bluuebunny/crossref_metadata_2025 huggingface dataset:
Neotropical freshwater fishes imperilled by unsustainable policies
Authors: Pelicice Fernando M , Azevedo‐Santos Valter M , Vitule Jean R S , Orsi Mário L , Lima Junior Dilermando P , Magalhães André L B , Pompeu Paulo S , Petrere Miguel , Agostinho Angelo A
Published: May 2017

Neotropical freshwater fishes are the most diverse on the planet (>5,500 species), although nations in Latin America have been negligent regarding their conservation. National policies have historically encouraged unsustainable practices, and recent decades have witnessed a sharp increase in harmful activities. Our aim with this review was to expose this situation and illustrate how national policies constitute the main threat to freshwater fish biodiversity. We explain that the most devastating, pervasive and systemic threats are rooted in official policies, particularly unsustainable activities (e.g. hydropower, water diversion, mining, aquaculture, agriculture and fishing), poor management/conservation (e.g. fish stocking and passages) and harmful legislation (e.g. poor licensing, non‐native species). We provide a broad portrait of the Neotropical scenario, where unsustainable policies have caused considerable damage to freshwater ecosystems, and focus on major examples from Brazil, where development projects have caused large‐scale losses to fish biodiversity. Such modus operandi of human development is incompatible with the persistence of biodiversity, and no simple solution is available to correct or minimize its effects. The current situation demands a profound behavioural shift towards better practices and policies, or these multiple high‐impact activities will continue eroding freshwater fish biodiversity and impairing essential ecosystem services.
Investor Pessimism and the German Stock Market: Exploring Google Search Queries
Authors: Dimpfl Thomas , Kleiman Vladislav
Published: May 2017

We analyze the relationship of retail investor sentiment and the German stock market by introducing four distinct investor pessimism indices (IPIs) based on selected aggregate Google search queries. We assess the predictive power of weekly changes in sentiment captured by the IPIs for contemporaneous and future DAX returns, volatility and trading volume. The indices are found to have individually varying, but overall remarkably high explanatory power. An increase in retail investor pessimism is accompanied by decreasing contemporaneous market returns and an increase in volatility and trading volume. Future returns tend to increase while future volatility and trading volume decrease. The outcome is in line with the conjecture of correction effects. Overall, the results are well in line with modern investor sentiment theory.
Relocation, relocation: perspectives on the spatio‐temporal impacts of health services transitions
Authors: Axon Stephen
Published: May 2017

Within the context of an ageing population and the need to sustain hospital budgets, the nature and future of UK healthcare is changing. In the late 2000s, Stafford Hospital in Staffordshire was the centre of substantial public concern over poor care and high mortality rates. The dissolution of Mid Staffordshire NHS Foundation Trust (which ran the hospital) combined with the University Hospital of North Staffordshire NHS Trust led to the creation of the University Hospitals of North Midlands NHS Trust in November 2014. The rebranding of Stafford Hospital (now County Hospital) and the University Hospital of North Staffordshire (now Royal Stoke University Hospital) to eliminate all mention of ‘Staffordshire’ reflects a sense of renewal and reorganisation of services. Despite this, the transfer of a number of services such as consultant‐led maternity, acute surgery and inpatient paediatrics services from the County Hospital to Royal Stoke University Hospital has led to substantial public outcry. This paper presents the results from five focus groups highlighting substantial concerns, emotions and implications regarding the spatial and temporal changes to accessing hospital services in Staffordshire. Perspectives towards the spatio‐temporal impacts of health services transitions reflected attitudes to, and experiences of, (relocated) services; accessibility and transport; communication and engagement; concern about capacity. Drawing on these results, the paper concludes with a new conceptual framework outlining the perspectives towards the spatio‐temporal impacts of health services transitions, and with implications for Trusts seeking to engage service users with changes to local provision.
Evaluation of outcomes of suction drainage in patients with haemophilic arthropathy undergoing total knee arthroplasty
Authors: Mortazavi S. M. J. , Firoozabadi M. A. , Najafi A. , Mansouri P.
Published: May 2017

Introduction

Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb.

Aim

We believed that without application of suction drainage after total knee arthroplasty (TKA), the risk of infection and haematoma formation will not increase while the need for blood transfusion because of decreased blood loss will be lesser.

Methods

In a prospective randomized clinical trial from April 2010 to April 2014, 176 patients with haemophilia who underwent TKA were included. The study group consisted of 88 patients (108 knees), in which we did not insert suction drain and the control group included 88 patients (106 knees), in which drain was inserted at the end of the surgery. All patients underwent TKA via anterior knee incision and medial parapatellar approach.

Results

The mean follow‐up period of study group and control group was 21 ± 11 months vs. 20 ± 9 months consecutively (P = 0.54). The mean hospital stay was 13 ± 8 days vs. 14 ± 8 days in study and control group consecutively (P = 0.40). In both groups, the major part of improvement in clinical knee society score was due to increase in pain subset (mean increase of 42 vs. 39 points consecutively) and to a lesser extent to alleviation of flexion contracture (mean increase of 13 vs. 15 points consecutively). We observed no differences in the mean visual analogue scale (VAS) value between both groups. Average functional outcome in both groups improved during follow‐up visits.

