bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward a Theory of Pedagogical Reduction: Selection, Simplification, and Generalization in an Age of Critical Education
Authors: Lewin David
Published: April 2019

In this article, David Lewin examines the processes of educational representation, simplification, and selection, proposing the term “pedagogical reduction” in order to clarify the role these processes play within pedagogy. Although this term is virtually unknown among Anglo‐American educational theorists, it reflects a substantial theoretical basis in the related German concept didaktishe Reduktion. Drawing on sources from the hermeneutic tradition, Lewin argues that education is fundamentally an interpretive exercise because selection and simplification require the interpretive judgment of educators, and that the hermeneutic constraints applied to education entail forms of reduction. He then examines pedagogical reduction within the curriculum areas of history, science, and philosophy in order to illustrate the generative and generalizing nature of pedagogical reduction, which takes students from particulars (objects, exercises, or events) to general or universal principles. Lewin discusses Comenius's 1658 textbook Orbis Sensualium Pictus in order both to illustrate pedagogical reduction as a historical form and to draw attention to a key historical moment in the development of educational representation and reduction. He then turns to an examination of skepticism of pedagogical reduction from progressive and critical pedagogies. The argument culminates in the suggestion that educational theory is too often presented with a false dilemma: either accept the need for a contrived educational experience disconnected from the experiences and concerns of life, or react against this flattened educational aspiration by seeking something authentic and progressive that meaninglessly conflates education and life. Understanding the proper place of reduction in education, Lewin concludes, is vital in mediating this dichotomy.
A study of PD‐L1 expression in intravascular large B cell lymphoma: correlation with clinical and pathological features
Authors: Gupta Gaurav K , Jaffe Elaine S , Pittaluga Stefania
Published: April 2019

Intravascular large B cell lymphoma (IVLBCL) is a rare, aggressive, extranodal large B cell lymphoma characterised by growth of tumour cells within the lumen of vessels, particularly capillaries. Programmed cell death ligand 1 (PD‐L1) is a cell surface glycoprotein that interacts with programmed death 1 (PD‐1) on the T cell surface, leading to modulation of the immune response. PD‐L1 is a targetable immune check‐point molecule that is expressed on neoplastic cells in various cancers, including a subset of lymphomas. We correlated the expression of PD‐L1 with clinical and pathological findings in this rare disease. Eleven cases of IVLBCL were identified in the archives of Laboratory of Pathology at the National Cancer Institute, NIH. A panel of immunostains (CD20, CD3, CD5, PD‐L1) was performed. The cases were classified as the classic form or the variant associated with haemophagocytic syndrome (HPS) based on published 2017 WHO criteria. Three cases (27.3%) were HPS variant and eight cases (72.7%) were the classic form. Five (45.5%) of 11 cases were CD5‐positive; two of three (66%) were HPS variants and three of eight (37.5%) were classic form. Overall, four of nine evaluable cases (44.4%) were positive for PD‐L1, three of which were classic. Only one CD5‐positive case was PD‐L1‐positive, a classic variant. In summary, a subset of IVLBCL express PD‐L1. Although limited, these data suggest that PD‐L1 is expressed in both the so‐called classic form as well as the HPS variant. PD‐L1 is expressed irrespective of CD5 expression. Finally, detection of PD‐L1 expression in a subset of IVLBCL lymphoma cases may identify patients who might benefit from targeted immunotherapy.
The Diremption of Love: Gillian Rose on Agency, Mortality, and Hegelian Feminism
Authors: Angermann Asaf
Published: April 2019

Gillian Rose (1947–1995) was an influential though idiosyncratic British philosopher whose work helped introduce the Frankfurt School's critical theory and renew interest in Hegel, Kierkegaard, and Jewish thought in Anglo‐American philosophy. After years of relative oblivion, her life and thought have recently received new attention in philosophy, sociology, and theology. However, her work's critical Hegelian contribution to feminist philosophy still remains unexplored. This article seeks to reassess the place and the meaning of feminism and gender identity in Rose's work by addressing both her philosophical writings and her personal memoir, written in the months preceding her untimely death. It argues that although Rose's overall work was not developed in a feminist context, her philosophy, and in particular her ethical‐political notion of diremption, is valuable for developing a critical feminist philosophy that overcomes the binaries of law and morality, inclusion and exclusion, power and powerlessness—and focuses on the meaning of love as negotiating, rather than mediating, these oppositions.
Time‐varying consumption tax, productive government spending, and aggregate instability
Authors: Bambi Mauro , Venditti Alain
Published: April 2019

In this paper we investigate if government balanced‐budget rules together with endogenous taxation may lead to aggregate instability in an endogenous growth framework. After highlighting the differences with the exogenous growth framework, we prove that under counter‐cyclical consumption taxes, while there exists a unique balanced growth path, sunspot equilibria based on self‐fulfilling expectations occur through a form of global indeterminacy. In addition, we argue that this result is empirically plausible for a large set of OECD countries and that it may also emerge with endogenous income taxes.
Comparative analysis on the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade) versus conventional electro surgery in post‐bariatric body‐contouring procedures: A retrospective randomised clinical study
Authors: Schlosshauer Torsten , Kiehlmann Marcus , Ramirez Pablo , Riener Marc‐Oliver , Djedovic Gabriel , Rieger Ulrich M.
Published: April 2019

