Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses.

Objective: To develop and determine the psychometrics properties of an instrument (V-scale) and to explore nurses' attitudes towards vital signs monitoring in the detection of clinical deterioration in general wards.

Design: Scale development with psychometric testing and a descriptive quantitative survey.

Setting: Tertiary acute care hospital.

Overexpression of an outer membrane protein associated with decreased susceptibility to carbapenems in Proteus mirabilis.

Proteus mirabilis isolates commonly have decreased susceptibility to imipenem. Previously, we found P. mirabilis hfq mutant was more resistant to imipenem and an outer membrane protein (OMP) could be involved.

Designing and evaluating an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care: randomized controlled trial.

Background: Web-based learning is becoming an increasingly important instructional tool in nursing education. Multimedia advancements offer the potential for creating authentic nursing activities for developing nursing competency in clinical practice.

Objective: This study aims to describe the design, development, and evaluation of an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care.

New aspects of RpoE in uropathogenic Proteus mirabilis.

Proteus mirabilis is a common human pathogen causing recurrent or persistent urinary tract infections (UTIs). The underlying mechanisms for P. mirabilis to establish UTIs are not fully elucidated.

Using simulation learning through academic-practice partnership to promote transition to clinical practice: a qualitative evaluation.

Aim: To explore the effect of an innovative simulation education programme on nursing students' transition-to-practice experiences.

Background: Academic-practice partnership is emerging as an important vehicle for improving nursing students' transition-to-practice. Using existing university resources, academic educators and alumni developed an innovative simulation educational programme known as the Simulated Professional Learning Environment (SIMPLE) to align the educational process with the realities of nursing practice.

An integrated organisation-wide data quality management and information governance framework: theoretical underpinnings.

Introduction: Increasing investment in eHealth aims to improve cost effectiveness and safety of care. Data extraction and aggregation can create new data products to improve professional practice and provide feedback to improve the quality of source data. A previous systematic review concluded that locally relevant clinical indicators and use of clinical record systems could support clinical governance.

Structures of trehalose synthase from Deinococcus radiodurans reveal that a closed conformation is involved in catalysis of the intramolecular isomerization.

Trehalose synthase catalyzes the simple conversion of the inexpensive maltose into trehalose with a side reaction of hydrolysis. Here, the crystal structures of the wild type and the N253A mutant of Deinococcus radiodurans trehalose synthase (DrTS) in complex with the inhibitor Tris are reported. DrTS consists of a catalytic (β/α)8 barrel, subdomain B, a C-terminal β domain and two TS-unique subdomains (S7 and S8).

The learning experiences of senior student nurses who take on the role of standardised patient: a focus group study.

The use of clinical simulation involving standardised patients is increasing in nursing education programmes. In this study, we sought to identify whether participation in simulation through taking on the role of standardised patients benefited student nurses in terms of knowledge and skill development, and if so, how. Data was collected in two focus group interviews with fifteen senior undergraduate nursing students in 2011 and subjected to processes of thematic analysis.

Defining dimensions of research readiness: a conceptual model for primary care research networks.

Background: Recruitment to research studies in primary care is challenging despite widespread implementation of electronic patient record (EPR) systems which potentially make it easier to identify eligible cases.

Methods: Literature review and applying the learning from a European research readiness assessment tool, the TRANSFoRm International Research Readiness instrument (TIRRE), to the context of the English NHS in order to develop a model to assess a practice's research readiness.

Results: Seven dimensions of research readiness were identified: (1) Data readiness: Is there good data quality in EPR systems; (2) Record readiness: Are EPR data able to identify eligible cases and other study data; (3) Organisational readiness: Are the health system and socio-cultural environment supportive; (4) Governance readiness: Does the study meet legal and local health system regulatory compliance; (5) Study-specific readiness; (6) Business process readiness: Are business processes tilted in favour of participation: including capacity and capability to take on extra work, financial incentives as well as intangibles such as social and intellectual capital; (7) Patient readiness: Are systems in place to recruit patients and obtain informed consent?

