bluuebunny/crossref_metadata_2025 huggingface dataset:
Aging Is Associated With Impaired Activation of Protein Homeostasis‐Related Pathways After Cardiac Arrest in Mice
Authors: Shen Yuntian , Yan Baihui , Zhao Qiang , Wang Zhuoran , Wu Jiangbo , Ren Jiafa , Wang Wei , Yu Shu , Sheng Huaxin , Crowley Steven D. , Ding Fei , Paschen Wulf , Yang Wei
Published: September 2018

Background

The mechanisms underlying worse outcome at advanced age after cardiac arrest (
CA
) and resuscitation are not well understood. Because protein homeostasis (proteostasis) is essential for cellular and organismal health, but is impaired after
CA
, we investigated the effects of age on proteostasis‐related prosurvival pathways activated after
CA
.

Methods and Results

Young (2–3 months old) and aged (21–22 months old) male C57Bl/6 mice were subjected to
CA
and cardiopulmonary resuscitation (
CPR
). Functional outcome and organ damage were evaluated by assessing neurologic deficits, histological features, and creatinine level.
CA
/
CPR
‐related changes in small ubiquitin‐like modifier conjugation, ubiquitination, and the unfolded protein response were analyzed by measuring
mRNA
and protein levels in the brain, kidney, and spinal cord. Thiamet‐G was used to increase O‐linked β‐N‐acetylglucosamine modification. After
CA
/
CPR
, aged mice had trended lower survival rates, more severe tissue damage in the brain and kidney, and poorer recovery of neurologic function compared with young mice. Furthermore, small ubiquitin‐like modifier conjugation, ubiquitination, unfolded protein response, and O‐linked β‐N‐acetylglucosamine modification were activated after
CA
/
CPR
in young mice, but their activation was impaired in aged mice. Finally, pharmacologically increasing O‐linked β‐N‐acetylglucosamine modification after
CA
improved outcome.

Conclusions

Results suggest that impaired activation of prosurvival pathways contributes to worse outcome after
CA
/
CPR
in aged mice because restoration of proteostasis is critical to the survival of cells stressed by ischemia. Therefore, a pharmacologic intervention that targets aging‐related impairment of proteostasis‐related pathways after
CA
/
CPR
may represent a promising therapeutic strategy.
Desmonostoc danxiaense sp. nov. (Nostocales, Cyanobacteria) from Danxia mountain in China based on polyphasic approach
Authors: CAI FANGFANG , YANG YIMING , WEN QIANZHI , LI RENHUI
Published: September 2018

The recently established genus Desmonostoc was characterized by forming macroscopic colonies with diffluent mucilaginous envelopes embedding long vegetative filaments and possessing long chains of akinetes. The establishment of this new genus was further supported by the clustering of the 16S rRNA gene, which have a distinctive phylogenetic placement outside of Nostoc. In this study, a new cyanobacterial species was isolated from a wet rocky wall in Danxia mountain, Guangdong province, southern China, and the novel strains of this new species were evaluated by combining morphological characteristic and molecular data on the 16S rRNA gene and 16S-23S internally transcribed spacer (ITS). This new taxon was found to be closest to Desmonostoc species. The separation of the new species described here as Desmonostoc danxiaense, using morphological and molecular traits, was based on differences in phenotypic, 16S rRNA gene, ITS sequence and its secondary structure.
A review of Sedum section Gormania (Crassulaceae) in western North America
Authors: ZIKA PETER F. , WILSON BARBARA L. , BRAINERD RICHARD E. , OTTING NICK , DARINGTON STEVEN , KNAUS BRIAN J. , NELSON JULIE KIERSTEAD
Published: September 2018

Sedum section Gormania was restricted to Oregon, Nevada and California in the western United States. After extensive field work from 2011 to 2016, we revised 17 members of the group using floral and vegetative characters, resulting in the acceptance of four new taxa in California. A serpentine endemic from the mountains of western Tehama County was recognized as S. rubiginosum. It was separated from S. kiersteadiae by its dense rosettes, overlapping stem leaves and non-apiculate corolla. A serpentine endemic from low elevation canyons in Del Norte County was described as S. patens. It was distinguished from S. laxum by its white spreading petals and yellow anthers. A plant of high elevation, serpentine and non-serpentine sites in Siskiyou County was circumscribed as S. marmorense; it differed from S. oregonense in its sepals and inflorescence with a thick granular waxy deposit, and leaves in dense rosettes. Sedum paradisum was segregated from S. obtusatum, raised to species level, and divided into two subspecies. Plants of the northern Sierra Nevada were newly defined as S. paradisum subsp. subroseum, separable with nodding young flowering shoots and a disjunct range in Butte, Plumas and Sierra counties. Sedum flavidum and Sedum eastwoodiae were removed from S. laxum sensu stricto, and raised to species rank, based on floral characters. We clarified the concept of S. obtusatum subsp. retusum, and restored it to the rank of species as S. sanhedrinum; it was restricted to Glenn, Lake, Mendocino, and Tehama counties, California. Sedum flavidum and S. oregonense as defined here showed more morphological variation than previously understood. Finally, we remarked on hybridization and cleistogamy observed in the field.
Fieber’s unpublished colour plates allow reassessing some of his Cixius species (Insecta: Hemiptera, Fulgoromorpha, Cixiidae)
Authors: KUNZ GERNOT , HOLZINGER WERNER E , SOULIER-PERKINS ADELINE
Published: September 2018

