Middle Phase Research Articles

Biotic response to Early Cretaceous climate warming in Hebei, northern China: Implications for the phased development of the Jehol Biota

The Early Cretaceous Jehol Biota in northern China is a terrestrial lagerstätte that contains exceptionally-preserved fossils, including birds, dinosaurs, pterosaurs, mammals, insects, and flowering plants. The biota underwent three developmental phases, with relatively limited biodiversity in an early phase that rapidly diversified in a middle phase; however, the relationship between this biological radiation and climate remains uncertain. In this paper, we study fossils from the early-to-middle phases of the Jehol Biota preserved in the Lower Cretaceous (middle Valanginian-lower Barremian) Dabeigou and Dadianzi formations of Hebei Province to ascertain climatic impact on biotic evolution. The occurrence of a cool to warm climate turnover during the deposition of these strata is inferred based on a synthesis of geochemical and paleontological evidence. Palaeogeographic distribution of the middle phase of the biota is wider and positioned more southerly than that of the early phase, possibly indicating that the biota in the early and middle phases lived in boreal and temperate climate realms, respectively. Biotic diversity shows an increasing trend from the early phase to the middle phase of the Jehol Biota, closely coinciding with the cool to warm turnover of the climate. The body sizes of some taxa in the middle phase were significantly smaller than those in the early phase, which is also interpreted as a climatic effect. This study represents the first attempt to correlate the response of terrestrial evolution of the Jehol Biota to climate change, with a focus on Early Cretaceous paleotemperatures.

Socially Shared Regulation and Performance in Group Work on Creativity Tasks: Analyzing Regulation Utterances

This study examined socially shared regulation of learning (SSRL) and motivation processes in a collaborative learning task that required creativity using the ICT tool of mind mapping. Thirty university students formed three groups, collaborating face-to-face to generate creative ideas. The following results were obtained from qualitative and quantitative data using psychological scales and utterance analysis. In the middle phase of the collaborative activity, there was a significant weak-to-moderate positive correlation between socially shared regulation of cognition, self-regulation, co-regulation, and socially shared regulation of intrinsic motivation and a deep level of regulation utterances. Moreover, there were significant weak-to-moderate correlations between behavioral and cognitive engagement, SSRL of monitoring and cognition, and the three modes of motivational regulation. Creative performance was significantly and moderately positively associated with socially shared regulation of cognition and total frequency of utterances in the group. Based on these findings, the implications for practice in university education are discussed from the perspective of socially shared regulation in collaborative learning.

Mapping of SARS-CoV-2 IgM and IgG in gingival crevicular fluid: Antibody dynamics and linkage to severity of COVID-19 in hospital inpatients

Mapping of SARS-CoV-2 IgM and IgG in gingival crevicular fluid: Antibody dynamics and linkage to severity of COVID-19 in hospital inpatients

Quantitative evaluation of the vertical mobility of the first tarsometatarsal joint during stance phase of gait

We determined how the in vivo mobility of the first tarsometatarsal (TMT) joint can be quantified during gait. Twenty-five healthy participants (12 females) with no history of foot disorders were included. Non-invasive ultrasound (US) with a three-dimensional motion analysis (MA) system was used to evaluate the kinematic characteristics of first TMT joint during stance phase of gait. US probe was positioned longitudinally above the first TMT joint and adjusted to its proximal dorsal prominence. Gait analysis was conducted by the MA system starting with the activation of B-mode US video at 80 frames per second and 60-mm depth for simultaneous capture. During stance phase, the first metatarsal was translated dorsally with respect to the medial cuneiform, returning to a neutral level at toe-off in all subjects. During middle stance phase, the medial cuneiform was stable in males but displaced in the plantar direction in females and was the primary contributor to the differences in sagittal mobility observed between groups. Quantitatively measuring sagittal mobility of the first TMT joint could be useful for the early detection of foot abnormalities. The dynamic characteristics of the medial cuneiform during gait in healthy females may be associated with a high prevalence of hallux valgus.