Postoperative wound‐healing problems are relatively high in post‐bariatric body‐contouring procedures, partly because of electrosurgery and the associated thermal tissue damage. This study is a retrospective randomised evaluation of the effect of a low‐thermal plasma dissection device (PEAK PlasmaBlade, Medtronic, Minneapolis, Minnesota) in comparison with conventional electrosurgery. A total of 24 patients undergoing upper arm or medial thigh lifting were randomised to PEAK PlasmaBlade on one side and to monopolar electrosurgery on the other side of the same patient. Wounds of 10 patients were examined histologically for acute thermal injury depth. Significantly lower total volume of drain output (61,1 ± 70,2 mL versus 95,1 ± 176,0 mL; P = .04) was found on the PEAK PlasmaBlade side compared with the electrosurgery side. Furthermore, the PEAK PlasmaBlade side showed fewer seromas (no case of seroma versus three seromas in the electrosurgery group) and less thermal damage (40% versus 70%; P = .26). Acute thermal injury depth from the PEAK PlasmaBlade was less than from monopolar electrosurgery (425 ± 171 μm versus 686 ± 1037 μm; P = .631). PEAK PlasmaBlade appears to be superior to traditional monopolar electrosurgery for post‐bariatric body‐contouring procedures because it demonstrated less tissue damage, lower total volume of drain output, and fewer postoperative seromas resulting in faster wound healing.
The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure
Authors: Calis Hasan , Guler Yilmaz , Sengul Serkan , Karabulut Zulfikar
Published: April 2019

Pilonidal sinus disease is a common disorder. We aimed to evaluate the effects of perioperative antibiotherapy on surgical site infections in pilonidal sinus patients who were treated with rhomboid excision with Limberg transposition procedure. A total of 104 patients between 18 and 40 years of age (52 males, 52 females) were included in the study. The patients were divided into two groups and evaluated because of the administration of perioperative antibiotherapy. On the 10th‐day, first‐month, and third‐month follow ups, the status of the wound was recorded. No significant difference was found between the ages, gender distribution, and smoking. Wound dehiscence rate was higher in the non‐antibiotic group on the 10th‐day, first‐month, and third‐month follow up, whereas the rate of superficial infection was higher in the antibiotic group. None of the patients had any signs of recurrence. Antibiotic administration did not provide a significant advantage in terms of wound healing, surgical site infection, and recurrence. We think that perioperative antibiotherapy, except for patients with immunosuppression, diffuse cellulitis, or a major coexisting disease who were treated with rhomboid excision with Limberg transposition procedure, does not have any effect on healing surgical site infections and delaying early recurrence.
Associations between person‐centred climate and perceived quality of care in nursing homes: A cross‐sectional study of relatives’ experiences
Authors: Lood Qarin , Kirkevold Marit , Sjögren Karin , Bergland Ådel , Sandman Per‐Olof , Edvardsson David
Published: April 2019

Aims

To explore the extent to which a more person‐centred climate could explain the variation in quality of care, as rated by relatives to nursing home residents in three countries.

Design

A cross‐sectional, correlational, anonymous questionnaire study.

Methods

Questionnaires were administered to 346 relatives to residents in six nursing homes in Australia, Norway and Sweden between April–June 2016. Relatives (N = 178) agreed to participate. Data were analysed using descriptive statistics and hierarchical multiple regression.

Results

The results showed that the relatives’ experiences of a more person‐centred climate were associated with higher ratings of the quality of care. A person‐centred climate of safety had the strongest unique association with the quality of care, explaining 14% of the variance in quality of care. In addition, the results indicated that the relatives in general were satisfied with the quality of care and that children to the residents rated the quality of care higher than partners or other relatives.

Conclusion

This study advances the understanding of the relationship between person‐centredness in nursing homes and quality of care, showing that person‐centred climate aspects of safety and hospitality have a significant role in the quality of care as perceived by relatives.

Impact

Person‐centredness in nursing homes is often mentioned as a quality of care indicator, but the empirical evidence for this suggestion is limited. This study expanded the evidence‐base for person‐centredness as a significant aspect of relatives’ experiences of the quality of care in nursing homes.
Looking toward 2030: Strengthening midwifery education through regional partnerships
Authors: Srisaeng Pakvilai , Upvall Michele J.
Published: April 2019

Aims

The purpose of this paper is to describe the impact of a regional capacity‐building project between Thailand and Laos that supports the United Nation's sustainable development goal 3 through midwifery education.

Design

Discussion paper based on an exemplar.

Data Sources

The International Confederation of Midwifery's standards of midwifery education and World Health Organization midwifery educator core competencies provided the framework for capacity‐building of Lao midwifery educators.

