Enhanced training in vascular access creation predicts arteriovenous fistula placement and patency in hemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study.

Objective: To investigate whether intensity of surgical training influences type of vascular access placed and fistula survival.

Summary Background Data: Wide variations in fistula placement and survival occur internationally. Underlying explanations are not well understood.

The instrumented instrument: characterization and training of manual skill in open suturing.

Instruction in the use of forceps and needle driver to suture tissues typically involves group didactic and demonstration sessions, followed by limited individual observation and coaching. Most motor learning required for dexterous suturing takes place during unsupervised practice with practice boards or during actual procedures in the operating room. We are developing surgical instruments with embedded microelectromechanical sensors for tracking instrument motion.

Case report: human exposure to dioxins from clay.

Context: For the general population, the dominant source of exposure to dioxin-like compounds is food. As part of the University of Michigan Dioxin Exposure Study (UMDES), we measured selected polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like polychlorinated biphenyls (PCBs) in serum of 946 subjects who were a representative sample of the general population in five Michigan counties.

Case Presentation: The total toxic equivalency (TEQ; based on 2005 World Health Organization toxic equivalency factors) of serum from the index case was 211 ppt on a lipid-adjusted basis, which was the highest value observed in the UMDES study population.

Improvement in survival associated with adult-to-adult living donor liver transplantation.

Background & Aims: More than 2000 adult-to-adult living donor liver transplantations (LDLT) have been performed in the United States, yet the potential benefit to liver transplant candidates of undergoing LDLT compared with waiting for deceased donor liver transplantation (DDLT) is unknown. The aim of this study was to determine whether there is a survival benefit of adult LDLT.

Methods: Adults with chronic liver disease who had a potential living donor evaluated from January 1998 to February 2003 at 9 university-based hospitals were analyzed.

Discriminating between strains of Escherichia coli using pulsed-field gel electrophoresis and BOX-PCR.

In this study, we evaluated two biomolecular techniques for discriminating between strains of Escherichia coli isolated form a variety of sources. The DNA of 211 strains of E. coli collected from dairy farms, calves, feces, pigs, primates, humans, and food products was analyzed by pulsed-field gel electrophoresis (PFGE) and repetitive-element polymerase chain reaction using the BOXA1 primer (BOX-PCR).

Analysis of the Third National Health and Nutrition Examination Survey (NHANES III) using expert ratings of job categories.

Background: Few epidemiologic studies have addressed the exposure-response relationships between work activities and symptomatic knee osteoarthritis (OA). This analysis used data from a national survey and ergonomists' ratings to address this issue.

Methods: Interview and knee X-ray data were obtained from the Third National Health and Nutrition Examination Survey.

Mortality, kidney disease and cardiac procedures following acute coronary syndrome.

Background: Cardiac interventions are underutilized in patients with chronic kidney disease (CKD) following acute coronary syndrome (ACS) partly due to nephrotoxicity concerns.

Methods: We analyzed outcomes of 4631 subjects with ACS enrolled in the Blockade of the Glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion trial, including time to death, time to reduced renal function (50% reduction in estimated glomerular filtration rate (eGFR) or development of end-stage renal disease (ESRD)) and percent change in eGFR from baseline.

Results: Subjects with a lower baseline eGFR were more likely to be older, female and have diabetes, hypertension, congestive heart failure or peripheral vascular disease (all P < 0.

Factors associated with intraocular pressure before and during 9 years of treatment in the Collaborative Initial Glaucoma Treatment Study.

Purpose: To evaluate, both at initial glaucoma diagnosis and during treatment, the role of demographic and clinical factors on intraocular pressure (IOP).

Design: Cohort study of patients enrolled in a randomized clinical trial.

Participants: Six hundred seven patients with newly diagnosed open-angle glaucoma (OAG) were enrolled at 14 centers in the United States.

Risk for cardiovascular outcomes among subjects with atherosclerotic cardiovascular disease and greater-than-normal estimated glomerular filtration rate.

Background And Objectives: Estimating equations for calculating glomerular filtration rate (eGFR) occasionally identify patients with elevated eGFR, yet the prognostic significance remains to be determined. This study sought to define the association of an elevated eGFR on the risk for death and cardiovascular outcomes among subjects with atherosclerotic cardiovascular disease.

Design, Setting, Participants, & Measurements: Data from 8941 subjects who had a history of atherosclerotic vascular disease and were enrolled in the Blockade of the Glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion trial were analyzed.

The influence of personal characteristics on the resilience of operating room nurses: a predictor study.

Background: Resilience in the workplace has been described as a means of facilitating adaptation in stressful environments, and therefore has application in nursing contexts. However, little research has examined how personal characteristics such as age, nursing experience and education contribute to resilience in clinical environments such as the operating room (OR).

Objective: First to identify the level of resilience, and second, investigate whether age, experience and education contribute to resilience in an Australian sample of OR nurses.

Aspirin prescription and outcomes in hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Background: We investigated aspirin-prescribing patterns and potential benefits on cardiovascular morbidity and mortality in hemodialysis patients.