1026-P: Retrospective Analysis of Caregiver Health Management Competence during an Occupation Therapy Coaching Telehealth Intervention

Occupation-based coaching is a collaborative, family-centered intervention which can empower caregivers of children with type 1 diabetes to establish independence with diabetes management. A RCT involving telehealth occupation-based coaching intervention was piloted with rural-dwelling caregivers with a child (2-12 years) diagnosed with type 1 diabetes. Ten caregivers received 1-hour weekly sessions across 12 weeks, which were digitally recorded and transcribed verbatim. Of the 12 sessions, two sessions/transcripts were randomly selected from each of the beginning, middle, and end phases per family. The average word count and rating at each phase were calculated and repeated measures ANOVA were used to evaluate how problem-solving progressed during the coaching sessions. Analyzing a total of 60 transcripts/sessions, we found that the percentage of parent mean word count increased significantly from 67.2 at the beginning to 67.9 at middle phase and then increased to 72.4 at the end (p=0.034) demonstrating a significant linear trend (p=0.019) . The percentage of interventionist word count significantly decreased from beginning to end phases (beginning: Mean=32.8, SD=15.0; middle: Mean=32.1, SD=17.8; end: Mean=27.6, SD=12.9, p=0.034) and showed significant linear trend (p=0.019) . Average rating on the Evidence of Independent Capacity Rating Scale where “A” indicates high level of independence and “C” indicates low level of independence from the interventionist improved significantly from a rating close to B and rating of B at the beginning and middle phases, respectively, and continued to improve to a rating close to A at the end phrase (p<0.001) ; significant linear trend of improvement was also noted (p<0.001) . Preliminary evidence suggests that occupation-based coaching supports rural-dwelling families to develop problem-solving skills and autonomy in caring for their child diagnosed with type 1 diabetes. Disclosure J.Shin: Research Support; Dexcom, Inc. V.D.Jewell: Research Support; Dexcom, Inc. Y.Qi: Research Support; Dexcom, Inc. A.D.Valdez: None. Funding Health Science Strategic Investment Faculty Development Grant, Creighton University

Prediction and programming of microemulsion phase behavior simulation

In the process of microemulsion flooding, microemulsion phase state may be affected by the adsorption of core and the distribution of oil and water, and the upper phase, the middle phase or the lower phase microemulsion will appear. Accurate description of microemulsion phase state and quantitative discrimination of equilibrium phase composition are of great theoretical value and research significance for the design of microemulsion flooding system and improving the recovery efficiency of microemulsion. Therefore, in this paper, microemulsion phase model is deeply studied. Aiming at the difficulty of solving the existing Hand model and the unknown parameters of the improved HLD-NAC model, we introduce the binodal curve range parameter D and the asymmetric migration degree parameter B, and establish a new phase behavior description method of the binodal curve, the two-phase plait point lines and the III-phase node line. Then the phase discrimination programming of microemulsion was carried out, and the change laws of phase number, phase type and mass fraction of equilibrium phases of any microemulsion system under different salinity were revealed. The results show that the simulation results of microemulsions accord with the salinity scanning law, and can accurately identify the complex microemulsion phase states.

When Do Epidemics End? Scientific Insights from Mathematical Modelling Studies

Quantitative assessments of when infectious disease outbreaks end are crucial, as resources targeted towards outbreak responses typically remain in place until outbreaks are declared over. Recent improvements and innovations in mathematical approaches for determining when outbreaks end provide public health authorities with more confidence when making end-of-outbreak declarations. Although quantitative analyses of outbreaks have a long history, more complex mathematical and statistical methodologies for analysing outbreak data were developed early in the 20th century and continue to be refined. Historically, such methodologies focused primarily on factors affecting the early and middle phases of an outbreak, with less attention given to determining how and when outbreaks end. This review discusses mathematical modelling methods from the last 20 years that have been developed for determining the ends of infectious disease outbreaks, and considers factors that affect the accuracy of such determinations. When disease surveillance systems provide timely and representative data to inform models, the timings of end-of-outbreak declarations can be fine-tuned to allow outbreaks to be declared over quickly and with a low risk of being incorrect. Premature declarations that outbreaks are over can undermine earlier achievements in disease control and may result in a resurgence of cases, but unnecessary delays in declaring outbreaks over can cause significant economic and social harm. Appropriate declarations that balance the benefits of relaxing control measures against the risk of a surge in cases allow public health resources to be conserved (and economic and social pressures to be reduced) while limiting the potential for additional transmission.

