bluuebunny/crossref_metadata_2025 huggingface dataset:
LIABILITY AND ANTIFRAUD INVESTMENT IN FINTECH RETAIL PAYMENT SERVICES
Authors: Yoon Kyoung‐Soo , Jun Jooyong
Published: March 2018

Motivated by recently introduced retail payment schemes using information technology, often called “FinTech,” we examine the effect of fraud liability regime on antifraud investment in a FinTech payment scheme, where the front‐end and back‐end services are vertically separated. In an environment where a FinTech payment service provider (FPP) covers only the front‐end services, delegating the back‐end services to an integrated payment service provider (IPP) such as banks and credit card companies, we show that under the IPP liability regime, the IPP invests more in general, while the respective investment depends on the range of the access fee under the FPP liability regime. Specifically, given a sufficiently great loss from accident, if the access fee is in a certain range, the FPP liability regime is superior in terms of antifraud investment. When the FPP makes its indirect revenue from its user base in addition to the revenue from user fees, we can observe greater antifraud investment under both liability regimes, but the overall decrease in fraud probability is higher under the IPP liability regime. Our results suggest that it might be desirable to induce FPP liability regime, which might necessitate regulating the access fee to achieve such an outcome. (JEL G23, G28, D43, L22)
Impact of cyclosporine‐A concentration in T‐cell replete haploidentical allogeneic stem cell transplantation
Authors: Yang Xiaofei , Yang Shuo , Sun Aining , Qiu Huiying , Tang Xiaowen , Han Yue , Wu Depei
Published: March 2018

This paper aims to study whether cyclosporine‐A (CSA) levels have an impact on the clinical outcome of patients with T‐cell replete haploidentical allogeneic hematopoietic stem cell transplantation (allo‐HSCT). We analyzed 140 consecutive patients who had been given T‐cell replete haploidentical allo‐HSCT in our institute to assess the effect of CSA concentration in the early stages of allo‐HSCT on clinical outcomes, such as hematopoietic recovery, acute graft vs host disease (aGVHD), infection, disease‐free survival (DFS), and overall survival (OS). The median concentrations of CSA in the blood in the 1st, 2nd, 3rd, and 4th week after allo‐HSCT were 218, 235, 263, and 270 ng/mL, respectively. Additionally, 46%, 40%, 27%, and 18% of the patients had CSA blood levels below 200 ng/mL during those weeks. In total, 39 patients developed aGVHD (grade II‐IV), for a cumulative incidence of 27.8%, at a median of 32 days. Patients having a low CSA concentration (below 200 ng/mL) in the 3rd week had a higher cumulative incidence of grade II‐IV aGVHD (P = .02). In addition, multivariate logistic regression analysis showed that low CSA concentration (below 200 ng/mL) in the 3rd week was an independent risk factor of grade II‐IV aGVHD (P = .02; odds ratio = 2.66; 95% CI, 1.15‐6.17). However, CSA levels during the first 4 weeks did not have a significant impact on the patients’ hematopoietic recovery, infection, DFS, and OS. Our data indicated that adequate management of CSA levels during the peri‐engraftment period might improve clinical outcomes for those with T‐cell replete haploidentical allo‐HSCT.
Real‐time histological imaging of a superficial non‐ampullary duodenal epithelial tumor using endocytoscopy
Authors: Yoshida Masao , Kakushima Naomi , Ono Hiroyuki
Published: March 2018

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Developing reduced SNP assays from whole‐genome sequence data to estimate introgression in an organism with complex genetic patterns, the Iberian honeybee (Apis mellifera iberiensis)
Authors: Henriques Dora , Parejo Melanie , Vignal Alain , Wragg David , Wallberg Andreas , Webster Matthew T. , Pinto M. Alice
Published: March 2018

The most important managed pollinator, the honeybee (Apis mellifera L.), has been subject to a growing number of threats. In western Europe, one such threat is large‐scale introductions of commercial strains (C‐lineage ancestry), which is leading to introgressive hybridization and even the local extinction of native honeybee populations (M‐lineage ancestry). Here, we developed reduced assays of highly informative SNPs from 176 whole genomes to estimate C‐lineage introgression in the most diverse and evolutionarily complex subspecies in Europe, the Iberian honeybee (Apis mellifera iberiensis). We started by evaluating the effects of sample size and sampling a geographically restricted area on the number of highly informative SNPs. We demonstrated that a bias in the number of fixed SNPs (FST = 1) is introduced when the sample size is small (N ≤ 10) and when sampling only captures a small fraction of a population's genetic diversity. These results underscore the importance of having a representative sample when developing reliable reduced SNP assays for organisms with complex genetic patterns. We used a training data set to design four independent SNP assays selected from pairwise FST between the Iberian and C‐lineage honeybees. The designed assays, which were validated in holdout and simulated hybrid data sets, proved to be highly accurate and can be readily used for monitoring populations not only in the native range of A. m. iberiensis in Iberia but also in the introduced range in the Balearic islands, Macaronesia and South America, in a time‐ and cost‐effective manner. While our approach used the Iberian honeybee as model system, it has a high value in a wide range of scenarios for the monitoring and conservation of potentially hybridized domestic and wildlife populations.
Dual specificity phosphatase DUSP6 promotes endothelial inflammation through inducible expression of ICAM‐1
Authors: Hsu Shu‐Fang , Lee Yu‐Bin , Lee Ying‐Chu , Chung Ai‐Ling , Apaya Maria Karmella , Shyur Lie‐Fen , Cheng Ching‐Feng , Ho Feng‐Ming , Meng Tzu‐Ching
Published: March 2018

