Experience of rehabilitation specialist nurses in providing bowel care for stroke patients: A qualitative study.

AIMS: This study aims to explore the experiences of rehabilitation specialist nurses in providing bowel care to stroke patients and to identify the factors that either facilitate or hinder their practice. DESIGN: This was a descriptive qualitative design study. METHODS: Between May 2022 and October 2022, we conducted in-depth and semi-structured interviews with 12 rehabilitation specialist nurses from two tertiary hospitals in Changsha, China. Thematic analysis was employed to analyse the interview transcripts. FINDINGS: Three key themes were revealed from our analysis: (1) acceptance of bowel care as a process, (2) high level of recognition improves the experience and (3) challenges stemming from limited knowledge and rights. Acceptance of bowel care as a dynamic process, coupled with a high level of recognition, enabled nurses to prioritize the health and safety of patients over personal feelings and achieve professional accomplishments. However, they encountered challenges in terms of professional development and restricted prescribing rights for bowel care. CONCLUSION: The experiences of rehabilitation specialist nurses in providing bowel care are dynamic. These findings have important implications for healthcare improvement, including the need for collaboration with healthcare professionals and nurturing nurses' self-identity, comprehensive training plans, innovative programs and expanding the scope of rehabilitation specialist nurses' rights. IMPACT: This study enhances our understanding of the challenges faced by rehabilitation specialist nurses caring for stroke patients with neurogenic bowel dysfunction. The findings provide insights into how to enhance bowel care experience and develop further in this field. REPORTING METHOD: This study adhered to the EQUATOR guideline and utilized the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTIONS: This study involved participants who were registered nurses, and there were no contributions from patients or public.

Effectiveness and safety of digital rectal stimulation and abdominal massage for neurogenic bowel dysfunction in stroke patients: a randomized controlled trial protocol.

BACKGROUND: Neurogenic bowel dysfunction (NBD) is a prevalent complication among stroke patients, significantly affecting their quality of life, duration of hospitalization, medical expenses, and even mortality. Although current guidelines suggest a conservative strategy for addressing bowel dysfunction, which includes techniques such as digital rectal stimulation (DRS) and abdominal massage, the availability of interventions remains limited in healthcare facilities. METHODS: This study follows a prospective randomized controlled parallel-group clinical trial design. The control group will receive standard care, while the intervention group will undergo a program that combines DRS and abdominal massage in addition to standard care. The duration of the intervention for both groups will be 6 weeks. The primary outcome measures will be the Wexner score. Furthermore, secondary outcomes measure will be assessed, including Bristol score, Patient Assessment of Constipation-Quality of Life (PAC-QoL), and Fecal Incontinence Quality of Life (FI-QoL). DISCUSSION: This study aims to evaluate the effectiveness and safety of a bowel rehabilitation program for stroke patients with NBD. The findings will provide information that can contribute to the formulation of bowel management strategies. TRIAL REGISTRATION: The study has been registered in the Chinese Clinical Registry under the number ChiCTR2300071709. This registration was completed on May 23, 2023. All items from the World Health Organization Trial Registration Data set are described in this manuscript.

Effects of a Modified Six-Sigma-Methodology-Based Training Program on Core Competencies in Rehabilitation Nurse Specialists.

PURPOSE: Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform-a modified Six-Sigma-based training program-against a conventional educational program on rehabilitation specialist nurses' core competencies, post-training performance, and satisfaction. METHODS: A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base's 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented. RESULTS: Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05). CONCLUSION: The modified training program strengthens rehabilitation nurses' base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.

Need to clamp indwelling urinary catheters before removal after different durations: a systematic review and meta-analysis.

OBJECTIVE: This meta-analysis aimed to evaluate the effect of bladder training by clamping on bladder urethral function in patients with indwelling urinary catheters used for different durations. DESIGN: Systematic review and meta-analysis. DATA SOURCES: The UpToDate, Cochrane Library, OVID, PubMed, China National Knowledge Infrastructure, CINAHL and Embase were screened from 1 January 2000 to 28 February 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCTs) or quasi-experimental designs comparing the efficacy of bladder training in patients with an indwelling urinary catheter by clamping or free drainage before urinary catheter removal were published in English or Chinese. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted the data and assessed the quality of studies. Continuous variables were analysed using mean difference and standardised mean difference (SMD) values with a 95% CI. Categorical variables were analysed using relative risk (RR) and 95% CI. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was urinary tract infection incidence, and secondary outcomes included hours to first voiding, incidence of urinary retention and recatheterisation and residual urine volume. RESULTS: Seventeen papers (15 RCTs and 2 quasi-RCTs) comprising 3908 participants were included in the meta-analysis. The pooled results of the meta-analysis showed that the clamping group had a significantly higher risk of urinary tract infections (RR=1.47; 95% CI 1.26 to 1.72; p<0.00001) and a longer hour to first void (SMD=0.19; 95% CI 0.08 to 0.29; p=0.0004) compared with the free drainage group. Subgroup analysis of indwelling urinary catheter use durations of ≤7 days indicated that clamping significantly increased the risk of urinary tract infection (RR=1.69; 95% CI 1.42 to 2.02, p<0.00001) and lengthens the interval to first void (SMD=0.26, 95% CI 0.11 to 0.41, p=0.0008) compared with free drainage. CONCLUSIONS: Bladder training by clamping indwelling urinary catheters increases the incidence of urinary tract infection and lengthens the hours to first void in patients with indwelling urinary catheters use durations of ≤7 days compared with the free drainage. However, the effect of clamping training on patients with an indwelling urinary catheter use duration of >7 days is unclear.

