care needs.Background. In Japan, discharge planning plays an important role in the smooth and timely discharge of clients from medical facilities. Discharge planning nurses often oversee such processes, especially for clients with high care needs. However, a conceptual model that guides discharge planning nurses during the discharge planning process is currently lacking.Design. Qualitative.Methods. A constant comparative approach was used to collect and analyse data from semi‐structured interviews conducted with 13 discharge planning nurses working at medical centres throughout Japan. Each discharge planning nurse described her discharge planning activities for a client with high care needs.Results. ‘Creating an agreed discharge’ was a core category of the discharge planning process carried out by discharge planning nurses. The process consisted of: (1) developing a blueprint, (2) reaching an agreement, (3) materialising the agreed plan and (4) sending the client home. The discharge planning nurse starts by developing a blueprint of client/family life after discharge. The blueprint guides each discharge planning nurse thereafter throughout their various activities. She or he also strives to reach an agreement with the client/family regarding the discharge plan. Discharge planning nurse activities detailed here are based on the client/family’s daily life, and adjustments to the plan are made within an agreeable range.Conclusions. Developing a blueprint, revising and refining it to establish an agreed discharge plan based on the client/family’s situations and preferences and coming to an agreement for further revisions and the final plan were essential in the discharge planning process. A precise projection of the client’s condition, community resource knowledge, estimating family care and understanding specific client/family thoughts on returning home were vital to a successful discharge planning process.Relevance to clinical practice. These findings may be useful for the development of discharge planning guidelines.
Opinion of Japanese rheumatology physicians on methods of assessing the quality of rheumatoid arthritis care
Authors: Higashi Takahiro , Fukuhara Shunichi , Nakayama Takeo 
Published: January 2011

AbstractObjective  To examine the opinion of rheumatology physicians in Japan regarding desirable quality assessment methods.Methods  We conducted a cross‐sectional self‐administered mail survey on a random sample of physicians and surgeons registered with the Japan Rheumatism Foundation. In the survey, respondents were asked to rank seven proposed assessment methods for the quality of rheumatoid arthritis care, namely patient satisfaction, risk‐adjusted outcomes such as complication incidence and admission rate, guideline compliance, waiting time at clinics, voting by local general practitioners, degree of newspaper and magazine reportage, and volume of patients receiving treatment for rheumatoid arthritis.Results  Among 531 respondents (response rate 48%), the respondents ranked patient satisfaction most favourably (mean rank 1.6), followed by complication/admission rate and number of patients. Guideline adherence was ranked almost the same as voting by local physicians. Waiting time and media reportage were not considered good methods for quality evaluation. Ranking distribution did not differ by working facility or place, volume of patients or years in practice. Multivariate analysis revealed that respondents who care for a large number of rheumatoid arthritis patients (>40 regular patients) were less likely to rank guideline adherence highly (first to third) than those who care for few patients (≤10 regular patients), with an odds ratio of 0.38 (P < 0.01) after adjustment for other variables.Conclusions  A majority of Japanese rheumatology physicians consider patient satisfaction the most trustworthy method of assessing the quality of rheumatoid arthritis care. Future research should explore convincing methods of assessing the technical quality of rheumatoid arthritis care.
CD4+Foxp3+ Regulatory T‐cell Impairment by Paclitaxel is Independent of Toll‐like Receptor 4
Authors: Zhu Y. , Liu N. , Xiong S. D. , Zheng Y. J. , Chu Y. W. 
Published: January 2011

AbstractPaclitaxel (PTX) is one of the most widely used clinical antitumour drugs in chemotherapy nowadays. Its effect on immune system has become a hot spot of research in recent years. Here, we demonstrated that PTX not only decreased the percentage of CD4+Foxp3+ regulatory T (Treg) cells both in vitro and in vivo but also impaired cell viability and cytokine production of Treg cells rather than CD4+Foxp3− effector T (Teff) cells. As PTX has been reported to mimic the activity of LPS to trigger the toll‐like receptor 4 (TLR4) signalling pathway in macrophages, we investigated the possible role of TLR4 in the effect of PTX. However, although TLR4 expression on Treg cells was higher than that on Teff cells, the expression level remained unaltered in both Treg and Teff cells after PTX treatment. Surface molecules and activation markers in Treg and Teff cells did not change, either. Further study showed that the effect of PTX on TLR4−/− mice deficient in TLR4 signalling was similar to that on C57BL/6 mice both in vivo and in vitro. These data indicate that the selective impairment of Treg cells by PTX is independent of TLR4.
Toxocara canis infection is associated with eosinophilia and total IgE in blood donors from a large Brazilian centre
Authors: Dattoli V. C. C. , Freire S. M. , Mendonça L. R. , Santos P. C. , Meyer R. , Alcantara‐Neves N. M. 
Published: January 2011

