Tailored Multifaceted Strategy for Implementing Fundamental Evidence-Based Nursing Care: An Evaluation Study.

: Extensive research has emphasised the persistent challenges and failures in providing hospitalised patients with fundamental evidence-based nursing care, often resulting in grave consequences for patient safety. Recommendations from implementation research indicate that a tailored theory- and research-based implementation strategy targeting contextual determinants can optimise the implementation of evidence-based clinical practice for the benefit of patients. This study evaluated the feasibility of an implementation strategy designed to improve the quality of nursing care by targeting behavioural and environmental barriers in a hospital setting.

Corticotropin-releasing hormone and vasopressin challenge affects metabolic, hematologic, and rumen fermentation parameters of growing beef steers.

The objective of this study was to evaluate the impacts of stress challenge duration on metabolic, hematologic, and rumen fermentation parameters of beef steers. Thirty steers (416 ± 19 kg) were used in a randomized complete block design with 2 blocks and 3 treatments. Treatments were intravenous injection of (1) saline at 0, 24, 48, and 72 h ( = 10; control); (2) corticotropin-releasing hormone (CRH) and vasopressin (VP) at 0 h and saline at 24, 48, and 72 h ( = 10; acute); or (3) CRH and VP at 0, 24, 48, and 72 h ( = 10; chronic).

Effects of protein concentration and beta-adrenergic agonists on ruminal bacterial communities in finishing beef heifers.

To improve animal performance and modify growth by increasing lean tissue accretion, beef cattle production has relied on use of growth promoting technologies such as beta-adrenergic agonists. These synthetic catecholamines, combined with the variable inclusion of rumen degradable (RDP) and undegradable protein (RUP), improve feed efficiency and rate of gain in finishing beef cattle. However, research regarding the impact of beta-adrenergic agonists, protein level, and source on the ruminal microbiome is limited.

Development of an Implementation Strategy Tailored to Deliver Evidence-Based and Person-Centred Nursing Care for Patients with Community-Acquired Pneumonia: An Intervention Mapping Approach.

Community-acquired pneumonia is a serious public health problem, and more so in older patients, leading to high morbidity and mortality. However, this problem can be reduced by optimising in-hospital nursing care. Accordingly, this study describes a systematic process of designing and developing a tailored theory- and research-based implementation strategy that supports registered nurses (RNs) in delivering evidence-based and person-centred care for this patient population in a hospital setting.

Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium.

Purpose: We assessed long-term outcomes in acutely admitted adult patients with delirium treated in intensive care unit (ICU) with haloperidol versus placebo.

Methods: We conducted pre-planned analyses of 1-year outcomes in the Agents Intervening against Delirium in the ICU (AID-ICU) trial, including mortality and health-related quality of life (HRQoL) assessed by Euroqol (EQ) 5-dimension 5-level questionnaire (EQ-5D-5L) index values and EQ visual analogue scale (EQ VAS) (deceased patients were assigned the numeric value zero). Outcomes were analysed using logistic and linear regressions with bootstrapping and G-computation, all with adjustment for the stratification variables (site and delirium motor subtype) and multiple imputations for missing HRQoL values.

Struggling to return to everyday life-The experiences of quality of life 1 year after delirium in the intensive care unit.

Background: Many critically ill patients report a change in their health-related quality of life after intensive care unit (ICU) discharge. Patients who experience delirium during their ICU stay are perceived as a fragile group of ICU survivors, and the 'quality of life' phenomenon needs to be studied among these patients.

Aim: To explore everyday life experiences of critically ill patients with delirium during the ICU stay, from ICU discharge until 1-year follow-up, focusing on their health-related quality of life and cognitive function.

Ongoing traumatic stress during a global pandemic.

Objective: The COVID-19 pandemic has been conceptualized as a potentially traumatic event, although heterogeneity in experience (e.g., isolation) and in type and severity of traumatic stress response (e.

Impacts of including Sweet Bran and wet distillers grains with solubles alone or in combination in finishing cattle diets on physically effective fiber concentrations and rumen buffering characteristics of feedlot cattle.