Tumor necrosis factor (TNF)‐α activates a diverse array of signaling pathways in vascular endothelial cells (ECs), leading to the inflammatory phenotype that contributes to the vascular dysfunction and neutrophil emigration in patients with sepsis. To date, it is not well understood what key regulator might coordinate signaling pathways to achieve inflammatory response in TNF‐α‐stimulated ECs. This study investigated the role of dual specificity phosphatase‐6 (DUSP6) in the regulation of endothelial inflammation. Using knockout mice, we found that DUSP6 is important for TNF‐α‐induced endothelial intercellular adhesion molecule‐1 (ICAM‐1) expression in aorta and in vein. Moreover, genetic deletion of Dusp6 in pulmonary circulation significantly alleviated the susceptibility of mice to lung injury caused by neutrophil recruitment during experimental sepsis induced by TNF‐α or lipopolysaccharide (LPS). The role of DUSP6 was further investigated in primary human umbilical vein endothelial cells (HUVECs). Employing RNAi approach in which endogenous DUSP6 was ablated, we showed a critical function of DUSP6 to facilitate TNF‐α‐induced ICAM‐1 expression and endothelial leukocyte interaction. Interestingly, DUSP6‐promoted endothelial inflammation is independent of extracellular signaling‐regulated kinase (ERK) signaling. On the other hand, inducible DUSP6 leads to activation of canonical nuclear factor (NF)‐κB‐mediated transcription of ICAM‐1 gene in TNF‐α‐stimulated human ECs. These results are the first to demonstrate a positive role of DUSP6 in endothelial inflammation‐mediated pathological process and the underlying mechanism through which DUSP6 promotes NF‐κB signaling in the inflamed ECs. Our findings suggest that manipulation of DUSP6 holds great potential for the treatment of acute inflammatory diseases.
Review: An overview and analysis of novel oral anticoagulants and their dental implications
Authors: Fortier Kevin , Shroff Deepti , Reebye Uday N.
Published: March 2018

Background

Dabigatran, rivaroxaban, apixaban and edoxaban are approved novel oral anticoagulants (NOACs) as alternatives to Vitamin K antagonists (VKA). Physicians are prescribing an ever‐increasing amount these drugs to their patients due to various advantages over existing medications.

Aims

The objective of this review is to provide the dental professional with current literature surrounding the emergence of NOACs, as well as various case studies on the subject, in an effort to guide clinical decision making regarding these medications. The pharmacological profiles of these NOACs and idarucizumab, a reversal agent for dabigatran, will be detailed in this review.

Materials and methods

A review of the literature on NOACs was undertaken and the Pubmed, Medline, and Embase databases were used to identify articles published in the English language. Additionally, major dental medicine journals were hand searched, followed by a review of the ClinicalTrials.gov database.

Results

Due to minimal research regarding dental treatment of patients on NOACs and minimal clinical experience of practitioners treating these patients, there is currently insufficient data to establish an evidence‐based NOAC management protocol in a dental setting.

Discussion

In this review, the most significant advantages of NOACs over VKAs was found to be limited interactions with other drugs as well as rapid onset and offset of action.

Conclusion

Despite these benefits, as well as various others, NOACs still lack specific management parameters as well as antidotes or reversal agents. Therefore, dental professionals must use caution when treating patients currently taking these specific anticoagulants.
Understanding Menstrual Migraine
Authors: Calhoun Anne H.
Published: March 2018

Premise

Menstrual‐related migraine is very prevalent, very disabling, yet very easy to manage given a good understanding of its cause.

Possible Solution

This article is intended to help with that understanding and to enable headache specialists to prescribe or create effective hormonal preventives of menstrual‐related migraine.
Tumour budding in pancreatic cancer revisited: validation of the ITBCC scoring system
Authors: Karamitopoulou Eva , Wartenberg Martin , Zlobec Inti , Cibin Silvia , Worni Mathias , Gloor Beat , Lugli Alessandro
Published: March 2018

Aims

Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with rising incidence. Biomarkers that would help the prognostic stratification of patients are needed urgently. Although tumour budding (BD) is a strong and independent prognostic factor in PDAC it is not included in histopathology reports, due partly to the lack of a standardised scoring system. The aim of the present work is to assess the reliability and reproducibility of the BD scoring system proposed recently by the International Tumour Budding Consensus Conference (ITBCC) 2016 in a well‐characterised PDAC cohort (n = 120) with complete clinicopathological and follow‐up information.