Franz Xaver Fieber was a leading Hemiptera taxonomist in the 19th century. The recent discovery of his unpublished drawings that go along with the original handwritten manuscript allow a reassessment of species descriptions from this century. In addition, we present an alphabet of Fieber's handwriting. We give an overview on the Cixiidae species he had described and reassess the status of the species names Cixius brachycranus Scott, 1870, Cixius intermedius Scott, 1870, Cixius pinicola Fieber, 1876, Tachycixius venustulus (Germar, 1830) and Tachycixius distinctus (Signoret, 1865). T. venustulus and T. distinctus are regarded as valid species. The synonymy of C. pinicola with T. venustulus is invalidated and C. pinicola is placed in synonymy with T. distinctus.
The Signature of Shallow Circulations, Not Cloud Radiative Effects, in the Spatial Distribution of Tropical Precipitation
Authors: Fläschner Dagmar , Mauritsen Thorsten , Stevens Bjorn , Bony Sandrine
Published: September 2018

Recent research suggests cloud–radiation interaction as key for intermodel differences in tropical precipitation change with warming. This motivates the hypothesis that intermodel differences in the climatology of precipitation, and in its response to warming, should reduce in the absence of cloud–radiation interaction. The hypothesis is explored with the aquaplanet simulations by the Clouds On-Off Klimate Intercomparison Experiment performed by seven general circulation models, wherein atmospheric cloud radiative effects (ACREs) are active (ACRE-on) and inactive (ACRE-off). Contrary to expectation, models’ climatology of tropical precipitation are more diverse in the ACRE-off experiments, as measured by the position of the intertropical convergence zone (ITCZ), the subtropical precipitation minima, and the associated organization of the tropical circulation. Also the direction of the latitudinal shift of the ITCZ differs more in simulations with inactive cloud radiative effects. Nevertheless, both in ACRE-on and ACRE-off, the same relationship between tropical precipitation and the mean vertical velocity (zonally, temporally, and vertically averaged) emerges in all models. An analysis framework based on the moist static energy budget and used in the moisture space is then developed to understand what controls the distribution of the mean vertical velocity. The results suggest that intermodel differences in tropical circulation and zonal-mean precipitation patterns are most strongly associated with intermodel differences in the representation of shallow circulations that connect dry and moist regions.
Decolonising research methodologies: opportunity and caution
Authors: Barnes Brendon R
Published: September 2018

Decolonising methodologies attempt to bring together a number of critical, indigenous, liberation, and feminist methodologies to strengthen decolonisation research. Decolonising methodologies have potential, but it is important to be aware of possible limitations. I argue that the manner in which decolonising methodologies is located in the paradigm debate is limiting and prescriptive, lacks clarity of the concepts that it draws on, reproduces problematic representations of the marginalised, overemphasises how much choice researchers have in choosing decolonising methodologies, and does not address the systemic barriers to decolonisation scholarship. Recommendations for how to strengthen decolonising methodologies are presented.
Robust H∞ gain neuro-adaptive observer design for nonlinear uncertain systems
Authors: Abdelkader Krifa , Kais Bouzrara
Published: September 2018

To guarantee convergent state estimates and exact approximations, it is highly desirable that observers can independently dominate the effects of unmodelled dynamics. Based on adaptive nonlinear approximation, this paper presents a robust H∞ gain neuro-adaptive observer (R H∞GNAO) design methodology for a large class of uncertain nonlinear systems in the presence of time-varying unknown parameters with bounded external disturbances on the state vector and on the output of the original system. The proposed R H∞GNAO incorporates radial basis function neural networks (RBFNNs) to approximate the unknown nonlinearities in the uncertain system. The weight dynamics of every RBFNN are adjusted online by using an adaptive projection algorithm. The asymptotic convergence of the state and parameter estimation errors is achieved by using Lyapunov cogitation under a well-defined persistent excitation condition, and without recourse to the strictly positive real condition. The repercussions of unknown disturbances are reduced by integrating an H∞ gain performance criterion into the proposed estimation approach. The condition imposed by this proposed observer approach, such that all estimated signals are uniformly ultimately bounded, is expressed in the form of the linear matrix inequality problem and warrants the demanded performances. To evaluate the performance of the proposed observer, various simulations are presented.
Retained surgical needle and gauze after cesarean section and adnexectomy: a case report and literature review
Authors: Gavrić Lovrec Vida , Cokan Andrej , Lukman Lara , Arko Darja , Takač Iztok
Published: September 2018

