Miracle-dz/UniFAR-FTUs huggingface dataset:
The attitudes of neonatal nurses towards extremely preterm infants.

AIM The paper is a report of a study of the attitudes of neonatal nurses towards extremely preterm infants. BACKGROUND Alongside advancing survival at extremely preterm gestational ages, ethical debates concerning the provision of invasive care have proliferated in light of the high morbidity. Despite nurses being the healthcare professionals who work closest with the infant and their family, their potential influence is usually ignored when determining how parents come to decisions about future care for their extremely premature infant. METHODS A Q methodology was employed to explore the attitudes of neonatal nurses towards caring for extremely preterm infants. Data were collected between 2007 and 2008 and analysed using PQMethod and Card Content Analysis. RESULTS Thirty-six nurses from six neonatal units in the United Kingdom participated. Although there was consensus around the professional role of the nurse, when faced with the complexities of neonatal nursing three distinguishing factors emerged: the importance of parental choice in decision-making, the belief that technology should be used to assess response to treatment, and the belief that healthcare professionals should undertake difficult decisions. CONCLUSION Neonatal nurses report unexpected difficulties in upholding their professionally defined role through highly complex and ever varied decision-making processes. Recognition of individual attitudes to the care of extremely preterm infants and the role of the family in the face of difficult decisions should facilitate more open communication between the nurse and the parents and improve the experience of both the nurse and the family during these emotional situations.
Evaluation of Chromosome 11p Imbalances in Aniridia and Wilms Tumor Patients

Newborn sporadic aniridia patients with an 11p13 deletion including the WT1 gene have an increased risk to develop Wilms tumor. At present a risk for Wilms tumor cannot be estimated in patients with deletions not extending into, but ending close to WT1. Therefore, it is important to determine the distance of deletion endpoints from the WT1 gene and survey these patients for a longer follow‐up time to obtain a more defined risk estimation. Using molecular methods, such as Multiplex Ligation‐dependent Probe Amplification (MLPA), deletion endpoints can be mapped more accurately than with FISH. We describe here the analysis of six aniridia patients, in two of these the deletions extend close to the 3′ end of WT1. At the ages of 3.8 and 4 years they have not developed a Wilms tumor, suggesting a low tumor risk in such patients. In addition we have studied 24 non‐AN cases with a higher likelihood for WT1 alterations with MLPA and found no deletions. In conclusion newborns with aniridia should be studied with molecular methods that can determine deletion endpoints in 11p13 exactly. For a better Wilms tumor risk estimation cases with deletion endpoints close to WT1 should be followed for at least 4–5 years. Furthermore germ line intragenic deletions affecting WT1 in patients with a higher likelihood for a WT1 association, for example, bilateral tumors, genitourinary aberrations, or nephrotic syndrome, were not found in this study, suggesting that deletions are rare events. © 2013 Wiley Periodicals, Inc.
Exploring leadership in community nursing teams.

AIMS This article is a report on a study investigating how leadership is perceived in community nursing teams and how these perceptions are translated into working practices of team leaders. BACKGROUND The consensus in community nursing literature is that leadership is important, and especially so in a time of change. However, little empirical evidence exists on how leadership works in practice. METHOD The study adopted an exploratory descriptive design, utilising individual semi-structured interviews and focus groups in four case-studies, with a total of 54 participants. Two case-studies focussed on district nursing teams and two involved public health nursing teams, located in two geographical areas. Participants debated their understanding of the concept of leadership, its associated practices and behaviours in teams, if they saw themselves as leaders, and what preparation was required. The study was undertaken in 2009. Framework analysis techniques were employed to analyse the data. FINDINGS A 'quasi-family' model of leadership emerged, with significant emphasis on the importance of personal relationships and support. Nursing grade had a greater impact on perceptions of leadership than geographical context or professional and clinical focus. CONCLUSION No clear fit with any existing theoretical framework was identified. However, nurses in the highest grade banding, in particular, demonstrated practices associated with transformational leadership. Nurses expressed the very clear need to be acknowledged, respected and valued, and that those who provided this support were regarded as good leaders.
Organizational risk management of resistance to care episodes in health facilities.

