Strengthening tRansparent reporting of reseArch on uNfinished nursing CARE: The RANCARE guideline

Unfinished, rationed, missed, or otherwise undone nursing care is a phenomenon observed across health-care settings worldwide. Irrespective of differing terminology, it has repeatedly been linked to adverse outcomes for both patients and nursing staff. With growing numbers of publications on the topic, scholars have acknowledged persistent barriers to meaningful comparison across studies, settings, and health-care systems. The aim of this study was thus to develop a guideline to strengthen transparent reporting in research on unfinished nursing care. An international four-person steering group led a consensus process including a two-round online Delphi survey and a workshop with 38 international experts. The study was embedded in the tRansparent reporting of reseArch on uNfinished nursing CARE (RANCARE) COST Action. Participation was voluntary. The resulting 40-item RANCARE guideline provides recommendations for transparent and comprehensive reporting on unfinished nursing care regarding conceptualization, measurement, contextual information, and data analyses. By increasing the transparency and comprehensiveness in reporting of studies on unfinished nursing care, the RANCARE guideline supports efficient use of the research results, for example, allowing researchers and nurses to take purposeful actions, with the goal of improving the safety and quality of health-care services

Wie wird die Autonomie von Menschen mit Multipler Sklerose, die in einem Heim leben, durch die Institution gewahrt?: (aus Sicht der Heimleitung und der MS-Betroffenen)

Die vorliegende Arbeit behandelt die Frage nach der Wahrung der Autonomie von MS-betroffenen Menschen in Institutionen. Dies aus der Sicht von befragten MS-betroffenen Menschen und von befragten Heimleitungen. Sie zeigt einerseits die Absicht und die Angebote der Heimleitungen, die Autonomie zu wahren und andererseits, wie die MS-betroffenen Menschen diese wahrnehmen und erleben. Die Untersuchung zeigt, dass die Heimleitungen die grösstmögliche Autonomie der MS-betroffenen Heimbewohner wahren wollen, die Umsetzung aber durch fehlende oder mangelnde Kommunikation erschwert wird. Die Arbeit stellt des Weiteren dar, wie die befragten MS-betroffenen Heimbewohner den Eintritt in eine Institution erleben und nach welchen Kriterien sie eine eigene Institution aufbauen würden. In der Schlussfolgerung zeigt die Arbeit Handlungsvorschläge für die Praxis auf, wie die Autonomie von MS-betroffenen Menschen in Institutionen gewahrt werden kann und stellt neue Fragen für die Praxis

Hindfoot joint pressure in supination sprains

Hindfoot trauma including ankle and subtalar sprains may be followed by osteochondral lesions and persisting pain originating from posttraumatic arthritis

Inositol-1,4,5-trisphosphate induced Ca2+release and excitation-contraction coupling in atrial myocytes from normal and failing hearts

We studied excitation–contraction coupling (ECC) and inositol-1,4,5-triphosphate (IP3)-dependent Ca2+ release in normal and heart failure (HF) rabbit atrial cells. Left ventricular HF was induced by combined volume and pressure overload. In HF atrial myocytes diastolic [Ca2+]i was increased, action potential (AP)-induced Ca2+ transients (CaTs) were larger in amplitude, primarily due to enhanced Ca2+ release from central non-junctional sarcoplasmic reticulum (SR) and centripetal propagation of activation was accelerated, whereas HF ventricular CaTs were depressed. The larger CaTs were due to enhanced IP3 receptor-induced Ca2+ release (IICR) and reduced mitochondrial Ca2+ buffering, consistent with a reduced mitochondrial density and Ca2+ uptake capacity in HF. Elementary IP3 receptor-mediated Ca2+ release events (Ca2+ puffs) were more frequent in HF atrial myoctes and were detected more often in central regions of the non-junctional SR compared to normal cells. HF cells had an overall higher frequency of spontaneous Ca2+ waves and a larger fraction of waves (termed arrhythmogenic Ca2+ waves) triggered APs and global CaTs. The higher propensity of arrhythmogenic Ca2+ waves resulted from the combined action of enhanced IICR and increased activity of sarcolemmal Na+–Ca2+ exchange depolarizing the cell membrane. In conclusion, the data support the hypothesis that in atrial myocytes from hearts with left ventricular failure, enhanced CaTs during ECC exert positive inotropic effects on atrial contractility which facilitates ventricular filling and contributes to maintaining cardiac output. However, HF atrial cells were also more susceptible to developing arrhythmogenic Ca2+ waves which might form the substrate for atrial rhythm disorders frequently encountered in HF