Conclusions: The model might enable the development of interventions to increase participation in primary care-based research and become a tool to measure the progress of practice networks towards the most advanced state of readiness.

Crystallization and preliminary crystallographic analysis of poly(3-hydroxybutyrate) depolymerase from Bacillus thuringiensis.

Poly[(R)-3-hydroxybutyrate] (PHB) is a microbial biopolymer that has been commercialized as biodegradable plastics. The key enzyme for the degradation is PHB depolymerase (PhaZ). A new intracellular PhaZ from Bacillus thuringiensis (BtPhaZ) has been screened for potential applications in polymer biodegradation.

Comparison of virtual patient simulation with mannequin-based simulation for improving clinical performances in assessing and managing clinical deterioration: randomized controlled trial.

Background: Virtual patient simulation has grown substantially in health care education. A virtual patient simulation was developed as a refresher training course to reinforce nursing clinical performance in assessing and managing deteriorating patients.

Objective: The objective of this study was to describe the development of the virtual patient simulation and evaluate its efficacy, by comparing with a conventional mannequin-based simulation, for improving the nursing students' performances in assessing and managing patients with clinical deterioration.

Unravelling the tangled taxonomies of health informatics.

Even though informatics is a term used commonly in healthcare, it can be a confusing and disengaging one. Many definitions exist in the literature, and attempts have been made to develop a clear taxonomy. Despite this, informatics is still a term that lacks clarity in both its scope and the classification of sub-terms that it encompasses.

EHR-based disease registries to support integrated care in a health neighbourhood: an ontology-based methodology.

Disease registries derived from Electronic Health Records (EHRs) are widely used for chronic disease management. We approached registries from the perspective of integrated care in a health neighbourhood, considering data quality issues such as semantic interoperability (consistency), accuracy, completeness and duplication. Our proposition is that a realist ontological approach is required to accurately identify patients in an EHR or data repository, assess data quality and fitness for use by the multidisciplinary integrated care team.

Big Data Usage Patterns in the Health Care Domain: A Use Case Driven Approach Applied to the Assessment of Vaccination Benefits and Risks. Contribution of the IMIA Primary Healthcare Working Group.

Background: Generally benefits and risks of vaccines can be determined from studies carried out as part of regulatory compliance, followed by surveillance of routine data; however there are some rarer and more long term events that require new methods. Big data generated by increasingly affordable personalised computing, and from pervasive computing devices is rapidly growing and low cost, high volume, cloud computing makes the processing of these data inexpensive.

Objective: To describe how big data and related analytical methods might be applied to assess the benefits and risks of vaccines.

Effectiveness of a patient education intervention in enhancing the self-efficacy of hospitalized patients to recognize and report acute deteriorating conditions.

Objective: To develop and pilot test the effectiveness of a patient education intervention in enhancing the self-efficacy of hospitalized patients to recognize and report symptoms of acute deteriorating conditions.

Method: Using cluster randomization, acute care general wards were randomized to the experimental and control groups. 34 patients in the experimental group received a 30-minute patient education intervention on Alert Worsening conditions And Report Early (AWARE) while 33 patients in the control group received the routine care only.

Integrating electronic health record information to support integrated care: practical application of ontologies to improve the accuracy of diabetes disease registers.

Background: Information in Electronic Health Records (EHRs) are being promoted for use in clinical decision support, patient registers, measurement and improvement of integration and quality of care, and translational research. To do this EHR-derived data product creators need to logically integrate patient data with information and knowledge from diverse sources and contexts.

Objective: To examine the accuracy of an ontological multi-attribute approach to create a Type 2 Diabetes Mellitus (T2DM) register to support integrated care.

Validating an ontology-based algorithm to identify patients with type 2 diabetes mellitus in electronic health records.