AIMS This article reports a study of organizational risk management approaches to resistance to care episodes in specific clinical areas: prevention measures, provision of subsequent support and follow-up by management and resultant organizational change. BACKGROUND Resistance to care describes a patient's unwillingness to be assisted by healthcare staff and is manifested in defensive behaviours ranging from minor non-compliance/dissent to aggression. It has previously been studied in aged care settings and focused on patient behaviours and appropriate responses. METHODS This was a cross-sectional survey of a representative sample of nurses (n = 5044) who were members of the New South Wales Nurses' Association in Australia, in 2008-2009. RESULTS Of 1132 participants, 80% reported being involved in resistance to care episodes during the previous month and this was higher in some settings. Episodes were not routinely reported internally, and often did not lead to organizational change. Nurses reported that talking with other staff was the most effective action in dealing with the consequences of these episodes. Half of the respondents considered that they were provided with sufficient support and follow-up after a resistance to care episode. Prevention measures and follow-up strategies adopted by employers varied across clinical settings. CONCLUSION Resistance to care is not confined to aged care settings, and risk management of resistance to care can increase safety in the workplace. Preventive strategies such as increased staff, training and security should be focused on high risk clinical areas; and appropriate support, follow-up and organizational change instituted in response to these episodes.
Surgical nurses' perceptions of ethical dilemmas, moral distress and quality of care.

AIM To describe surgical nurses' perceived levels of ethical dilemmas, moral distress and perceived quality of care and the associations among them. BACKGROUND Nurses are committed to providing quality care. They can experience ethical dilemmas and moral distress while providing patient care. Little research has focused on the effect of moral distress or ethical dilemmas on perceived quality of care. DESIGN Descriptive, cross-sectional study. METHOD After administration and institutional Research Ethics Committee approval, a researcher requested 119 surgical nurses working in two Israeli hospitals to fill out three questionnaires (personal background characteristics; Ethical Dilemmas in Nursing and Quality of Nursing Care). Data collection took place from August 2007 to January 2008. RESULTS Participant mean age was 39·7 years. The sample consisted mostly of women, Jewish and married staff nurses. The majority of nurses reported low to moderate levels of ethical dilemma frequency but intermediate levels of ethical dilemma intensity. Frequency of ethical dilemmas was negatively correlated with level of nursing skill, meeting patient's needs and total quality of care. No important correlations were found between intensity of ethical dilemmas and quality of care. CONCLUSIONS Levels of ethical dilemma frequency were higher than intensity. Nurses tended to be satisfied with their level of quality of care. Increased frequency of ethical dilemmas was associated with some aspects of perceived quality of care. RELEVANCE TO CLINICAL PRACTICE Quality of care is related to ethical dilemmas and moral distress among surgical nurses. Therefore, efforts should be made to decrease the frequency of these feelings to improve the quality of patient care.
Structural Characterization of Viral Ortholog of Human DNA Glycosylase NEIL1 Bound to Thymine Glycol or 5-Hydroxyuracil-containing DNA*

Background: Nei is a DNA glycosylase of the base excision repair pathway. Results: We present two crystal structures of an Nei bound to thymine glycol or 5-hydroxyuracil. Conclusion: Mutational analysis of active site residues suggests that lesion recognition happens before the damaged base is everted into the active site. Significance: These are the first structures of any Nei in complex with a damaged base. Thymine glycol (Tg) and 5-hydroxyuracil (5-OHU) are common oxidized products of pyrimidines, which are recognized and cleaved by two DNA glycosylases of the base excision repair pathway, endonuclease III (Nth) and endonuclease VIII (Nei). Although there are several structures of Nei enzymes unliganded or bound to an abasic (apurinic or apyrimidinic) site, until now there was no structure of an Nei bound to a DNA lesion. Mimivirus Nei1 (MvNei1) is an ortholog of human NEIL1, which was previously crystallized bound to DNA containing an apurinic site (Imamura, K., Wallace, S. S., and Doublié, S. (2009) J. Biol. Chem. 284, 26174–26183). Here, we present two crystal structures of MvNei1 bound to two oxidized pyrimidines, Tg and 5-OHU. Both lesions are flipped out from the DNA helix. Tg is in the anti conformation, whereas 5-OHU adopts both anti and syn conformations in the glycosylase active site. Only two protein side chains (Glu-6 and Tyr-253) are within hydrogen-bonding contact with either damaged base, and mutating these residues did not markedly affect the glycosylase activity. This finding suggests that lesion recognition by Nei occurs before the damaged base flips into the glycosylase active site.
The Body Multiple