Although the incidence of retained surgical items (RSIs) is low, it is nevertheless an important preventable cause of patient injury that can ultimately lead to the patient's death and to subsequent high medical and legal costs. Unintentional RSI is the cause of 70% of re-interventions, with a morbidity of 80% and mortality of 35%. The most common RSIs are sponges or gauze (gossypiboma or textiloma), while retained surgical instruments and needles are rare. Perioperative counting of equipment and materials is the most common method of screening for RSIs, while a diagnosis can later be confirmed by the clinical appearance and by imaging studies. We present a rare case of a 43-year-old patient who was admitted to our hospital because of two retained needles following a cesarean section, despite several subsequent laparotomies. One needle had been removed previously, but in addition to the remaining needle, we also removed a retained gauze. The diagnosis of RSIs is extremely important, and safe surgical practices including the addition of new imaging technologies should be encouraged to detect RSIs.
Interdigitating dendritic cell sarcoma located in the groin: a case report and literature review
Authors: Wang Hong-Tao , Xu Hong-Yang , Zhang Rong , Liu Zhuo-Gang , Zhang Guo-Jun
Published: September 2018

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare subtype of dendritic cell neoplasms, and current knowledge on this tumor is limited. We herein report a case of an IDCS in a 64-year-old man who presented with a right inguinal mass combined with extensive retroperitoneal, pulmonary, hepatic, renal, and bone marrow infiltration. Because of the advanced stage of the disease, we performed five cycles of chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP); doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD); and ABVD combined with cisplatin, and one cycle of radiotherapy. The patient’s inguinal mass became smaller during the treatment, but there was no change in the extent of infiltration at the other sites. The patient died 8 months after the initial diagnosis. We also herein review the etiology, diagnosis, differential diagnosis, treatment, and prognosis of IDCS, and analyze the characteristics of IDCS in Chinese patients.
Acute cardiac dyspnea in the emergency department: diagnostic value of N-terminal prohormone of brain natriuretic peptide and galectin-3
Authors: Stoica Alexandra , Şorodoc Victoriţa , Lionte Cătălina , Jaba Irina M. , Costache Irina , Anisie Ecaterina , Tuchiluș Cristina , Rusalim Petriș Ovidiu , Sîrbu Oana , Jaba Elisabeta , Ceasovschih Alexandr , Vâţă Luminiţa , Şorodoc Laurenţiu
Published: September 2018

Objective

This study was performed to determine whether a dual-biomarker approach using N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3 optimizes the diagnosis and risk stratification of acute cardiac dyspnea. Atypical clinical manifestations and overlapping pathologies require objective and effective diagnostic methods to avoid treatment delays.

Methods

This prospective observational study included 208 patients who presented to the emergency department for acute dyspnea. NT-proBNP and galectin-3 were measured upon admission. The patients were divided into two groups according to the etiology of their clinical manifestations: cardiac and non-cardiac dyspnea. The patients’ New York Heart Association functional class, left ventricular ejection fraction, and discharge status were assessed.

Results

Diagnostic criteria for acute heart failure were fulfilled in 61.1% of the patients. NT-proBNP and galectin-3 were strongly and significantly correlated. Receiver operating characteristic analysis revealed similar areas under the curve for both markers in the entire group of patients as well as in the high-risk subsets of patients.

Conclusions

The diagnostic performance of NT-proBNP and galectin-3 is comparable for both the total population and high-risk subsets. Galectin-3 adds diagnostic value to the conventional NT-proBNP in patients with acute cardiac dyspnea, and its utility is of major interest in uncertain clinical situations.
An Examination of the Prescription Renewal Process and Implications for Primary Care Physicians and Community Pharmacists
Authors: Pattin Anthony J. , Devore Nathan , Fowler Jonathan , Weldy David
Published: September 2018

In physician practices and pharmacies, staff members work to process prescription renewals so that patients receive a steady supply of medications. These functions are essential to ensure patients have continuous access to medications and remain adherent to prescribed therapies. Despite the incorporation of e-prescribing software programs to ease management of these processes, barriers to effective management of the prescription renewal process exist. Mismanagement of pharmacy adherence programs can ultimately lead to patients receiving inappropriate medications and excessive use of staff resources. The objective of this article is to examine the prescription renewal process in both the primary care setting and the pharmacy and report challenges associated with the process. A literature review was conducted to find studies that describe pharmacists’ and physicians’ handlings of prescription renewals, use of e-prescribing software, and benefits and barriers to using these technologies. Although studies report e-prescribing software improves efficiency in the prescription renewal process, there is a need to reduce technological problems that create challenges in use. It is recommended that staff within physician practices and pharmacies standardize prescription renewal processes and educate patients about the prescription renewal process.
Solidarity after nature: From biopolitics to cosmopolitics
Authors: Hendrickx Kim , Van Hoyweghen Ine
Published: September 2018