Conclusion

We can conclude that there is no rationale for the use of drain after primary TKA.
Let's Talk Period! Preliminary results of an online bleeding awareness knowledge translation project and bleeding assessment tool promoted on social media
Authors: Reynen E. , Grabell J. , Ellis A. K. , James P.
Published: May 2017

Introduction

Undiagnosed bleeding disorders are common and can pose significant health risks, especially for women. Recently, a self‐administered bleeding assessment tool (Self‐BAT) was validated in von Willebrand disease.

Aim

To increase awareness of undiagnosed bleeding disorders through the use of an informational website (http://letstalkperiod.ca) targeted at women in their reproductive years.

Methods

The Let's Talk Period website was built in consultation with a medical communications company and focus groups of women, with the aim of clearly presenting key messages around menstrual bleeding. The website was promoted through social media and local and national interviews. Upon completion of the online Self‐BAT available at http://letstalkperiod.ca, the result is displayed to the user along with a recommendation to seek medical attention if the score is abnormal.

Results

During the initial 3‐month period, there were 5158 page views from 64 countries. A total of 489 individuals, 95% female, completed the online Self‐BAT. The mean Self‐BAT score was 6, range 0‐44. Abnormal Self‐BAT scores were reported in 45% of the respondents, of whom 96% were female. The most commonly reported bleeding symptoms were menorrhagia (98%) and postpartum haemorrhage (82%). Bleeding symptoms were similar across different geographical areas.

Conclusion

An online screening tool is an effective method of identifying individuals concerned with abnormal bleeding. A significant portion of the general population report experiencing symptoms of abnormal bleeding. In women, the most frequently reported bleeding symptoms were menorrhagia and postpartum haemorrhage.
“It's a fight to get anything you need” — Accessing care in the community from the perspectives of people with multimorbidity
Authors: Ho Julia W. , Kuluski Kerry , Im Jennifer
Published: May 2017

Background

There is a growing interest in redesigning health‐care systems to better manage the increasing numbers of people with multimorbidity. Knowing how patients experience health‐care delivery and what they need from the health‐care system are critical pieces of evidence that can be used to guide health system reforms.

Objective

The purpose of this study was to understand the challenges patients with multimorbidity face in accessing care in the community, and the implications for patients and their families.

Methods

A secondary analysis of qualitative data was conducted on semi‐structured interviews with 116 patients who were receiving care in an urban rehabilitation facility in 2011. Exploratory interpretive analysis was used to identify themes about access to care.

Results

Challenges occurred at two levels: at the health system level and at the individual (patient) level. Issues at the health system level fell into two broad categories: availability of services (failing to qualify, coping with wait times, struggling with scarcity and negotiating the location of care) and service delivery (unreliable care, unmet needs, incongruent care and inflexible care). Challenges at the patient level fell into the themes of logistics of accessing care and financial strain. Patients interacted and responded to these challenges by: managing the system, making personal sacrifices, substituting with informal care, and resigning to system constraints.

Conclusion

Identifying the barriers patients encounter and the lengths they go to in order to access care highlights areas where policy initiatives can focus to develop appropriate and supportive services that are more person and family‐centred.
Detection of viral hepatitis E in clinical liver biopsies
Authors: Prost Sandrine , Crossan Claire L , Dalton Harry R , De Man Robert A , Kamar Nassim , Selves Janick , Dhaliwal Catharine , Scobie Linda , Bellamy Christopher O C
Published: May 2017

Aims

To determine the relative utility of in‐situ testing for hepatitis E virus (HEV) RNA and paraffin‐section polymerase chain reaction (PCR) to diagnose HEV infection in paraffin‐embedded clinical liver biopsies, and to correlate with clinicopathological characteristics.

Methods and results

We evaluated in‐situ and quantitative PCR (qPCR)‐based approaches to identifying HEV in clinical liver biopsies from infected patients from multiple centres, correlating with clinical setting (immunocompetent, allograft or immunosuppressed native liver) and histological findings. Thirty‐six biopsies from 29 patients had histological data, 27 and 23 of which had satisfactory material for in‐situ RNA testing and tissue qPCR, respectively. Both approaches specifically identified HEV infection, but tissue qPCR was significantly more sensitive than RNAscope in‐situ testing (P = 0.035). In immunocompetent but not immunosuppressed patients the tissue qPCR yield correlated with the severity of lobular hepatitis (rho = 0.94, P < 0.001). qPCR viral yield was comparably high in allografts and immunosuppressed native livers and significantly greater than with native liver infection. Immunosuppressed patients showed reduced severity of hepatitis and cholestatic changes, compared with immunocompetent patients. Indeed, HEV‐infected liver allografts could show minimal hepatitis for many months. In individual cases each technique was useful when serum was not available to identify chronic infection retrospectively (in biopsies taken 4–31 months before diagnosis), to identify persistent/residual infection when contemporary serum PCR was negative and to identify cleared infection.