The Body Multiple is an extraordinary ethnography of an ordinary disease. Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations. The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice. Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine.
Effects of the ResQPod® on Maximum Concentration and Time to Maximum Concentration of Epinephrine in a Porcine Cardiac Arrest Model

Effects of the ResQPod® on Maximum Concentration and Time to Maximum Concentration of Epinephrine in a Porcine Cardiac Arrest Model Cardiac arrest remains one of the leading causes of mortality with more than 900 occurrences daily in the United States alone claiming an estimated 325,000 lives each year, 1,000 people a day or one person every two minutes. The ResQPod®, an impedance threshold device (ITD), was developed to augment cardiac output during cardiopulmonary resuscitation (CPR). The American Heart Association (AHA) Guidelines 2005 for CPR and Emergency Cardiac Care gave the ResQPod® a Class IIa recommendation. The Class IIa recommendation means the intervention has very good evidence to support its use. Conversely, the 2010 AHA Guidelines state that it was not possible to determine the relative contribution of an ITD to the improved outcome. The use of an ITD may be considered by trained personnel as a CPR adjunct in adult cardiac arrest
Abstract S4-05: Impact of intrinsic subtype by PAM50 and other gene signatures on pathologic complete response (pCR) rates in triple-negative breast cancer (TNBC) after neoadjuvant chemotherapy (NACT) +/- carboplatin (Cb) or bevacizumab (Bev): CALGB 40603/150709 (Allianc

Background: Adding either Cb or Bev to standard NACT significantly increases pCR rates in TNBC (Sikov et al, SABCS 2013). Genomic analysis may help us to identify determinants of response within this clinical phenotype. Methods: Patients (pts) with clinical stage II-III TNBC received weekly paclitaxel x 12 followed by ddAC x 4 +/- Cb and/or Bev. Pre-treatment biopsies were collected in formalin, RNAlater and OCT; residual disease at surgery was biopsied when possible. Illumina mRNA sequencing (RNAseq) was performed. Gene expression values were normalized to a TCGA subset of clinically TNBC samples prior to downstream analysis. pCR was defined as the absence of residual invasive cancer in the breast (ypT0/is). For each molecular signature, prognostic (effect on pCR in the overall study population) and predictive (effect of the addition of Cb or Bev, separately, on pCR) relationships were explored with logistic regression models. Results: PAM50 subtype analysis was performed on 367 pre-treatment samples (of 443 pts who started NACT); pCR results were available for 360, comprising the analysis subset. 87% of these displayed a basal-like gene expression pattern, 2% claudin-low, 4% HER2-enriched, Conclusions: Selection criteria led to accrual of a high % of pts with basal-like tumors, limiting our ability to assess prognostic or predictive impact of intrinsic subtype on pCR. Given that limitation, the magnitude of pCR benefit with Cb was consistent across subtypes, while a basal-like pattern was predictive of greater pCR increment with Bev. Ongoing studies will test a large number of other gene signatures and biomarkers, including the Lehmann et al subtypes. Recognition of clinically relevant subpopulations within TNBC may distinguish pts likely to achieve a pCR from those for whom an investigational approach might be considered. Citation Format: William M Sikov, William T Barry, Katherine A Hoadley, Brandelyn N Pitcher, Baljit Singh, Sara M Tolaney, Charles S Kuzma, Timothy J Pluard, George Somlo, Elisa R Port, Mehra Golshan, Donald A Berry, Olwen M Hahn, Lisa A Carey, Charles M Perou, Clifford A Hudis, Eric P Winer. Impact of intrinsic subtype by PAM50 and other gene signatures on pathologic complete response (pCR) rates in triple-negative breast cancer (TNBC) after neoadjuvant chemotherapy (NACT) +/- carboplatin (Cb) or bevacizumab (Bev): CALGB 40603/150709 (Allianc [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr S4-05.
Evaluation of mental health recovery and Wellness Recovery Action Planning education in Ireland: a mixed methods pre-postevaluation.