Distribution characteristics and main influencing factors of selenium in surface soil of natural selenium-rich area: a case study in Langao County, China.

In order to study the distribution of selenium in surface soil and its main influencing factor, we collected 360 surface soil samples and four groups of soil profiles with 210 corresponding parent rock samples in Langao County, Shaanxi Province (a typical high-selenium area of Daba Mountain). Samples were analyzed for trace elements by using ICP-MS, ICP-OES and HG-AFS. The results show the following. (1) selenium content in surface soils of Langao County varies greatly (0.03-16.96 mg/kg). The mean selenium content in surface soils of Langao County is 0.99 mg/kg, higher than the global (0.4 mg/kg) and China (0.29 mg/kg) soil average, and 3.4 times the mean of soil selenium in China. (2) Selenium content of bedrock in Langao County also varies greatly (0.01-56.22 mg/kg), with an average selenium content of 2.02 mg/kg, which is 40 times higher than the upper crust (0.05 mg/kg). (3) Selenium content in the strata of the Late Precambrian-Early Paleozoic and its variation is an important factor affecting the spatial variation of soil selenium content. The black rock series (carbonaceous slate and silicon-bearing carbonaceous slate) of the Upper Ediacaran-Cambrian on the north side has the highest mean selenium content (> 7.92 mg/kg), and the selenium content of the surface soil in the distribution area can reach up to 16.96 mg/kg. The Middle Cambrian, Upper Cambrian, Ordovician and Silurian (limestone and marl) in the south has the lowest mean selenium content (< 2 mg/kg), and the selenium content of surface soil in the distribution area is lower than 0.8 mg/kg mostly. (4) Soil samples at different depths in the same soil profile have similar composition of rare earth elements (REE), and bedrock and corresponding topsoil has similar composition of REE. This study indicates the selenium content in the topsoil varies greatly, even in high-selenium area. And the difference of selenium distribution is closely related to the original selenium content of the bedrock.

The coarse-grained models of poly(ethylene oxide) and poly(propylene oxide) homopolymers and poloxamers in big multipole water (BMW) and MARTINI frameworks.

Polyethylene oxide (PEO) and poly(propylene oxide) (PPO), especially their tri-block copolymers PEO-PPO-PEO (poloxamers), have a broad range of applications in biotechnology and medical science. Understanding their specific interactions with biomembranes is the key to unveil the unique features of poloxamers either as membrane-healing or membrane pore-forming agents. Based on the coarse-graining convention of the MARTINI force field and the big multipole water (BMW) model, which has a three charged site topology and can reproduce the correct dipole moment of four-water clusters, we generated coarse-grained (CG) models with analytical and numerical potentials for PEO and PPO homopolymers and poloxamers in dilute solution. The effective bonded interaction potentials between CG beads were determined from the probability distributions of bond lengths, angles and dihedrals that are determined from atomistic simulations. The nonbonded interaction parameters were fine-tuned to reproduce the conformational properties of atomistic PEO and PPO homopolymers and poloxamers via extensive CG simulations of PEO and PPO homopolymers and poloxamers in a BMW water environment. The reported CG models provide a promising framework for a comprehensive understanding of the microstructural, conformational, and dynamic properties of poloxamers and their delicate interactions with other species in an explicit water environment.

Micellization of Pluronic P123 in Water/Ethanol/Turpentine Oil Mixed Solvents: Hybrid Particle-Field Molecular Dynamic Simulation.