Methods and results

BD was scored independently by two pathologists on haematoxylin and eosin‐stained PDAC sections by assessing the densest budding area at ×20 magnification (one hot‐spot, 0.785 mm2), regardless of intra‐ or peritumoural localisation, and assigned to four categories: BD0: no buds; BD1: one to four buds; BD2: five to nine buds; and BD3: ≥ 10 buds. Findings were correlated to patient and tumour characteristics and interobserver agreement was assessed. The weighted kappa value for BD category was 0.62 (0.5–0.73), indicating strong agreement. Increasing BD category (BD3 versus BD0–2) correlated with higher grade (P = 0.002) and shorter overall [OS, P < 0.0001, hazard ratio (HR) = 3.234, 95% confidence interval (CI) = 1.95–5.37] and disease‐free survival (DFS, P = 0.0135, HR = 1.974, 95% CI = 1.15–3.39). BD (BD3 versus BD0–2) was an independent prognostic factor for OS and DFS, after adjusting for tumour–node–metastasis (TNM) stage by using both the 8th American Joint Committee on Cancer (AJCC) edition (OS: P = 0.0031, HR = 2.298, 95% CI = 1.32–0.99; DFS: P = 0.0458, HR = 1.713, 95% CI = 1.01–2.91) and the 7th AJCC edition (OS: P < 0.0001, HR = 2.795,95% CI = 1.71–4.57 and DFS: P = 0.00786, HR = 1.643, 95% CI = 0.95–2.86).

Conclusions

ITBCC scoring is a simple, reliable and reproducible method to evaluate BD in PDAC and facilitates its documentation in histopathology reports, allowing the prognostic stratification of PDAC patients.
MINING SURPLUS: MODELING JAMES A. SCHMITZ'S LINK BETWEEN COMPETITION AND PRODUCTIVITY
Authors: Greenwood Jeremy , Weiss David
Published: March 2018

James A. Schmitz documents, in a well‐known case study (Journal of Political Economy 113 (2005), 582–625), a dramatic rise in productivity in the American and Canadian iron‐ore industry following an increase in competition from Brazil. Prior to the increased competition, the industry was not competitive. Economic profits were divided between business and unions. Schmitz attributes the increase in productivity to a change in work practices in the industry, as old negotiated union work rules were abandoned or modified. This research formalizes a mechanism through which a rise in competition can lead to increased productivity in the iron‐ore industry.
SEARCH, ADVERSE SELECTION, AND MARKET CLEARING
Authors: Cho In‐Koo , Matsui Akihiko
Published: March 2018

We examine a dynamic decentralized trading model with infinitesimal sellers and buyers to investigate whether or not the market fails to clear in the limit of search friction vanishing. A seller, who has private information about product quality, and a buyer are matched to bargain over price. They form a long‐term relationship if they reach agreement. They return to the matching pool if they fail to agree or the existing relationship is dissolved. The market fails to clear if and only if the ratio of agents' patience over the dissolution rate exceeds a threshold.
Host sensitization of Mn4+ in self‐activated Na2WO2F4:Mn4+
Authors: Hu Tao , Lin Hang , Gao Yan , Xu Ju , Wang Jiaomei , Xiang Xiaoqing , Wang Yuansheng
Published: March 2018

Self‐activated compound serving as host sensitizer for trivalent rare‐earth ions has been intensively studied, but only in more recent years did it extend to non‐rare‐earth ions. In the present work, it is demonstrated for the first time that the parity‐forbidden Mn4+ red emission can be effectively enhanced by utilizing the strong parity‐allowed absorption of O2−–W6+ charge transfer band and the energy transfer from “WO2” groups to Mn4+ ions. Hopefully, the presently studied self‐activated Na2WO2F4 can be developed as stable color converter for field‐emission displays.
New method for controllable accelerated aging of marble: Use for testing of consolidants
Authors: Sassoni Enrico , Graziani Gabriela , Franzoni Elisa , Scherer George W.
Published: March 2018

Research is needed on novel consolidants to restore weathered marble, because the available products exhibit limitations. To test new consolidants, samples with features similar to naturally weathered marble (i.e., near‐surface damage) are recommended. We developed a novel method that produces decayed samples with a gradient in properties that can be tuned to any desired level, in terms of depth from the surface and decrease in dynamic elastic modulus. The idea is to produce near‐surface damage by putting a marble sample in contact with a plate at a certain temperature for a certain time, calculated by a mathematical model. The model was used to predict the heating conditions to produce a certain decrease in dynamic elastic modulus in the first 1 cm from the surface, comparable to naturally weathered marble. Good confirmation of the model predictions was found experimentally. The suitability of using thermally “weathered” samples for testing consolidants was demonstrated in the case of a hydroxyapatite‐based treatment. The mathematical model can be tailored to other lithotypes or ceramics, using the relevant property data.
Effects of pyrocarbon on morphology stability of SiC nanowires at high temperatures
Authors: Cheng Chunyu , Li Hejun , Fu Qiangang , Li Lu , Guo Liping , Yin Xuemin , Tian Xinfa
Published: March 2018