AIM To report a study evaluating the effectiveness of a Wellness Recovery Action Planning education programme. BACKGROUND Internationally, mental health policy is advocating using recovery approaches to care. Underpinning these approaches is investment in education in recovery principles and methods and a need to provide evidence of the impact of this education. DESIGN The study design employed a mixed methods approach. METHODS Using questionnaires and focus groups, we evaluated 2- and 5-day Wellness Recovery Action Planning Education Programmes and assessed participants' attitudes towards recovery, knowledge of recovery and Wellness Recovery Action Planning beliefs. Data were collected between 2009 and 2010. Participants were people with personal experience of mental health problems, practitioners in mental health services and family members/carers of those with mental health problems. RESULTS Comparing the pre and postmeasures showed that the programme increased participants' knowledge of and attitudes towards recovery and Wellness Recovery Action Planning. Although this increase was statistically significant for the 2-day programme, it was not so for the 5-day programme. Participants reported being very positive and enthusiastic about the programme and the benefits they had achieved personally and professionally as a result of participating. CONCLUSIONS This exploratory study shows that providing mental health practitioners and people with personal experience of mental health problems with a systematic education and training in recovery principles using the Wellness Recovery Action Planning approach leads to positive changes in people's knowledge, skills and attitudes towards recovery. This education appeared to inspire, invigorate and empower people, and for many, it was a life changing experience.
Women's perceptions and experiences of group cognitive behaviour therapy and other group interventions for postnatal depression: a qualitative synthesis.

AIM This paper is a report of a systematic review that aimed to synthesize qualitative evidence relating to women's perceptions and experiences of group cognitive behaviour therapy and other group interventions for postnatal depression. BACKGROUND Postnatal depression may occur in women following childbirth, resulting in a range of distressing symptoms such as sadness, fatigue, and feelings of inability to look after their baby. Women tend to prefer psychological interventions. However, access to individual psychological therapy is limited by cost, waiting times, and availability of therapists. DATA SOURCES A comprehensive literature search was conducted in 17 major psychological, medical, health-related and health economics electronic bibliographic databases. DESIGN A qualitative evidence synthesis was conducted using thematic synthesis. REVIEW METHODS Databases were searched from 1966-January 2008. A total of 116 full papers were screened against the inclusion criteria. Included papers were quality assessed. The original review protocol was restricted to evidence on group cognitive behaviour therapy. However, due to the paucity of evidence, the inclusion criteria were broadened to include other group interventions. A thematic synthesis was undertaken of the data extracted from the included papers. RESULTS Six studies were included. Specific benefits were that treatment enabled women to develop better relationships with their baby and understand postnatal depression. Negative aspects of treatment included difficulties in applying cognitive behavioural techniques, and unfavourable social comparisons with other group members. CONCLUSIONS Women have contrasting perceptions and experiences of group treatment. This suggests that greater attention should be focused on identifying those most likely to benefit from these treatments in a group environment.
KARAKTERISTIK PEMERIKSAAN IMUNOHISTOKIMIA PADA PASIEN KANKER PAYUDARA DI RSUP SANGLAH PERIODE 2003-2012

