bluuebunny/crossref_metadata_2025 huggingface dataset:
Content analysis of nursing diagnoses in mental health records in Portugal
Authors: Gonçalves P.D.B. , Sequeira C.A.C. , e Silva M.A.T.C.P.
Published: October 2018

Aims

To identify the diagnoses documented by nurses in Portugal to describe the nursing needs within the scope of mental health nursing and the main problems in documenting these needs.

Background/Introduction

The diagnosis process is an essential step in nursing care planning. This process should be carried out by nurses in a rigorous and standardized manner, in order to ensure quality practices and to obtain indicators that can increase the visibility of nursing care.

A descriptive study combining

1. quantitative content analysis of nursing diagnosis records written by nurses working in 39 psychiatry departments of the Portuguese National Health Service, and 2. An focus group meeting with 14 nurses exploring the results of first study phase. Qualitative and quantitative data were analysed by content analysis.

Findings

The 2014 initial diagnosis records were systematized into 78 final diagnostic categories, which may represent the most relevant diagnoses in the field of mental health nursing in Portugal. The main problems found in the diagnostic identification by nurses included lack of a standardized language; confusion between nursing diagnoses and focus areas and identification of incongruent clinical judgements.

Discussion/Conclusion

The changes observed in the fields of behaviour, emotions and psychological process correspond to the largest concentration of nursing diagnoses and challenges in Portugal. This study revealed the lack of standardized language used by nurses in defining diagnoses. The problems identified in the diagnoses documentation suggest that more training in this area is needed.

Nursing Implications

This study provides information on the most relevant diagnoses in the area of mental health nursing in Portugal and may offer an important contribution towards improving nursing informatics systems and care to patients by means of standardization of language used in diagnosis definitions.

Implication for Nursing Policies

The standardization of language used by mental health nurses may contribute towards producing health indicators that provides evidence to policymakers about the contribution made by nursing care towards improved population health.
Crickets increase sexual signalling and sperm protection but live shorter in the presence of rivals
Authors: Noguera José C.
Published: October 2018

The sociosexual environment animals experience through their life can shape the evolution of key life history traits, including longevity. Male–male competition, for instance, may influence the resources allocated to traits involved in male reproductive success. Here, I test whether lifelong exposure to a competitor male influences male investment in pre‐ and post‐copulatory sexual traits (calling effort and sperm quality) and how this affected the oxidative status and longevity of male field crickets (Gryllus bimaculatus). As expected, the visual exposure to a mating competitor promoted a higher calling effort in the male crickets but resulted in a decline in the haemolymph antioxidant content. The haemolymph antioxidant content negatively covaried with the antioxidant content of the sperm but interestingly, only when the males were exposed to a competitor. This suggests that when mating competition is high, males may prioritize sperm antioxidant protection against somatic maintenance. Finally, I provide evidence that male–male competition imposes additional costs to reproduction, as males exposed to a mating competitor lost a significant proportion of body antioxidant defences and body mass over time and in long term, had a reduced lifespan. Overall, this study strongly suggests that intrasexual competition may impose additional oxidative costs during reproduction for males, with negative consequences on lifespan. Moreover, the results highlight the role of oxidative stress as a physiological mechanism underlying the trade‐off between reproduction‐longevity and through which sexual selection may contribute to the evolution of senescence patterns.
A Non‐Flagellated Member of the Myxogastria and Expansion of the Echinosteliida
Authors: Fiore‐Donno Anna Maria , Tice Alexander K. , Brown Matthew W.
Published: October 2018

Myxogastria (also called Myxomycetes or plasmodial slime‐moulds) are mostly known through their usually conspicuous fruiting bodies. Another unifying trait is the presence of a facultative flagellate stage along with the obligate amoeboid stage. Here we show with two‐gene phylogenies (SSU rRNA and EF‐1alpha genes) that the incertae sedis, non‐flagellate Echinosteliopsis oligospora belongs to the dark‐spore clade (Fuscisporidia) of the Myxogastria. In addition, we confirm that Echinostelium bisporum, firstly described as a protostelid, belongs to the Echinosteliida, which are divided into three major clades and are paraphyletic to the remaining Fuscisporidia.
Reduction in maternal serum values of glucose and gamma‐glutamyltransferase after supplementation with alpha‐lipoic acid in women with gestational diabetes mellitus
Authors: Aslfalah Hadise , Jamilian Mehri , Rafiei Fatemeh , Khosrowbeygi Ali
Published: October 2018

Aim

Alpha‐lipoic acid (ALA) is a short chain fatty acid which has a key role in energy production. ALA is also known as a universal antioxidant. The aim of the present study was to explore the effects of ALA supplementation in women with gestational diabetes mellitus.

Methods

A randomized double‐blind placebo‐controlled clinical trial study was designed. Women with gestational diabetes mellitus (n = 60) during 24–28 weeks of gestation were selected and divided randomly into drug (n = 30) and placebo (n = 30) groups. Drug group supplemented with ALA (100 mg/day) for 8 weeks. The biochemical markers were measured before and after the intervention and considered significant at a P‐value less than 0.05.