What is sustaining the divide between nature and nurture, even though sciences like epigenetics have been challenging it for at least two decades? Evelyn Fox Keller asked this question and considered it a logical problem rooted in terminological confusion within the sciences. In this article, we propose a complementary diagnosis of the problem: the nature-nurture divide is (re-)mobilized when society faces questions of inclusion and solidarity. With examples stemming from the fields of insurance and health care, immigration policy and epigenetics, we demonstrate how the nature-nurture divide is performed through techniques of classification for a politics of solidarity. We identify a common operation to these different examples that we coin ‘biopolitical imputation’. We use this term to draw attention to how (Western) societal institutions, including science, create solvable problems out of complex situations, defining human actors and their agency along the lines of the nature–nurture divide as a moral guide. We argue that the tenacity of the nature–nurture divide is therefore not only a logical problem needing better scientific concepts, but also a cosmopolitical problem asking for a more profound reflection on the ontology and ethics of solidarity in order to move beyond the biopolitics of nature versus nurture.
Alignments and differentiations: People with illness experiences seeking legitimate positions as health service developers and producers
Authors: Jones Marjaana , Pietilä Ilkka
Published: September 2018

Health policies and strategies promote the involvement of people with illness experiences in service development and production, integrating them into settings that have traditionally been domains of health professionals. In this study, we focus on the perspectives of people with personal illness experiences and explore how they justify involvement, position themselves as legitimate actors and forge collaborative relationships with health professionals. We have used discourse analysis in analysing individual interviews conducted with peer support workers and experts by experience (n = 17) who currently work in Finnish health services. The interviewees utilised discourses of empowerment, efficiency and patient-centeredness, aligning themselves with the justifications constructed by patient movements additionally to those found in current health policies. Both groups wanted to retain critical distance from professionals in order to voice criticisms of current care practices, yet they also frequently aligned themselves with professionals in order to gain legitimacy for their involvement. They adopted professional traits that moved them further from being lay participants sharing personal experiences and adopted an expert position. Although national-level policies provided backing and legitimacy for involvement, the lack of local-level guidance could hinder the practical implementation and make involvement largely dependent of professionals’ discretion.
Estimates of prediabetes and undiagnosed type 2 diabetes in Denmark: The end of an epidemic or a diagnostic artefact?
Authors: Jørgensen Marit Eika , Ellervik Christina , Ekholm Ola , Johansen Nanna Borup , Carstensen Bendix
Published: September 2018

Background: Up-to-date information on undiagnosed type 2 diabetes and prediabetes based on current diagnostic criteria is lacking. The study aimed to model the total numbers of people with undiagnosed type 2 diabetes and prediabetes in Denmark based on existing population-based surveys. Methods: Two population-based Danish studies with information on HbA1c, date of examination, gender, age and known type 2 diabetes were identified: the Danish General Suburban Population Study, n = 21,205, and the Danish Health Examination Survey, n = 18,065. The prevalence of known, undiagnosed and pre-diabetes were estimated in the Danish General Suburban Population Study, and population-level age-specific prevalence of known type 2 diabetes was estimated from national registers. The Danish Health Examination Survey was included for sensitivity analysis. Combining estimates of the survey participation rate among known type 2 diabetes patients with known overall participation rates from the studies allowed for the correction of survey prevalence to plausible population-level estimates of age- and gender-specific prevalence. Results: The prevalence of known, undiagnosed and pre-diabetes was highest among men, increasing with age with a peak at age 70. Applying the survey-based prevalence to the entire Danish population, the estimated number (May 2011) with undiagnosed type 2 diabetes was 60,681, corresponding to 24% of all type 2 diabetes cases, and 292,715 had prediabetes, about 50% more than the total type 2 diabetes population. Conclusions: Estimates of undiagnosed type 2 diabetes and prediabetes are dramatically lower than reported in previous studies (60,681 vs 200,000 and 292,715 vs 750,000); however, whether this reflects a true decrease in incidence or the change to HbA1c-based diagnostic criteria is not clear.
Data analytics of call log data to identify caller behaviour patterns from a mental health and well-being helpline
Authors: O’Neill Siobhan , Bond Raymond R , Grigorash Alexander , Ramsey Colette , Armour Cherie , Mulvenna Maurice D
Published: September 2018

This work presents an analysis of 3.5 million calls made to a mental health and well-being helpline, seeking to answer the question, what different groups of callers can be characterised by specific usage patterns? Calls were extracted from a telephony informatics system. Each call was logged with a date, time, duration and a unique identifier allowing for repeat caller analysis. We utilized data mining techniques to reveal new insights into help-seeking behaviours. Analysis was carried out using unsupervised machine learning (K-means clustering) to discover the types of callers, and Fourier transform was used to ascertain periodicity in calls. Callers can be clustered into five or six caller groups that offer a meaningful interpretation. Cluster groups are stable and re-emerge regardless of which year is considered. The volume of calls exhibits strong repetitive intra-day and intra-week patterns. Intra-month repetitions are absent. This work provides new data-driven findings to model the type and behaviour of callers seeking mental health support. It offers insights for computer-mediated and telephony-based helpline management.
Low to Intermediate Dose Atropine Administration During Dobutamine Stress Echocardiography in the Pre-Liver Transplant Population
Authors: Snipelisky David , Shipman Justin , Olson Nicole , Pellikka Patricia , Aqel Bashar , McCully Robert , Watt Kymberly
Published: September 2018

Introduction:

Dobutamine stress echocardiography (DSE) is frequently used to screen for obstructive coronary artery disease in the pre-liver transplant evaluation. Although atropine is a commonly used adjunctive medication, no study has evaluated its side effect profile in patients with end-stage liver disease (ESLD).