To understand the effect of pyrocarbon (PyC) on the morphology stability of SiC nanowires at high temperatures (1800‐2100°C), a PyC layer was prepared to wrap the 3C‐SiC nanowire by chemical vapor deposition. The results showed that the existence and thickness of PyC layer played a crucial role in stabilizing the structures and morphology of SiC nanowires. The SiC nanowires without PyC layer transformed to platelet‐shaped structures above 1800°C. The SiC nanowires with a ~1.5 μm PyC layer could keep their structures and morphology at 2100°C, while the SiC nanowires with a ~1 μm PyC layer could not maintain their microstructures at this temperature. The stability of SiC nanowires at high temperature might be related to the vapor phase nucleation, thermodynamics phase transformation and the stacking faults (SFs) expansion, which could be limited by the PyC layer. Therefore, preparing a protective PyC layer with an appropriate thickness might be a potential method to extend the practical applications of SiC nanowires at high temperatures.
Improving early prediction of academic failure using sentiment analysis on self‐evaluated comments
Authors: Yu L.C. , Lee C.W. , Pan H.I. , Chou C.Y. , Chao P.Y. , Chen Z.H. , Tseng S.F. , Chan C.L. , Lai K.R.
Published: March 2018

This study presents a model for the early identification of students who are likely to fail in an academic course. To enhance predictive accuracy, sentiment analysis is used to identify affective information from text‐based self‐evaluated comments written by students. Experimental results demonstrated that adding extracted sentiment information from student self‐evaluations yields a significant improvement in early‐stage prediction quality. The results also indicate the limited early‐stage predictive value of structured data, such as homework completion, attendance, and exam grades, due to data sparseness at the beginning of the course. Thus, applying sentiment analysis to unstructured data (e.g., self‐evaluation comments) can play an important role in improving the accuracy of early‐stage predictions. The findings present educators with an opportunity to provide students with real‐time feedback and support to help students become self‐regulated learners. Using the exploring results for improvement in teaching and learning initiatives is important to maintain students' performances and the effectiveness of the learning process.
Molecular mechanism and therapy application of necrosis during myocardial injury
Authors: Xu Tao , Ding Wei , Tariq Muhammad Akram , Wang Yu , Wan Qinggong , Li Mengyang , Wang Jianxun
Published: March 2018

Necrosis is an ancient topic which gains new attraction in the research area these years. There is no doubt that some necrosis can be regulated by genetic manipulation other than an accidental cell death resulting from physical or chemical stimuli. Recent advances in the molecular mechanism underlying the programmed necrosis show a fine regulation network which indicates new therapy targets in human diseases. Heart diseases seriously endanger our health and have high fatality rates in the patients. Cell death of cardiac myocytes is believed to be critical in the pathogenesis of heart diseases. Although necrosis is likely to play a more important role in cardiac cell death than apoptosis, apoptosis has been paid much attention in the past 30 years because it used to be considered as the only form of programmed cell death. However, recent findings of programmed necrosis and the related signalling pathways have broadened our horizon in the field of programmed cell death and promote new pharmacological application in the treatment of heart diseases. In this review, we summarize the advanced progress in these signalling pathways and discuss the pathos‐physiological relevance and therapeutic implication of targeting necrosis in heart diseases treatment.
The European Semester and EU Social Policy
Authors: Copeland Paul , Daly Mary
Published: March 2018

Europe 2020 and the European Semester signal a major change of direction in EU social policy with new governance arrangements, policy orientations and politics. This paper analyses 290 Country Specific Recommendations and 29 interviews to answer two questions: 1) What type of social policy is being advanced by the EU at present? 2) How are EU social actors able to advance EU social policy under current conditions? It argues that the degree of progress in EU social policy in the European Semester (2011–15) has been conditional and contingent. EU social policy is more oriented to supporting market development than it is to correcting for market failures. We explain these developments by a combination of factors including the strong agency exerted by some social actors in a context of constraint, the moderation of expectations and the adoption of strategic practices by key actors, and political divisions among the Member States.
An Alternative to the 3PL: Using Asymmetric Item Characteristic Curves to Address Guessing Effects
Authors: Lee Sora , Bolt Daniel M.
Published: March 2018

Both the statistical and interpretational shortcomings of the three‐parameter logistic (3PL) model in accommodating guessing effects on multiple‐choice items are well documented. We consider the use of a residual heteroscedasticity (RH) model as an alternative, and compare its performance to the 3PL with real test data sets and through simulation analyses. Our results suggest advantages to the RH approach, including closer fit to real data, more interpretable parameter estimates, and greater psychological plausibility.
Preventing Homelessness for System‐Involved Youth
Authors: Britton Linda , Pilnik Lisa
Published: March 2018

Too many youth and young adults find themselves on the streets, couch‐surfing with friends, in emergency shelters or worse, after exiting the child welfare and juvenile justice systems. In some circumstances, youth have had court hearings until their exit from the legal system, but those hearings have not focused on long‐range plans of youth and emergencies youth may encounter. In other circumstances, there has been little or no planning prior to discharge, especially for young people who leave the juvenile justice system. Courts can and should prevent, alleviate or end youth homelessness for youth who appear before them through strategies that are enumerated in the recently‐passed NCJFCJ resolution. This article expounds on three of these strategies – coordinating transition and re‐entry plans, insisting on effective legal representation of youth, and utilizing sound judicial leadership. It also describes the concurrent efforts of the Coalition for Juvenile Justice and the American Bar Association's Homeless Youth Legal Network to remove legal barriers and improve outcomes for youth and young adults experiencing homelessness.
Production of Clostridium perfringens spores and their recovery from artificially spiked spices and herbs
Authors: Lins Philipp
Published: March 2018