Implications for nursing: Knowledge gained from this 2‐year project (October 2015–November 2017) increased the teaching confidence of midwifery educators while linking international standards and competencies to curriculum revision. In addition, capacity‐building projects based on a needs assessment and implementation from regional partners may result in policy changes at the local and national level.

Conclusion

Partnerships are essential to meeting the sustainable development goals. These regional partnerships may be highly effective in creating sustainable capacity‐building projects.

Impact

Maternal mortality and preventing deaths of children under 5 years old continues to be a challenge across the globe despite progress made in recent years. Progress toward sustainable development goal 3, requires efforts addressed in sustainable development goal17, partnership. Laos has one of the highest maternal mortality rates in Southeast Asia. A project to increase capacity of midwifery educators demonstrated the benefit of regional partnerships in Laos to have an impact on sustainable development goal 3 ultimately improving maternal outcomes throughout the country.

Partnerships especially those between countries in the same region, are crucial to the success of meeting the sustainable development goals.
Democratic Control of Information in the Age of Surveillance Capitalism
Authors: Sangiovanni Andrea
Published: April 2019

Carol Gould's article offers a powerful argument against the sufficiency of informed consent in an age of surveillance capitalism. In this review, I assess the three main claims that Gould makes in her article, namely that (1) democratic control is required by the all‐affected principle; (2) democratic control is a means of ensuring that surveillance corporations and governments track public, rather than merely private, interests; and (3) democratic control is constitutive of freedom as self‐development and self‐transformation.
Biogeographical history constrains climatic niche diversification without adaptive forces driving evolution
Authors: Coelho Marco Túlio P. , Rodrigues João Fabrício M. , Diniz‐Filho José Alexandre F. , Rangel Thiago F.
Published: April 2019

Aim

To evaluate the effect of biogeographical history on climatic niche diversification.

Location

Simulated clades evolving in South America.

Methods

We modelled species evolution under neutral community dynamics and purposely assumed that climatic niche is an emergent property of species. This assumption allows us to better understand whether phylogenetic niche conservatism could be observed when climatic niche is only constrained by biogeographical processes of dispersal and speciation. We varied speciation and dispersal probability, calculating phylogenetic signal of niche overlap and distance between niche centroids for each emergent artificial biota. We then compared the phylogenetic signal of our model with the expectation of climatic niche evolution under Brownian motion (BM).

Results

We found that phylogenetic signal of climatic niche in the spatially explicit neutral model is usually higher than expected by chance, but lower than expected by BM evolution. Because simulated climatic niches have lower phylogenetic signal than expected by BM evolution, standard ecological and evolutionary interpretation would suggest that climatic niche evolved with little variation over time caused by strong evolutionary constraints. However, our model assumes that climatic niche does not evolve by adaptive forces and is only a consequence of stochastic dispersal and speciation over space and time.

Main conclusions

Our study reinforces the strong imprints of biogeographical processes on climatic niche evolution, even when no adaptive forces are driving niche diversification. Therefore, although testing phylogenetic signal is the most common approach in studies evaluating phylogenetic patterns in climatic niche conservatism, our results reinforce previous claims that these patterns alone are not capable of distinguishing the possible effect of space in the retention of climatic niche. Biogeographical processes alone can leave imprints in patterns of climatic niche overlap between related species. A careful evaluation of macroevolutionary models underlying phylogenetic patterns of niche variation among species is important to avoid pitfalls related to interpretation of mechanisms of niche diversification.
Parallel Miocene dispersal events explain the cosmopolitan distribution of the Hypogymnioid lichens
Authors: Divakar Pradeep K. , Wei Xin‐Li , McCune Bruce , Cubas Paloma , Boluda Carlos G. , Leavitt Steven D. , Crespo Ana , Tchabanenko Svetlana , Lumbsch H. Thorsten
Published: April 2019

Aim

Contemporary species’ distributions are shaped by both geography and historical events, such as extinction, diversification in specific areas and long‐distance dispersals. In the most diverse family of lichen‐forming fungi, Parmeliaceae, the Hypogymnioid clade, is an example of an evolutionary lineage comprised of species occurring in temperate to subpolar regions in both hemispheres. Here, we elucidate the timing of diversification events and the impact of historical events on the species distribution in this lineage.

Location

Worldwide.

Taxon

Genera Arctoparmelia, Brodoa, Hypogymnia and Pseudevernia (Parmeliaceae).

Methods

Our sampling focused on the most diverse genus of the clade, Hypogymnia, including c. 70% of the described species. We reconstructed phylogenetic relationships using a multi‐locus data set, estimated divergence times, and inferred ancestral distributions.

Results

Our analyses suggest that the ancestor of the Hypogymnioid clade occurred in the Holarctic. In each of the four genera, all recovered as monophyletic here, diversification have occurred largely during the Miocene and Pliocene. A number of currently accepted species did not form monophyletic groups, especially in cases where specimens were collected from distinct geographic areas, with multiple, distinct clades corresponding to the geographic region of origin. Our results suggest that only a very few species in the Hypogymnioid clade have cosmopolitan distributions, all of which reproduces using vegetative propagules including both symbiotic partners.