Research Question:

What is the safety of atropine in candidates undergoing pre-liver transplant evaluation when atropine is used in stress testing?

Design:

This multicenter, prospective study enrolled patients over a 6-month period undergoing pre-liver transplant evaluation. Each patient completed a questionnaire assessing anticholinergic-related symptoms within 24 hours of testing and 48 hours following. Comparisons were made among patients receiving any atropine dose versus those who did not and among patients receiving at least 1 mg atropine and those receiving less/none.

Results:

Forty patients were evaluated, and 32 (80%) had adjunctive atropine administered. No differences in clinical characteristics were noted. In comparisons among patients receiving any dose of atropine with those who did not, questionnaire results indicated a higher rate of nausea prior to testing and higher overall symptom severity following testing in patients not receiving atropine. In comparisons among patients receiving less than 1 mg atropine with those receiving at least 1 mg atropine, no difference in pre- or posttesting questionnaire responses was present. No patient in the study required reversal agents or hospitalization within 7 days of testing.

Conclusions:

Atropine, a hepatically metabolized medication, did not predispose patients with ESLD to an increased symptom burden, and clinical outcomes related to DSE were unaffected.
A Quality Control Study of the Adherence to Recommended Physiological Targets for the Management of Brain-Dead Organ Donors in South Australian Intensive Care Units
Authors: Sampson Brett G. , Wilson Steven R. , Finnis Mark E. , Hodak Alison M. , Jones Philippa N. , O’Connor Stephanie L. , Chapman Marianne J.
Published: September 2018

Background:

The Australian and New Zealand Intensive Care Society and the Australasian Transplant Coordinators Association provide recommendations on the physiological management of brain-dead donors.

Problem statement:

How often physiological targets are prescribed for brain-dead donors in Australian intensive care units (ICUs), and how well these compare to recommended targets is unknown. It is also unknown how often recommended targets are achieved, irrespective of prescribed targets.

Methods:

We performed a retrospective, observational quality control study in 81 adult (>18 years) brain-dead donors to describe how often physiological targets were prescribed, comparing these to current guidelines. We determined the proportion of observations within the recommended target range, irrespective of any prescribed target. We aimed to identify poor adherence to recommended targets to guide future quality improvement initiatives.

Outcomes:

Seventy-four (91%) donors had at least 1 prescribed physiological target written on the ICU chart, with a median of 2 (range 2-5), and a maximum of 13 targets. Prescribed targets appeared to adhere well with recommended targets. Most recommended physiological targets were met irrespective of any prescribed target. However, one-quarter of serum sodium observations and one-third of blood glucose levels were above the recommended target.

Implications for practice:

Quality improvement initiatives are required to improve the prescription of physiological targets in brain-dead donors in South Australia. Serum sodium and serum glucose targets were not met. However, this most likely reflects the need for current guidelines to be updated in line with current evidence.
Silencing the seventh trumpet: Analyzing the effect of private schooling on voting behavior
Authors: Kingsbury Ian
Published: September 2018

The United States has one of the lowest election turnout rates in the developed world. Consequently, social scientists are perpetually seeking to expand upon their knowledge of what factors are associated with voting, or the lack thereof. Commonly identified factors including age, income, race, and educational attainment have been studied extensively. However, while the quantity of education is deemed important, the type of education is overlooked. The limited literature that exists on the topic suggests that private schools have a positive effect on civic outcomes, including voter participation. In using a rich, nationally representative dataset—the Understanding America Study based out of the University of Southern California—this study reexamines whether attending a private school has an effect on whether Americans vote. It also sheds light on a heretofore-unanswered question: How does private schooling affect which candidate an individual supports? Overall, the data indicate that private schooling appears to have no impact on voter turnout, but that attending some private school appears to have a liberalizing effect.
On the relation between age and the importance attached to historical events
Authors: de Regt Sabrina , van der Lippe Tanja , Jaspers Eva
Published: September 2018