Clostridium perfringens spores are able to persist under harsh conditions, and thus, are predestined as high risk hazards in the food category dried spices and herbs. In the present study, C. perfringens spores were produced, and then, screened toward their susceptibility to the antimicrobial activity of nine condiments. While heat activation for induction of spore germination led to a significant increase in recovery by almost 1 log10 colony forming units, the supplementation of germinants was negligible. The enumeration of C. perfringens before heat treatment revealed no detrimental effects by potential antimicrobial active compounds of the condiments. However, after heat activation a significant reduced recovery was determined for cinnamon and allspice in comparison to the control but it was still higher than without treatment. Probably, the heat improved the extraction of compounds inhibiting the germination of the spore and/or the outgrowth of the cell.

Practical applications

This study contributes to the understanding of the production of C. perfringens spores and their recovery from artificially spiked condiments. For an efficient spore production the following four factors are essential with decreasing importance, namely (a) the strain selection, (b) the preparation via a two‐step approach, (c) the heat activation, and (d) the supplementation of germination factors. The detection of the actual contamination is of major importance especially for food control institutions. Neglecting the heat activation poses a potential risk for underestimation and false‐negatives during food control analyses. Consequently, it is recommended to enumerate before and after heat treatment to detect vegetative cells as well as spores.
EMPOWERing Hospitalized Older Adults to Deprescribe Sedative Hypnotics: A Pilot Study
Authors: Wilson Marnie Goodwin , Lee Todd C. , Hass Aaron , Tannenbaum Cara , McDonald Emily G.
Published: March 2018

Objectives

To distribute the EMPOWER patient education brochure and use hospitalization as an opportunity to reduce inappropriate sedatives.

Design

Participants were sequentially recruited until we achieved 30‐day follow‐up telephone and pharmacy records for 50 individuals. The proportion meeting the primary outcome was compared with that of a control cohort and with rates of cessation achieved in the community.

Setting

Fifty‐two‐bed medical clinical teaching unit in Montréal, Canada.

Participants

Inpatients aged 65 and older who were chronic, regular sedative users.

Measurements

The primary outcome was short‐term sustained cessation 30‐days after discharge. As a secondary outcome, we compared self‐reported sleep disturbance before and after the intervention.

Results

Sedatives were deprescribed in 32 of 50 (64%) participants who received the EMPOWER brochure, which was significantly higher than our historical rate of 21% (p<.001). Participants did not report significant worsening in their quality of sleep after sedative cessation.

Conclusion

Hospitalized individuals are willing to deprescribe, and contact with the healthcare system provides the opportunity to initiate the process with educational brochures. This type of intervention requires few resources and is feasible and inexpensive.
Treatment of disseminated Strongyloides spp. infection in an infant Sumatran orangutan (Pongo abelii)
Authors: Kleinschmidt Laura M. , Kinney Matthew E. , Hanley Christopher S.
Published: March 2018

Strongyloides nematodes have been reported in all species of great apes with orangutans ≤5 years old most susceptible to severe clinical disease. This brief communication describes the first published case of antemortem diagnosis and treatment of disseminated strongyloidiasis in a clinically affected 5‐month‐old Sumatran orangutan (Pongo abelii).
Empowering members of a rural southern community in Nigeria to plan to take action to prevent maternal mortality: A participatory action research project
Authors: Esienumoh Ekpoanwan E , Allotey Janette , Waterman Heather
Published: March 2018

Aims and objectives

To facilitate the empowerment of members of a rural community to plan to take action to prevent maternal mortality.

Background

Globally, about 300,000 maternal deaths occur yearly. Sub‐Saharan Africa and Southern Asia regions account for almost all the deaths. Within those regions, India and Nigeria account for over a third of the global maternal deaths. Problem of maternal mortality in Nigeria is multifaceted. About 80% of maternal deaths are avoidable, given strategies which include skilled attendants, emergency obstetric care and community mobilisation. In this article, a strategy of community empowerment to plan to take action to prevent maternal mortality is discussed.

Design

Participatory action research was used.

Methods

Twelve volunteers were recruited as coresearchers into the study through purposive and snowball sampling who, following an orientation workshop, undertook participatory qualitative data collection with an additional 29 community members. Participatory thematic analysis of the data was undertaken which formed the basis of the plan of action.

Results

Community members attributed maternal morbidities and deaths to superstitious causes, delayed referrals by traditional birth attendants, poor transportation and poor resourcing of health facilities. Following critical reflection, actions were planned to empower the people to prevent maternal deaths through community education and advocacy meetings with stakeholders to improve health and transportation infrastructures; training of existing traditional birth attendants in the interim and initiating their collaboration with skilled birth attendants.

Conclusion

The community is a resource which if mobilised through the process of participatory action research can be empowered to plan to take action in collaboration with skilled birth attendants to prevent maternal mortality.