Results

Maternal circulating values of fasting blood sugar (P < 0.001), gamma‐glutamyltransferase (P < 0.001) and alanine transaminase (P = 0.031) were decreased in the drug group after the intervention. However, values of urea, creatinine, uric acid, aspartate transaminase and alkaline phosphatase were not changed significantly after the trial.

Conclusion

The present study has shown that supplementation with 100 mg/day of ALA had some beneficial effects on glucose metabolism and liver function in women with gestational diabetes mellitus.
Do Prior Experiences of Top Executives Enable or Hinder Product Market Entry?
Authors: Ener Hakan
Published: October 2018

How firms achieve entry into new‐to‐the‐firm product markets is an important but overlooked topic. Some aspiring entrants fail during product development, and they miss the opportunity to enter. In such contexts, firms often take action to de‐risk entry, for example, by drawing upon the experience of top executives with market‐specific expertise obtained in prior jobs. However, the empirical evidence from this study shows that beyond a narrow threshold, greater prior experience in the top executive team was associated with a greater likelihood of failed entry attempts among the firms that I tracked over two decades in the biotechnology industry. This result held across product markets with low and high degrees of dynamism. Based on the literature on dynamic managerial capabilities, where entry into new markets indicates managers’ ability to reconfigure organizational resources and adapt to a changing environment, this study’s main contribution is to illustrate how and why experience matters for entry.
Aloe vera in treatment of oral submucous fibrosis: A systematic review and meta‐analysis
Authors: Al‐Maweri Sadeq Ali , Ashraf Sajna , Lingam Amara Swapna , Alqutaibi Ahmed , Abdulrab Saleem , Alaizari Nader , Halboub Esam
Published: October 2018

The management of oral submucous fibrosis (OSF) is quite challenging, and as yet, no effective therapy is available for its management. The present systematic review and meta‐analysis sought to assess the effectiveness of aloe vera in alleviating pain and clinical signs of OSF. A comprehensive search in PubMed/Medline, Scopus, and Web of Science databases was conducted to identify the relevant randomized clinical trials. RevMan 5.3 software was used for data analysis. Six randomized controlled trials fulfilled the inclusion criteria. The results of meta‐analysis showed statistically significant differences between aloe vera and control groups in alleviating pain/burning sensation at the end of the first and second month, in favor of aloe vera, but no significant differences were found at the end of the third month. With regard to objective clinical outcomes, no statistically significant differences were found between the groups. Aloe vera has a promising effect in reducing pain/burning sensation and clinical improvement in patients with OSF. However, owing to the marked heterogeneity of the included studies, conducting well‐designed trials with long follow‐up periods, standardized outcome measures and adequate sample sizes are warranted.
Illuminating the World Cup effect: Night lights evidence from South Africa
Authors: Pfeifer Gregor , Wahl Fabian , Marczak Martyna
Published: October 2018

This paper evaluates the economic impact of the $14 billion preparatory infrastructure investments for the 2010 FIFA World Cup in South Africa. We use satellite data on night light luminosity at municipality and electoral district level as a proxy for economic activity, applying synthetic control methods for estimation. For the average World Cup municipality, we find significantly positive, short‐run effects before the tournament, corresponding to a reduction of unemployment by 1.3 percentage points. At the electoral district level, we reveal distinct effect heterogeneity, where especially investments in transport infrastructure are shown to have long‐lasting, positive effects, particularly in rural areas.
The spatial extent of agglomeration economies across the wage earnings distribution
Authors: Håkansson Johan , Isacsson Gunnar
Published: October 2018

We investigate the spatial extent of agglomeration economies across the wage earnings distribution using economic mass (total employment) in four distance bands around each individual’s establishment in a quantile regression framework. We control for observable and unobservable individual and establishment characteristics. Remaining endogeneity in the model is assessed with a set of instrumental variables. Results indicate a positive effect of economic mass on wage earnings up to 25 km away from the establishment. The spatial extent of agglomeration economies is similar across the wage earnings distribution. However, increases in economic mass shift the wage earnings distribution in a nonsymmetric way.
The Chinese mosaic: Cultural diversity and creative cities
Authors: Zhang Cui
Published: October 2018

This paper identifies the extent to which cultural diversity induced by internal migration affects urban innovation in China. We measure cultural diversity by an index of “plurality” of provinces of origin. Using the 2000 and 2005 population census data, we find that innovative activities are higher in cities with a higher degree of cultural diversity. Further heterogeneity analysis shows that cultural diversity, not only of the highly skilled, but also of the low skilled, has a positive effect on innovation. Our study contributes to the scarce evidence on the effect of cultural diversity on innovation in developing countries.
What Expertise Can Tell About Mathematical Learning and Cognition
Authors: Sella Francesco , Cohen Kadosh Roi
Published: October 2018