SummaryObjective  To investigate the association between Toxocara canis infection and total IgE levels and eosinophilia in blood donors from a large Brazilian city.Methods  Two hundred and sixty‐eight blood donors from a government blood bank were tested. No helminth infection was diagnosed by parasitological stool examination. Total IgE levels and T. canis infection status were determined by ELISA. Eosinophil levels were determined using an automatic blood cell counter.Results  Toxocara canis IgG antibodies were found in 124 (46.3%); 102 (38.0%) had eosinophilia ≥4% and 29 (10.8%) had eosinophilia ≥10%, respectively; 140 (52.2%) individuals had total IgE antibodies above the cut‐off levels. Both total IgE and eosinophil levels ≥10% were positively associated with the infection.Conclusion  This study revealed a high prevalence of T. canis infection in blood donors, highlighting the need for screening for this infection. It also demonstrated that this population otherwise healthy has higher levels of blood eosinophils and total IgE and that both parameters are associated with T. canis infection.
Poxvirus infection in a cat with presumptive human transmission
Authors: Herder Vanessa , Wohlsein Peter , Grunwald Dorothea , Janssen Hanno , Meyer Hermann , Kaysser Philipp , Baumgärtner Wolfgang , Beineke Andreas 
Published: January 2011

AbstractThe present report describes a case of generalized cowpox virus infection with necrotizing facial dermatitis in a cat and a likely transmission to an animal keeper. The viral aetiology was confirmed by histopathology, immunohistochemistry, PCR, virus isolation, DNA sequencing and electron microscopy. Histopathological examination of the cat’s skin revealed a severe, necrotizing dermatitis with ballooning degeneration and hyperplasia of epithelial cells with pathognomonic cytoplasmic eosinophilic inclusion bodies. Additionally, at post‐mortem examination, a systemic poxvirus infection was detected affecting pancreas, thymus, lymph node, liver and lung. The human patient’s skin biopsy revealed an ulcerative dermatitis with epidermal hyperplasia and ballooning degeneration. Serological investigation displayed a high orthopoxvirus‐specific antibody titre in the human patient. Environmental factors increase the natural reservoir host population for cowpox viruses, such as voles, which results in a higher risk of infection for cats and subsequently for humans. Due to this zoonotic potential, a cowpox virus infection must be considered as an aetiological differential in cases of necrotizing dermatitis in cats.
Liver and combined lung and liver transplantation for cystic fibrosis: Analysis of the UNOS database
Authors: Arnon Ronen , Annunziato Rachel A. , Miloh Tamir , Padilla Maria , Sogawa Hiroshi , Batemarco Linda , Willis Asha , Suchy Frederick , Kerkar Nanda 
Published: January 2011

Arnon R, Annunziato RA, Miloh T, Padilla M, Sogawa H, Batemarco L, Willis A, Suchy F, Kerkar N. Liver and combined lung and liver transplantation for cystic fibrosis: Analysis of the UNOS database. Pediatr Transplantation 2011: 15: 254–264. © 2011 John Wiley & Sons A/S.Abstract:  A proportion of patients with CF develop cirrhosis and portal hypertension. LT and combined LLT are rarely performed in patients with CF. To determine the outcome of LT and LLT in patients with CF. Patients with CF who had LT or LLT between 10/1987 and 5/2008 were identified from UNOS database. A total of 182 children (<18 yr) and 48 adults underwent isolated LT for CF. Seven more children and eight adults with CF underwent combined LLT. One‐ and five‐yr patient and graft survival were not significantly different in patients who underwent LT in comparison with patients who underwent LLT (patient survival: LT; 83.9%, 75.7%, LLT; 80%, 80%; graft survival: LT; 76.1%, 67.0%, LLT; 80.0%, 80.0%, respectively). The two major causes of death after LT were pulmonary disease (15 patients, 22.7%) and hemorrhage (12 patients, 18.2%). Bilirubin was identified as a risk factor for death, and previous liver transplant and prolonged cold ischemic time were identified as risk factors for graft loss in LT patients. LT is a viable option for children and young adults with CF and end‐stage liver disease. Outcome of LLT patients with CF was comparable to the outcome of patients with CF who underwent isolated LT.
Mortality of a herbivorous insect is greater on non‐indigenous congeneric compared to native rush in coastal salt marsh
Authors: Harvey Kerinne J , Britton David R , Minchinton Todd E 
Published: January 2011