Main conclusions

While the diversification occurred predominantly in the Northern Hemisphere during the Miocene, a long‐distance dispersal event from the Northern to the Southern Hemisphere, resulted in diversification of a clade of species largely restricted to the Southern Hemisphere. Similar to other groups in this diverse family, our study highlights the need for re‐evaluation of species boundaries among members of the Hypogymnioid clade.
Out of the Mediterranean? Post‐glacial colonization pathways varied among cold‐water coral species
Authors: Boavida Joana , Becheler Ronan , Choquet Marvin , Frank Norbert , Taviani Marco , Bourillet Jean‐François , Meistertzheim Anne‐Leila , Grehan Anthony , Savini Alessandra , Arnaud‐Haond Sophie
Published: April 2019

Aim

To infer cold‐water corals’ (CWC) post‐glacial phylogeography and assess the role of Mediterranean Sea glacial refugia as origins for the recolonization of the northeastern Atlantic Ocean.

Location

Northeastern Atlantic Ocean and Mediterranean Sea.

Taxon

Lophelia pertusa, Madrepora oculata.

Methods

We sampled CWC using remotely operated vehicles and one sediment core for coral and sediment dating. We characterized spatial genetic patterns (microsatellites and a nuclear gene fragment) using networks, clustering and measures of genetic differentiation.

Results

Inferences from microsatellite and sequence data were congruent, and showed a contrast between the two CWC species. Populations of L. pertusa present a dominant pioneer haplotype, local haplotype radiations and a majority of endemic variation in lower latitudes. Madrepora oculata populations are differentiated across the northeastern Atlantic and genetic lineages are poorly admixed even among neighbouring sites.

Conclusions

Our study shows contrasting post‐glacial colonization pathways for two key habitat‐forming species in the deep sea. The CWC L. pertusa has likely undertaken a long‐range (post‐glacial) recolonization of the northeastern Atlantic directly from refugia located along southern Europe (Mediterranean Sea or Gulf of Cadiz). In contrast, the stronger genetic differentiation of M. oculata populations mirrors the effects of long‐term isolation in multiple refugia. We suggest that the distinct and genetically divergent, refugial populations initiated the post‐glacial recolonization of the northeastern Atlantic margins, leading to a secondary contact in the northern range and reaching higher latitudes much later, in the late Holocene. This study highlights the need to disentangle the influences of present‐day dispersal and evolutionary processes on the distribution of genetic polymorphisms, to unravel the influence of past and future environmental changes on the connectivity of cosmopolitan deep‐sea ecosystems associated with CWC.
PI3‐kinase/Akt pathway‐regulated membrane transportation of acid‐sensing ion channel 1a/Calcium ion influx/endoplasmic reticulum stress activation on PDGF‐induced HSC Activation
Authors: Zuo Longquan , Zhu Yueqin , Hu Lili , Liu Yanyi , Wang Yinghong , Hu Yamin , Wang Huan , Pan Xuesheng , Li Kuayue , Du Na , Huang Yan
Published: April 2019

Acid‐sensing ion channel 1a (ASIC1a) allows Na+ and Ca2+ flow into cells. It is expressed during inflammation, in tumour and ischaemic tissue, in the central nervous system and non‐neuronal injury environments. Endoplasmic reticulum stress (ERS) is caused by the accumulation of misfolded proteins that interferes with intracellular calcium homoeostasis. Our recent reports showed ASIC1a and ERS are involved in liver fibrosis progression, particularly in hepatic stellate cell (HSC) activation. In this study, we investigated the roles of ASIC1a and ERS in activated HSC. We found that ASIC1a and ERS‐related proteins were up‐regulated in carbon tetrachloride (CCl4)‐induced fibrotic mouse liver tissues, and in patient liver tissues with hepatocellular carcinoma with severe liver fibrosis. The results show silencing ASIC1a reduced the expression of ERS‐related biomarkers GRP78, Caspase12 and IREI‐XBP1. And, ERS inhibition by 4‐PBA down‐regulated the high expression of ASIC1a induced by PDGF, suggesting an interactive relationship. In PDGF‐induced HSCs, ASIC1a was activated and migrated to the cell membrane, leading to extracellular calcium influx and ERS, which was mediated by PI3K/AKT pathway. Our work shows PDGF‐activated ASIC1a via the PI3K/AKT pathway, induced ERS and promoted liver fibrosis progression.
The impact of mentor–mentee rapport on nurses’ professional turnover intention: Perspectives of social capital theory and social cognitive career theory
Authors: Pham Thi Tuan Linh , Teng Ching‐I , Friesner Daniel , Li Kai , Wu Wan‐Er , Liao Yen‐Ni , Chang Yin‐Tzu , Chu Tsung‐Lan
Published: April 2019

Aims and objectives

This study examines the impacts of mentor–mentee rapport on willingness to mentor/be mentored, self‐efficacy, outcome expectations, career interest and subsequently on nurses’ professional turnover intention.