Conclusions

qPCR is more effective than in‐situ RNA testing to identify HEV infection in paraffin‐embedded liver biopsies and has diagnostic utility in selected settings.
Associations between prevalence of adult atopic dermatitis and occupational characteristics
Authors: Kwak Yeunhee , Kim Yoonjung
Published: May 2017

Aim

To examine the prevalence of adult atopic dermatitis according to occupational status.

Background

While atopic dermatitis is more prevalent among children, some adults also suffer from it. The disease causes considerable difficulty in these adults' social lives at school or work, suggesting that they require high‐quality health care. Given the chronic nature and environmental determinants of atopic dermatitis, its associations with occupational characteristics must be clarified.

Design

An exploratory cross‐sectional analysis using secondary data.

Method

Participants were 662 people diagnosed with atopic dermatitis, all 19 years old or older; raw data were taken from the Korea National Health and Nutrition Examination Survey V (2010‐2012) and VI (2013‐2014).

Results

Manual workers (adjusted odds ratio 2.50, 95% confidence interval, 1.30‐4.83), paid workers (1.70, 1.15‐2.51), regular workers (1.83, 1.18‐2.85), and full‐time workers (1.88, 1.23‐2.89) all showed increased odds of currently suffering from atopic dermatitis.

Conclusion

Prevalence rates of atopic dermatitis differed by occupational characteristics, which suggests the need for interventions seeking to prevent symptom recurrence that are tailored to occupational characteristics. We expect this study to provide helpful baseline data for better policy‐making.
Risk factors of falls among inpatients with cancer
Authors: Jun M.D. , Lee K.M. , Park S.A.
Published: May 2017

Aim

To investigate the risk factors and predictors of falls according to the general characteristics, conscious state, physical condition and treatment of hospitalized patients with cancer.

Background

Inpatients with cancer experience falls more frequently than those without cancer, and the degree of injuries is more severe among inpatients with cancer. A specific fall prevention strategy is needed for each patient. Prevention of falls in patients with cancer is very important for improving the quality of nursing care.

Methods

This retrospective study included matched case–control patients. We evaluated patients between January 1, 2013, and December 31, 2014. A total of 356 patients (fall group, 178; non‐fall group, 178) were included. For fall prediction, logistic regression was performed on the variables that were statistically significant in the univariate analysis.

Results

The variables that were significant predictors of falls were the use of an assistive device, history of falls and fatigue.

Discussion

The predictors of falls in patients with cancer include physical conditions and general characteristics. Fall prevention strategies in patients with cancer should be planned individually with multifaceted aspects, including physical symptom management.

Limitations

The study was conducted at a single cancer center in Korea; thus, our results cannot be generalized. Additionally, in Korea, it is common to have family members or private caregivers for patient care, and this might have influenced the results.

Conclusion and implications for nursing and health policy

The predictive factors for falls reflect the nature of the patient's environment, culture and disease. Falls have a negative effect on patient safety and can significantly influence quality of life. Policies for patient safety need more specialized and customized approaches.
Foreign Ownership and Corporate Cash Holdings in Emerging Markets
Authors: Vo Xuan Vinh
Published: May 2017

This article examines the link between foreign ownership and corporate cash holdings. We utilize a data sample of firms listed on the Ho Chi Minh City stock exchange covering the period 2007–2015. Employing different econometric techniques for panel data, we find that higher foreign ownership is associated with more corporate cash holdings. This finding suggests that foreign investors in the Vietnam stock market are subject to precautionary motive and agency motive forcing firms to hold more cash. However, the outcome suggests potential agency problems because managers might subsequently use this cash reserve for their own advantages. These problems are even more pronounced in emerging markets where investor protection mechanism is weak. Accordingly, this highlights the importance of a monitoring mechanism to refrain corporate managers from investing in value‐destroying projects.
Synthesis of nanocrystalline photoluminescent mullite using sacrificial cotton wool and filter paper templates
Authors: Kool Arpan , Thakur Pradip , Bagchi Biswajoy , Hoque Nur Amin , Banerjee Somtirtha , Das Sukhen
Published: May 2017

Nanocrystalline mullite has been synthesized by sintering of absorbed monophasic aluminosilicate precursors into cotton wool and filter paper cellulosic structures. Effects of molybdenum and tungsten doping on template mediated mullite at 1200°C and 1400°C have been investigated using differential thermal analysis (DTA), X‐ray diffraction analysis (XRD), Fourier transform infrared spectroscopy (FTIR) and field emission scanning electron micrographs (FESEM). Microstructures of the sintered samples revealed successful replication of cellulosic structure with the formation of dense mullite phases having grain diameter in the range of 50‐80 nm. Strong photoluminescence emissions in the UV and visible regions result from the oxygen vacancies and Al–O bonds present in mullite structures.
Validating the European Health Literacy Survey Questionnaire in people with type 2 diabetes: Latent trait analyses applying multidimensional Rasch modelling and confirmatory factor analysis
Authors: Finbråten Hanne Søberg , Pettersen Kjell Sverre , Wilde‐Larsson Bodil , Nordström Gun , Trollvik Anne , Guttersrud Øystein
Published: May 2017

Aim

To validate the European Health Literacy Survey Questionnaire (HLS‐EU‐Q47) in people with type 2 diabetes mellitus.