Diabetes Mellitus and its impact on Quality of life

To narrate the characteristic of life of patients having type II Diabetes mellitus (DM2) & the factors influencing it. Methods: This was a cross-sectional study. Patients with diabetes mellitus type 2 (DM2) who were over the age of 18 were chosen. Age, gender, profession, matrimonial status, time of type two diabetes development, other diseases, depressive status were all evaluated as factors that affect quality of life (Beck Depression Inventory). A (HRQOL) scale was utilised to assess the quality of life by using the thirty-six-item short-form survey (SF-36). Based on their SF-36 patients were separated into three groups. Results: One thousand three hundred and ninty four sample had a middle phase of 62 years. An average score of 50.1 was assigned to the global HRQOL. According to bivariate analysis, phase, matrimonial status, gender, employment, comorbidities, DM2 duration, and other diseases all had an effect on HRQOL. In the regression model (logistic), age (OR 1.04) and depression (OR 4.4) were identified as independent factors that influenced overall quality of life. Conclusion: The HRQoL of DM2 patients is lower, which is associated to a higher risk of depression. The presence of depression and advanced age have a negative impact on the patient's HRQoL.

A comprehensive review on microemulsions: a potential novel drug delivery system

Microemulsions are excellent candidates as potential drug delivery systems because of their improved drug solubilization, long shelf life, and ease of preparation and administration. The formulation of microemulsion for pharmaceutical use requires a thorough understanding of the properties uses, and limitations of the microemulsion. Three distinct microemulsions – oil external, water external and middle phase can be used for drug delivery, depending upon the type of drug delivery upon the type of drug and the site of action. In this article, Since the term micro emulsion’ was first coined almost fifty years ago to describe clear, isotropic, thermodynamically stable systems composed of oil, water, surfactant and cosurfactant, numerous and varied reports of the applications of microemulsions have appeared in the literature. Reports of the use of microemulsions in separation science began to appear in the literature in the early 1990’s when they were first used as mobile phases for HPLC and as carrier electrolytes for CE separations, particularly for pharmaceutical applications.

In-Session-Reflective-Functioning in Anorexia Nervosa: An Analysis of Psychotherapeutic Sessions of the ANTOP Study.

ObjectivePrevious research suggests that patients with anorexia nervosa (AN) show an impaired capacity to mentalize (reflective functioning, RF). RF is discussed as a possible predictor of outcome in psychotherapeutic processes. The study aimed to explore RF in sessions of patients with AN and its association with outcome and type of treatment.MethodsA post-hoc data analysis of selected cases from a randomized trial on outpatient psychotherapy for AN was conducted. Transcripts from 84 sessions of 28 patients (early phase, middle phase, and end of treatment) were assessed using the In-Session-Reflective-Functioning-Scale [14 cognitive-behavior therapy, enhanced (CBT-E); 14 focal psychodynamic therapy (FPT); 16 with good, 12 with poor outcome after 1 year]. Relations between the level of RF, type of treatment, and outcome were investigated using mixed linear models. Additionally, associations with depressive symptoms, weight gain, and therapeutic alliance were explored.ResultsMean in-session RF was low. It was higher in FPT when compared to CBT-E treatments. The findings point to an association between RF increase and a positive outcome. An increase in BMI in the first half of treatment was associated with higher subsequent in-session RF. There was no association between RF and depressive symptoms or the therapeutic alliance.DiscussionPatients with AN show a low capacity to mentalize in sessions, which seems to be at least partly dependent on the degree of starvation. The results suggest a possible relationship between an increase in in-session RF and outcome, which has to be replicated by further studies.

The Dibenzyl Isoquinoline Alkaloid Berbamine Ameliorates Osteoporosis by Inhibiting Bone Resorption.

Postmenopausal osteoporosis (PMOP) is a kind of primary osteoporosis that is characterized by decreased bone density and strength. Berbamine is a nonbasic quaternary benzylisoquinoline plant alkaloid that has been widely used in the clinic to treat leukopenia in China. We found that berbamine inhibited RANKL-induced osteoclastogenesis of bone marrow-derived macrophages (BMMs) in vitro, which mainly occurred in the middle phase and late phase. The gene and protein expression levels of osteoclast-related molecules, including CTSK, MMP-9, NFATc1, CD44 and DC-STAMP, were also downregulated by berbamine. In vivo, we treated PMOP mice with berbamine for 8 weeks and found that the extent of osteoporosis was alleviated significantly according to micro-CT scanning, hematoxylin-eosin staining, DC-STAMP immunohistochemical staining and TRAP immunohistochemical staining in the distal femurs of the mice. Our findings demonstrate that berbamine has an inhibitory effect on the osteoclastogenesis of BMMs and can prevent bone loss after ovariectomy in vivo. This study provides evidence that berbamine is a potential drug for the prevention and treatment of PMOP.