Study Design: Cohort study.

Setting & Participants: Data included 28,320 randomly selected hemodialysis patients from the Dialysis Outcomes and Practice Patterns Study I and II.

Predictors of early mortality among incident US hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Mortality risk among hemodialysis (HD) patients may be highest soon after initiation of HD. A period of elevated mortality risk was identified among US incident HD patients, and which patient characteristics predict death during this period and throughout the first year was examined using data from the Dialysis Outcomes and Practice Patterns Study (DOPPS; 1996 through 2004). A retrospective cohort study design was used to identify mortality risk factors.

Risk factors for group B streptococcal colonization: potential for different transmission systems by capsular type.

Purpose: Group B Streptococcus (GBS) is a common inhabitant of the bowel and vaginal flora, with known transmission routes including sexual contact and vertical transmission from mother to infant. Food-borne transmission is also possible, as GBS is a known fish and bovine pathogen. We conducted a prospective cohort study in order to identify risk factors for acquisition.

Development of a theoretically derived model of resilience through concept analysis.

Background: Resilience refers to a dynamic process that results in adaptation in the context of significant adversity (Margalit 2004). The concept of resilience has been of interest to various professional groups for many years; however, it is only recently that the nursing profession has begun to recognise its potential contribution in diverse clinical contexts.

Objective: First, to identify current theoretical and operational definitions of resilience and second, to identify and describe defining attributes of resilience.

Resilience in the operating room: developing and testing of a resilience model.

Aim: This paper is a report of a study to examine the relation of perceived competence, collaboration, control, self-efficacy, hope, coping, age, experience, education and years of employment to resilience in operating room (OR) nurses.

Background: Resilience is viewed as a vital attribute for nurses because it augments adaptation in demanding and volatile clinical environments such as ORs. However, there has been little research into the utility of resilience as a means of dealing with workplace stress, and there is only limited understanding of variables that explain resilience in the context of nursing.

Expert consensus ratings of job categories from the Third National Health and Nutrition Examination Survey (NHANES III).

Background: A method of occupational physical exposure assessment is needed to improve analyses using large data sets (e.g., national surveys) that provide only job title/category information as a proxy for exposure.

Relationship between interdialytic weight gain and blood pressure among prevalent hemodialysis patients.

Background: Hypertension is common in hemodialysis patients; however, the relationship between interdialytic weight gain (IDWG) and blood pressure (BP) is incompletely characterized. This study seeks to define the relationship between IDWG and BP in prevalent hemodialysis subjects.

Study Design, Setting, & Participants: This study used data from 32,295 dialysis sessions in 442 subjects followed up for 6 months in the Crit-Line Intradialytic Monitoring Benefit (CLIMB) Study.

Operating theater culture: implications for nurse retention.

Health service delivery in the operating theater is vulnerable to shortages because of the unique environment, post-registration training requirements, and the occupational subculture that characterizes social relations. The aim of this mini-ethnography is to explore characteristics of organizational culture of the operating theater and how this culture is communicated and sustained. The field setting is an eight-theater department in a major hospital in Queensland, Australia.

Severe psychiatric problems in right hepatic lobe donors for living donor liver transplantation.

Background: The morbidity and mortality from donation of a right hepatic lobe for living donor liver transplantation (LDLT) is an important issue for this procedure. We report the prevalence of severe psychiatric postoperative complications from the Adult-to-Adult Living Donor Liver Transplantation Cohort study (A2ALL), which was established to define the risks and benefits of LDLT for donors and recipients.

Methods: Severe psychiatric complications were evaluated in all donors from the A2ALL study who were evaluated between 1998 and February 2003.

Phenotypic and genotypic antimicrobial resistance patterns of Escherichia coli isolated from dairy cows with mastitis.

Pulsed field gel electrophoresis (PFGE) patterns, susceptibility to 26 antimicrobial agents used in veterinary and human medicine, and prevalence of antimicrobial resistance genes of Escherichia coli isolated from cows with mastitis were evaluated. Among 135 E. coli isolates, PFGE analysis revealed 85 different genetic patterns.

Fear of blindness in the Collaborative Initial Glaucoma Treatment Study: patterns and correlates over time.

Purpose: The objective of this study was to describe the prevalence of fear of blindness (FOB) and the factors associated with FOB during 5 years of follow-up in the Collaborative Initial Glaucoma Treatment Study.

Design: Randomized controlled clinical trial.

Participants: A total of 607 newly diagnosed patients with open-angle glaucoma were recruited from 14 clinical centers in the United States.

Risk factors for urinary complications after renal transplantation.

Urinary complications are common following renal transplantation. The aim of this study is to evaluate the risk factors associated with renal transplant urinary complications. We collected data on 1698 consecutive renal transplants patients.

Exploring subdomain cooperativity in T4 lysozyme I: structural and energetic studies of a circular permutant and protein fragment.

Small proteins are generally observed to fold in an apparent two-state manner. Recently, however, more sensitive techniques have demonstrated that even seemingly single-domain proteins are actually made up of smaller subdomains. T4 lysozyme is one such protein.