Relevance to clinical practice

Interventions to prevent maternal deaths should include community empowerment to have better understanding of their circumstances as well as their collaboration with health professionals.
The role of empathy and emotional intelligence in nurses’ communication attitudes using regression models and fuzzy‐set qualitative comparative analysis models
Authors: Giménez‐Espert María del Carmen , Prado‐Gascó Vicente Javier
Published: March 2018

Aims and objectives

To analyse link between empathy and emotional intelligence as a predictor of nurses’ attitudes towards communication while comparing the contribution of emotional aspects and attitudinal elements on potential behaviour.

Background

Nurses’ attitudes towards communication, empathy and emotional intelligence are key skills for nurses involved in patient care. There are currently no studies analysing this link, and its investigation is needed because attitudes may influence communication behaviours.

Design

Correlational study.

Method

To attain this goal, self‐reported instruments (attitudes towards communication of nurses, trait emotional intelligence (Trait Emotional Meta‐Mood Scale) and Jefferson Scale of Nursing Empathy (Jefferson Scale Nursing Empathy) were collected from 460 nurses between September 2015–February 2016.

Two different analytical methodologies were used: traditional regression models and fuzzy‐set qualitative comparative analysis models.

Results

The results of the regression model suggest that cognitive dimensions of attitude are a significant and positive predictor of the behavioural dimension. The perspective‐taking dimension of empathy and the emotional‐clarity dimension of emotional intelligence were significant positive predictors of the dimensions of attitudes towards communication, except for the affective dimension (for which the association was negative). The results of the fuzzy‐set qualitative comparative analysis models confirm that the combination of high levels of cognitive dimension of attitudes, perspective‐taking and emotional clarity explained high levels of the behavioural dimension of attitude.

Conclusions

Empathy and emotional intelligence are predictors of nurses’ attitudes towards communication, and the cognitive dimension of attitude is a good predictor of the behavioural dimension of attitudes towards communication of nurses in both regression models and fuzzy‐set qualitative comparative analysis. In general, the fuzzy‐set qualitative comparative analysis models appear to be better predictors than the regression models are.

Relevance to clinical practice

To evaluate current practices, establish intervention strategies and evaluate their effectiveness. The evaluation of these variables and their relationships are important in creating a satisfied and sustainable workforce and improving quality of care and patient health.
STOPDVTs: Development and testing of a clinical assessment tool to guide nursing assessment of postoperative patients for Deep Vein Thrombosis
Authors: O'Brien Alanna , Redley Bernice , Wood Beverley , Botti Mari , Hutchinson Anastasia F
Published: March 2018

Aims and objectives

To develop and test a clinical tool to guide nurses’ assessment of postoperative patients for Deep Vein Thrombosis.

Background

Preventing venous thromboembolism in hospitalised patients is an international patient safety priority. Despite high‐level evidence for optimal venous thromboembolism prophylaxis, implementation is inconsistent and the incidence of Deep Vein Thrombosis remains high.

Methods

A two‐stage sequential multi‐method design was used. In stage 1, the STOPDVTs tool was developed using a review of the literature and focus groups with local clinical experts. Stage 2 involved pilot testing the tool with 38 surgical nurses who conducted repeated assessments on a prospective sample of 50 postoperative orthopaedic patients.

Results

Stage 1: The focus group members who were members of the nursing leadership team agreed on eight local and systemic signs and symptoms that should be included in a nursing patient assessment tool for early Deep Vein Thrombosis. Local symptoms were pain in the limbs, calf swelling and tightness, changes in the affected limb's skin temperature. Systemic signs included in the tool were as follows: increased shortness of breath, increased respiratory and heart rates, and decreased oxygen saturation. Stage 2: The STOPDVTs tool had acceptable face and content validity, the agreement between the expert nurse and surgical nurses on assessments of individual signs and symptoms varied between 44%–94%. Surgical nurses were less likely than the expert nurse to identify signs indicative of Deep Vein Thrombosis.

Conclusion

Despite finding the STOPDVTs clinical assessment tool was a useful guide for nursing assessment, surgical nurses often underestimated the potential importance of clinical signs. The findings reveal a gap in nursing knowledge and skill in assessing for Deep Vein Thrombosis in postoperative orthopaedic patients.

Relevance to clinical practice

This study identified a possible risk to patient safety related to under‐recognition of the signs and symptoms of possible Deep Vein Thrombosis (DVT) in postoperative orthopaedic patients. The findings demonstrate the feasibility of developing and implementing a protocol for consistent screening by nurses for possible DVT in the postoperative period.
Recognition of preclinical signs of dementia: A qualitative study exploring the experiences of family carers and professional care assistants
Authors: Jenkins Catharine , Feldman Gerald
Published: March 2018

Aims and objectives

To identify preclinical signs of dementia by exploring the experiences of family caregivers and professional care assistants.

Background

Dementia results in disability, emotional strain and financial loss for people with dementia, family members and nations. Informal identification of social and behavioural risk signifiers could facilitate timely interventions with potential to delay onset of serious disability.

Design

A retrospective qualitative approach using a naturalistic interpretive design was used. Focus groups enabled in‐depth understanding of the participants’ experiences of life or work with people who subsequently developed dementia.