Background

Workplace relationships, whether positive or negative, influence nurse turnover within an organisation. Yet little is known about the effects of mentoring on nurses’ intentions to leave the nursing profession.

Design

A cross‐sectional, survey‐based research design was used to collect data from a large medical centre in Northern Taiwan.

Methods

Study concepts were measured using scales from social capital theory (SCT), social cognitive career theory (SCCT) and the nursing literature. Partial least square structural equation modelling was used to test all study hypotheses. The STROBE statement was chosen as the EQUATOR checklist.

Results

For mentors, rapport was positively related to willingness to mentor, which was positively related to outcome expectations, and further, positively related to career interest and negatively related to professional turnover intention. For mentees, rapport was positively related to willingness to be mentored, which was positively related to self‐efficacy, outcome expectations and ultimately to career interest. Career interest was negatively related to professional turnover intentions.

Conclusions

Rapport between mentors and mentees may be an important means to retain nurses in the profession.

Relevance to clinical practice

Managers should consider taking steps to enhance rapport between mentors and mentees. In doing so, managers improve nurse retention, a critical component of providing high‐quality patient care.
Validation of a Chinese version critical‐care pain observation tool in nonintubated and intubated critically ill patients: Two cross‐sectional studies
Authors: Chen Jie , Hu Fen , Yang Jian , Wu Xiao‐Ying , Feng Yi , Zhan Yan‐Chun , An You‐Zhong , Lu Qian , Zhang Hai‐Yan
Published: April 2019

Aims and objectives

To validate the Chinese version of the Critical‐Care Pain Observation Tool (CPOT) in nonintubated and intubated ICU patients.

Background

While CPOT was found to have the best psychometric properties among objective pain assessment scales, there is no Chinese version CPOT for nonintubated patients.

Design

Cross‐sectional design was used in these two observational studies.

Methods

Seventy‐six nonintubated patients and 53 intubated patients were assessed to examine internal consistency, criterion‐related and discriminative validity of CPOT in the first study. Pain assessment during low pain condition as well as increased pain condition was performed by Numeric Rating Scale (NRS) and the Chinese version COPT. Forty nonintubated patients and 43 intubated patients were assessed to examine inter‐rater reliability in the second study. A bedside nurse and a researcher independently executed paired pain assessments with CPOT in the same conditions. The STROBE Statement was followed to guide these studies.

Results

The Cronbach's α in nonintubated patients and intubated patients was 0.903–0.930 and 0.868–0.870. The intraclass correlation coefficients (ICCs) in nonintubated patients ranged from 0.959–0.982, and the ICC in intubated patients ranged from 0.947–0.959, confirming the inter‐rater reliability. The moderately positive Pearson's correlations between CPOT and NRS scores (r = 0.757–0.838 in nonintubated patients, r = 0.574–0.705 in intubated patients) indicated the criterion‐related validity. A significant increase in CPOT scores in the increased pain condition compared with those acquired in the low pain condition verified the discriminative validity.

Conclusions

The Chinese version of CPOT was presented to be valid and reliable for both nonintubated and intubated critically ill adults, which could be applicable for pain assessment in patients in ICU.

Relevance to clinical practice

This study provides an applicable pain assessment tool for both nonintubated patients and intubated patients in ICU.
The impact of congenital heart disease on the psychological well‐being and quality of life of Hong Kong Chinese adolescents: A cross‐sectional study
Authors: So Serana Chun Yee , Li William Ho Cheung , Ho Ka Yan
Published: April 2019

Aims and objectives

To examine the psychological well‐being and quality of life of Hong Kong Chinese adolescents with congenital heart disease.

Background

Congenital heart disease (CHD) in adolescents is associated with having negative psychological impact and impairment to quality of life. A literature review revealed that most studies on the impact of CHD on the psychological well‐being and quality of life of adolescents to date have been conducted in Western populations.

Method

A cross‐sectional design was employed. Adolescents aged 12–18 with CHD attending an outpatient clinic in an acute public hospital were invited to participate. Another similar age group of healthy Chinese adolescents was also invited to participate for comparison purposes. Subjects were asked to respond to the Chinese version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales, Center for Epidemiologic Studies Depression Scale for Children, Rosenberg Self‐Esteem Scale and a demographic sheet. A STROBE checklist was completed.

Results

Adolescents with CHD exhibited more depressive symptoms, lower self‐esteem and poorer quality of life than their healthy counterparts. Disease severity might affect the self‐esteem, depressive symptoms and quality of life of adolescents with CHD. Disease severity, depressive symptoms, self‐esteem level and types of treatment received were associated with the quality of life of adolescents with CHD.

Conclusions

Hong Kong Chinese adolescents suffering from CHD experience negative impacts on their psychological well‐being and quality of life. In this group, disease severity may affect psychological well‐being and quality of life. Specifically, quality of life of adolescents with CHD was associated with disease severity, depressive symptoms, self‐esteem level and the type of treatment received.