Novel corneal morphological alterations in Vogt-Koyanagi-Harada disease.

To determine whether visual function, especially when dependent on the anterior segment of ocular tissue, is altered during high-dose steroid treatment for Vogt-Koyanagi-Harada disease (VKH). Retrospective case series METHODS: This case series included 18 eyes of 18 patients with VKH who received high-dose steroid therapy as initial treatment. All patients underwent anterior swept-source optical coherent tomography (CASIA-2) examinations during their clinical course to measure the central corneal thickness (CCT), average central corneal power (ACCP), maximum curvature (Kmax) and anterior chamber depth (ACD). The treatment duration was classified into the initial phase (earliest initial phase eIP; 0-1 month, initial phase: IP; 1-3months), middle phase (MP; 3-6 months), and late phase (LP; 6-9 months). The CCT decreased significantly after treatment (eIP vs. IP, p<0.01, eIP vs. MP, p<0.01; eIP vs. LP, p<0.01). The CCT at eIP was correlated with the flare value at 0M (R2=0.22). The change in Kmax at MP and LP was correlated with the flare value at 0M. Moreover, CCT at MP was correlated with rate of change in nasal angle open distance (AOD) at IP and rate of change in temporal AOD at IP. This study was the first to reveal morphological changes in the anterior segment of the eye in VKH using CASIA-2, which may affect visual acuity and the astigmatic axis. It is vital to assess corneal morphology to determine the cause of visual function deterioration in patients with VKH.

Donor activation focused rehabilitation approach to hand closing nerve transfer surgery in individuals with cervical level spinal cord injury.

Case Series. To describe the donor activation focused rehabilitation approach (DAFRA) in the setting of the hand closing nerve transfers in cervical spinal cord injury (SCI) so that therapists may apply it to treatment of individuals undergoing this procedure. United States of America-Academic Level 1 Trauma Center. We reviewed the records of individuals with cervical SCI who underwent nerve transfer to restore hand closing and post-surgery DAFRA therapy at our institution. The three post-surgery phases of DAFRA included (1) early phase (0-12 months) education, limb preparation, and donor activation exercises, (2) middle phase (12-24 months) volitional recipient muscle activation and (3) late phase (18 + months) strengthening and incorporation of motion in activities of daily living. Subtle gains in hand closing were first observed at a mean of 8.4 months after hand closing nerve transfer surgery. Remarkable improvements including discontinuation of assistive devices, independence with feeding and urinary function, and measurable grip were observed. Function continued to improve slowly for one to two more years. A deliberate, slow-paced (monthly for >2 years post-surgery) and incremental therapy program-DAFRA-can be used to improve outcomes after nerve transfer to restore hand closing in cervical SCI. This work was made possible by funding from the Craig H. Neilsen Foundation Spinal Cord Injury Research on the Translation Spectrum (SCIRTS) Grant: Nerve Transfers to Restore Hand Function in Cervical Spinal Cord Injury (PI: Ida Fox).

Impacts of chilling at the tillering phases on rice growth and grain yield in Northeast China

AbstractChilling is a major constraint on rice production in mountainous regions of the tropics and in the temperate rice‐growing zones of the world. In this study, our goal is to quantify the impacts of chilling at the tillering phases on rice growth and grain yield. In 2017 and 2018, we conducted a factorial chilling treatment at four temperatures (T1, T2, T3 and T4) and four duration days (D2, D4, D6 and D8) on rice plants at the early, middle and late tillering phases. The results showed that chilling at the tillering phases delayed rice growth period. The rice grain yield slightly increased with decrease in chilling temperature but significantly decreased with increase in chilling duration at the tillering phases. For the chilling treatment at T1 (lowest temperature), the D2 (shortest duration) had positive effects on rice yield, while the D8 (longest duration) had adverse effects on rice yield. The middle and late tillering phases were the critical growth phases for rice spike numbers formation, with the increase in temperature and duration, the rice spike numbers per plant significantly decreased. The decrease in chilling temperature and increase in chilling duration both decreased rice thousand‐grain weight under chilling treatments at tillering phases. The prolongation of days from emergence to flowering led to increase in rice aboveground biomass per plant and allocation index of stem; however, the decrease in days from flowering to maturity led to reduction in allocation index of panicle and grain yield under chilling treatments at tillering phases. This study could help farmers to better understand the impacts of chilling on rice growth and yield, especially for rice that are prone to chilling.