Methods

Purposive sampling was used to recruit family carers and professional carers who had cared for people who later developed dementia. The data from focus groups were fully transcribed and anonymised, and transcripts were analysed by two researchers. These researchers coded and analysed the transcripts independently; subsequently, overlapping and similar themes were identified and consensus reached on final themes. A third researcher was invited to review the analysis and ensure trustworthiness of the study findings.

Results

Findings revealed that preclinical signs of dementia were identifiable in retrospect Participants’ accounts resulted in four themes, “Lowered Threshold of Frustration”, “Insight and Coping Strategies,” “Early signs of poor memory” and “Alarming Events.”

Conclusions

Earlier recognition of preclinical signs of dementia would allow affected individuals to follow health promotion advice and plan for the future. Identification of social exclusion prior to diagnosis has implications for antistigma campaigns and development of “dementia‐friendly communities.”

Relevance to clinical practice

Healthcare professionals could work with those at risk, facilitating lifestyle changes to postpone symptoms and advance planning for improved autonomy. Predementia should be viewed as a disability for which reasonable adjustments can be made at a community level, to enhance and extend emotional well‐being and social inclusion.
Barriers to medication error reporting among hospital nurses
Authors: Rutledge Dana N , Retrosi Tina , Ostrowski Gary
Published: March 2018

Aims and objectives

The study purpose was to report medication error reporting barriers among hospital nurses, and to determine validity and reliability of an existing medication error reporting barriers questionnaire.

Background

Hospital medication errors typically occur between ordering of a medication to its receipt by the patient with subsequent staff monitoring. To decrease medication errors, factors surrounding medication errors must be understood; this requires reporting by employees. Under‐reporting can compromise patient safety by disabling improvement efforts.

Design

This 2017 descriptive study was part of a larger workforce engagement study at a faith‐based Magnet®‐accredited community hospital in California (United States).

Methods

Registered nurses (~1,000) were invited to participate in the online survey via email. Reported here are sample demographics (n = 357) and responses to the 20‐item medication error reporting barriers questionnaire. Using factor analysis, four factors that accounted for 67.5% of the variance were extracted. These factors (subscales) were labelled Fear, Cultural Barriers, Lack of Knowledge/Feedback and Practical/Utility Barriers; each demonstrated excellent internal consistency.

Results

The medication error reporting barriers questionnaire, originally developed in long‐term care, demonstrated good validity and excellent reliability among hospital nurses. Substantial proportions of American hospital nurses (11%–48%) considered specific factors as likely reporting barriers. Average scores on most barrier items were categorised “somewhat unlikely.” The highest six included two barriers concerning the time‐consuming nature of medication error reporting and four related to nurses’ fear of repercussions.

Conclusions

Hospitals need to determine the presence of perceived barriers among nurses using questionnaires such as the medication error reporting barriers and work to encourage better reporting.

Relevance to clinical practice

Barriers to medication error reporting make it less likely that nurses will report medication errors, especially errors where patient harm is not apparent or where an error might be hidden. Such under‐reporting impedes collection of accurate medication error data and prevents hospitals from changing harmful practices.
Identification of additional sources of resistance to Puccinia striiformis f. sp. hordei (PSH) in a collection of barley genotypes adapted to the high input condition
Authors: Verma Ramesh P. S. , Selvakumar Rajan , Gangwar Om P. , Shekhawat Pradeep S. , Bhardwaj Subhash C. , Rehman Sajid , Sharma‐Poudyal Dipak , Gyawali Sanjaya
Published: March 2018

A total of 336 barley genotypes consisting of released cultivars, advanced lines, differentials and local landraces from the ICARDA barley breeding programme were screened for seedling and adult‐plant resistances to barley stripe rust pathogen (Puccinia striiformis f. sp. hordei [PSH]). Seedling resistance tests were undertaken at Shimla, India by inoculating 336 barley genotypes with five prevalent PSH races [Q (5S0), 24 (0S0‐1), 57 (0S0), M (1S0) and G (4S0)] in India. Barley genotypes were also evaluated at the adult‐plant stage for stripe rust resistance at Durgapura (Rajasthan, India) in 2013 and 2014, and at Karnal (Haryana, India) in 2014 under artificial PSH infection in fields, using a mixture of the five races. Twelve barley genotypes (ARAMIR/COSSACK, Astrix, C8806, C9430, CLE 202, Gold, Gull, Isaria, Lechtaler, Piroline, Stirling, and Trumpf) were resistant to all five PSH races at the seedling and adult‐plant stages. Two of these genotypes, Astrix and Trumpf, were part of international differentials and reveal that five races were avirulent to genes Rps4 (yr4), rpsAst, rpsTr1 and rpsTr2. These genes were highly effective against PSH races prevalent in India. The virulence/avirulence formula reported in this study helped to determine the effectiveness of PSH resistance genes against Indian races. Forty‐five genotypes showed adult‐stage plant resistance (APR) in the field. The identified PSH resistant genotypes may possess novel resistance genes and might serve as potential donors of PSH resistance at seedling and APR in the future. Further research is needed to determine the nature of resistance genes through allelic studies and mapping of these genes.
Sleep deprivation compromises resting‐state emotional regulatory processes: An EEG study
Authors: Zhang Jinxiao , Lau Esther Yuet Ying , Hsiao Janet H.
Published: March 2018

