Health professionals' decision-making in wound management: a grounded theory.

Aim: To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice.

Background: With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area.

Design: A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice.

PaCO2 in surfactant, positive pressure, and oxygenation randomised trial (SUPPORT).

Objective: To determine the association of arterial partial pressure of carbon dioxide PaCO2 with severe intraventricular haemorrhage (sIVH), bronchopulmonary dysplasia (BPD), and neurodevelopmental impairment (NDI) at 18-22 months in premature infants.

Design: Secondary exploratory data analysis of Surfactant, Positive Pressure, and Oxygenation Randomised Trial (SUPPORT).

Setting: Multiple referral neonatal intensive care units.

Prophylactic indomethacin and intestinal perforation in extremely low birth weight infants.

Objective: Prophylactic indomethacin reduces severe intraventricular hemorrhage but may increase spontaneous intestinal perforation (SIP) in extremely low birth weight (ELBW) infants. Early feedings improve nutritional outcomes but may increase the risk of SIP. Despite their benefits, use of these therapies varies largely by physician preferences in part because of the concern for SIP.

Doing the month in a Taiwanese postpartum nursing center: an ethnographic study.

Traditionally Chinese and Taiwanese postpartum women conducted postpartum ritual practices, called "doing the month," at home. Today, many Taiwanese women undertake this ritual in postpartum nursing centers. However, little is known about how the traditional practices are being transformed in relation to contemporary health care in Taiwan.

Pathogens penetrating the central nervous system: infection pathways and the cellular and molecular mechanisms of invasion.

The brain is well protected against microbial invasion by cellular barriers, such as the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). In addition, cells within the central nervous system (CNS) are capable of producing an immune response against invading pathogens. Nonetheless, a range of pathogenic microbes make their way to the CNS, and the resulting infections can cause significant morbidity and mortality.

The otolaryngologist's role in newborn hearing screening and early intervention.

Infant hearing loss is common. Screening is performed in more than 98% of US infants. Otolaryngologists play an important role in identification and management of infants and children who are deaf and hard of hearing.

Biomimetic scaffolds facilitate healing of critical-sized segmental mandibular defects.

Objective: To investigate the efficacy of biomimetic PLGA scaffolds, alone and in combination with bone morphogenic protein (BMP-2) and adipose-derived stem cells (ASCs), to heal a critical-sized segmental mandibular defect in a rat model.

Study Design: Prospective animal study.

Methods: ASCs were isolated and cultured from the inguinal fat of Lewis rat pups.

Validity of an early risk score for older adults.

Objectives: To determine if a risk score developed in hospitalised older adults in the UK in 1962 is correlated with other measures of health and if this risk score predicts death or institutionalisation in community-living older adults.

Methods: A total of 1,735 older adults residing in the community in 1991 were followed over five years. We replicated the original risk index, a composite score of cognitive status, disability and continence.

Surgery and neurodevelopmental outcome of very low-birth-weight infants.

Importance: Reduced death and neurodevelopmental impairment among infants is a goal of perinatal medicine.

Objective: To assess the association between surgery during the initial hospitalization and death or neurodevelopmental impairment of very low-birth-weight infants.

Design, Setting, And Participants: A retrospective cohort analysis was conducted of patients enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 through 2009 and evaluated at 18 to 22 months' corrected age.

A cytokine-delivering polymer is effective in reducing tumor burden in a head and neck squamous cell carcinoma murine model.

Objective: This study aimed to evaluate the therapeutic efficacy of a novel polymer platform delivering cisplatin and cytokines in the treatment of head and neck squamous cell carcinoma (HNSCC).

Study Design: In vivo study.

Setting: Academic research laboratory.

An international multicenter study on HIV-1 drug resistance testing by 454 ultra-deep pyrosequencing.

The detection of mutant spectra within the viral quasispecies is critical for therapeutic management of HIV-1 infections. Routine clinical application of ultrasensitive genotyping requires reproducibility and concordance within and between laboratories. The goal of the study was to evaluate a new protocol on HIV-1 drug resistance testing by 454 ultra-deep pyrosequencing (454-UDS) in an international multicenter study.

Respiratory outcomes of the surfactant positive pressure and oximetry randomized trial (SUPPORT).

Objective: To explore the early childhood pulmonary outcomes of infants who participated in the National Institute of Child Health and Human Development's Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial (SUPPORT), using a factorial design that randomized extremely preterm infants to lower vs higher oxygen saturation targets and delivery room continuous positive airway pressure (CPAP) vs intubation/surfactant.

Study Design: The Breathing Outcomes Study, a prospective secondary study to the Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial, assessed respiratory morbidity at 6-month intervals from hospital discharge to 18-22 months corrected age (CA). Two prespecified primary outcomes-wheezing more than twice per week during the worst 2-week period and cough longer than 3 days without a cold-were compared for each randomized intervention.

Impulsivity-related cognition in alcohol dependence: Is it moderated by DRD2/ANKK1 gene status and executive dysfunction?

Perceived impaired control over alcohol use is a key cognitive construct in alcohol dependence that has been related prospectively to treatment outcome and may mediate the risk for problem drinking conveyed by impulsivity in non-dependent drinkers. The aim of the current study was to investigate whether perceived impaired control may mediate the association between impulsivity-related measures (derived from the Short-form Eysenck Personality Questionnaire-Revised) and alcohol-dependence severity in alcohol-dependent drinkers. Furthermore, the extent to which this hypothesized relationship was moderated by genetic risk (Taq1A polymorphism in the DRD2/ANKK1 gene cluster) and verbal fluency as an indicator of executive cognitive ability (Controlled Oral Word Association Test) was also examined.

Evaluating retinopathy of prematurity screening guidelines for 24- to 27-week gestational age infants.