The investigation of mathematical expertise can shape numerical and mathematical cognition theories by providing insights about the modifications that the neurocognitive system undergoes when mastering mathematical knowledge. In particular, both qualitative and quantitative methods should be combined within a developmental perspective to identify those promoting factors that lead some individuals to focus their interests on mathematics and possibly become experts in the field. The behavioral and neural differences in math experts constitute valuable information to study the limits of the mastering of mathematical knowledge, which ultimately represents a powerful form of formal human reasoning.
Implementing small‐scale poultry‐for‐nutrition projects: Successes and lessons learned
Authors: Nordhagen Stella , Klemm Rolf
Published: October 2018

This paper examines Helen Keller International's model for nutrition‐sensitive poultry production using a programme implemented in four diverse African contexts—three rural and one urban. Consecutive cross‐sectional surveys conducted every 5 months among ~15% of participating households show that despite project‐provided training and inputs, there was only limited uptake of many “best practices.” Few households constructed improved henhouses; vaccination rates varied and were highest when support was provided. Poultry mortality was high. Egg productivity remained average for village poultry systems, and egg consumption remained low (two to six eggs consumed per household per fortnight). However, children whose mothers were exposed to project messages on nutrition were more likely to eat eggs, and consumption was consistently higher among households with chickens. Women's involvement in chicken rearing was widespread, but their control over revenues from the sale of poultry products was limited. Key lessons learned from implementation were as follows: (a) strong behaviour change communication is needed to encourage egg consumption, (b) nutrition‐sensitive village poultry programmes should often focus more on improved practices than improved breeds, (c) supporting women's chicken production is not a route to empowerment without complementary activities that directly support women's ownership and decision making. There is also a need for rigorous research on the role of village poultry in livelihoods, food systems, and consumption as well as the structure of poultry and egg markets in low‐resource areas.
An agriculture–nutrition intervention improved children's diet and growth in a randomized trial in Ghana
Authors: Marquis Grace S. , Colecraft Esi K. , Kanlisi Roland , Aidam Bridget A. , Atuobi‐Yeboah Afua , Pinto Comfort , Aryeetey Richmond
Published: October 2018

Stunting in Ghana is associated with rural communities, poverty, and low education; integrated agricultural interventions can address the problem. This cluster randomized controlled trial tested the effect of a 12‐month intervention (inputs and training for poultry farming and home gardening, and nutrition and health education) on child diet and nutritional status. Sixteen clusters were identified and randomly assigned to intervention or control; communities within clusters were randomly chosen, and all interested, eligible mother–child pairs were enrolled (intervention: 8 clusters, 19 communities, and 287 households; control: 8 clusters, 20 communities, and 213 households). Intention‐to‐treat analyses were used to estimate the effect of the intervention on endline minimum diet diversity (≥4 food groups), consumption of eggs, and length‐for‐age (LAZ)/height‐for‐age (HAZ), weight‐for‐age (WAZ), and weight‐for‐length (WLZ)/weight‐for‐height (WHZ) z‐scores; standard errors were corrected for clustering. Children were 10.5 ± 5.2 months (range: 0–32) at baseline and 29.8 ± 5.4 months (range: 13–48) at endline. Compared with children in the control group, children in the intervention group met minimum diet diversity (adjusted odds ratio = 1.65, 95% CI [1.02, 2.69]) and a higher LAZ/HAZ (β = 0.22, 95% CI [0.09, 0.34]) and WAZ (β = 0.15, 95% CI [0.00, 0.30]). Sensitivity analyses with random‐effects and mixed‐effects models and as‐treated analysis were consistent with the findings. There was no group difference in WLZ/WHZ. Integrated interventions that increase access to high‐quality foods and nutrition education improve child nutrition.
An egg for everyone: Pathways to universal access to one of nature's most nutritious foods
Authors: Morris Saul S. , Beesabathuni Kalpana , Headey Derek
Published: October 2018

Eggs are a highly nutritious food but have been shown to be infrequently consumed in many low‐income countries, especially by women and children. We collate country‐level data on egg production, availability, consumption, prices, industry structure, and contextual trends and use these to estimate current patterns and likely future outcomes under four alternative scenarios. These scenarios are as follows: incremental change based on expected economic growth and urbanisation (the base scenario); enhanced productivity of independent small producers; aggregated production in egg hubs; and the accelerated spread of large‐scale intensive production. All scenarios are modelled out to 2030 using a mix of regression and deterministic models. We find that children's consumption of eggs is highly correlated with national availability, and both are a function of egg prices. Eggs are unavailable, expensive, and infrequently consumed by children in much of South Asia and sub‐Saharan Africa. The base scenario results in modest increases in production in low‐income regions. Focusing efforts on independent small producers can only boost rural consumption in a handful of countries where poultry ownership is unusually high and would be expensive and logistically challenging to scale. Aggregation of production, with minimum flock sizes of 5,000 layers per farm, is a more promising pathway to increasing availability in rural areas. To meet the needs of urban populations, large‐scale intensive production is needed. Intensive production brings down prices significantly, allowing many more poor households to access and consume eggs. Recent experience in countries such as Thailand confirms that this is both feasible and impactful.
See the Benefit: Adversity Appraisal and Subjective Value in Negotiation
Authors: Lewis Benjamin , Olekalns Mara , Smith Philip L. , Barker Caza Brianna
Published: October 2018