The critical years hypothesis is an influential hypothesis in the social sciences. According to this hypothesis, events occurring during adolescence or young adulthood are most important. This hypothesis is significant because if generations do indeed differ from each other because they were socialized in different contexts, the succession of generations has the potential to change societies. In this study, we test the validity of the critical years hypothesis using data from the Dutch Longitudinal Internet Studies for the Social Sciences Immigrant Panel. We first compare the power of the critical years hypothesis to that of alternative patterns, after which we conduct a structural examination of the conditionality of the critical years hypothesis. We test our hypotheses according to both open-ended and closed-ended questions. The results provide only limited evidence for the critical years hypothesis.
Occupational Health Surveillance, Screening, and Prevention Activities in Occupational Health Nursing Practice
Authors: Rogers Bonnie , Livsey Kae
Published: September 2018

Occupational health nursing practice is broad and encompasses surveillance, screening, and prevention activities as part of the scope of practice. While there has been some controversy about who is responsible for these activities, it is clear occupational health nurses play a pivotal role in overseeing, managing, implementing, and evaluating these programs. In fact, recent OSHA standards have included broad language that permits licensed health care professionals acting within their legal scope of practice to conduct medical and health surveillance activities.

While the contributions of occupational health nurses are well documented, little is known about the degree and emphasis in practice related to surveillance, screening, and prevention programs. This study examined the scope of independent and interdependent practice by occupational health nurses related to these activities and found 71% of occupational health nurses had overall responsibility for program management, and the majority performed surveillance, screening, and prevention functions as independent practice. Physician supervision for any of these activities ranged from only 0% to 8% in reporting. The results of this study validate the independent functioning in scope of occupational health nursing practice related to surveillance, screening, and prevention activities while recognizing the contributions all providers make to a healthy work force.
Urinary Incontinence
Authors: Fitzgerald Sheila T. , Palmer Mary H. , Berry Susan J. , Hart Kristin
Published: September 2018

Until recently, the impact of urinary incontinence (UI) on working women, a population generally characterized as healthy, has not been the focus of research. Women employed full time at a large university center participated in a cross sectional survey about UI. Of the 1,113 women surveyed, age 18 and older, 21 % (n = 232) reported UI at least monthly. Incontinent women were significantly older and had a higher body mass index than continent women. Using disposable products, limiting fluids, avoiding caffeinated beverages, using voiding schedules, and keeping extra clothes or underwear were strategies used to manage UI at work. Responses to an open ended question related to the impact of UI on working life included: interference with sleep and resulting fatigue at work, embarrassment, alteration of concentration, and emotional distress. Implications for nurses are discussed in relation to assessment, education, and management of UI in the occupational setting.
Health and Safety at Work in Switzerland
Authors: Bischofberger Iren
Published: September 2018

Switzerland, surrounded by European Union (EU) member states, rejected a 1992 referendum to join the European Economic Communities (EEC), which currently includes 15 member states. As a result, the country has had difficulties resolving economic issues with health and safety interests. This study analyzed the consequences of selected EU Directives of Health and Safety at Work in a country that chose not to join the EU. The Directives went into effect throughout the entire EU in 1993.

Executive directors and safety advisors from the Swiss company “Migros” participated in a two round Delphi survey focused on timing, feelings, and preference of the legal system in relation to the EU, prioritizing selected EU directives, and implementing health and safety concepts. The results showed the effects of the Directives (although not legally required) demand careful consideration particularly in terms of the timing of the implementation and the priorities of the Swiss health and safety legal system. The two professional groups involved showed congruent opinions on several questions, presenting a solid foundation for planning common action. In conclusion, the growing awareness of occupational health and safety aspects observed during the survey should be pursued among all Migros key staff in decision making positions in occupational safety and health. In this way, Migros could serve as a role model in the occupational health and safety field, much as it has long been recognized as a pioneer in funding social causes throughout Swiss society.
Unrecognized High Blood Pressure
Authors: Capriotti Teri , Kirby Lynn Garvey , Smeltzer Suzanne C.
Published: September 2018

Hypertension continues to be prevalent in the general population despite the public's increased awareness of cardiovascular disease. Population-wide detection and prevention of hypertension are high priority goals within preventive health care. According to recent National Heart, Lung, and Blood Institute (NHLBI) guidelines, high normal blood pressure (BP) (systolic 130 to 139 nun Hg or diastolic 85 to 89 mm Hg) is not an innocuous condition (NHLBI, 1997). High normal BP is a detectable, modifiable, antecedent condition to overt hypertension. Little is known about the incidence of high normal BP in the general population and of its relationship to stress. This study examined the prevalence of high normal and hypertensive levels of blood pressure in a convenience sample of 94 volunteer employees from a midsize corporation. Blood pressure and level of reported stress were assessed. Findings revealed rates of 11% and 30% high normal and hypertensive blood pressure levels, respectively. Ninety-six percent of participants assumed their blood pressures were normal. As in other studies, those employees with hypertensive blood pressure reported higher stress levels than normotensive employees. However, the population with high normal BP did not report significantly higher stress levels than normotensive employees. These findings suggest high normal and hypertensive blood pressures are prevalent cardiovascular disease risk factors among employees in the workplace. Most employees are unaware of their elevated BP and the risk of high normal BP. Occupational health nurses are in a strategic position to take a proactive approach to population-wide hypertension prevention by initiating worksite BP screening and education programs.
Burnout and the Power of One
Authors: Sitzman Kathy
Published: September 2018

