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Ranheim A, Kärner A, Arman M, Rehnsfeldt AW, Berterö C. International Journal of Nursing Practice 2010; 16 : 241–247
Embodied reflection in practice—‘Touching the core of caring’ A study was performed with the aim of clarifying the integration of the caring act of touch with reflection on caring theory. Seven participant nurses in elderly care volunteered as ‘coresearchers’ and performed a caring act called Rhythmical Embrocation, together with reflective dialogues on caring theory. The project lasted for 6 months and at the end qualitative interviews with participants were used to evaluate the study. The findings showed an opening of awareness, embodied moments of presence and an extended ability to act creatively in caring. In this study, the movement between theory and practice was the integration of the caring act with reflection on basic caring concepts. Implications for praxis development are that implementation and reflection by teams over certain caring acts might open the door to an expanded view of one's own caring ability that in the long run will benefit the patient.  相似文献   
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Context: Corneal collagen cross linking (CCL) with ultraviolet A (UVA) has been proposed as a treatment for the progression of corneal ectasia associated with keratoconus and post-laser-assisted in situ keratomileusis (LASIK) ectasia. Despite the reports about safety of procedure, we consider that UVA of sunlight can effect riboflavin saturated and de-epitelizated cornea early after CCL.

Objectives: To evaluate the UVA blockage capability of 11 different silicone hydrogel contact lenses which are widely used after CCL treatment.

Methods: Eleven different silicone hydrogel and daily disposable contact lenses were evaluated. The UVA light at 365?nm wavelength for UVA source and UV light meter to measure UVA radiation were used. 3, 9 and 18?mW/cm2 power of UV radiance was applied centrally to the each type of contact lenses. The power of UVA transmittance for each radiance and percentage of blockage were evaluated for each brand. Also, protection factor (PF) was calculated.

Results: The senofilcon A and narafilcon A had the highest blockage and lowest transmittance (p?=?0.02). PF was significantly higher in the senofilcon A and narafilcon A at 3, 9 and 18?mW/cm2 (p?=?0.0001). And also, the hilafilcon B, filcon IV, nelfilcon A, enfilcon A, lotrafilcon A and lotrafilcon B had the highest UVA transmittance.

Conclusion: The narafilcon A and the senofilcon A may be a good options for epithelial healing after CCL procedure to protect the cornea from UVA of sunlight. And also, the hilafilcon B, filcon IV, nelfilcon A, enfilcon A, lotrafilcon A and lotrafilcon B contact lenses that have high-UVA transmittance feature can be a treatment choice for contact lens-assisted CCL technique in thin corneas.  相似文献   
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Objective: The aim of present study was to evaluate the indications and the complications associated with neonatal exchange transfusion (ET) performed for hyperbilirubinemia.

Methods: This study included overall 306 neonates who underwent ET between 2005 and 2012. The demographic characteristics of patients, causes of jaundice and adverse events occurred during or within 1 week after ET were recorded from their medical files. Those newborns that underwent ET were classified as either “otherwise healthy” or “sick” group.

Results: Of the 306 patients who underwent ET, 244 were otherwise healthy and had no medical problems other than jaundice. The remaining 62 patients were classified as sick that had medical problems other than jaundice ranging from mild to severe. The mean gestational age was 37.6?±?2.5 weeks and the mean peak total bilirubin levels was 25.8?±?6.6?mg/dl. The mean age at presentation was 5.4?±?3.8?d for all infants. The most common cause of hyperbilirubinemia was ABO isoimmunization (27.8%). None of newborns died secondary to ET. Three infants had had necrotizing enterocolitis, and also three infants had had acute renal failure. The most common encountered complications of ET procedure were hyperglycemia (56.5%), hypocalcaemia (22.5%) and thrombocytopenia (16%).

Conclusions: Our data showed that ABO isoimmunization was the most common cause of hyperbilirubinemia. Even mortality was not seen, very rare but major gastrointestinal and renal complications were associated with ET. The majority of adverse events associated with ET were laboratory abnormalities mainly hyperglycemia, hypocalcaemia and thrombocytopenia which were asymptomatic and treatable.  相似文献   
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Objective

To ascertain whether temporal and geographic interest in seeking cardiovascular disease (CVD) information online follows seasonal and geographic patterns similar to those observed in real-world data.

Methods

We searched Google Trends for popular search terms relating to CVD. Relative search volumes (RSVs) were obtained for the period January 4, 2004, to April 19, 2014, for the United States and Australia. We compared average RSVs by month and season and used cosinor analysis to test for seasonal variation in RSVs. We also assessed correlations between state-level RSVs and CVD burden using an ecological correlational design.

Results

RSVs were 15% higher in the United States and 45% higher in Australia for winter compared with summer (P<.001 for difference for both). In the United States, RSVs were 36% higher in February compared with August, while in Australia, RSVs were 75% higher in August compared with January. On cosinor analysis, we found a significant seasonal variability in RSVs, with winter peaks and summer troughs for both the United States and Australia (P<.001 for zero amplitude test for both). We found a significant correlation between state-level RSVs and mortality from CVD (r=0.62; P<.001), heart disease (r=0.58; P<.001), coronary heart disease (r=0.48; P<.001), heart failure (r=0.51; P<.001), and stroke (r=0.60; P<.001).

Conclusion

Google search query volumes related to CVD follow strong seasonal patterns with winter peaks and summer troughs. There is moderate to strong positive correlation between state-level search query volumes and burden of CVD mortality.  相似文献   
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The aim of this study was to assess the quantity of interstitial cells of Cajal (ICC) in the lower esophageal sphincter (LES) in achalasia. LES muscle was obtained from 11 achalasia and nine esophageal cancer (control) patients during surgery. Immunohistochemistry was performed and average cell counts per high-power field (HPF) were obtained. Overall, more ICC were observed in achalasia (median = 14.0 cells/HPF; range = 0–22.6 cells/HPF) as compared with controls (median = 6.2 cells/HPF; range = 1.6–10.8 cells/HPF) (P = 0.047). There were two subsets of findings within the achalasia group: 8/11(73%) had an increased quantity of ICC (median = 17.1 cells/HPF; range = 11.6–22.6; P = 0.015) as compared with controls, whereas the remaining 3/11(27%) had a paucity of ICC (median = 0 cells/HPF; range = 0–2; P = 0.02). ICC levels were positively correlated with age of the patient (P = 0.043). Our study demonstrates that subsets of abnormal ICC levels are observed in idiopathic achalasia of the esophagus.  相似文献   
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Natural products have served as inspirational scaffolds for the design and synthesis of novel antineoplastic agents. Here we present our preliminary efforts on the synthesis and biological evaluation of a new class of electrophilic steroids inspired by the naturally occurring taccalonolides. We demonstrate that these simplified analogs exhibit highly persistent antiproliferative properties similar to the taccalonolides and retain activity against resistant cancer cell lines that warrants further preclinical development.  相似文献   
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