Background: The implantable cardioverter defibrillator (ICD) is the most effective treatment available for terminating potentially life-threatening ventricular tachycardia and ventricular fibrillation and reducing the risk of mortality. Despite its established health benefits, ICD therapy is accompanied by a unique array of patient and psychological factors meriting ample research attention. The purpose of this paper is to examine research trends and results regarding patient factors in cardiac and ICD research and to discuss key areas for future research. Hypothesis: An increase in articles associated with patient factors in cardiac and ICD research will be shown over time. Methods: The Medical Subject Heading (MeSH) system in PubMed was used to index articles under a range of psychosocial headings for both cardiovascular disease and ICDs to quantify the frequency of articles published across time, the journals most frequently utilized, the most productive institutions, and the most common areas of inquiry. Results: A significant positive relationship was revealed between patient factors in cardiac research (r = 0.96, p < 0.01) and ICD research (r = 0.88, p < 0.01) over time. Research is limited by the small number of investigations and institutions. Of the 178 articles on patient factors in ICD research, the most frequent areas of inquiry were psychosocial treatment (70.79%), anxiety (33.15%), quality of life (32.02%), and depression (29.78%). Conclusion: Future research examining positive adjustment is warranted, especially in light of increased prophylactic ICD implantation and possible decreased treatment burden associated with decreased shocks.

Central nervous system (CNS) infection with Morganella morganii is very rare. We describe a 38-year-old female patient with frontal brain abscess caused by M morganii who was unsuccessfully treated. We also review all reported cases of Morganella CNS infections with an emphasis on treatment modalities and outcomes. Aggressive surgical management and appropriate antimicrobial therapy can lead to cure, but the mortality rate for these infections remains high.

Natural products and health foods have recently received a lot of attention both by health professionals and the common population for improving overall well-being, as well as in the prevention of diseases including cancer. In this line, all types of fruits and vegetables have been reevaluated and recognized as valuable sources of nutraceuticals. The great number of potentially active nutrients and their multifunctional properties make cactus pear (Opuntia spp.) fruits and cladodes perfect candidates for the production of health-promoting food and food supplements. Although traditionally appreciated for its pharmacological properties by the Native Americans, cactus pear is still hardly recognized because of insufficient scientific information. However, recent studies on Opuntia spp. have demonstrated cactus pear fruit and vegetative cladodes to be excellent candidates for the development of healthy food. Therefore, this review summarizes current knowledge on the chemical composition of Opuntia cacti with particular emphasis in its use as food and medicine.

Background: Dementia friendly initiatives share similarities with the age-friendly movement in a focus on active engagement and creating a good quality of life for older adults. Dementia friendly initiatives offer a welcoming optimistic narrative in dementia studies by embracing dignity, empowerment, and autonomy to enable well-being throughout the dementia trajectory. Purpose: The purpose of this review is to explore the current science of dementia friendly initiatives, identify gaps, and inform future research. Method: Quantitative, qualitative, and conceptual/theoretical peer-reviewed dementia friendly research literature were evaluated for their current evidence base and theoretical underpinnings. Results: The dementia friendly initiatives research base is primarily qualitative and descriptive focused on environmental design, dementia awareness and education, and the development of dementia friendly communities. Person-centered care principles appear in dementia friendly initiatives centered in care settings. Strong interdisciplinary collaboration is present. Research is needed to determine the effect of dementia friendly initiatives on stakeholder-driven and community-based outcomes. Due to the contextual nature of dementia, the perspective of persons with dementia should be included as dementia friendly initiatives are implemented. Theory-based studies are needed to confirm dementia friendly initiative components and support rigorous evaluation. Dementia friendly initiatives broaden the lens from which dementia is viewed.

Aims and objectives: To analyse the perceived characteristics of an effective nursing clinical instructor and methods for measure instructor effectiveness. This review also examined importance of characteristics based on student age. Background: The clinical instructor has a vital role in clinical education. While the role may be well defined, the characteristics these instructors need to do their jobs effectively are not. Design: An integrative review from 1985 to present using four key terms: nursing, clinical, teaching and effectiveness. This review revealed 37 articles that met the inclusion criteria for analysis. Methods: Inclusion criteria included studies related to nursing clinical teaching effectiveness of the clinical instructor in a direct patient care setting. An integrative review table of the studies was made by the author. Keywords were analyzed in the results column, and same concepts were grouped together. Results: A synthesis of current research revealed three dominant themes: competency, the ability to develop interpersonal relationships and certain personality traits. The analysis of the literature suggests the ability to develop interpersonal relationships is the most valued skill. Overall, approachability emerged as the most important personality trait needed to be an effective clinical instructor. The analysis also revealed a difference regarding the priority of characteristics based on age of the student. Conclusion: The analysis of the literature suggests the ability to develop interpersonal relationships is the most valued skill for clinical instructors. Overall, approachability emerged as the most important personality trait needed to be an effective clinical instructor. Relevance to clinical practice: Future studies should continue to evaluate the extent of the dominant themes especially considering the rise of the millennial student generation.

