• Haas Capps posted an update 5 days, 9 hours ago

    AIM To examine the associations between compassion competence and missed nursing care, professional quality of life, and quality of life among clinical nurses. BACKGROUND Compassionate care has been demonstrated to have a positive impact on outcomes for patients, employees, and organizations. However, little is known about the associations of compassion competence and missed nursing care, professional quality of life, and the quality of life among clinical nurses. METHODS A survey was conducted with 1,556 Korean clinical nurses. The associations between compassion competence and missed nursing care, professional quality of life, and quality of life were examined using multivariate linear regression. RESULTS Compassion competence was negatively associated with missed nursing care and burnout but positively associated with compassion satisfaction, secondary traumatic stress, and quality of life. CONCLUSIONS Our results extend the literature on the significant influence of compassionate care by providing evidence of its positive effects on missed nursing care, compassion satisfaction, burnout, and quality of life in clinical nurses. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers should implement programs to improve compassion competence in clinical nurses to address missed nursing care and burnout and improve compassion satisfaction and quality of life, thus improving quality of care, patient experience, and patient safety. This article is protected by copyright. All rights reserved.BACKGROUND Sensory symptoms are defined as atypical behavioral responses to daily sensory stimuli that impact on the performance of everyday routines. Sensory symptoms have been observed in young people with and without developmental concerns. There is uncertainty, however, regarding the best way to identify and manage sensory symptoms. The aim of this paper is  to provide a review of current best evidence regarding measurement of and interventions for sensory symptoms. METHODS A narrative review methodology is adopted to address the aims of this paper. First, sensory symptoms are defined, and then, an overview of the evidence for the relationship between sensory symptoms and childhood function is provided. Second, commonly used sensory assessment tools are summarized and evaluated. Finally, an overview and critique of the evidence for sensory and nonsensory-based interventions addressing sensory symptoms are given. RESULTS The terminology used to describe sensory symptoms varies by discipline, and several cont progress in this field, however, new intervention studies must address the question of ‘what intervention works for whom?’. © 2020 Association for Child and Adolescent Mental Health.OBJECTIVE To describe median manubriotomy to access the ventral aspect of the caudal cervical and cranial thoracic spine and report the outcomes in dogs with lesions affecting the spinal cord at C6-T2 vertebral bodies. buy AZD1080 To evaluate possible complications of this technique and clinical outcomes. STUDY DESIGN Cadaveric study and short case series. STUDY POPULATION Two cadavers and nine dogs with lesions affecting the spinal cord at C6, C7, T1 or T2 vertebral bodies or corresponding intervertebral spaces. METHODS Two cadavers were used for demonstration purposes. Medical records (2013-2019) were reviewed for dogs undergoing median manubriotomy to facilitate access to the ventral aspect of C6-T2 vertebral bodies and/or corresponding intervertebral disc spaces. Data on preoperative and postoperative neurological status and diagnostic imaging, surgical technique, and complications were retrieved. RESULTS Indications for surgery included C7-T1 disc extrusions in five dogs, caudal cervical misalignment in three dogs, and C7-T1 and T1-T2 disc protrusions in one dog. The vertebral bodies of C6 to T2 were consistently visualized after median manubriotomy. Preoperative clinical signs resolved in five dogs and improved in two dogs. One dog was euthanized for lack of improvement, and one dog died of pulmonary thromboembolism. CONCLUSION Median manubriotomy improved the surgical access to the ventral aspect of caudal cervical and cranial thoracic spine without related complications. CLINICAL SIGNIFICANCE Median manubriotomy can be considered in dogs undergoing ventral decompression and/or stabilization of C7-T1 and T1-T2 intervertebral disc spaces. © 2020 The American College of Veterinary Surgeons.PURPOSE A prospective clinical study to compare for the first time the accuracy of digital and conventional maxillary implant impressions for completely edentulous patients. MATERIALS AND METHODS Sixteen patients received maxillary implant supported fixed complete dentures. After the verification of the conventional final casts, the casts were scanned with a desktop (extraoral) scanner. Intraoral full-arch digital scans were also obtained with scan bodies and STL files. Extraoral and intraoral scans were superimposed and analyzed with reverse engineering software. The primary outcome measure was the assessment of accuracy between scans of the verified conventional casts and digital full-arch impressions. The secondary outcome was the effect of the implant number on the 3D accuracy of impressions with Spearman’s rank correlation coefficient. RESULTS The 3D deviations between virtual casts from intraoral full-arch digital scans and digitized final stone casts generated from conventional implant impressions were found to be 162 ± 77 μm. In the 4-implant group, 5-implant group, and 6-implant group the 3D deviations were found to be 139 ± 56 μm, 146 ± 90 μm, and 185 ± 81 μm, respectively. There was a positive correlation between increased implant number and 3D-deviations, but there was no statistically significant difference (p = 0.191). CONCLUSIONS The 3D accuracy of full-arch digital implant scans lies within previously reported clinically acceptable threshold. Full-arch digital scans and a complete digital workflow in the fabrication of maxillary fixed complete dentures may be clinically feasible. © 2020 by the American College of Prosthodontists.Unlike most enzymes, which exhibit stereospecific substrate binding, racemases and epimerases bind and catalyze the reversible interconversion of enantiomeric and epimeric pairs of substrates.  Over the past 15 years, a growing number of racemase and epimerase structures have been solved, furnishing insights into the nature of chiral recognition of substrates by these enzymes.  Those enzymes catalyzing stereoinversion of a carbon acid substrate via a direct 1,1-proton transfer mechanism all bind their substrates in a mirror-image packing orientation.  This does not apply generally to epimerases and racemases that use other mechanisms, such as NADH-dependent epimerases that employ a “flipping” mechanism.  In general, polar groups are bound and fixed at the three binding determinants on the protein defining a pseudo-mirror plane, while nonpolar groups may be mobile.  The hydrogen atoms on each stereocenter are positioned antipodal with respect to the pseudo-mirror plane, making a two-base mechanism imperative.  Recognition that mirror-image packing is the common binding mode for enantiomeric or epimeric substrates of these enzymes should inform modelling/docking studies and protein engineering.