Relevance to clinical practice

The findings contribute to clinical care guidelines and serve as a reference in developing nursing intervention to adolescents with CHD so as to uphold quality of care. Clinical trial registration: NCT03255850 (Clinical trial.gov).
Implementing mandatory early warning scoring impacts nurses’ practice of documenting free text notes
Authors: Bunkenborg Gitte , Smith‐Hansen Lars , Poulsen Ingrid
Published: April 2019

Aims and objectives

To evaluate whether implementing the Modified Early Warning Scoring system impacts nurses’ free text notes related to Airway, Breathing, Circulation and Pain in general ward medical and surgical patients.

Background

The quality of nursing documentation in patient health records is important to secure patient safety, but faces multiple challenges whether being paper‐based or electronic. Nurses’ ability to draw a complete picture of the patient situation is thereby compromised. Structured use of the Modified Early Warning Score, found to reduce unexpected death, might affect nurses’ free text documentation of clinical observations.

Design

A prospective, pre‐ and postinterventional, nonrandomised study adhering to the EQUATOR guideline TREND.

Methods

Data on nurses’ free text notes were obtained in 1,497 patient records during one preinterventional (March–June 2009) and two postinterventional study periods (September–December 2010 and March–June 2011) in a Danish university hospital. Data were organised by the Airway, Breathing and Circulation principles and by nurses’ working shifts in the 56 hr surrounding the first recording of deviating vital parameters or a Modified Early Warning Score ≥ 2. Preinterventional free text notes were compared with notes from the two postinterventional periods, respectively.

Results

In the 8‐hr working shift where deviations in vital parameters were recorded for the first time, nurses’ free text notes related to patients’ breathing (B) increased significantly, comparing 2009 with 2010 and 2011, respectively. In the 24 hr following initial deviations in vital parameters, a significant increase in free text notes was identified concerning Airway, Breathing and Circulation‐related symptoms or problems.

Conclusion

Mandatory use of the Modified Early Warning Score and related implementation activities significantly impacts nursing documentation of free text notes.

Relevance to clinical practice

Nurses’ practice of communicating observed clinical symptoms by documenting free text notes should be supported through measures to enhance situation awareness.
How to use visual methods to promote health among adolescents: A qualitative study of school nursing
Authors: Laholt Hilde , Guillemin Marilys , McLeod Kim , Beddari Ellinor , Lorem Geir
Published: April 2019

Aims and objectives

Public health nurses attended a 3‐day course to learn the use of visual methods in health dialogue with adolescents. The aim of this study was to explore how to use visual methods to promote health among adolescents in a school nursing context.

Background

Photovoice is a visualising technique that enables adolescents to participate in health promotion projects in a school setting. Photovoice also enhances work of public health nurses and other health professionals.

Design

This was a qualitative action research study. We developed and conducted a course in visual methods and used data from focus group discussions in combination with participant observations involving public health nurses working in school health services.

Methods

We conducted focus group interviews (n = 40) using separate semi‐structured discussion guides before and after a course in visual methods. The interviews were audio recorded and transcribed verbatim, and we documented the workshops (n = 8) through field notes. We collected the data from January–October 2016. Data were analysed and coded into themes and subthemes using systematic text condensation. We reported the study in accordance with the COREQ checklist.

Findings

Public health nurses found photovoice useful in school nursing. The use of images offered pupils an active role in dialogues and more control in defining the topics and presenting their stories. When nurses allowed adolescents to bring images into conversations, they discovered new insights into public health promotion. The public health nurses pointed out the benefits and challenges of using new methods in practice.

Conclusion

Public health nurses considered photovoice to be useful in health promotion and other public health issues. Involving pupils in bringing images to conversations offered them an active role and voice in health promotion.

Relevance to clinical practice

We recommend the use of photovoice and visual technologies (e.g., smartphones) in health promotion activities for adolescents.
'Hands‐off/poised' or 'Hands‐on' method among Chinese midwives: A cross‐sectional survey
Authors: Zhou Xuan , Ma Dong‐Mei , Wang Fang , Tian Yanping , Xu Xinfen
Published: April 2019

Aims and objectives

To determine midwives' preference for “Hands‐on” and “Hands‐off/poised” methods and to explore the impact factors.

Background

With the increasing rate of obstetric anal sphincter injuries, great controversy surrounds the “Hands‐on” or “Hands‐off” method during childbirth to decrease obstetric anal sphincter injuries incidence. Without regular records and related research, determining the use of this technique in China is difficult.

Design

This study used a quantitative study design, following the EQUATOR guidelines (STROBE).

Methods

A nationwide cross‐sectional online survey was conducted using respondent‐driven sampling across 31 provinces in China from 1st October 2017–31st December 2017. A total of 6,425 midwives were involved. Descriptive analyses, chi‐square test and binary logistic regression were undertaken.

Results

A total of 5,225 questionnaires were returned; 55.8% of the participants preferred the “Hands‐off/poised” method. The impact factors included hospital categories, total work experience in a birth unit in years, theoretical education and skill training. In the study, for situations with increased OASI risk, 100% of the midwives in the “Hands‐off” group expressed willingness to change to the “Hands‐on” method whether there was concern about impending obstetric anal sphincter injuries.

