Mcdanielkragh1335

ntage.Recent climate change is altering the timing, duration and volume of river and stream flows globally, and in many regions, perennially flowing rivers and streams are drying and switching to intermittent flows. Profound impacts on aquatic biota are becoming apparent, due in part to the strong influence of flow regime on the evolution of life history. We made predictions of life-history responses for 13 common aquatic invertebrate species (four caddisflies, five mayflies, two stoneflies, a dragonfly and an amphipod), to recent flow regime change in Australian mediterranean climate streams, based on historic studies in the same streams. Size distributions, phenology, voltinism and synchrony were compared, revealing five main responses. More than half of the species were restricted to perennially flowing streams and were absent from those that had switched to intermittent flows (including all four caddisfly species). These formerly common species are at risk of extinction as climate change progresses. Two mayfly species had divergent responses in voltinism and synchrony, and one relied on drought micro-refuges to persist. One stonefly species changed development timing to suit the new flow regime, and the amphipod species retreated to subterranean refuges. Two formerly common species were not detected at all during 2016-2017. In addition, a new mayfly species and a caddisfly species proliferated under new flow regimes, because they had life histories suited to brief hydroperiods. Importantly, previous life history rarely predicted species' actual responses to climate-driven flow regime change, raising doubts about the veracity of predictions based on species traits. This is because a species' potential for flexible phenology or growth rate is not necessarily indicated by life-history traits.

To explore the concept of therapeutic communication within the nurse-patient relationship, using concept analysis.

Therapeutic communication is a term that is often used in the nursing and related sciences literature, and yet it is still an ambiguous concept. Concept clarification is required to support other healthcare professionals' understanding and to guide theory development and practice.

A concept analysis methodology was used, as proposed by Walker and Avant.

A systematic literature search was performed using the Cochrane database, Science Direct, Health Source Nursing/Academic Edition, Academic Search Complete, MEDLINE and PsycARTICLES with studies published within the last 20 years.

The framework by Walker and Avant was adopted. The attributes, antecedents, consequences and uses of the concept were identified.

The attributes were information exchange, mutual respect, engagement and managing health issues of concern to the patient. The antecedents were those related to the nurse and those related to the patient. IAP inhibitor The consequences included patient satisfaction, quicker recovery time, high-quality health care outcomes and positive nurse-patient relationship outcomes.

A theoretical definition of the concept was developed. The attributes, antecedents and consequences identified in this paper can be used in nursing education, research and managerial and organizational planning.

A theoretical definition of the concept was developed. The attributes, antecedents and consequences identified in this paper can be used in nursing education, research and managerial and organizational planning.

Ectopic pregnancy implantation on the tubal stump after salpingectomy is a rare location for extrauterine pregnancy, whose pathogenesis is still unknown. The purpose of this study was to examine whether the time interval elapsed from salpingectomy may predispose the embryo to implantation on the tubal stump in the next pregnancy subsequent to tube removal.

Nine women operated for stump pregnancy (study group) between 2008 and 2019 were retrospectively identified. For each case in the study group, 12 consecutive cases that underwent laparoscopic salpingectomy constituted the control group. A sample size of 100 control patients was calculated to achieve statistical power (97.8%) and an α of 0.05. The control groups were triple-matched with the study group for patients' age, indications for salpingectomy (tubal pregnancy or hydrosalpinx prior to in vitro fertilization treatment) and mode of conception of the subsequent pregnancy following salpingectomy.

Nine women underwent surgery for stump pregnancy during the study period. All women had a surgical history of laparoscopic salpingectomy. The time interval from prior salpingectomy to subsequent pregnancy was significantly shorter in study group than in the control group (4.3± 2.1months vs. 15.6± 13.7months, respectively, p= 0.016).

A possible association between the short time interval from prior salpingectomy to ectopic implantation on the tubal stump in the subsequent pregnancy was found. The clinical implications of these findings and in particular whether patients should be advised to wait at least 4months from the salpingectomy to the subsequent pregnancy remain unclear.

A possible association between the short time interval from prior salpingectomy to ectopic implantation on the tubal stump in the subsequent pregnancy was found. The clinical implications of these findings and in particular whether patients should be advised to wait at least 4 months from the salpingectomy to the subsequent pregnancy remain unclear.

The purpose of this study was to evaluate the current state and clinical characteristics of spontaneous hemoperitoneum in pregnancy (SHiP) in Japan by performing a comprehensive survey.

We reviewed data on pregnant women who developed SHiP during 2013-2017 (for 5 years), and were admitted to any of the perinatal centers in Japan. The survey assessed maternal background and maternal and neonatal prognosis. We divided the cases into two groups, favorable and poor prognosis groups, and made comparisons between the two groups.

Of the 407 facilities in Japan, 267 (66%) facilities responded to our survey. Overall, 31 cases of SHiP were registered. Maternal death occurred in one case (3%) due to liver bleeding with an unknown cause. Of 23 cases with a SHiP onset during pregnancy, 12 (53%) had been misdiagnosed as placental abruption. The prognosis for the fetuses included miscarriage or stillbirth in three cases (10%) and asphyxia in 12 cases (42%). There was no significant correlation between the amount of intra-abdominal blood loss and neonatal prognosis based on umbilical artery pH.