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To assess the mid-term efficacy and safety of anterior urethroplasty using an autologous tissue-engineered oral mucosa graft (MukoCell
).
The data of 77 patients with anterior urethral strictures undergoing treatment with MukoCell
at a tertiary center from June 2016 to May 2019 were analyzed. Patients' characteristics, pre- and postoperative diagnostics, perioperative complications, and follow-up data were obtained. The overall stricture-free survival, outcomes of the different surgical techniques, stricture localizations, stricture length, early complications of the procedure and risk factors of recurrence were assessed.
The median follow-up period was 38months (interquartile range 31-46). The overall recurrence-free rate of anterior urethroplasty using MukoCell
was 68.8%, 24 patients (31.2%) developed a recurrence of the stricture. The stricture recurrences were observed at a median of 7months (interquartile range 3-13) only in patients with at least one previous surgery or repeated dilatations in their medical history. No oral-urethral adverse events related to the use of MukoCell
were observed, except for a urethrocutaneous fistula (1.3%) requiring reoperation.
Anterior one-stage urethroplasty using MukoCell
showed in our hands a mid-term success rate of up to 68.8% without significant adverse events after a median follow-up period of 38months. This procedure might be an alternative option for long-segment urethral reconstruction.
Anterior one-stage urethroplasty using MukoCell® showed in our hands a mid-term success rate of up to 68.8% without significant adverse events after a median follow-up period of 38 months. This procedure might be an alternative option for long-segment urethral reconstruction.
To identify factors that facilitate participation in shared governance and attendance at unit meetings.
Shared governance and unit meetings are crucial for education and communication. Current literature explores barriers to participation and attendance; however, removal of barriers may be insufficient to bring about behaviour change in nurses.
Secondary analysis of data from 511 clinical nurses, who worked at one of nine facilities within one large health care system in the Midwest United States, was used to address our aim.
Shared governance participants and unit meeting attendees were most satisfied with nursing as a career and more likely to be optimistic that nurses could change things, than non-participants and non-attendees, and this difference was statistically significant (p<.05). The organizational variable most associated with participation and attendance dealt with paid time-off to attend meetings. Personal reasons for participation and attendance were the opportunity to express opinions and to hear opinions of others.
Organizations should encourage nurses to express their opinions and ensure that nurses are paid for the time spent participating in meetings.
While some variables cannot be controlled by organizations, nursing leadership can provide opportunities for nurses to become more active and participate in decision-making.
While some variables cannot be controlled by organizations, nursing leadership can provide opportunities for nurses to become more active and participate in decision-making.
The literature emphasizes the importance of the intensive care unit (ICU) diary to fill the gaps and recover the delusional memories of patients admitted to ICU in order to build the history of their illness. The ICU diary is a measure originally intended to support the severely ill patient, but it would also seem to be useful for family members and carers. According to our analysis of the literature, this study is the first description of the contents of ICU diaries in the Italian context.
The aim of the study was to describe the contents of ICU patients' diaries filled in by their caregivers, in order to explore the experience and significance attributed to the diaries.
A qualitative longitudinal narrative investigation was conducted at an ICU during the period from April 2016 to April 2017 with a sample composed of 32 families.
The participants were caregivers selected through purposive sampling. An ICU nurse explained the study to caregivers and offered the opportunity to participate.
The sample included 32 diaries. Through the analysis we identified seven themes future plans and memories; the people who care for the patient and the context; the love surrounding the patient; the clinical progression of the patient and the passage of time; what happens outside the patient's life; references to the usefulness/non-usefulness of the diary; communication/reflection on the likely death of the patient.
Some themes emerged that have never explored in the literature, and it would be necessary to understand whether the themes that emerged depend on cultural issues.
The diaries could be adapted to the Italian context and this could make the diary a common practice in Italy as well.
The diaries could be adapted to the Italian context and this could make the diary a common practice in Italy as well.
Social Jetlag (SJL) is a condition leading to many important physical, mental, behavioral, and cognitive problems in adolescents.
The sample of this study, which used a descriptive and correlational design, consisted of 247 high school students. The SJL parameters were informed by the literature, while chronotype was identified using the Morningness-Eveningness Scale for Children. The factors associated with SJL were determined using a structured questionnaire.
Students' SJL value was 2 h 10 min ± 0111. As students' tendency to be an evening chronotype increased, the SJL value increased, as well (r = -0.472; p < 0.001). In terms of SJL, student's grade level (β = -0.167; p = 0.004) and chronotype (β = -0.438; p < 0.001) were a negative risk factor, while spending time in bed with TV/computer/smartphone before sleeping (β = 0.127; p = 0.031) was a positive risk factor.
The students had a high SJL value. The results might be useful for nurses to develop intervention strategies to improve adolescents sleep habits.
The students had a high SJL value. The results might be useful for nurses to develop intervention strategies to improve adolescents sleep habits.