The hybrid particle-field molecular dynamics simulation method (MD-SCF) was applied to study the self-assembly of Pluronic PEO20-PPO70-PEO20 (P123) in water/ethanol/turpentine oil- mixed solvents. In particular, the micellization process of P123 at low concentration (less than 20%) in water/ethanol/turpentine oil-mixed solvents was investigated. The aggregation number, radius of gyration, and radial density profiles were calculated and compared with experimental data to characterize the structures of the micelles self-assembled from P123 in the mixed solvent. This study confirms that the larger-sized micelles are formed in the presence of ethanol, in addition to the turpentine oil-swollen micelles. Furthermore, the spherical micelles and vesicles were both observed in the self-assembly of P123 in the water/ethanol/turpentine oil-mixed solvent. The results of this work aid the understanding of the influence of ethanol and oil on P123 micellization, which will help with the design of effective copolymer-based formulations.

Emulsifying properties development of pork myofibrillar and sacroplasmic protein irradiated at different dose: A combined FT-IR spectroscopy and low-field NMR study.

The present study investigated the effect of different irradiation dose (0, 3, 5 and 7 kGy) on the emulsifying properties development of pork myofibrillar protein (MP) and sacroplasmic protein (SP). The results showed that emulsifying activities of SP was significantly impaired by the increasing irradiation dose, while that of MP were only observed to be significantly improved at 3 kGy irradiation (P < .05). The increasing irradiation dose caused the increase of SP carbonyl groups and the decrease of its sulfhydryl groups (P < .05), while 3 kGy irradiation decreased the carbonyl groups of MP and increased ζ-potential significantly (P < .05). LF-NMR results revealed that the water hydration in MP structure was dose-dependent. FT-IR data displayed that irradiation caused minor change of SP in the amide I region from 1700 to 1600 cm-1, while ≥5 kGy irradiation significantly contributed to the denatured aggregated ß-sheet components of MP.

Effect of different irradiation dose treatment on the lipid oxidation, instrumental color and volatiles of fresh pork and their changes during storage.

This study mainly investigated the effect of different doses irradiation (0, 3, 5 or 7kGy) on the quality changes of pork during 4°C storage by determining the irradiation off-odor intensity, thiobarbituric acid reactive substances (TBARs), fatty acid composition, volatiles and color of the samples during whole storage. The results showed that ≥7kGy irradiation could make the samples produce obvious irradiation off-odor. However, after 7days storage irradiation off-odor was reduced. Lipid oxidation was also promoted by irradiation. Benzyl methyl sulfide was produced newly and significantly increased (P<0.05) by irradiation. Fatty acids in pork samples decreased significantly with irradiation dose increase within the range of <7kGy, but significantly increased (P<0.05) in samples of 7kGy. Irradiation significantly increased the a* values regardless of storage time but had little effects on b* and L* values, and the increase of a* values was dose-dependent.

Combined effect of predatory zooplankton and allelopathic aquatic macrophytes on algal suppression.

The present study evaluated the combined effects of four typical predatory zooplankton and allelopathic aquatic macrophytes on algal control in a microcosm system. It would determine the effects of diverse species and biological restoration on the growth of harmful water-bloom microalgae in great lakes polluted by excess nutrients. It was found that the mixtures of each zooplankton and the floating plant Nymphoides peltatum had stronger inhibitory effects on harmful water-bloom microalgae than the individual species in clean or eutrophic water bodies. In addition, a community of four zooplankton types had a synergistic effect on algal inhibition. Algal suppression by the zooplankton community was enhanced significantly when the macrophyte was co-cultured in the microcosm. Furthermore, Chlorella pyrenoidosa was more susceptible than Microcystis aeruginosa when exposed to grazing by zooplankton and the allelopathic potential of the macrophyte. Algal inhibition was also weaker in eutrophic conditions compared with the control. These findings indicate that diverse species may enhance algal inhibition. Therefore, it is necessary to restore biological diversity and rebuild an ecologically balanced food chain or web to facilitate the control of harmful algal blooms in eutrophic lakes.

Environmental monitoring and assessment of the water bodies of a pre-construction urban wetland.

It is planned that the Dayanghan Wetland in China will be transformed into a national park but little is known about its current water quality and pollution status. Thus, we monitored the physical and chemical characteristics of the Dayanghan Wetland, which showed that the water quality was generally good. However, the chemical oxygen demand was more than double the reference value, which may be attributable to previous tillage for vegetable crops and other farmlands. In addition, nickel and chromium caused low-level pollution in the water bodies of the Dayanghan Wetland. The mean trophic level index and nutrient quality index were 39.1 and 2.69, respectively. Both indices suggest that the water bodies of the Dayanghan Wetland are in a mesotrophic state and that no eutrophication has occurred. The study would provide a precise report on the status of environmental quality of the water bodies of a typical pre-construction wetland for the administration and decision of the local government and the planning agent.