Emerging evidence has demonstrated the strong link between cardiorespiratory fitness and multiple aspects of health (i.e., physiological, physical, psychosocial, cognitive), independent of physical activity, among school-aged children and youth. Cardiorespiratory fitness is a trait that does not vary substantially from day-to-day, and provides an indication of recent physical activity levels, making it an important possible indicator of population health. Thus, the objective of this dissertation was to investigate the utility of cardiorespiratory fitness, measured using the 20 m shuttle run test, as a broad, holistic health indicator for population health surveillance among children and youth. To achieve this objective we completed seven manuscripts, all prepared for submission to peer-reviewed, scientific journals: 1. Systematic review of the relationship between 20 m shuttle run performance and health indicators among children and youth. 2. Review of criterion-referenced standards for cardiorespiratory fitness: What percentage of 1 142 026 international children and youth are apparently healthy? 3. Cardiorespiratory fitness is associated with physical literacy among Canadian children aged 8 to 12 years. 4. International variability in 20 m shuttle run performance in children and youth: Who are the fittest from a 50-country comparion? A systematic review with pooling of aggregate results. 5. Making a case for cardiorespiratory fitness surveillance among children and youth. 6. International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries. 7. Temporal trends in the cardiorespiratory fitness of 965 264 children and youth representing 19 countries since 1981. Combined, this dissertation provides support for the importance of cardiorespiratory fitness for health surveillance among school-aged children and youth. Results from the international analysis highlighted the variability across countries, with countries in North-Central Europe and Africa having the highest cardiorespiratory fitness, and countries in South America having the lowest cardiorespiratory fitness. The results indicated that declines in cardiorespirtory fitness may have stabilized in recent years in some high- and middle-income countries. This dissertation also identified two methods (criterion- and normative-referenced standards) to interpret cardiorespirtory fitness levels among children and youth, methods that could be used to inform future consensus, surveillance, and cardiorespiratory fitness guidelines.

Background: In a sustaining, durable project, an effective code review process is key to ensuring the long-term quality of the code base. As the size of the software continues to increase, although the code inspections have many benefits, the time it takes, the manpower makes it not a good method in some larger projects.  Nowadays more and more industry performs modern code reviews for their project in order to increase the quality of the program. Only a few papers have studied the relationship between code reviewers and code review quality. We need to explore the relationships among code review, code complexity, and reviewers. Finding out which part of the code the reviewers pay more attention to in the code review and how much effort it takes to review. This way we can conduct code reviews more effectively. Objectives: The objective of our study is to investigate if code complexity relates to how software developers to review code in terms of code review length, review frequency, review text quality, reviewer’s sentiment. What’s more, we want to research if the reviewer’s experience will have an impact on code review quality. In order to find a suitable way to conduct a code review for different complexity codes.  Methods: We conduct an exploratory case study. The case and unit of analysis is the open-source project, Cassandra. We extract data from Cassandra Jira (a proprietary issue tracking product), the data are the reviewer’s name, review content, review time, reviewer’s comments, reviewer’s sentiment, comment length, and the review file(java file). Then we use CodeMR to calculate the complexity of the file, it uses some coupling and code complexity metrics. The reviewer’s sentiment is analyzed by a text analysis API. After we collect all these data we use SPSS to do a statistic analysis, to find whether there are relationships between code complexity and these factors. What’s more, we have a workshop and send out questionnaires to collect more input from Cassandra developers. Results: The results show that code review frequency is related to code complexity, complex code requires more review. Reviewer’s sentiment is related to code complexity, reviewer’s sentiment towards complex code is more positive or negative rather than neutral. Code review text quality is related to the reviewer’s experience, experienced reviewers leave a comment with higher quality than novice reviewers. On the other hand, the code review length and review text quality are not related to code complexity. Conclusions: According to the results, the code with higher code complexity related to the more frequent review, and the reviewer's emotions are more clear when reviewing more complex code. Training experienced reviewers are also very necessary because the results show that experienced reviewers review the code with higher quality. From the questionnaire, we know developers believe that more complex code needs more iterations of code review and experienced reviewers do have a positive effect on code review, which gives us a guide on how to do code review based on a different level of code complexity.

An increased awareness on competitive priorities and capabilities has been seen among firms. The main focus of this research are the operations capabilities which are connected to the competitive priorities in a company. The purpose of this research is to investigate critical operations priorities and capabilities with the following two research questions:   RQ1: Which critical operations priorities can be identified in the literature? RQ2: Which critical operations capabilities can be identified in the literature?   The competitive priorities represent the company's future emphasis on the manufacturing, indicate the strategic position that is desired in the marketplace and support the corporate strategy. Operations capabilities can be defined as company-specific sets of skills, processes and routines which are developed within the operations strategy management. By conducting a systematic literature review seven priorities and 17 capabilities were identified in total.  The developed taxonomy will help companies identify and develop their company-specific operations priorities and capabilities. It can also be used as a framework for other researchers within this area.