To assess the effects of workplace fun on nurse innovative behaviour and to confirm the intermediary function of affective commitment.
Employee innovative behaviour has a crucial function in survival and development of an organisation. On the basis of the theory of social exchange, there has been inadequate study of the influence of workplace fun on nurse innovative behaviour mediated by affective commitment.
A cross-sectional, descriptive correlational research design was conducted for 331 Chinese nurses from five public hospitals. The measurements were obtained from a questionnaire on workplace fun, affective commitment, nurse innovative behaviour and a sociodemographic datasheet. Descriptive statistics were used to analyse the personal profile, and inferential statistics were used to test hypotheses.
We identified a positive correlation between workplace fun and nurse innovative behaviour. Affective commitment had a mediating effect.
Workplace fun and affective commitment can promote nurse innovative behaviour.
Managers need to provide measures that promote workplace fun and affective commitment to enhance nurse innovative behaviour.
Managers need to provide measures that promote workplace fun and affective commitment to enhance nurse innovative behaviour.
The complex electrophysiological phenomena related to the atrioventricular node (AVN) are due to its complex anatomical structures. Aside from the inferior nodal extension (INE), other node-like tissues, such as the retroaortic node (RN), have been described less extensively and may also share the mechanism of normal conduction and abnormal conduction in AVN re-entrant tachycardia.
High-density sections of the entire AVN were obtained from rats and rabbits. Fibrosis was analyzed by Masson's trichrome staining. Connexin (Cx43, Cx40, and Cx45) and ion channel (Na
1.5, Ca
3.1, and HCN4) proteins were immunohistochemically labeled for the analysis of tissue features. Three-dimensional (3D) reconstruction of the AV junction was performed to clarify the relationships among different structures.
The RN expressed the same connexin isoforms as the compact node (CN) and INE. Na
1.5 labeling was observed at low levels in the CN, RN, and INE, where Ca
3.1 and HCN4 were expressed. The CN connected with the RN in a narrow strip pattern at the start of the CN. The RN presented as a shuttle shape and was the only tissue directly connected with the atrium in the anterior septum.
The RN connects with the AVN anatomically, suggesting that direct electrical conduction occurs between them. The entrance of the atria into the AVN is distal to the RN, which may form the fast AVN pathway.
The RN connects with the AVN anatomically, suggesting that direct electrical conduction occurs between them. The entrance of the atria into the AVN is distal to the RN, which may form the fast AVN pathway.
Klebsiella pneumoniae has been reported to develop increased antibiotic resistance. Ceftazidime-avibactam (CZA) is a novel antibiotic with activity against serine-lactamase. find more Here, we investigated the sensitivity of carbapenem-resistant K.pneumoniae (CRKP) to CZA and the mechanisms of drug resistance in our hospital.
Patient characteristics were obtained from medical records. K.pneumoniae and its antibiotic susceptibility were determined using the Vitek-2 Compact instrument. The antibiotic resistance genes KPC, NDM, OXA-48, VIM, IMP, CIM, SPM, TMB, SMB, SIM, AIM and DIM were detected using real-time PCR. Multilocus sequence typing was used for genetic RELATEDNESS analysis. In total, 121 CRKP strains were isolated from patients in the intensive care unit (51·2%), senior ward (12·4%) and neurosurgery department (10%). With an average age of 72·5years, most patients were in care for respiratory (34·7%), brain (20·7%), digestive tract (13·2%) and cardiovascular (8·3%) diseases. Specimens were predominantly obtained from sputum (39·67%), urine (29·75%) and blood (6·61%).
Of 23 CZA-resistant CRKP strains (19·01%), ST11 being the most common at 56·52%, 11 NDM-1-positive (47·83%) and four NDM-5-positive (17·39%) strains were detected.
Our study indicates that CZA resistance occurs in ~19·01% CRKP strains and that bla
and bla
might be critical for resistance.
Our study indicates that CZA resistance occurs in ~19·01% CRKP strains and that blaNDM-1 and blaNDM-5 might be critical for resistance.
This study aims to explore the relationship between work environment, job characteristics and person-centred care for people with dementia in nursing homes.
Person-centred care approaches have become a dominant indicator for good quality of care in nursing homes. Little is known about the relationship between work environment, job characteristics and person-centred care in nursing homes.
Cross-sectional data from the LAD study were used. Direct care staff (n=552) of nursing homes (n=49) filled an online questionnaire about work environment characteristics and person-centred care. To examine relationships, multilevel linear regression analyses were conducted.
Associations were found between a higher transformational leadership style, less social support from a leader, a higher unity in philosophy of care, higher levels of work satisfaction, more development opportunities, better experienced teamwork and staff-reported person-centred care.
In a complex nursing home environment, person-centred care is influenced by organisational and work characteristics, shared values and interpersonal relationships.
Read More: https://www.selleckchem.com/products/sch-527123.html
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