Resting‐state spontaneous neural activities consume far more biological energy than stimulus‐induced activities, suggesting their significance. However, existing studies of sleep loss and emotional functioning have focused on how sleep deprivation modulates stimulus‐induced emotional neural activities. The current study aimed to investigate the impacts of sleep deprivation on the brain network of emotional functioning using electroencephalogram during a resting state. Two established resting‐state electroencephalogram indexes (i.e. frontal alpha asymmetry and frontal theta/beta ratio) were used to reflect the functioning of the emotion regulatory neural network. Participants completed an 8‐min resting‐state electroencephalogram recording after a well‐rested night or 24 hr sleep deprivation. The Sleep Deprivation group had a heightened ratio of the power density in theta band to beta band (theta/beta ratio) in the frontal area than the Sleep Control group, suggesting an affective approach with reduced frontal cortical regulation of subcortical drive after sleep deprivation. There was also marginally more left‐lateralized frontal alpha power (left frontal alpha asymmetry) in the Sleep Deprivation group compared with the Sleep Control group. Besides, higher theta/beta ratio and more left alpha lateralization were correlated with higher sleepiness and lower vigilance. The results converged in suggesting compromised emotional regulatory processes during resting state after sleep deprivation. Our work provided the first resting‐state neural evidence for compromised emotional functioning after sleep loss, highlighting the significance of examining resting‐state neural activities within the affective brain network as a default functional mode in investigating the sleep–emotion relationship.
Promoting CPAP adherence in clinical practice: A survey of Swedish and Norwegian CPAP practitioners’ beliefs and practices
Authors: Broström Anders , Pakpour Amir H. , Nilsen Per , Gardner Benjamin , Ulander Martin
Published: March 2018

The benefits of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea are well established, but adherence tends to be low. Research exploring CPAP practitioners’ beliefs around determinants of CPAP adherence, and the actions they use in clinical practice to promote CPAP adherence is lacking. This study aimed to: (i) develop and validate a questionnaire to assess beliefs and current practices among CPAP practitioners; (ii) explore practitioners’ beliefs regarding the main determinants of patient adherence, and the actions practitioners most commonly use to promote CPAP adherence; and (iii) explore the associations between perceived determinants and adherence‐promotion actions. One‐hundred and forty‐two CPAP practitioners in Sweden and Norway, representing 93% of all Swedish and 62% of all Norwegian CPAP centres, were surveyed via a questionnaire exploring potential determinants (18 items) and adherence‐promotion actions (20 items). Confirmatory factor analysis and second‐order structural equational modelling were used to identify patterns of beliefs, and potential associations with adherence‐promotion actions. Patients’ knowledge, motivation and attitudes were perceived by practitioners to be the main determinants of CPAP adherence, and educating patients about effects, management and treatment adjustments were the most common practices. Knowledge was shown to predict educational and informational actions (e.g. education about obstructive sleep apnea and CPAP). Educational and informational actions were associated with medical actions (e.g. treatment adjustment), but knowledge, attitude and support had no association with medical actions. These findings indicate that a wide variety of determinants and actions are considered important, though the only relationship observed between beliefs and actions was found for knowledge and educational and informational actions.
Feasibility of integrating calcium and iron–folate supplementation to prevent preeclampsia and anemia in pregnancy in primary healthcare facilities in Kenya
Authors: Omotayo Moshood O. , Dickin Katherine L. , Pelletier David L. , Martin Stephanie L. , Kung'u Jacqueline K. , Stoltzfus Rebecca J.
Published: March 2018

Calcium (Ca) supplementation to prevent preeclampsia can save maternal and newborn lives, but there are no program models for integration into existing antenatal care platforms. We used a program impact pathway model to guide the design of integrated Ca and iron–folate (IFA) supplementation in Kenya. We provided healthcare providers with job aids (posters and counseling cards), trained them on counseling techniques and supplementation guidelines, and developed behavior change materials for pregnant women (pill‐taking calendars). We allocated health facilities to prescribe either 1.0 or 1.5 g/day Ca, with standard IFA. We collected implementation data from 16 facilities and 990 women. We also explored effects of supplementation on percentage of the population meeting recommended daily allowance. Supplements and job aids were available during 90% of facility spot‐check episodes; calendar availability was lower (78%). Over 98% of clients received Ca and IFA supplements, but only 76% received enough Ca supplements to last between antenatal care visits. Among clients that still had pills by return date, adherence was 77% and 83% for the IFA and Ca regimen, respectively. When 1.5 g/day of Ca supplements were prescribed, over 75% of participants met recommended daily allowance. Only 54% met the recommended daily allowance when 1.0 g was prescribed. This study illustrates a systematic approach for integrating Ca supplementation into primary healthcare and demonstrates that such integration is feasible when contextual bottlenecks are addressed. Policy makers and program planners should pay attention to supply chain, healthcare worker dispensing behavior, and appropriateness of regimen for their settings.