Negotiation scholars know relatively little about how negotiators can overcome adverse circumstances and end negotiations with an enhanced sense of satisfaction. Using a series of two negotiations simulations, we tested whether cognitive reappraisal influences negotiators' responses to adverse experiences. After completing a negotiation in which they either did – or did not – encounter difficulties, participants identified a challenging moment and wrote about either the benefits or harms they associated with that moment. They then completed a second negotiation and reported their post‐negotiation satisfaction using the Subjective Value Inventory. Compared to negotiators who did not encounter adversity, those negotiators who did encounter challenges and engaged in benefit finding reported higher levels of process and relationship satisfaction than those who engaged in harm finding. We also found that negotiators reported greater process and relationship satisfaction under adverse circumstances (hard negotiation or harm‐finding appraisal) when their partners used inclusive language (we, ours, us) in the second negotiation.
Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients
Authors: Chou Yu‐Hsiang , Huang Wei‐Lieh , Chang Chin‐Hao , Yang Cheryl C. H. , Kuo Terry B. J. , Lin Shuei‐Liong , Chiang Wen‐Chih , Chu Tzong‐Shinn
Published: October 2018

Aim

Autonomic dysfunction contributes to cardiovascular morbidity/mortality and can be evaluated with heart rate variability (HRV). This study is to evaluate the prognostic significance of HRV on renal function in non‐dialysis chronic kidney disease (CKD) patients.

Methods

We enrolled 326 non‐dialysis CKD patients in this prospective observational study. The median follow‐up period was 2.02 years. Five‐minutes of electrocardiography recordings obtained at enrolment were reprocessed to assess HRV. Five frequency‐domain measures and one time‐domain measures were obtained. Rapid CKD progression was defined as annual estimated glomerular filtration rate (eGFR) loss over 30% per year or eGFR decline rate over 3 mL/min per 1.73 m2 per year. The prevalence of abnormal HRV, associated factors of HRV and impact of HRV on the risk of CKD progression were analyzed.

Results

The abnormality of HRV increased along with the severity of CKD. In patients with stage 5 CKD, the proportion of abnormal ln(low frequency power) (LF), ln(high frequency power) (HF), lnLF/HF were 69.5, 52.8 and 50%, respectively. Associated factors of HRV included advanced CKD, diabetes mellitus, serum albumin, severe proteinuria, Beck Anxiety Inventory score, erythropoietin use, renin‐angiotensin system inhibitors and heart failure. Multivariate logistic regression model analysis revealed lower lnLF/HF, hypertension and severe proteinuria were the risk factors of rapid CKD progression.

Conclusion

The prevalence of autonomic dysfunction measured by HRV among each stage CKD patients is different. Most patients in advanced CKD stage have reduced values of HRV parameters. The estimation of lnLF/HF also provided prognostic information on CKD progression in addition to classical risk factors.
Differing pathways to resiliency: A grounded theory study of enactment of resilience among acute care nurses
Authors: Ang Shin Yuh , Uthaman Thendral , Ayre Tracy Carol , Lim Siew Hoon , Lopez Violeta
Published: October 2018

It is well‐recognized that nurses are exposed to high levels of stress, thus resilience has been postulated as a key trait in enabling nurses to cope successfully and remain in the profession. In this qualitative study, we used Glaser's approach to grounded theory. Nine nurses who scored low and nine nurses who scored high on the Connor–Davidson Resilience Scale were recruited for one‐on‐one semistructured interviews of the factors contributing to their work‐related stress and how they overcome these stressors. Three categories emerged from the data: outlook on work, self‐efficacy, and coping responses. These categories led to the emergence of the theory “differing pathways to resiliency”. Despite the stresses experienced at work, some nurses were highly resilient, while others were not. Highly‐resilient nurses tend to adopt active coping mechanisms, whereas nurses who have low resilience tend to undertake passive measures to let nature runs its course. The emerging theory provided an understanding of the different pathways to resiliency and how nurse leaders can potentially develop and grow the level of resiliency among nurses.
Difficulties faced by Korean disaster relief workers while providing humanitarian aid: A descriptive study
Authors: Kwag Myeongji , Lee Ogcheol
Published: October 2018

The aim of the present study was to identify difficulties experienced by Korean disaster relief workers during humanitarian aid deployment. A convenience sample of disaster relief workers aged >18 years, who had been dispatched to an overseas disaster site, were recruited; 107 relief workers completed the Humanitarian Aid Difficulty Scale that consists of 23 items comprising five factors. The average difficulty rating was 2.64 on a five point scale. By item, participants gave the highest scores for bathroom use and the lowest scores for cooperation among team members. By factor, infrastructure was rated as the greatest difficulty, followed by health conditions, goods and equipment, culture and customs, and cooperation. Considering sociodemographic characteristics, there were significant age differences in the culture and customs factor, as well as significant occupation differences in the cooperation, culture and customs, and goods and equipment factors. These findings highlight the need to improve the welfare of workers. It is recommended that further research be conducted according to occupation and with repeated measurement prior to, in the middle of, and after deployment of relief workers.
Abandoned spaces and technology displacement by labour: the case of hand car washes
Authors: Clark Ian
Published: October 2018