Background

The HLS‐EU‐Q47 latent variable is outlined in a framework with four cognitive domains integrated in three health domains, implying 12 theoretically defined subscales. Valid and reliable health literacy measurers are crucial to effectively adapt health communication and education to individuals and groups of patients.

Design

Cross‐sectional study applying confirmatory latent trait analyses.

Methods

Using a paper‐and‐pencil self‐administered approach, 388 adults responded in March 2015. The data were analysed using the Rasch methodology and confirmatory factor analysis.

Results

Response violation (response dependency) and trait violation (multidimensionality) of local independence were identified. Fitting the “multidimensional random coefficients multinomial logit” model, 1‐, 3‐ and 12‐dimensional Rasch models were applied and compared. Poor model fit and differential item functioning were present in some items, and several subscales suffered from poor targeting and low reliability. Despite multidimensional data, we did not observe any unordered response categories.

Conclusion

Interpreting the domains as distinct but related latent dimensions, the data fit a 12‐dimensional Rasch model and a 12‐factor confirmatory factor model best. Therefore, the analyses did not support the estimation of one overall “health literacy score.” To support the plausibility of claims based on the HLS‐EU score(s), we suggest: removing the health care aspect to reduce the magnitude of multidimensionality; rejecting redundant items to avoid response dependency; adding “harder” items and applying a six‐point rating scale to improve subscale targeting and reliability; and revising items to improve model fit and avoid bias owing to person factors.
A longitudinal, mixed methods investigation of newly qualified nurses’ workplace stressors and stress experiences during transition
Authors: Halpin Yvonne , Terry Louise M. , Curzio Joan
Published: May 2017

Aim

To investigate transition in newly qualified nurses through an exploration of their stressors and stress experiences during their first 12 months postqualifying.

Background

Globally, thousands of new nurses qualify annually. They are crucial for the profession and healthcare service delivery. Work‐related stress has multiple serious consequences, yet there is a lack of robust, empirical evidence that directly analyses newly qualified nurses and the stress they feel and experience in the workplace. Understanding what causes newly qualified nurses’ stress is vital to retaining and nurturing this vital component of the workforce.

Design

Longitudinal, explanatory sequential mixed methods, cohort study.

Methods

At the point of qualification (n = 288), 6 months postqualifying (n = 107) and 12 months postqualifying (n = 86), newly qualified nurses completed the Nursing Stress Scale, with 14 completing a one‐to‐one interview at 12 months postqualifying. Data were collected from 2010 ‐ 2012. Inferential statistics, “thematic analysis” and “side‐by‐side comparisons in a discussion” were used for analysis.

Results

Workload was consistently the highest reported stressor with inadequate staffing and managing multiple role demands given as explanations. Incivility within the workplace was a noted stressor. Conversely, being part of “a good team” provided a civil, supportive, facilitative work environment. Entering nurse education with previous healthcare experience had a mediating effect on the reported frequency of stressors.

Conclusions

Newly qualified nurses encounter multiple work‐related stressors over their first 12 months postqualifying, which are intrinsically entwined with their transition. Employing organizations need to be more proactive in managing their workload and addressing workplace incivility.
Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: A modified Delphi consultation
Authors: Perry Lin , Nicholls Rachel , Duffield Christine , Gallagher Robyn
Published: May 2017

Aim

To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce.

Background

The nursing workforce experiences rates of ill health above that of other workforces, yet there is little investment in workplace health promotion.

Design

The study used a modified Delphi design conducted between September and November 2015.

Methods

Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility.

Results

Mental health strategies were prioritized as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions; smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups.

Conclusions

Study findings prompt consideration of health promotion opportunities to support nurses’ health and well‐being. Findings identified key workplace health promotion priorities and provide direction for policy makers and managers to promote nursing and midwifery workforce health.
Nurse vs. physician‐led care for obstructive sleep apnoea: A systematic review and meta‐analysis of randomized trials
Authors: Gong Fengqiu , Chen Xiaojun , Wu Yaoye , Yao Dianye , Xie Lihong , Ouyang Qiuyi , Wang Ping , Niu Gang
Published: May 2017

Aim

To evaluate the effectiveness of nurse‐led care for obstructive sleep apnoea compared with physician‐led care.

Background

The incidence of obstructive sleep apnoea is increasing worldwide. There is a need for cost‐effective care models to ease off the pressure on tertiary care centres and divert care to the community.

Design

Systematic review and meta‐analysis.