Conclusion

The “Hands‐off/poised” method is heavily practised by Chinese midwives. However, majority of the midwives adopt “Hands‐on” method in the face of high risk for obstetric anal sphincter injuries. Further studies are needed to determine the association between obstetric anal sphincter injuries rate and perineal management for low‐risk birth.

Relevance to clinical practice

The result indirectly illustrates the application of “Hands‐off/poised” technique in China and provides evidence for the international midwifery organisation to understand the status of Chinese midwifery to some extent. It also provides the latest data for further study of these two methods and the study of the relationship between hands‐off/poised method and obstetric anal sphincter injuries.
Relationships between illness representations, physical activity and depression in chronic kidney disease
Authors: Nah Ryan , Robertson Noelle , Niyi‐Odumosu Faatihah A. , Clarke Amy L. , Bishop Nicolette C. , Smith Alice C.
Published: April 2019

Background

Chronic Kidney Disease (CKD) is exacerbated by depression and confers significant healthcare costs. Whilst adverse impacts may be mitigated by physical activity, many patients with CKD remain physically inactive, with this physical inactivity potentially influenced by how CKD is appraised.

Objectives

The study aims to explore the relationship between physical activity, depression and illness representations in CKD.

Methods

Patients with CKD but not requiring dialysis completed the Revised Illness Perception Questionnaire (IPQ‐R), Beck Depression Inventory (BDI‐II) and Short‐Form International Physical Activity Questionnaire (IPAQ‐SF). Demographic information was obtained via medical records. Correlation and regression analyses were conducted to determine the relationship of illness representations with levels of physical activity. Moderation and mediation analyses were performed to investigate the role of depression in any relationship between illness representations and physical activity levels.

Results

Seventy respondents, 60 % male, with a mean age of 60 ± 16 years, took part in the study. Of illness representation dimensions, personal control was positively associated with levels of physical activity whilst timeline cyclical (a subscale of the IPQ‐R relating to patient beliefs about the nature of their illness) was a significant predictor. Severity of depression was neither a moderator nor a mediator of illness representations and levels of physical activity.

Conclusion

Facets of illness representations had significant relationships with levels of physical activity. Future research concerning the development and validation of psychological interventions based on an illness representations framework for patients with CKD not requiring dialysis is proposed. The efficacy of such interventions could be then evaluated using a randomised controlled method.
Patients’ perceptions of their experience, control and knowledge of fluid management when receiving haemodialysis
Authors: Glyde Megan , Keane David , Dye Louise , Sutherland Ed
Published: April 2019

Background

Person‐centred care is increasingly promoted, empowering patients to become more involved in their treatment rather than being passive recipients of care (Barnes et al. 2013). Haemodialysis is typically required three times a week, with fluid management decision‐making occurring at each treatment session (Ahmed et al. 2017). However, no research has yet explored how haemodialysis patients’ perceptions of their fluid management may impact upon this decision‐making.

Objectives

This study sought to explore patients’ perceptions of their fluid management.

Method: Design, Participants & Approach

Semi‐structured interviews were conducted with 12 patients undergoing in‐hospital haemodialysis treatment. These were digitally recorded one‐to‐one interviews to allow for verbatim transcription. The data was analysed by thematic analysis, generating thematic patterns across patients’ experiences, control and knowledge of their fluid management.

Results

Five themes were produced: determining who has the expertise, impediments affecting patients’ lifestyle, additional difficulty of experiencing comorbidities, perceived quality of care, and establishing consistency.

Conclusions

Despite varied levels of patient participation in their treatment, overall there appears to be a limited understanding of specific areas of fluid management. The implications for further research and the development of shared‐care are discussed.
Association of Teacher‐Level Factors With Implementation of Classroom‐Based Physical Activity Breaks
Authors: Abi Nader Patrick , Hilberg Evan , Schuna John M. , John Deborah H. , Gunter Katherine B.
Published: April 2019

BACKGROUND

Classroom‐based physical activity (CBPA) breaks are a common strategy to increase elementary school children's physical activity (PA) levels. There is limited research examining how teacher‐level factors impact teacher implementation of CBPA breaks. In this study, we assessed the relationship of teacher‐level factors with teacher use of a CBPA resource.

METHODS

We randomized 6 elementary schools in rural Oregon into control (N = 3) or intervention (N = 3) conditions. Each teacher at intervention schools received the CBPA resource. Teachers at control schools received 1 CBPA‐Toolkit per grade level to share, and received no training. We surveyed teachers on their use of the toolkit, implementation support and self‐efficacy, and value for PA. Logistic regression was used to examine the odds of toolkit use by teacher‐level factors.

RESULTS

Among survey respondents (N = 83), 57% were self‐identified toolkit users and 48% attended a training. Training participation and teacher implementation self‐efficacy were associated with greater odds of using the toolkit (odds ratio, OR = 7.76 [95% confidence interval, CI = 1.39‐43.19] and OR = 5.54 [95% CI = 1.24‐23.87], respectively).