The diffusion of hand car washes is in contradistinction to vogue arguments about automation and new technology. However, what is absent from the literature is a focus on abandoned spaces as a capitalist commodity and the displacement of technology by labour which is particularly associated with the emergence of low‐cost informalised areas of work that occupy and self‐regulate these spaces. The contribution of this research to new knowledge is a theoretically informed empirical derivation of abandoned spaces which low‐cost businesses such as hand car washes occupy to inform two research propositions; one, the spatial dimension to abandoned spaces derives from economic restructuring from above; this restructuring informs restructuring from below rather than as an independent development of migrant‐dominated sectors of work and employment such as hand car washes. Two, that the application of new technology can be displaced by, operates in conjunction with or relies on low‐cost labour‐intensive providers where labour practices tend towards informalisation.
Genome editing in Streptococcus mutans through self‐targeting CRISPR arrays
Authors: Gong Tao , Tang Boyu , Zhou Xuedong , Zeng Jumei , Lu Miao , Guo Xiaoxin , Peng Xian , Lei Lei , Gong Bo , Li Yuqing
Published: October 2018

Streptococcus mutans is the primary etiological agent of human dental caries. Its major virulence factors, glucosyltransferases (Gtfs), utilize sucrose to synthesize extracellular polysaccharides (EPS), leading to the formation of dental plaque biofilm. The current study was designed to develop a novel self‐targeting gene editing technology that targeted gtfs to inhibit biofilms formation. The CRISPR‐Cas system (ie, clustered regularly interspaced short palindromic repeat, with CRISPR‐associated proteins) provides sequence‐specific protection against foreign genetic materials in archaea and bacteria, and has been widely developed for genomic engineering. The first aim of this study was to test whether components of the CRISPR‐Cas9 system from S mutans UA159 is necessary to defend against foreign DNA. The data showed that a suitable PAM site, tracrRNA, Cas9, and RNase III are indispensable elements to perform normal function of S mutans CRISPR‐Cas9 system. Based on these results, we designed self‐targeting CRISPR arrays (containing spacer sequences identifying with gtfB) and cloned them onto plasmids. Afterward, we transformed the plasmids and editing templates into UA159 (self‐targeting) to acquire desired mutants. Our data showed that this technology performed well and was able to successfully edit gtfB or gtfBgtfC genes. This resulted in high reduction in EPS synthesis and was able to breakdown biofilm formation, which is also a promising tool for dental clinics in order to prevent the formation of S mutans biofilms in the future.
Associations between maternal obesity and severe maternal morbidity: Findings from the French EPIMOMS population‐based study
Authors: Siddiqui Ayesha , Azria Elie , Howell Elizabeth A. , Deneux‐Tharaux Catherine ,   the EPIMOMS Study Group
Published: October 2018

Background

Maternal obesity is increasing. There is growing evidence of its effect on severe maternal morbidity. We assessed prepregnancy obesity as an independent risk factor for severe maternal morbidity by timing and cause.

Methods

We designed a case‐control analysis within the EPIMOMS prospective population‐based study conducted in six French regions in 2012‐2013 (182 309 women who delivered at ≥22 weeks). Cases were all women who experienced severe maternal morbidity during pregnancy to 42 days postpartum as per a multicriteria definition derived by national expert consensus (n = 2540, severe maternal morbidity prevalence 1.4%). Controls were randomly selected from the same health centres (n = 3651). The association between obesity and severe maternal morbidity was assessed from fitting multivariable logistic regression models: overall, by timing (antepartum and intrapartum/ postpartum), and by cause.

Results

Prepregnancy obesity was associated with overall severe maternal morbidity (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.14, 1.59) and antepartum severe maternal morbidity (OR 2.07, 95% CI 1.61, 2.65), but not with intra/postpartum severe maternal morbidity (OR 1.15, 95% CI 0.96, 1.38). Among antepartum severe maternal morbidity, severe hypertensive disorders were most strongly associated with obesity (OR 2.50, 95% CI 1.85, 3.40) but the risk of antepartum severe maternal morbidity due to other causes was also increased among obese women (OR 1.64, 95% CI 1.13, 2.37). Obesity was not associated with severe postpartum haemorrhage (OR 1.12, 95% CI 0.92, 1.37).

Conclusion

Obesity is associated with an increased risk of antepartum, but not intra/ postpartum, severe maternal morbidity.
Adjuvant effects of medicinal herbs and probiotics for fish vaccines
Authors: Soltani Mehdi , Lymbery Alan , Song Seong Kyu , Hosseini Shekarabi Pezhman
Published: October 2018

The most prominent limiting factor in aquaculture nowadays is infectious diseases as they lead to massive economic losses. These diseases are often partly controlled by vaccination, herbs or probiotics. Despite the fact that vaccination is the most effective prophylactic approach to disease prevention, researchers have started to use plant‐derived products and probiotics as adjuvants to boost the efficacy of fish vaccines. This review describes the efficacy and potency of plant extracts/essences and probiotics as adjuvants for various vaccines in aquaculture.
Decomposing service exports adjustments along the intensive and extensive margin at the firm‐level
Authors: Christen Elisabeth , Pfaffermayr Michael , Wolfmayr Yvonne
Published: October 2018