Data sources

We searched major electronic databases (MEDLINE, EMBASE, AMED, British Nursing Index, CINAHL, HMIC, PsycINFO, Health Business Elite and the Cochrane Central Register of Controlled Trials CENTRAL) from inception till December 2016 using a structured search strategy for all randomized trials evaluating nurse‐led treatment interventions for adults with obstructive sleep apnoea compared with physician‐led ones. We screened relevant articles against a predefined inclusion criterion. We applied no search limitations.

Review methods

We assessed the risk of bias as per Cochrane recommendations. We calculated weighted mean difference with 95% confidence intervals for continuous outcomes and used a random‐effects model to meta‐analyse data.

Results

We screened 309 articles and only four studies met our inclusion criteria. All studies used continuous‐positive airway pressure as the main treatment strategy with similar compliance rate in both comparison groups. The scores of the Epworth Sleepiness Scale, the SF‐36 questionnaires for vitality, physical function and the SF‐36 mental health were all similar between the two groups. There was a significant heterogeneity in all meta‐analyses (I2 > 92%).

Conclusion

Nurse‐led care for adults with obstructive sleep apnoea is non‐inferior to physician‐led care. More research is needed to standardize nurse‐led interventions and evaluate their long‐term effectiveness and cost‐effectiveness.
Emergency medical services providers' perspective of end‐of‐life decision making for people with intellectual disabilities
Authors: McGinley Jacqueline , Waldrop Deborah P , Clemency Brian
Published: May 2017

Background

Emergency medical services (EMS) providers are often called to rapidly determine and act upon patients' wishes for end‐of‐life care. People with intellectual disabilities are living increasingly longer with complex conditions leading to international calls for person‐centred advance care planning. Yet, best estimates suggest that very few people with intellectual disabilities document their wishes.

Methods

This exploratory‐descriptive study incorporated mixed methods to analyse data collected consecutively (surveys, n = 239; interviews, n = 48) with EMS providers from five agencies. Data were subjected to a sequential quantitative–qualitative analysis applying a critical discourse analysis framework.

Results

Findings indicate that 62.7% had treated a person with intellectual disability who had medical orders directing end‐of‐life care. Three themes (provider familiarity, organizational processes, sociocultural context) offer insights about how medical orders inform EMS providers during calls involving people with intellectual disabilities.

Conclusion

Multiple contexts influence how wishes are documented and care provided to people with intellectual disabilities near life's end.
Improving the occupational skills of students with intellectual disability by applying video prompting combined with dance pads
Authors: Lin Mei‐Lan , Chiang Ming‐Shan , Shih Ching‐Hsiang , Li Meng‐Fang
Published: May 2017

Background

Individuals with intellectual disability (ID) are prone to inattention, are slow in learning and reaction, and have deficits in memory skills. Providing proper vocational education and training for individuals with intellectual disability is able to enhance their occupational skills.

Materials and Methods

This study applied video prompting to provide instructional prompts to help participants accurately perform an assigned occupational activity. A control system installed with developed software was used to turn a standard dance pad into a sensor to detect the participants’ standing position and to automatically trigger video prompting.

Results

The results show that the participants’ correct performance of the target behaviour improved significantly after their exposure to the video prompting intervention, and this positive outcome remained consistent during the maintenance phase.

Conclusion

Video prompting combined with dance pads was a feasible approach to improving the occupational skills of the three students with intellectual disability.
HIF‐2α regulates non‐canonical glutamine metabolism via activation of PI3K/mTORC2 pathway in human pancreatic ductal adenocarcinoma
Authors: Li Wenzhu , Chen Changhao , Zhao Xiaohui , Ye Huilin , Zhao Yue , Fu Zhiqiang , Pan Wenwei , Zheng Shangyou , Wei Lusheng , Nong Tianwen , Li Zhihua , Chen Rufu
Published: May 2017

Hypoxia‐inducible factor‐2α (HIF‐2α) plays an important role in increasing cancer progression and distant metastasis in a variety of tumour types. We aimed to investigate its biological function and clinical significance in human pancreatic ductal adenocarcinoma (PDAC). A total of 283 paired PDAC tissues and adjacent normal tissues were collected from patients who underwent surgery or biopsy at Sun Yat‐sen Memorial Hospital between February 2004 and October 2016. In this study, we noted that HIF‐2α expression was significantly up‐regulated in PDAC, positively associated with disease stage, lymph‐node metastasis and patient survival, and identified as an independent prognostic factor of PDAC patients. We demonstrated that HIF‐2α silencing could reduce proliferation, migration and invasion of PDAC cells in vitro. The similar effect on growth was demonstrated in vivo. Furthermore, we noted that knock‐down of HIF‐2α significantly decreased the expression of glutamate oxaloacetate transaminase 1 (GOT1). Importantly, we confirmed that the PI3K/mTORC2 pathway promoted GOT1 expression by targeting HIF‐2α. Our study validated HIF‐2α was an important factor in PDAC progression and poor prognosis and may promote non‐canonical glutamine metabolism via activation of PI3K/mTORC2 pathway. Targeting HIF‐2α represents a novel prognostic biomarker and therapeutic target for patients with PDAC.
Use of clinical guidelines in remote Australia: A realist evaluation
Authors: Reddy Sandeep , Orpin Victoria , Herring Sally , Mackie‐Schneider Stephanie , Struber Janet
Published: May 2017

Aim

The aim of this evaluation was to assess the acceptability, accessibility, and compliance with the 2014 editions of the Remote Primary Health Care Manuals (RPHCM) in health care centres across remote areas of Northern and Central Australia.