Horse‐riding as a habitual activity among the early medieval Avar population of the cemetery of Csokorgasse (Vienna): Sex and chronological differences

AbstractLittle is known about sex and gender differences in the daily life activities of early medieval Avar populations. Of particular interest is habitual horse‐riding, which is assumed to be typical for these populations. Importantly, fundamental changes in the “Avar lifestyle” occurred over time and this may have led to less horse‐riding. This study identifies possible sex and chronological differences in the prevalence of metric and nonmetric traits indicating habitual horse‐riding within the adult population of the Avar cemetery Wien11‐Csokorgasse in Austria. A total of 149 skeletons from this cemetery (ca. 625–800 AD) were analyzed. Poirier's facets, plaque, and cribriform changes of the femur‐neck junction were documented, and the index of ovalization (IOA) of the acetabulum was calculated. Males surpassed females significantly in the prevalence of Poirier's facets of the right (p = 0.011) and the left femur (p = 0.048) and showed significantly higher IOAs of the right (p = 0.019) and the left (p = 0.037) acetabulum. Among males, no chronological differences in the appearance of nonmetric traits and the IOA were detected. In contrast, females showed a significantly higher IOA during the earliest phases of this burial ground (Early Avar period 2/Middle Avar period 1; 625–675 AD), indicating a chronological decline of habitual horse‐riding. Horse‐riding was a typical male activity. Our results, however, suggest that a particular segment of women practiced horse‐riding habitually. From the early to the middle phase of the studied Avar cemetery, its prevalence declined in females, pointing to changes in female daily life activities.

Importance of triple soluting-out effect in the formation of aqueous three-phase systems: Thermodynamics and applications in extraction of biomolecules

A comprehensive experimental study was conducted on aqueous triphasic systems (A3PSs) to increase molecular understanding of the soluting effect phenomenon occurring in these systems. The influence of several ionic liquids, polymers and salts was studied, demonstrating that a triple soluting-out effect is a required phenomenon to formation of an A3PS. For aqueous quaternary systems 1-butyl-3-methylimidazolium bromide ([Bmim][Br]) + trisodium citrate (Na3Cit) + polypropylene glycol 400 (PPG400) and [Bmim][Br] + disodium sulfate (Na2SO4) + PPG400 which were able to form A3PS, the respective phase diagrams were determined at 318.15 K. For aqueous [Bmim][Br] + Na2SO4 + PPG400 system, the equilibrium compositions of three coexisting phases (tie-surfaces) were determined. The results showed that, there are an aqueous polymer-rich phase with the least amount of water (top phase), an aqueous salt-rich phase with the greatest amount of water (bottom phase), and an aqueous IL/polymer-rich phase with large amount of water (middle phase). In order to study the soluting effects occurring in these systems, deviations from the semi-ideal behavior were addressed using the isopiestic measurements. The obtained evidence showed that the triple soluting-out effect is resulted from the unfavorable IL-salt, IL-polymer, and polymer-salt, interactions and it leads to preferential hydration of solutes and thereby creation of three aqueous polymer-rich, salt-rich, and IL/polymer-rich phases in solution for entropy reason. From isopiestic data, for quaternary solutions the constant water activity lines in mono- and biphasic regions show large negative deviations from the semi-ideal hydration model and magnitude of these deviations in monophasic region are larger than those in biphasic region. In three-phasic solutions, the values of deviations became positive. The distribution behavior of three amino acids including L-proline (Pro), L-phenylalanine (Phe), and L-leucine (Leu) in aqueous [Bmim][Br] + Na2SO4 + PPG400 three-phase system was investigated. The results showed that, because of hydrophilic property of the studied amino acids and some favorable amino acid-IL interactions, these analytes are more enriched in the salt-rich or IL/polymer-rich phases than in the polymeric phase.

Ambivalence resolution in the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: An exploratory case study

Patient ambivalence towards change is a central therapeutic target in the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). However, we do not know if and how patients resolve ambivalence across the sessions and modules of the UP. Previous studies have identified two types of ambivalence resolution—dominance and negotiation—and different patterns of resolution for recovered and unchanged cases. Objectives: This exploratory single case study aimed to describe the frequency of observed ambivalence resolution strategies across UP sessions and evaluate the impact of distinct ambivalence resolution strategies on ambivalence. Method: Sixteen sessions of a recovered case were coded with observational measures of ambivalence and ambivalence resolution. Results: Observed ambivalence significantly decreased; dominance remained highly frequent across sessions, and negotiation increased from the beginning to the middle phase of treatment but not from the middle to the final phase. Negotiation was significantly associated with ambivalence reduction. Conclusion: The progression of ambivalence resolution strategies differed from previous studies with distinct therapeutic approaches; promoting negotiation between the different parts of the client’s inner conflict across the whole therapy may be valuable in dealing with patient ambivalence in UP treatment.