We welcome Kathy Sitzman as author of the new column, Express Speak. This bimonthly feature will discuss issues relevant to personal and professional growth in occupational and environmental health nursing. We look forward to hearing your comments on and personal experiences with these issues. Write to: Express Speak, AAOHN Journal, 6900 Grove Road, Thorofare, NJ 08086, or e-mail: jkilpatrick@slackinc.com .
Accessing the Internet
Authors: Dibenedetto Deborah V.
Published: September 2018

We welcome Deborah DiBenedetto as the new Informatics columnist and are pleased that Ms. DiBenedetto has agreed to share her expertise with our readers. The Journal welcomes general questions related to informatics. Address questions to: Informatics Column, AAOHN Journal, 6900 Grove Road, Thorofare, NJ 08086, or e-mail: aaohn@slackinc.com .
Information Seeking Behavior of Occupational Health Nurses
Authors: Lathey Jonathan W. , Hodge Bernadette
Published: September 2018

A questionnaire designed to study the information seeking behavior of professional nurses was mailed to 600 occupational health nurses who work and reside in New York State. A 28% response rate (165 usable replies) was obtained. Results indicated respondents most need to know about government regulations relating to health care, new developments in their area of specialization, drug information, and the psychological aspects of disease. The respondents most frequently looked to peers and colleagues in their agency, personal files and books, and professional organizations as important sources of information. Whereas respondents were less apt to rely on the Internet, MEDLINE, or the hospital library as sources of information used for professional purposes, 38.8% did report they frequently used the Internet to seek health related information. Also, the majority of respondents (65%) indicated interest in continuing education, if it were available, in using the Internet to access health related information. The present study suggests professional nursing organizations have an opportunity to meet members' needs by expediting members' efforts to access and evaluate information using emerging information technologies.
What is the Difference between Absence Tracking and Case Management?
Authors: Kalina Christine M. , Haag Annette B. , Tourigian Robin , Wassel Mary Lou
Published: September 2018

At the request of our readers, we present this special feature on case management. This feature appears on an occasional basis in the Journal. Based on the suggestion of a reader, we are using a Panel approach to provide a forum for sharing ideas, viewpoints, and perspectives. We have put together a group of individuals with expertise from a variety of case management arenas who have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of the AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the Panel. This month's Panel members include Christine M. Kalina, Annette B. Haag, Robin Tourigian, and Mary Lou Wassel.
Health Hazards and Preventive Measures of Farm Women
Authors: Meeker Bonnie Juve' , Carruth Ann , Holland Catherine B.
Published: September 2018

Currently, an increasing number of farms are family owned and women are directly involved in the farming operations as an independent manager or partner. Women play an important role in farm management by marketing farm products, purchasing materials, and financial planning. Because of this involvement, women can be exposed to potential health hazards that can result in chronic illness, debilitation, or death. This study explored and described health hazards affecting farm women in southeast Louisiana, preventive measures used by farm women, and their consistency in using protective equipment with varying levels of time commitment toward farm operations. This cross sectional study included women older than 18 whose family participated in farming operations. A stratified, random sample design with parishes comprising the strata and simple random selection without replacement within each stratum was used to select family addresses. A total of 519 women who met the criteria completed a structured 30 minute telephone interview conducted using The Louisiana Farm Health and Injury Survey instrument. Information elicited included farm work characteristics, prevention practices, and demographics. Results showed that women working 1 to 20 hours per week were less likely to wear personal protective equipment (PPE) than women working more than 20 hours per week. This included wearing seat belts on tractors; using hearing, eye, or breathing protection; and wearing gloves or boots. No differences were found between groups for use of skin protection, hair holders, or helmets on all terrain vehicles (ATVs). The researchers concluded that if nursing interventions such as teaching and counseling related to prevention methods could be provided, the incidence of acute and chronic illnesses and traumatic injury would decline.
Gertrude Stewart, AAIN President from 1957 to 1959
Authors: Lukes Eileen
Published: September 2018

Gertrude Stewart, President of AAIN from 1957 to 1959, died recently. In honor of her memory as we celebrate the contributions of many of our colleagues throughout the past 50 years, we take pleasure in again sharing her 1999 interview with Eileen Lukes in honor of her 100th birthday.
An Exploratory Study of Motor Vehicle Use in Home Visiting Nurses
Authors: Sitzman Kathleen L. , Pett Marjorie A. , Bloswick Donald S.
Published: September 2018

Driving is a fundamental function of home care and hospice professionals. This study presents the first published information on occupational health issues related to motor vehicle use in this group. Findings and recommendations should be considered for organizations and visiting staff.
Aching Backs? A Glimpse into the Hazards of Nursing
Authors: Uhl Joan E. , Wilkinson William E. , Wilkinson Connie S.
Published: September 2018