This study evaluated the effects of Sweet Bran (SB) and wet distillers grains with solubles (WDGS) in the diet alone or in combination on physically effective neutral detergent fiber (peNDF), ruminal pH, and rumination behavior of finishing beef cattle. For this study, 455 steers (373 ± 15.5 kg) were allocated to 48 pens in a randomized complete block design.

The Stressful Memory Assessment Checklist for the Intensive Care Unit (SMAC-ICU): Development and Testing.

Stressful or traumatic memories of an intensive care stay may lead to long-term psychological morbidity. Memory assessment is therefore essential to aid in the patients' recovery process. Acknowledging the large cohort of post ICU patients during the SARS-CoV-2 pandemic, a simple tool for the evaluation of ICU memories is needed.

Feeding a high-energy finishing diet upon arrival to high-risk feedlot calves: effects on health, performance, ruminal pH, rumination, serum metabolites, and carcass traits.

This study evaluated the impacts of feeding a high-energy finishing diet during both the receiving and finishing period compared with a lower-energy receiving diet with adaptation to the finishing diet on health, performance, serum chemistry, ruminal pH, rumination, and carcass characteristics of high-risk feedlot cattle. Five truck-load blocks of steers (n = 101) and bulls (n = 299) were used in a generalized complete block design and randomly assigned to receive: 1) finishing diet for the entire feeding period (FIN) or 2) receiving diet for the first 56 d, followed by a transition to the finishing diet (REC). All cattle were fed ad libitum and consumed the same diet by day 74.

'Stolen Time'-Delivering Nursing at the Bottom of a Hierarchy: An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing for Patients with Community-Acquired Pneumonia.

The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses' (RNs') adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP.

Mental health and resilience during the coronavirus pandemic: A machine learning approach.

Objective: This study explored risk and resilience factors of mental health functioning during the coronavirus disease (COVID-19) pandemic.

Methods: A sample of 467 adults (M age = 33.14, 63.

Multi-Scale Organization of the Genome.

Interphase chromatin, despite its appearance, is a highly organized framework of loops and bends. Chromosomes are folded into topologically associating domains, or TADs, and each chromosome and its homolog occupy a distinct territory within the nucleus. In , genome organization is exceptional because homologous chromosome pairing is in both germline and somatic tissues, which promote interhomolog interactions such as transvection that can affect gene expression in .

Mortality and HRQoL in ICU patients with delirium: Protocol for 1-year follow-up of AID-ICU trial.

Background: Intensive care unit (ICU)-acquired delirium is frequent and associated with poor short- and long-term outcomes for patients in ICUs. It therefore constitutes a major healthcare problem. Despite limited evidence, haloperidol is the most frequently used pharmacological intervention against ICU-acquired delirium.

The power of appraisals in predicting PTSD symptom improvement following cognitive rehabilitation: A randomized clinical trial.

Background: Patients with PTSD often voice concern over their perceived change in cognitive functioning. However, these negative appraisals do not always align with objective neuropsychological performance, yet are strongly predictive of PTSD symptom severity and self-reported functional impairment.

Methods: The present study involves a secondary analysis examining the role of appraisals of a subsample of 81 adults with full or subthreshold PTSD on treatment outcomes in a randomized controlled trial investigating the effectiveness of a cognitive rehabilitation treatment, Strategic Memory and Reasoning Training (n = 38), compared to a psychoeducation control arm, the Brain Health Workshop (n = 43).

Cognitive Training for Mild Traumatic Brain Injury and Posttraumatic Stress Disorder.

Although there is evidence of mild cognitive impairments for many individuals with mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD), little research evaluating the effectiveness of cognitive training interventions has been conducted. This randomized controlled trial examined the effectiveness of a 9-h group cognitive training targeting higher-order functions, Strategic Memory Advanced Reasoning Training (SMART), compared to a 9-h psychoeducational control group in improving neurocognitive functioning in adults with mTBI and PTSD. A sample of 124 adults with histories of mild TBI ( = 117) and/or current diagnoses of PTSD ( = 84) were randomized into SMART ( = 66) or Brain Health Workshop (BHW; = 58) and assessed at three time points: baseline, following training, and 6 months later.