Comprehensive separation of a wide variety of compounds from olive leaves by counter-current chromatography with three-phase solvent system.

The three-phase solvent system counter-current chromatography has been of great research interest, because it can separate compounds with a wide range of polarity. The solvent system of n-hexane/methyl tert-butyl ether/acetonitrile/water (5:5:7:5, v/v) was used for counter-current chromatographic comprehensive separation of olive leaves. The study adopted the normal elution mode. The middle phase and the lower phase (at a volume ratio of 7:3) were pumped into the column simultaneously, followed by eluting with the upper, middle, and lower phases in sequence. The retention rate of the stationary phase measured by the experiment was 73.5%. The upper phase was used to elute the nonpolar compounds, then the mobile phase was switched to the middle phase to elute the moderately hydrophobic compounds, finally, the polar compounds were eluted by the lower phase remaining in the chromatographic column. This method successfully separated eight compounds in one step within 270 min and five compounds were identified. The logP values of these five compounds were 7.44, 7.86, 4.16, -0.11, and 0.96, respectively, covering a wide range of polarities. The present study demonstrated that the three-phase solvent has a strong extraction capacity for ingredients from extremely hydrophilic compounds to extremely hydrophobic compounds.

An Analysis on the Factors for Cervical Insufficiency Causing Adverse Emotions Among Pregnant Women at Different Gestation Phases.

BackgroundTo analyze the anxiety, depression, and related factors among pregnant women with cervical insufficiency, so as to provide a reference for clinical psychological intervention as an adjuvant therapy.MethodsA total of 101 cases in China with cervical insufficiency were included in the observation group by a convenience sampling method, and 114 normal healthy women of childbearing age were selected as the control group. Participants were investigated and observed for anxiety and depression by SAS and SDS, respectively, to analyze the emotional state and influencing factors of the patients with cervical insufficiency. Stratified by the first, second and third trimesters, our study used whether depressive or not and whether anxiety or not as the dichotomous variables. A multivariate Logistic regression was adopted to analyze the influencing factors. Relevant influencing factors were screened out by the forward stepwise method in combination with professional knowledge and the number of variables.ResultsThere were statistical significant differences in SAS and SDS between observation group and control group and the incidence rate of anxiety and depression was higher in pregnant women with CI. Multivariate Logistic regression demonstrated that history of abnormal pregnancy was the main influencing factor for anxiety and depression in the early and middle gestation phases, and cervical insufficiency was the factor influencing the anxiety in early gestation and both anxiety and depression in the late gestation phase.ConclusionCervical insufficiency may have a negative impact on the emotions of pregnant women. Individualized and targeted mental care should be added into clinic work to prevent negative outcomes.

Taking the Time: Developing Trust with the Hospitalized Patient.

Background and Purpose: Interpersonal trust is trust between two people and is an important component of the nurse-patient relationship in the hospital setting. Interpersonal trust entails good will, familiarity, risk, power imbalance, and vulnerability. This grounded theory study was undertaken to explain how interpersonal trust develops with the nurse from the perspective of the hospitalized adults. Methods: Face-to-face interviews were conducted with 20 hospitalized adults in their private hospital room. Data analysis was conducted concurrently with data collection using constant comparison. Results: The resulting model had six categories within the core category Taking the Time which reflected nursing presence. The beginning phase had two categories reflecting the patient Feeling Vulnerable and Relying on the Nurse. The middle phase had three categories reflecting the nurse Having a Positive Vibe, Seeing Me as a Person and Caring About Me. The endpoint of developing trust was the patient Feeling Comfortable. Patients perceived the nurse as in control of trust development in the hospital setting. Implications for Practice: The nurse conveying a positive attitude was a principal facilitator to trust development. A barrier to trust development was the nurse seeing the patient as a checklist and not as a person. When trust was established, the patient was more willing to ask questions. When trust did not develop, the patient avoided the nurse and attempted to complete activities on their own such as ambulating to the bathroom. The nurse taking the time and establishing trust contributes to safe patient care.