Background: Improving healthcare for people with chronic conditions requires clinical information systems that support integrated care and information exchange, emphasizing a semantic approach to support multiple and disparate Electronic Health Records (EHRs). Using a literature review, the Australian National Guidelines for Type 2 Diabetes Mellitus (T2DM), SNOMED-CT-AU and input from health professionals, we developed a Diabetes Mellitus Ontology (DMO) to diagnose and manage patients with diabetes. This paper describes the manual validation of the DMO-based approach using real world EHR data from a general practice (n=908 active patients) participating in the electronic Practice Based Research Network (ePBRN).

Serratia marcescens arn, a PhoP-regulated locus necessary for polymyxin B resistance.

Polymyxins, which are increasingly being used to treat infections caused by multidrug-resistant bacteria, perform poorly against Serratia marcescens. To investigate the underlying mechanisms, Tn5 mutagenesis was performed and two mutants exhibiting increased polymyxin B (PB) susceptibility were isolated. The mutants were found to have Tn5 inserted into the arnB and arnC genes.

Interprofessional simulation-based education program: a promising approach for changing stereotypes and improving attitudes toward nurse-physician collaboration.

An effective working relationship between physicians and nurses is enhanced by fostering positive perceptions and collaborative attitudes between the two professions. This brief paper examines the effect of an interprofessional simulation-based communication education program in enhancing medical and nursing students' perceptions of each other's profession and their attitudes toward nurse-physician collaboration. Pretest-Posttest design was conducted on 96 medical and nursing students who demonstrated the existence of professional stereotypes in the baseline data.

Effect of oral appliance on endothelial function in sleep apnea.

Objectives: This study evaluated the effects of mandibular advancement device (MAD) on serum levels of nitric oxide derivatives and endothelial function by endothelium-dependent flow-mediated dilation (FMD) in obstructive sleep apnea syndrome (OSAS).

Methods: Thirty patients with moderately severe-to-severe OSAS who desired MAD and 15 healthy controls were prospectively enrolled. FMD was measured by high-resolution B-mode ultrasonography, while serum NO x level from peripheral blood samples was measured by ELISA.

Post-impact fatigue damage monitoring using fiber Bragg grating sensors.

It has been shown that impact damage to composite materials can be revealed by embedded Fiber Bragg Gratings (FBG) as a broadening and splitting of the latter's characteristic narrow peak reflected spectrum. The current work further subjected the impact damaged composite to cyclic loading and found that the FBG spectrum gradually submerged into a rise of background intensity as internal damages progressed. By skipping the impact, directing the impact to positions away from the FBG and examining the extracted fibers, we concluded that the above change is not a result of deterioration/damage of the sensor.

Effect of uvulopalatopharyngoplasty on leptin and endothelial function in sleep apnea.

Objectives: This study evaluated the effects of uvulopalatopharyngoplasty (UPPP) on serum leptin levels and endothelial function in patients with obstructive sleep apnea syndrome (OSAS).

Methods: Fifteen healthy subjects and 35 patients with moderate to severe OSAS who desired UPPP were prospectively enrolled. The serum levels of leptin and nitric oxide derivative (NOx) from their peripheral blood samples were measured by enzyme-linked immunosorbent assay.

The RNA chaperone Hfq is involved in stress tolerance and virulence in uropathogenic Proteus mirabilis.

Hfq is a bacterial RNA chaperone involved in the riboregulation of diverse genes via small noncoding RNAs. Here, we show that Hfq is critical for the uropathogenic Proteus mirabilis to effectively colonize the bladder and kidneys in a murine urinary tract infection (UTI) model and to establish burned wound infection of the rats. In this regard, we found the hfq mutant induced higher IL-8 and MIF levels of uroepithelial cells and displayed reduced intra-macrophage survival.

Nurses' self-confidence and attitudes in using the Glasgow Coma Scale: a primary study.

Aims: The aim of this study was to examine nurses' self-confidence and attitudes towards the Glasgow Coma Scale (GCS).

Background: The GCS measures the depth and duration of impaired consciousness. However, there is an increasing evidence that problems are encountered in completing some aspects of the GCS.