Method

To undertake a comprehensive evaluation that considered context, the evaluation used a realist evaluation framework. The evaluation used a variety of methods including interviews and survey to develop and test a programme theory.

Results

Many remote health practitioners have adopted standardized, evidence‐based practice because of the use of the RPHCM. The mechanisms that led to the use of the manuals include acceptance of the worth of the protocols to their clinical practice, reliance on manual content to guide their practice, the perception of credibility, the applicability of RPHCM content to the context, and a fear of the consequences of not using the RPHCMs. Some remote health practitioners are less inclined to use the RPHCM regularly because of a perception that the content is less suited to their needs and daily practice or it is hard to navigate or understand.

Conclusion

The evaluation concluded that there is work to be done to widen the RPHCM user base, and organizations need to increase support for their staff to use the RPHCM protocols better. These measures are expected to enable standardized clinical practice in the remote context.
Examining practical nursing experiences to discover ways in which to retain and invigorate the remaining functions of the elderly with a demented and complex disability in nursing homes
Authors: Park Min‐Sun , Lim Sun‐Young , Kim Eun‐Young , Lee Su‐Jung , Chang Sung‐Ok
Published: May 2017

Aim

The bedridden elderly with moderate‐to‐severe dementia account for a large proportion of the residents in nursing homes and form a specialized group requiring customized care in order to encourage their remaining functions, which determine the quality of their residual life. The purpose of this study was to search for ways to invigorate and foster the remaining functions of this complex‐disability group, based on practical nursing strategies in nursing homes.

Methods

The qualitative thematic analysis was done by conducting in‐depth interviews with 29 nurses working at 11 different nursing homes in South Korea.

Results

This study proposed four main themes and 19 sub themes as keys for providing specialized nursing care to the elderly with physical and cognitive disabilities. The main themes encourage the residents' remaining functions: (i) accurate identification of an elderly resident's physical, cognitive, and behavioral baseline is necessary in order to determine their functional levels; (ii) nurses provide meticulous management to support the remaining functions in order to prevent further deterioration; (iii) optimized know‐how, based on accumulated experience and knowledge, is reflected in nursing strategies that maximize the effects of nursing interventions; and (iv) steady compliance with nursing guidelines and standards in nursing homes creates the best therapeutic environment and brings unexpected positive changes in the elderly's status.

Conclusion

A practical nursing strategy to target the group with a demented and complex disability in nursing homes was developed through thematic analysis of the empirical knowledge of nurses. The findings provide new insights for developing specialized nursing interventions and practical nursing models in long‐term care facilities.
Male‐Partnered Bisexual Women's Perceptions of Disclosing Sexual Orientation to Family Across the Transition to Parenthood: Intensifying Heteronormativity or Queering Family?
Authors: Goldberg Abbie E. , Allen Katherine R. , Ellawala Themal , Ross Lori E.
Published: May 2017

Drawing from queer and communication privacy management frameworks, this study examines the narratives of 22 bisexual, male‐partnered women who were interviewed during the perinatal period and one year postnatally about their disclosures of sexual identity to family of origin. Most women rarely discussed their sexual identity with family; participants who had disclosed described such disclosures as provoking discomfort. Some women stated that their parental status seemed to invalidate the need to talk about their sexual history or identity with family, due its declining salience and increased concerns about judgment. This study reveals how partnership and parenthood statuses contribute to the intensification of heteronormative pressures in relation to family. Therapists should attend to the role of heteronormative values regarding partnering, family‐building, and parenting.
A new insight into the ability to resist Ischemic brain injury: Does hibernation matter?
Authors: Nathaniel Thomas I. , Stewart Bianca , Williams Jessica , Hood Michael , Imeh‐Nathaniel Adebobola
Published: May 2017

Read the commented article ‘Arctic ground squirrel hippocampus tolerates oxygen glucose deprivation independent of hibernation season even when not hibernating and after ATP depletion, acidosis and glutamate efflux’ on doi: 10.1111/jnc.13996.
How whales used to filter: exceptionally preserved baleen in a Miocene cetotheriid
Authors: Marx Felix G. , Collareta Alberto , Gioncada Anna , Post Klaas , Lambert Olivier , Bonaccorsi Elena , Urbina Mario , Bianucci Giovanni
Published: May 2017