Objective: To determine whether current retinopathy of prematurity (ROP) screening guidelines adequately identify treatable ROP in a contemporary cohort of extremely low gestation infants.

Study Design: Data from the Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial were used. Inborn infants of 24 (0)/7 to 27 (6)/7 weeks gestational age (GA) with consent before delivery were enrolled in 2005 to 2009.

Women's management of urinary incontinence in daily living.

Purpose: We investigated strategies used by older and working-aged women to manage urinary incontinence (UI) in their daily lives.

Design: Cross-sectional, descriptive study.

Subjects And Setting: The sample comprised 103 older (>65 years; mean = 74.

Implementation of a pharmacist-driven pain management consultation service for hospitalised adults with a history of substance abuse.

Background: Pain management in adult patients with concomitant substance use disorders (SUDs) presents a clinical challenge in the absence of objective assessment criteria. Effective pain management is dependent on the clinician's ability to differentiate true pain symptoms from manipulative behaviours. Successful strategies for achieving effective pain control in these patients include implementing a multidisciplinary team approach, use of non-opioid and non-pharmacologic alternatives, and judicious use of opioid analgesics.

Defining the critical-sized defect in a rat segmental mandibulectomy model.

Importance: Advances in tissue engineering offer potential alternatives to current mandibular reconstructive techniques; however, before clinical translation of this technology, a relevant animal model must be used to validate possible interventions.

Objective: To establish the critical-sized segmental mandibular defect that does not heal spontaneously in the rat mandible.

Design And Setting: Prospective study of mandibular defect healing in 29 Sprague-Dawley rats in an animal laboratory.

Altered expression of inflammation-associated genes in oviductal cells following follicular fluid exposure: implications for ovarian carcinogenesis.

Evidence indicates that high-grade serous ovarian carcinoma (HGSOC) may originate from lesions within the distal fallopian tube epithelium (FTE). Our previous studies indicate that fallopian tube epithelial cells from carriers of germline mutations in breast cancer susceptibility genes exhibit a pro-inflammatory gene expression signature during the luteal phase, suggesting that delayed resolution of postovulatory inflammatory signaling may contribute to predisposition to this ovarian cancer histotype. To determine whether exposure of tubal epithelial cells to periovulatory follicular fluid alters expression of inflammation-associated genes, we used an ex vivo culture system of bovine oviductal epithelial cells.

Neurodevelopmental outcomes of extremely low birth weight infants with spontaneous intestinal perforation or surgical necrotizing enterocolitis.

Objective: To determine if extremely low birth weight infants with surgical necrotizing enterocolitis have a higher risk of death or neurodevelopmental impairment and neurodevelopmental impairment among survivors (secondary outcome) at 18-22 months corrected age compared with infants with spontaneous intestinal perforation and infants without necrotizing enterocolitis or spontaneous intestinal perforation.

Study Design: Retrospective analysis of the Neonatal Research Network very low birth weight registry, evaluating extremely low birth weight infants born between 2000 and 2005. The study infants were designated into three groups: (1) spontaneous intestinal perforation without necrotizing enterocolitis; (2) surgical necrotizing enterocolitis (Bell's stage III); and (3) neither spontaneous intestinal perforation nor necrotizing enterocolitis.

From biomarkers to medical tests: the changing landscape of test evaluation.

Regulators and healthcare payers are increasingly demanding evidence that biomarkers deliver patient benefits to justify their use in clinical practice. Laboratory professionals need to be familiar with these evidence requirements to better engage in biomarker research and decisions about their appropriate use. This paper by a multidisciplinary group of the European Federation of Clinical Chemistry and Laboratory Medicine describes the pathway of a laboratory assay measuring a biomarker to becoming a medically useful test.

The relevance of Marjory Warren's writings today.

Marjory Warren was one of the initial geriatricians in the United Kingdom. She established specialized geriatric units, held important administrative positions, and wrote influential papers where she argued for the need of the specialty of geriatric medicine and outlined principles for inpatient care of older adults with chronic illness. We compare and contrast Warren's early papers describing these principles with contemporary models for improving inpatient care of older adults and the need for the specialty of geriatrics.

A novel nicotinic mechanism underlies β-amyloid-induced neuronal hyperexcitation.

There is a significantly elevated incidence of epilepsy in Alzheimer's disease (AD). Moreover, there is neural hyperexcitation/synchronization in transgenic mice expressing abnormal levels or forms of amyloid precursor protein and its presumed, etiopathogenic product, amyloid-β1-42 (Aβ). However, the underlying mechanisms of how Aβ causes neuronal hyperexcitation remain unclear.

Comparison of rocuronium and succinylcholine on postintubation sedative and analgesic dosing in the emergency department.

Objectives: Rocuronium and succinylcholine are both commonly used neuromuscular blockers for rapid sequence intubation in the emergency department (ED). The objective of this study was to determine if patients who receive rocuronium are more likely to receive lower doses of postintubation sedatives and analgesics compared with patients who receive succinylcholine.

Methods: This was a retrospective cohort study carried out in a tertiary, academic ED.

CCL21 Chemokine Therapy for Lung Cancer.

Lung cancer remains a challenging health problem with more than 1.1 million deaths worldwide annually. With current therapy, the long term survival for the majority of lung cancer patients remains low, thus new therapeutic strategies are needed.

The role of failure modes and effects analysis in showing the benefits of automation in the blood bank.

Background: Failure modes and effects analysis (FMEA) is a risk management tool used by the manufacturing industry but now being applied in laboratories.

Study Design And Methods: Teams from six South Korean blood banks used this tool to map their manual and automated blood grouping processes and determine the risk priority numbers (RPNs) as a total measure of error risk.

Results: The RPNs determined by each of the teams consistently showed that the use of automation dramatically reduced the RPN compared to manual processes.