Changing Perspectives: Offloading a Patient With a Diabetic Foot Ulcer as Opposed to Offloading a Diabetic Foot Ulcer.

Diabetic foot ulcers (DFUs) represent a tremendous burden to health care systems. Offloading is one of the key tenants to healing DFU and knee-high irremovable offloading devices are considered the gold standard for offloading DFU. However, the gold standard is rarely utilized in clinical practice.

Effects of PB6 and/or chromium propionate supplementation on serum chemistry, complete blood count, and fecal spp. count in high-risk cattle during the feedlot receiving and finishing periods.

The study objective was to determine the effects of PB6 and/or chromium propionate supplementation on serum chemistry, complete blood count, and fecal spp. count in high-risk beef cattle during a 56-d feedlot receiving period and the subsequent finishing period. Four truckload blocks of crossbred beef bulls ( = 300) and steers [ = 84; total 384; average initial body weight (BW) = 220 ± 16.

Effects of PB6 and/or chromium propionate supplementation on clinical health, growth performance, and carcass traits of high-risk cattle during the feedlot receiving and finishing periods.

The study objective was to determine the effects of PB6 and/or chromium propionate supplementation on health, growth performance, and carcass characteristics of high-risk beef cattle during a 56-d feedlot receiving period and the subsequent finishing period. Four truckload blocks of crossbred beef bulls ( = 300) and steers [ = 84; body weight (BW) = 220 ± 16.2 kg] were sourced from regional auction markets and assigned randomly to treatments arranged in a 2 × 2 factorial.

Social engagement, self-efficacy, and posttraumatic stress symptoms across 6 months of psychotherapy.

Objective: The current study was conducted in a naturalistic treatment setting to examine whether and how perceptions about social engagement, trauma coping self-efficacy, and posttraumatic stress symptoms (PTS) influence one another across 6 months of psychotherapy for trauma survivors.

Method: The sample included 183 clients who reported exposure to traumatic events and significant PTS (PCL-5 ≥ 33). Participants (M  = 37.

Predictors of Posttraumatic Stress Disorder, Anxiety, and Depression Symptoms in Survivors of Torture Living in the United States.

A constellation of psychosocial factors contributes to the complex trauma symptoms that survivors of torture may experience. We examined the roles of pretrauma, peritrauma, and postmigration factors as predictors of posttraumatic stress disorder, depression, and anxiety in a sample of 101 culturally heterogeneous torture survivors residing in the United States. Predictors included demographic variables (sex, education, marital status), peritrauma torture type variables generated by principal components analysis (PCA), and postmigration variables (employment status, legal immigration status, and family separation).

Assessment of caregiver expectations of physician communication in a pediatric setting.

Background: In pediatrics, communication often occurs through an intermediary such as a caregiver. The goal of this study is to assess caregiver communication expectations and determine if meeting expectations influences caregiver satisfaction or instruction retention.

Methods: A survey study was performed at the Children's Hospital of Philadelphia.

Acute cognitive effects of the hypocretin receptor antagonist almorexant relative to zolpidem and placebo: a randomized clinical trial.

Study Objectives: Hypnotic medications can adversely affect behavior during unanticipated awakenings during the night. Animals treated with the hypocretin (Hcrt) receptor antagonist almorexant (ALM) have less acute cognitive impairment compared to the GABAA receptor modulator zolpidem (ZOL). This study aimed to determine whether ALM produces less acute cognitive impairment than ZOL in human subjects.

Food Allergy Management at School.

Background: Approximately 8% of schoolchildren in the United States experience potentially life-threatening food allergies. They must diligently avoid allergenic foods and have prompt access to epinephrine to treat anaphylaxis. These prevention strategies must be sustained without interruption, posing a range of challenges at school.