Baleen is a comb‐like structure that enables mysticete whales to bulk feed on vast quantities of small prey, and ultimately allowed them to become the largest animals on Earth. Because baleen rarely fossilises, extremely little is known about its evolution, structure and function outside the living families. Here we describe, for the first time, the exceptionally preserved baleen apparatus of an entirely extinct mysticete morphotype: the Late Miocene cetotheriid, Piscobalaena nana, from the Pisco Formation of Peru. The baleen plates of P. nana are closely spaced and built around relatively dense, fine tubules, as in the enigmatic pygmy right whale, Caperea marginata. Phosphatisation of the intertubular horn, but not the tubules themselves, suggests in vivo intertubular calcification. The size of the rack matches the distribution of nutrient foramina on the palate, and implies the presence of an unusually large subrostral gap. Overall, the baleen morphology of Piscobalaena likely reflects the interacting effects of size, function and phylogeny, and reveals a previously unknown degree of complexity in modern mysticete feeding evolution.
The relationship between smoking and convivial, intimate and negative coping alcohol consumption in young adults
Authors: Kritsotakis George , Konstantinidis Theocharis , Androulaki Zacharenia , Rizou Efthymia , Asprogeraka Eleni Maria , Pitsouni Vasiliki
Published: May 2017

Aims and objectives

To explore the gender‐specific associations of smoking with convivial, negative coping and intimate drinking contexts in young adults.

Background

Alcohol and cigarettes co‐use is common and to be more effective in prevention activities, we need to understand the drinking contexts that facilitate their co‐occurrence.

Design

Descriptive cross‐sectional survey in the context of the LATO study (Lifestyle & Attitudes in a Student Population) in Greece.

Methods

Of the 1,138 students who provided full data during November–December 2012, those who have smoked ≥1 cigarette/last month were defined as smokers. Based on the “Drinking Context Scale‐9”, we created low, moderate and high probabilities of drinking in each context and in total. Multivariate logistic regression analyses were performed.

Results

Participants reported higher probabilities to drink, in descending order, in the convivial (31.5%), negative coping (10.4%) and intimate (5.4%) contexts. Adjusted odds ratios for smoking were significantly higher for individuals who reported a moderate (OR = 2.15, 95% CI 1.51–3.05) to high (OR = 3.64, 95% CI 2.59–5.11) probability of drinking in any context. Moreover, female participants with high probabilities for drinking in convivial and negative coping contexts had higher odds ratios of engaging in smoking (convivial OR = 1.87, 95% CI = 1.23–2.85; coping OR = 2.66, 95% CI = 1.39–5.10) whereas this association was noticed only for convivial settings in male participants (OR = 2.88, 95% CI = 1.91–4.319). For women only, drinking in intimate contexts was protective against smoking (OR = 0.32, 95% CI = 0.10–0.98).

Conclusions

Smoking is differentially related to drinking context based on gender. Prevention interventions targeting smoking and alcohol co‐use in late adolescence may be more effective if employing a context and gender‐specific approach.

Relevance to clinical practice

Nurses have a critical role in providing motivational interviewing in individuals and organise and execute health‐promoting activities in larger groups for modifying their health risk behaviours. The social context should be carefully considered during assessments and prevention interventions.
Counselling parents on young children's healthy diet: A modified scoping review
Authors: Holmberg Fagerlund Bettina , Helseth Sølvi , Owe Jenny , Glavin Kari
Published: May 2017

Aims and objectives

To map and describe key information in existing research about counselling of parents of children aged 0–2 years on the child's healthy diet in preventive healthcare settings, particularly in public health nursing.

Background

Many parents are likely to be concerned with their infant's food‐related happiness “here and now,” disregarding the child's long‐term health and development related to feeding practices. Hence, a focus on counselling parents in considering young children's healthy diet is important.

Design

A modified scoping review with an inductive qualitative content analysis of selected empirical studies.

Methods

Systematic searches in EMBASE (1996–2015 Week 46), Ovid Nursing Database (1946–2015 November Week 1), Ovid MEDLINE and Ovid OLDMEDLINE (2000—18 November 2015) and CINAHL (2000—22 December 2015), using search terms based on aims.

Results

Eight included studies, with participants per sample ranging from 19–>500. Research designs were focus group discussions and/or interview study (n = 2), cluster‐randomised trials (n = 2), randomised controlled trials (n = 2), a follow‐up interview study (n = 1) to a previous randomised controlled trial and a cross‐sectional electronic questionnaire study (n = 1). The studies included a total sample of 2,025 participants, 42 of them in interview studies. Findings indicate parents' perceptions of inconsistency, misconceptions and uncertainty related to the recommendations on child feeding from the authorities. Thus, adapted advice could impact healthier child diet. Maternal knowledge on child feeding and reduced use of food as a reward are mediators for improved diet quality in children.

Conclusions

Counselling on young children's healthy diet should be anticipatory, consistent and adapted to the family.

Relevance to clinical practice

Due to inconsistent recommendations and omitted focus on anticipatory counselling on child feeding, parents might perceive pressure and uncertainty related to the child's diet.
Music therapy and musical stimulation in the context of prematurity: A narrative literature review from 2010–2015
Authors: Palazzi Ambra , Nunes Camila Canani , Piccinini Cesar Augusto
Published: May 2017

Aims and objectives

To examine empirical studies of musical stimulation and music therapy carried out with preterm infants and their parents published from 2010–2015.