Using a panel data set of Austrian service exporting firms this paper examines the determinants of service exports at the firm/destination country level. We implement a random effects Heckman sample selection firm‐level gravity model as well as a fixed effects Poisson model. Expected firm‐level service exports are decomposed into the intensive and extensive margins of adjustment as a response to counterfactual changes. We find market demand to be a key determinant. Results also suggest high service export potentials due to regulatory reform in partner countries within the EU. Adjustments at the extensive margin only play a marginal role. Increases in firm size as well as changes in distance related costs are most effective in developing new export relationships in services.
The Performance Of A Consumption Augmented Asset Index In Ranking Households And Identifying The Poor
Authors: Ngo Diana K. L. , Christiaensen Luc
Published: October 2018

Asset ownership indices are widely used as inexpensive proxies for consumption. We show that these indices can be augmented using dichotomous indicators for consumption, which are equally easy to obtain. Using multiple rounds of Living Standards Measurements Study surveys from Malawi, Uganda, Rwanda, Tanzania, and Ghana, we construct indices using different item subcategories and perform a meta‐analysis comparing the indices to per capita consumption. The results show that the standard asset indices, derived from durable ownership and housing characteristic indicators, perform well in urban settings. Yet, in rural samples and when identifying the extreme poor, household rankings and poverty classification accuracy can be meaningfully improved by adding indicators of food and semi‐durable consumption. We find small improvement from using national weights in urban samples but no improvement from using alternative construction methods. With most of Africa’s poor concentrated in rural areas, these are important insights.
Fourier‐series‐based virtual fields method combining with moiré interferometry for characterising elastic modulus distribution of laser repaired GH4169
Authors: Cao Q. K. , Xie H. M. , Wang H.
Published: October 2018

Laser cladding is an effective technology for repairing damaged components with high efficiency and low cost. Characterisation for the mechanical properties of the repaired structure is of great importance to evaluate its reliability. In this study, the mechanical properties of laser repaired GH4169 are investigated by Fourier‐series‐based virtual fields method and moiré interferometry. The elastic modulus distribution of the whole structure is identified to understand the mechanical performance of the repaired zone and base material. A uniaxial tensile test is performed and the full‐field deformation is measured by moiré interferometry. With the measured strain field, the distribution of modulus in repaired structures can be calculated. In addition, simulation experiments of moiré interferometry are conducted to optimise the parameters of Fourier‐series‐based virtual fields method to improve the accuracy of the proposed method. On the basis of these results, experiments on the repaired GH4169 material are performed and the variation of modulus in the whole structure is identified. The results verify that the proposed method is effective for characterising modulus distribution of the laser repaired structures, and will have a good prospect for further application.
Linguistically diverse general practice teaching
Authors: Lyon Alison , Tan Lawrence , Abbott Penny , Hu Wendy , Reath Jenny
Published: October 2018

Background

Learning about general practice in a context of linguistic diversity is an understudied area. There may be additional learning needs or unrecognised opportunities in this environment. This study explores the experiences of general practitioners (GPs) and medical students on placement where consultations are conducted in a language other than English (LOTE).

Method

We conducted 19 semi‐structured interviews with medical students and GP supervisors who consult in LOTE. We explored experiences of learning, and teaching strategies implemented by GP supervisors. Thematic analysis was undertaken.

Results

Participants reported that LOTE consultations provided unique learning opportunities, including use of interpreters and development of cross‐cultural communication skills. Facilitators to learning included the GP engaging the student in the consultation by interpreting, and patients being open to student participation. Some students described language as a barrier to learning, where they had difficulty in following the consultation. Time required for interpreting limited interaction and learning in GP consultations. We identified ways to navigate the language barrier; including the GP acting as interpreter, and students learning key phrases in the consultation language to build rapport.

Discussion

Learning in the linguistically diverse General Practice environment can be optimised through an active and collaborative approach between the GP, student, and patients. Our findings highlight specific barriers and facilitators to learning. Our participants identified a variety of techniques, including skills in interpreter use and cross‐cultural communication skills which can transcend language barriers, to create valuable opportunities for medical students to learn in this setting.

Medical students increasingly experience clinical placements in general practices within diverse communities
Multilevel National Analysis of Nursing Students’ Perceived Opportunity to Access Evidence‐Based Tools During Their Clinical Learning Experience
Authors: Palese Alvisa , Gonella Silvia , Grassetti Luca , Destrebecq Anne , Mansutti Irene , Terzoni Stefano , Zannini Lucia , Altini Pietro , Bevilacqua Anita , Brugnolli Anna , Dal Ponte Adriana , De Biasio Laura , Fascì Adriana , Grosso Silvia , Mantovan Franco , Marognolli Oliva , Nicotera Raffaela , Randon Giulia , Tollini Morena , Canzan Federica , Saiani Luisa , Dimonte Valerio
Published: October 2018

Background

Easy‐to‐access tools have been demonstrated to improve evidence‐based practice (EBP) competences among nursing students. However, students’ perception of access to EBP tools (e.g., clinical practice guidelines [CPGs], protocols) is unknown.