Pendahuluan: Kanker payudara masih menempati insiden tertinggi dari seluruh jenis keganasan pada wanita. Berdasarkan data yang tercatat di RSUP Sanglah Denpasar, sebanyak 200 kasus baru ditemukan setiap tahunnya. Pemeriksaan profil imunohistokimia telah digunakan secara luas sebagai dasar dalam mengklasifikasikan kanker payudara secara molekuler. Ekspresi reseptor hormon (ER,PR) dan HER-2 yang ditemukan pada pemeriksaan imunohistokimia berguna untuk menentukan pilihan terapi yang sesuai dengan kebutuhan pasien. Tujuan dari studi deskriptif ini adalah untuk mengetahui karakteristik profil imunohistokimia pasien kanker payudara di RSUP Sanglah Denpasar periode 2003-2012 berdasarkan ekspresi reseptor hormon, HER-2 dan subtipe kanker. Selanjutnya dijabarkan kembali mengenai karakteristik dari masing-masing subtipe berdasarkan umur, grading histopatologi dan stadium kankernya. Metode: Penelitian ini menggunakan rancangan penelitian deskriptif retrospektif dengan megambil data sekunder pasien kanker payudara yang telah melakukan pemeriksaan imunohistokimia di RSUP Sanglah tahun 2003-2012. Hasil: Dari 1014 pasien kanker payudara yang datang ke RSUP Sanglah Denpasar, hanya 147 (14,49%) pasien bersedia melakukan pemeriksaan imunohistokimia. Reseptor hormon negatif ganda (ER-,PR-) serta ekspresi HER-2 negatif ditemukan terbanyak dengan 80 (54,4%) dan 110 (74,8%). Berdasarkan subtipenya luminal A dan basal-like/triple negatif merupakan subtipe dominan dengan masing-masing 55 kasus (37,4%) diikuti dengan HER-2 positif sebanyak 23 (15,6%), dan luminal B sebanyak 14 (9,5%). Kesimpulan: Proporsi pemeriksaan imunohistokimia pasien kanker payudara di RSUP Sanglah sangat sedikit yaitu 147 (14,49%) selama periode 2003-2012. Reseptor hormon negatif ganda dan HER-2 negatif terbanyak dengan 80 kasus (54,4%) dan 110 kasus (74,8%). Berdasarkan subtipe, luminal A dan basal-like/triple negatif merupakan kasus dominan dengan masing-masing 55 (37,4%) kasus.
Surveillance of drug resistance to anti-tuberculosis drugs in districts of Hoogli in West Bengal and Mayurbhanj in Orissa.

Background: The Central TB Division (CTD) Government of India initiated a systematic drug resistance surveillance (DRS) as per the global guidelines among new TB patients reporting to health facilities under RNTCP. The data obtained from two districts of the eastern part of the country conducted by National TB Institute (NTI) are presented in this study. Objective: To measure the levels and pattern of resistance to anti-tuberculosis drugs among "newly diagnosed" sputum smear positive pulmonary tuberculosis cases in two identified districts namely Hoogli of West Bengal and Mayurbhanj of Orissa. Results: Of the total 693 smear positive specimens subjected for culture from both the districts 545 (78.6%) were culture positive for M. tuberculosis 62 (8.9%) were culture negative and 86 (12.4%) were contaminated. Culture negativity and contamination rates were 7.9% & 9.9% from Mayurbhanj district and 10% and 14.9% respectively from Hoogli district. The resistance to any drug was 5.4% in Mayurbhanj and 16.7 in Hoogli district. The resistance level to all the four primary drugs ranged from 0.4% to 3.9% in Mayurbhanj and 1.9% to 13.7% in Hoogli district. MDR was 0.7% (95% CI: 0.0% - 1.7%) and 3.0% (95% CI: 1 % - 5.1 %) in Mayurbhanj and Hoogli districts respectively. Conclusion: The study demonstrates that the levels of H R and MDR in these two districts are within the expected levels when compared with other studies conducted in India as per global DRS guidelines. However in order to document success of RNTCP in reducing the levels of MDR TB particularly in younger population it is now necessary to conduct DRS in much larger population. (authors)