Background

Prematurity constitutes a global health problem that can impact the development of the preterm infant and the well‐being of the parents. Music‐based interventions may benefit the infant, parents and their relationship. In our review, we distinguished between musical stimulation and music therapy, as we found no previous studies that had made this distinction.

Design

This is a narrative literature review.

Methods

A search was undertaken in PubMed, PsycINFO and LILACS using the terms “music,” “music therapy,” “singing,” “prematurity” and “preterm.” Thirty studies were included and analysed according to the following categories: (i) aims of the study, (ii) participants, (iii) design, (iv) type of intervention, (v) assessment and measures and (vi) main results.

Results

The vast majority of the studies focused on the preterm infants and used an experimental design. Few studies carried out family‐centred interventions, despite this having been noted as an important factor in effective interventions. Musical stimulation studies used more recorded music, whereas music therapy studies used more individualised interventions with live music.

Conclusions

Both musical stimulation and music therapy demonstrated significant effects on preterm infants and their parents. However, compared to musical stimulation studies, interventions performed by music therapists provided more individualised care and tended to show greater effects on infants' physiological and behavioural responses.

Relevance to clinical practice

Our review showed that music therapy interventions may provide individualised, effective and family‐centred care. There is a significant need for these types of interventions in the neonatal intensive care unit (NICU).
The relationship between sleep disturbance and glycaemic control in adults with type 2 diabetes: An integrative review
Authors: Zhu Bingqian , Hershberger Patricia E , Kapella Mary C , Fritschi Cynthia
Published: May 2017

Aims and objectives

To explore and synthesise current research to assess the state of science about the relationship between sleep disturbance and glycaemic control in adults with type 2 diabetes.

Background

Sleep disturbance is suggested a risk factor for type 2 diabetes. Diabetes alone is a leading cause of death, but when coupled with sleep disturbance poses additional health risks. However, little is known about the relationship between sleep disturbance and glycaemic control in people with overt diabetes.

Design

An integrative review.

Methods

Whittemore and Knafl's methodology guided this integrative review. Original studies published before October 2016 were identified through systematic searches of seven databases using terms: diabet*; sleep or insomnia; glycem* or glucose or A1C or HbA1c or sugar; and their combinations. The matrix and narrative synthesis were employed to organise and synthesise the findings, respectively. The Crowe Critical Appraisal Tool was used to evaluate the study quality.

Results

A total of 26 studies were identified; 17 of which reported significant relationships between sleep measures and glycaemic control. In 13 studies, sleep duration was associated with glycaemic control in both linear (n = 2) and nonlinear (n = 3) relationships; however, eight studies reported no significant relationships. Sleep quality was significantly related to glycaemic control in 14 of 22 studies. Nine studies found no relationship between any measure of sleep and glycaemic control.

Conclusions

There is strong evidence supporting the relationship between sleep quality and glycaemic control but further examination of the relationship between sleep duration and glycaemic control is warranted. Sleep disturbance, particularly impaired sleep quality, could potentially influence glycaemic control in adults with type 2 diabetes.

Relevance to clinical practice

Nurses who treat patients with diabetes should include assessment of sleep, education for healthy sleep, and referral for treatment of sleep disturbance in order to maximise the potential for achieving good glycaemic control.
Spectral Signal Density of Carotid Plaque Using Dual‐Energy Computed Tomography
Authors: Reynoso Exequiel , Rodriguez‐Granillo Gastón A. , Capunay Carlos , Deviggiano Alejandro , Meli Francisco , Carrascosa Patricia
Published: May 2017

BACKGROUND AND PURPOSE

Plaque characterization using virtual monochromatic imaging derived from dual‐energy computed tomography (CT) angiography requires the determination of normal signal density values of each plaque component. We sought to explore the signal density values of carotid plaque components using dual‐energy compared to conventional single‐energy CT angiography (CTA), and to establish the energy level with the largest differences between plaque components.

METHODS

The present prospective study involved consecutive patients referred for carotid artery evaluation by CTA. Two scans (single‐energy and dual‐energy CTA) were performed in all patients, and a single radiologist analyzed the data. Single‐source dual‐energy CTA allowed the generation of virtual monochromatic images from 40 to 140 keV.

RESULTS

A total of 35 internal carotid artery lesions were examined in 20 symptomatic patients. The mean age was 72.3 ± 6.7 years, and 9 (45%) patients were male. Internal carotid artery geometrical variables including lumen area (P = .96), vessel area (P = .97), and percent area stenosis (P = .99) did not differ between groups (single‐energy CTA, and dual‐energy CTA at 40, 70, 100, and 140 keV). Differences between signal densities of different tissues were largest at 40 keV (calcium/lumen, P < .0001; fat/noncalcified, P < .0001).

CONCLUSIONS

In the present pilot investigation, virtual monochromatic imaging at low‐energy levels derived from dual‐energy CTA allowed the largest differences in attenuation levels between tissues, without affecting vessel or plaque geometry.