Objective A systematic review and meta-analysis was conducted to assess the efficacy of low-sodium salt substitutes (LSSS) as a potential intervention to reduce cardiovascular (CV) diseases. Methods Five engines and ClinicalTrials.gov were searched from inception to May 2018. Randomised controlled trials (RCTs) enrolling adult hypertensive or general populations that compared detected hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), overall mortality, stroke and other CV risk factors in those receiving LSSS versus regular salt were included. Effects were expressed as risk ratios or mean differences (MD) and their 95% CIs. Quality of evidence assessment followed GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. Results 21 RCTs (15 in hypertensive (n=2016), 2 in normotensive (n=163) and 4 in mixed populations (n=5224)) were evaluated. LSSS formulations were heterogeneous. Effects were similar across hypertensive, normotensive and mixed populations. LSSS decreased SBP (MD-7.81 mm Hg, 95% CI-9.47 to-6.15, p<0.00001) and DBP (MD-3.96 mm Hg, 95% CI-5.17 to-2.74, p<0.00001) compared with control. Significant increases in urinary potassium (MD 11.46 mmol/day, 95% CI 8.36 to 14.55, p<0.00001) and calcium excretion (MD 2.39 mmol/day, 95% CI 0.52 to 4.26, p=0.01) and decreases in urinary sodium excretion (MD-35.82 mmol/day, 95% CI-57.35 to-14.29, p=0.001) were observed. Differences in detected hypertension, overall mortality, total cholesterol, triglycerides, glucose or BMI were not significant. Quality of evidence was low to very low for most of outcomes. Conclusions LSSS significantly decreased SBP and DBP. There was no effect for detected hypertension, overall mortality and intermediate outcomes. Large, long-term RCTs are necessary to clarify salt substitute effects on clinical outcomes. / Wellcome Trust / Revisión por pares

Background: Sepsis is a condition that can result in death by failure or lack of treatment. Mortality has decreased over the past decade and thus is due to increased awareness and improved management of disease cases. Despite this decline, the death rate is still high and increased knowledge to detect and prevent sepsis in time is needed to reduce the suffering and serious complications. Aim: The aim is to illustrate nursing knowledge of the role in caring for patients with sepsis. Method: A literature review study based on an analysis of eight quantitative and two qualitative articles of research. Results: The result showed that nurses experienced that a lack of knowledge exists, long experience in nurses are valuable and that assessment tools can improve nurses' detection of sepsis. Nurses experienced detection of sepsis as a difficult, defiant and stressful task but it could facilitate trough teamwork. Conclusion Combination of knowledge and exertion of assessment tools improve the quality of care and reduce mortality. The result showed that experience and education among nurses are important for improving the competence to early identification of sepsis. / Sjukdomstillståndet sepsis är ett globalt folkhälsoproblem med högt dödsantal vilket skapar stort lidande. Sepsis framkallar ett stört systemiskt svar av immunförsvaret som utlöser livshotande symtom och ett snabbt utvecklande sjukdomsförlopp. Sjukdomen utvecklar en inflammation i hela kroppen oavsett om infektionen finns i blodet eller inte. Studiens syfte var att belysa sjuksköterskans erfarenheter av att vårda patienter med sepsis. Bristande kunskap påverkar omhändertagandet av patienter med sepsis som leder till förseningar och i värsta fall komplikationer. Sjuksköterskors erfarenheter var att kartläggning av sjukdomsförloppet är utmanande, tidsberoende och att stort ansvar läggs på deras axlar. Det framkom att det inte finns tillräcklig kunskap hos sjuksköterskor och att de inte känner trygghet i hur en patient med sepsis skall handläggas. Utbildning och erfarenhet lyftes fram som stärkande faktorer för att kompensera bristen på kunskap. Genom att utbilda sjuksköterskor om tidiga tecken på sepsis och passande omvårdnadsåtgärder kunde professionen stärkas i vårdandet av dessa patienter. Sjuksköterskans erfarenhet belystes och ansågs vara viktigt för teamarbetet med andra professioner och behandlingen av patienter med sepsis. Lång arbetserfarenhet bland sjuksköterskor kunde effektivisera vården, inge trygghet till kolleger och öka patientsäkerheten. Ett fåtal sjuksköterskor var medvetna om bedömningsverktyg och hur de skulle användas. Resultatet visar på att efter införande av bedömningsverktyg i vårdandet av patienter med sepsis förbättrades handläggningen, vården säkerställdes och dödligheten minskade. Bedömningsverktyg är viktigt för att ställa diagnos och likaså mätning av vitalparametrar. Användning av bedömningsverktygen resulterade i att sjuksköterskor lättare kom ihåg alla omvårdnadsåtgärder och att risken för missar minimerades. Sjuksköterskor upplevde stor arbetsbelastning i vårdandet av patienter med sepsis på grund av högt tempo, stort patientflöde och stressig arbetsmiljö. Patienter fick vänta länge på akutmottagningen innan de fick tillsyn och vårdprioritet som följd av sjuksköterskornas arbetsbelastning. Erfarenheterna var att de inte hade tillräckligt med tid för patienterna och att bedömningarna blev bristfälliga på grund av underbemanning. Det kan leda till komplikationer och ökad dödlighet för patienten vilket medförde att sjuksköterskor upplevde oro och stress. Sjuksköterskor bör ha tillräcklig kompetens att identifiera och handlägga patienter med sepsis då det ofta är de som först möter dessa patienter.