This study evaluates a combination of extant and collected data that compute frequency and exposure to back injuries reported by nursing employees at a Northwest Medical Center system. A major problem of interest, and the focus of this study is whether there is objective evidence to support the commonly held belief that lifting patients is the main cause of back injuries experienced by nurses; and whether job classification and worksite unit might be confounded with back injuries reported and what demographic characteristics of the nursing personnel, e.g., sex, age, job classification, and worksite unit, might be confounded with occupations that are high at risk for back injuries. Personnel records and injury report forms provided objective data for 659 registered nurses, licensed practical nurses, and nurse aides. Injury report forms providing data for 123 nursing personnel filed during the most recent consecutive twelve-month period between January 1, 1982 and April 30, 1985, were abstracted, summarized, and analyzed for number of back injuries reported using DataBase III and SPSSx computer programs on an IBM-AT system. In addition, on-site observations of patient lifts were made for ten eight-hour shifts on 15 different occasions and different worksites by a nurse-research analyst.

These observation data were compared with self-report questionnaire responses representing over 54% of the total population of nurses within this medical center system. An inverse relationship of reported numbers of patient lift per shift was found for the observation and self-report data. Of the 2.5 females to males reporting back injuries, the average age was 43 years, with greater numbers of those injuries working on surgical and medical units versus lesser numbers injured from psychiatry and long-term care units in decreasing order.

The Chi-square test was used to compute associations found not significant between reported high and low numbers of lifts and the incidence of back injuries. The t-test compared data from the observed and self-reported number of patient lifts and provided a significant (t = p <.001) difference in favor of self-report for number of lifts per eight-hour shift. Results of this study will contribute to increasing validity of lifting patients resulting in back injuries and further study of feasible and effective methods for evaluating back injuries and preventive interventions for nursing personnel who are at high risk of developing or sustaining back injury from any cause, while on the job.
Hypertension
Authors: Wilkinson William E.
Published: September 2018

A hospital hypertension control and prevention program should consist of detection, referral, evaluation, and follow-up. The benefits of such a program have proven to outweigh the costs in numerous general industries. It is postulated that the same benefits will accrue to hospital personnel and the hospital budget. However, careful record keeping, more research, and dissemination of program results are needed to determine the cost effectiveness of hypertension prevention and control programs in hospital settings.
Exposure to Blood and Body Fluid
Authors: Sass Jennifer , Bertolone Kathy , Denton Diane , Logsdon M. Cynthia
Published: September 2018

Due to lack of previous research, this study examined the factors associated with non-compliance in follow up human immunodeficiency virus (HIV) testing among health care workers after blood and/or body fluid exposure. A descriptive correlation design was used with 178 health care workers who did not return for recommended follow up HIV testing post-blood and/or body fluid exposure at three urban hospitals. The 36 question Likert scale was designed to measure the five concepts of the Health Belief Model: susceptibility, seriousness, benefit, barriers, and health motivation. The internal consistency reliability measured .48. Forty five subjects (25%) returned the questionnaire. The most significant factor determined to affect return rate for follow up testing was related to benefits and susceptibility (F=4.57, df=2,42, R=.42, P=.02). Return rate was most significantly correlated with the idea of decreasing the chance of dying from acquired immunodeficiency syndrome (AIDS) (r= .31, P=.04). Similar results of recommended future studies may indicate changes in post-exposure education or institutional policies and procedures.
Nursing Staff Back Injuries
Authors: Cohen-Mansfield Jiska , Culpepper William J. , Carter Patricia
Published: September 2018

This report describes the period prevalence and costs of back injuries to nursing staff of long term care facilities in comparison to nurses employed industry wide and to other occupations industry wide. The period prevalence of back injuries to nursing staff in long term care facilities was highest for nurse aides, followed by LPNs and then RNs. Nurses (combined) had a period prevalence of back injuries nearly 1.5 times higher than all employees of long term care facilities and 6 times higher than all occupations combined industry wide. Within long term care facilities, nurses sustaining back injuries were younger and had been employed for a shorter period of time than the average for all nurses employed in long term care facilities. Back injuries accounted for more than half of the indemnity and medical costs for all injuries incurred in nursing homes and industry wide. The findings highlight the need for better prevention and rehabilitation.
Workplace Violence
Authors: Gates Donna M.
Published: September 2018

The purpose of this descriptive study was to describe occupational health nurses' beliefs about workplace violence and violence prevention education. The study examined what nurses believe about their intentions and ability to provide violence prevention education, as well as barriers they perceive to providing such programs. A survey was sent to a random sample of 700 members of the AAOHN; 357 surveys were used for data analysis. The study found that many occupational health nurses believe they and their companies are at risk for violence. In addition, many of the occupational health nurses had experienced harassment, threats, or assaults at their workplaces during the previous 12 months. Few occupational health nurses had provided violence prevention programs in their workplaces or intended to provide such programs during the following 12 months. The largest barrier to providing violence prevention education was the employer did not recognize violence prevention education as part of the nurse's job responsibilities.