AbstractWithin endangered coastal salt marsh of south‐east Australia, the non‐indigenous rush Juncus acutus L. (Juncaceae) is displacing the native rush Juncus kraussii Hochst. (Juncaceae), with concurrent changes to the structure and composition of insect species assemblages. Here we test hypotheses that the abundance of a common and widespread sap‐sucking herbivore, the planthopper Haplodelphax iuncicola Kirkaldy (Hemiptera: Delphacidae), differed between the non‐indigenous J. acutus and the native J. kraussii, and that these differences were due to differential survivorship. Surveys at two salt marshes revealed that there were significantly fewer H. iuncicola on J. acutus than J. kraussii, and that J. kraussii at sites not invaded by J. acutus supported more than double the number of H. iuncicola than J. kraussii at invaded sites. A field experiment enclosing H. iuncicola on both Juncus species revealed complete mortality of planthoppers on the non‐indigenous rush J. acutus in about 2 weeks, whereas there was greater than 80% survivorship on the native rush J. kraussii. Measurements of plant architecture showed that J. acutus is structurally different to the native rush J. kraussii, with thicker, taller and less densely packed stems, suggesting that J. acutus might therefore provide unsuitable habitat or food resources for H. iuncicola. These results suggest that J. acutus does not play a functionally similar role to J. kraussii for native insect assemblages.
Floral visitation in the Australian native shrub genus Acrotriche R.Br (Ericaceae): an abundance of ants (Formicidae)
Authors: Schneemilch Melanie , Williams Craig , Kokkinn Michael 
Published: January 2011

AbstractThe genus Acrotriche is a group of predominantly winter flowering Australian native plants with small flowers that use a unique method of secondary pollen presentation. The mating system of one species has been determined as requiring transfer of pollen from one plant to another to enable effective pollination and floral conformity in other species suggests similar breeding systems. Previous authors have suggested non‐flying mammal pollination for members of the genus based on floral traits and reports of floral consumption; however, this hypothesis does not stand up to scrutiny. Acrotriche floral traits can also be interpreted as indicative of crawling invertebrate pollination. The identification of floral visitors and their potential for pollination has not been conducted previously for any Acrotriche species. To identify potential pollinators, the floral visitors to six different species of Acrotriche were observed throughout an entire 24 h period at a range of sites throughout South Australia. Ants were identified as the most common and abundant floral visitors for all Acrotriche species. Ant pollination is considered rare due to the negative effects that ant secretions can have on pollen viability. To determine these effects in relation to Acrotriche, pollen germination experiments were undertaken after contact with the integument of several ant species. Reductions in pollen viability varied between plants and ant species but in all experiments viable pollen remained after ant contact. These results, along with observed behaviour of ant visitors, indicate that ants may contribute to pollination in Acrotriche.
Introduction to biodegradable polylactic acid ureteral stent application for treatment of ureteral war injury
Authors: Li Gang , Wang Zhong‐Xin , Fu Wei‐Jun , Hong Bao‐Fa , Wang Xiao‐Xiong , Cao Lei , Xu Fu‐Qiang , Song Qiang , Cui Fu‐Zhai , Zhang Xu 
Published: January 2011

Study Type – Therapy (case series)Level of Evidence 4OBJECTIVE• To study the operability and effectiveness of a biodegradable ureteral stent for clinical treatment of ureteral war injury using a canine model.MATERIALS AND METHODS• A device was designed and employed to generate firearm fragment wounds in unilateral ureters (on randomly chosen sides) of nine beagles (Group A). The wounded ureters were then debrided and sutured.• Intravenous pyelography (IVP) and radioactive renography were performed 40, 80 and 120 days postoperatively. In Group B, firearm fragment wounds were made to the bilateral ureters in nine beagles. A polylactic acid stent was placed unilaterally (on a randomly chosen side) whereas the ureter on the other side was debrided and sutured without stenting.• Both IVP and radioactive renography were performed 40, 80 and 120 days postoperatively. The operability and effectiveness of the biodegradable ureteral stent were studied thereafter.RESULTS• In Group A, hydronephrosis and hydroureter occurred and worsened postoperatively on the wounded sides in all nine beagles. The ratio of the renal partial concentration indices (RPCI) between the kidneys (unwounded side : wounded side) increased.• The ratio of the kidney washout half‐time between the kidneys (unwounded side : wounded side) decreased. In Group B, neither hydronephrosis nor hydroureter was found postoperatively in the stented ureters but both occurred in the unstented ureters in all nine beagles.• The ratio of RPCI between kidneys (stented side : unstented side) increased whereas the kidney washout half‐time ratio between the stented and unstented sides decreased. Differences were significant.CONCLUSION• In Group A, the new canine model for firearm fragment wounds was tested and proved to be operable and effective. In Group B, hydronephrosis and hydroureter were effectively prevented in ureters by biodegradable stent placement compared with the non‐stented ureters where hydronephrosis and hydroureter occurred. The renal concentration capacity was effectively protected and the half‐time of kidney washout was shortened.