Aims

To explore: (1) nursing students’ opportunity to access EBP tools during their education, and (2) associated factors.

Methods

A national cross‐sectional study including all Italian nursing programs. Nursing students were deemed eligible according to the following inclusion criteria: Those who (1) were attending or just ended their practical rotation lasting at least 2 weeks at the time of the survey, and (2) expressed through written informed consent their willingness to take part in the study. Participants were asked about their perceived opportunity to access EBP tools during their most recent clinical learning experience (from 0 – not at all to 3 – always). A set of explanatory variables was collected at the individual, nursing program, and regional levels by using a questionnaire.

Results

Nine thousand six hundred and seven (91.6%) out of 10,480 nursing students took part in the study. Overall, 4,376 (45.6%) students perceived not at all or only a small opportunity to access EBP tools during their most recent clinical rotation. In the multilevel analysis, factors promoting access were mainly set at the clinical learning environment level (high safety and nursing care quality, high self‐directed learning opportunities, high quality of the learning environment, and being supervised by a clinical nurse). In contrast, male gender and lower academic class were associated with a lower perception of accessibility to EBP tools. A consistent variability in the perceived opportunity to access EBP tools emerged across regions.

Linking Evidence to Action

Evidence‐based decision‐making is increasingly expected from nurses. Therefore, nursing faculties should safeguard and continuously improve students’ competence regarding EBP, by implementing strategies mainly at the nursing program and regional levels.
School Rehabilitation Program’s (SRP) Contribution to School Management and Students’ Academic Performance to Beneficiary Schools in Cebu Province, Philippines
Authors: Pestaño Aurora Q. , Ypanto Dwight J. , Villeta Ricky B. , Baclayon Milagros B. , Sevilla Chanine F. , Avenido Jessica M. , Susada Jessie S.
Published: October 2018

In an educational setting, the management and environment are bound to affect the whole learning environment. This study determines the impact of the Ramon Aboitiz Foundation Incorporated School Rehabilitation Program (RAFI-SRP) to beneficiary schools. The Descriptive-correlational design is utilized to establish the level of assessments for school buildings regarding its milieu, environment, management, and students’ academic performance during their occupancy of the RAFI classrooms. In the exploratory data analyses, multivariate principal component analysis (PCA) and regression are used. Results show that RAFI-SRP affects school management. The more new school buildings are built, the better is the performance of the school administrators. Moreover, RAFI-SRP has a modest influence on the academic performance of students among the community beneficiaries as a whole. This result may be owed to the fact that academic performance is multifactorial, such that the interplay of factors may be intrinsic and extrinsic. RAFI-SRP is just one amongst the extrinsic factors to the learners' academic performance to contend with.
Evaluation of Physical and Physiological Characteristics of the Olympic Champion Turkish Deaf Men’s National Handball Team
Authors: Gümüş Mustafa , Eler Serdar
Published: October 2018

The aim of this study is to evaluate physical and physiological characteristics of the Olympic Champion Turkish Deaf Men’s National Handball Team. A total of 20 athletes participated in the study with age average of 27 ± 6.26 years, sports age average of 11.45±5.35 years, average height of 180.3±6.70 cm and an average body weight of 82.49±10.38 kg. In the evaluation of the data SPSS 19.0 program was used, frequency and distribution is observed, average standard deviation, maximum, and minimum values were taken. The average Body Mass Index (BMI) of the athletes were determined as 25.01±1.48 kg/m2, average Baseline Metabolic Rate (BMD) were 8643±924.06 (kJ), average Body Fat Percentage (%) were 12.86± .79%, average Fat Free Weight (FFM) were 71.59±7.37 kg, Visceral Fat Rating was 2.75±1.39, average right-left handgrip strength were 47.5±7.38-46.6±7.14 kg, average double foot jump with fixed-free hand values were 30.1±3.62 - 36.5±4.45 cm, average right-left hand visual reaction rate were 258.9±17.77 - 261.8±23.04 msec, average pro-agility agility test were 5.22±0.18 sec, and the average flexibility were 11.9±5.22 cm. As a result, physical and physiological characteristics of the Olympic Champion Turkish Deaf Men’s National Handball Team is compared to the evaluated literature; While the height, body weight, BMI, reaction speed, agility and body fat ratio values is parallel to other handball players, the flexibility and jumping values were found to be lower than other hearing-impaired athletes and handball players. In particular, grip strength values are higher than other hearing-impaired athletes, and parallel to the values of handball players.
Well That Was Unexpected: Effect of Intimacy and Commitment on Responses to an Interpersonal Expectancy Violation
Authors: Wong Norman
Published: October 2018

This investigation explored the effect an individual’s level of relational commitment and intimacy has on his or her perceptions of and responses to a positive or negative expectancy violation performed by their dating partner. One hundred-ninety undergraduates were randomly assigned to read 1 of 4 scenarios depicting a situation involving their dating partner committing either a positive/negative expectancy violation. Participants were asked to assess the situation in terms of the nature of the expectancy violation (positive/negative), violation severity, and level of unexpectedness. Moreover, they were asked the extent to which they were willing to talk about the situation with the other person. Results found that perceived intensity of violations varied depending on both the nature of the expectancy violation and commitment/intimacy level. Highly committed/intimate respondents reported greater willingness to discuss negative expectancy violations with the other person than less committed/intimate respondents, but reported lower likelihood in using negativity as their strategy. Less committed/intimate respondents reported greater willingness to discuss positive expectancy violations compared to their highly committed/intimate counterparts.
Diagnosis and management of otitis media with effusion in a tertiary hospital in Kano: a best practice implementation project
Authors: Ahmed Abdulazeez , Kolo Emmanuel , Aluko Abdulakeem , Abdullahi Hamisu , Ajiya Abdulrazaq , Bello-Muhammad Nafisatu , Raji Hanifat , Tsiga-Ahmed Fatimah
Published: October 2018

Objective:

To implement the best available practice to improve the diagnosis and management of OME according to best available evidence at the Aminu Kano Teaching Hospital, Kano, Nigeria.

Introduction:

Otitis media with effusion (OME) is characterized by the presence of fluid in the middle ear, without signs and symptoms of an acute infection. It has high rates of physician visits and is a common cause of hearing impairment in affected children. In Nigeria, the prevalence is estimated to range from 8% to 25.2%.

Methods:

The current quality improvement project was conducted using the Joanna Briggs Institute approach for clinical audits, involving a baseline audit, an implementation of change phase and a follow-up audit, using Practical Application of Clinical Evidence System software. Eleven evidence-based audit criteria were used for this project. The same audit criteria were used for the baseline and follow-up audit. The sample size was 20 for both the baseline and follow-up. Implemented change involved the introduction of pneumatic otoscope use in the department and educational sessions with clinicians and caregivers. The project was conducted from July to November 2017.

Results:

Implementation of strategies to improve practice led to large increases in compliance with audit criteria, particularly Criteria 1, 6, 9 and 10 (from 0–25% to 70–100%). Paradoxically, a decrease in compliance was observed for two criteria.

Conclusion:

The current project succeeded in increasing clinician compliance with best available evidence. The most significant evidence-based change seen was in the use of pneumatic otoscope, whereas the most difficult barrier to overcome was resistance to change.
Clinical management of cancer-related fatigue in hospitalized adult patients: a best practice implementation project
Authors: Wang Ning , Yang Zhihui , Miao Jingxia , Mi Xue , Liu Suting , Stern Cindy , Porritt Kylie , Zhang Lili
Published: October 2018

Objectives:

This project aimed to identify and promote evidence-based practice in the management of cancer related fatigue (CRF) in the oncology unit of Nanfang Hospital, affiliated with the Southern Medical University in People's Republic of China.

Introduction:

Cancer-related fatigue is one of the most common symptoms in patients with cancer and significantly affects their functioning and quality of life. However, it is often inadequately addressed and evidence-based practices are not always followed.

Methods:

The Joanna Briggs Institute (JBI) has a validated audit and feedback tool to assist with best practice implementation audits. The JBI Practical Application of Clinical Evidence System (PACES) was used in this project. A three-phase project was undertaken: i) a pre-implementation audit of current practice against evidence-based audit criteria, ii) identification of barriers and implementation of strategies to improve practice using the JBI Getting Research into Practice (GRiP) tool and iii) a post-implementation audit.

Results:

The baseline audit results identified non-compliance to best practice in all areas of CRF. Strategies to improve practice involved relevant education for nurses, establishment of a CRF management routine and related documentation systems and displaying and distributing educational materials for the patients. Improved compliance was shown across all audit criteria in post-evaluation.

Conclusions:

The implementation of institution specific evidence-based resources demonstrated immediate improvement in CRF management and practice. Continuous effort is required to maintain changes and further improve practice. Future projects should focus on measuring the impact of changed practice on patient outcomes.
Admission and discharge criteria for adolescents requiring inpatient or residential mental healthcare: a scoping review protocol
Authors: Evans Nicola , Edwards Deborah
Published: October 2018

Review objective/question

The question of this review is: what are the admission and discharge criteria for mental health inpatient care for adolescents?

The objective is to identify the criteria:

For admission to mental health inpatient or residential care for adolescents

For discharge from mental health inpatient or residential care for adolescents

For not admitting adolescents to mental health inpatient or residential care.
Simultaneous localization of a surface ship and a submerged towed source (L)
Authors: Song H. C. , Byun Gihoon
Published: October 2018

The cascade of blind deconvolution and array invariant has been successful for localizing a single source, either a surface ship or a submerged source, using a vertical array without knowledge of the environment or source waveform in shallow water. In this letter, the blind deconvolution is extended to a two-source case where individual Green's functions are separately extracted by exploiting a distinct group of modes strongly excited at different source depths. The subsequent array invariant confirms that a surface ship and a towed source at 50-m depth can be simultaneously localized using a 56-m long vertical array in 100-m deep shallow water.