CONCLUSION

CBPA tools supported with training aimed at developing teachers' implementation self‐efficacy increased the likelihood of teachers employing CBPA tools.
MT1 and MT2 melatonin receptors are expressed in nonoverlapping neuronal populations
Authors: Klosen Paul , Lapmanee Sarawut , Schuster Carole , Guardiola Beatrice , Hicks David , Pevet Paul , Felder‐Schmittbuhl Marie Paule
Published: April 2019

Melatonin (MLT) exerts its physiological effects principally through two high‐affinity membrane receptors MT1 and MT2. Understanding the exact mechanism of MLT action necessitates the use of highly selective agonists/antagonists to stimulate/inhibit a given MLT receptor. The respective distribution of MT1 and MT2 within the CNS and elsewhere is controversial, and here we used a “knock‐in” strategy replacing MT1 or MT2 coding sequences with a LacZ reporter. The data show striking differences in the distribution of MT1 and MT2 receptors in the mouse brain: whereas the MT1 subtype was expressed in very few structures (notably including the suprachiasmatic nucleus and pars tuberalis), MT2 subtype receptors were identified within numerous brain regions including the olfactory bulb, forebrain, hippocampus, amygdala and superior colliculus. Co‐expression of the two subtypes was observed in very few structures, and even within these areas they were rarely present in the same individual cell. In conclusion, the expression and distribution of MT2 receptors are much more widespread than previously thought, and there is virtually no correspondence between MT1 and MT2 cellular expression. The precise phenotyping of cells/neurons containing MT1 or MT2 receptor subtypes opens new perspectives for the characterization of links between MLT brain targets, MLT actions and specific MLT receptor subtypes.
Identification of oxidative stress–related Xdh gene as a di(2‐ethylhexyl)phthalate (DEHP) target and the use of melatonin to alleviate the DEHP‐induced impairments in newborn mouse ovaries
Authors: Liu Jing‐Cai , Li Lan , Yan Hong‐Chen , Zhang Teng , Zhang Pan , Sun Zhong‐Yi , De Felici Massimo , Reiter Russel J. , Shen Wei
Published: April 2019

This study, using an in vitro ovary culture model, investigates the mechanisms through which di(2‐ethylhexyl)phthalate (DEHP) impairs germ cell cyst breakdown and primordial follicle assembly. The results indicate the latter effects exerted by 10 or 100 µmol/L DEHP in cultured newborn ovaries were associated with increased levels of reactive oxygen species (ROS) and apoptosis. Based on a transcriptome analysis, we found the expression of the oxidative stress–related gene Xdh (xanthine dehydrogenase) was significantly upregulated in DEHP‐cultured ovaries. Two treatments, namely Xdh RNAi or the addition of melatonin to the ovary culture, inhibited the increase in Xdh expression and ROS levels caused by DEHP and, at the same time, reduced apoptosis and the impairment of primordial follicle assembly in the treated ovaries. Together, the results identify Xdh gene as one of the major targets of DEHP in newborn ovaries and that the consequent increased level of ROS is possibly responsible for the increment of apoptosis and primordial follicle assembly impairment. At the same time, they highlight that melatonin alleviates the effects of DEHP as with other endocrine‐disrupting compounds on the ovary.
The Gender Gap in Early Career Wage Growth: The Role of Children, Job Mobility, and Occupational Mobility
Authors: Reshid Abdulaziz Abrar
Published: April 2019

During the first 10 years in the Swedish labor market, male university graduates experience a faster wage growth than females. We investigate the role job and upward occupational mobility have for the creation of gender difference in early career wage growth; and the role of motherhood as an underlying mechanism. We find that although men and women change jobs and occupations at the same rate, women receive a significantly lower wage returns to mobility than men. We find evidence that women's lower return to occupational mobility is largely explained by motherhood, while the evidence for job mobility is rather weak.
New Evidence on Why Many African Firms Perform Poorly
Authors: Faruq Hasan A.
Published: April 2019

This study examines a potential explanation for the poor performance of many African countries: African firms generally produce low value‐added and less ‘complex’ products due to a weak legal system and widespread corruption. Using data on manufacturing firms from Kenya, Ghana and Tanzania, this study finds that: (i) corruption and weak legal system are associated with lower efficiency among firms that produce more complex products and (ii) corruption matters more for firm efficiency than legal system. These results remain unchanged under various scenarios and may have important policy implications.
Association between watching TV whilst eating and children's consumption of ultraprocessed foods in United Kingdom
Authors: Martines Renata Mariana , Machado Priscila Pereira , Neri Daniela Almeida , Levy Renata Bertazzi , Rauber Fernanda
Published: April 2019

This study aimed to assess the association between watching TV whilst eating and consumption of ultraprocessed foods amongst children aged 4–10 years old in the United Kingdom. Cross‐sectional data from the UK National Diet and Nutrition Survey (NDNS 2008–2012) were analysed. Dietary data were derived from 4‐day food diaries of 1,277 children, and the dietary contribution of ultraprocessed foods was assessed. Meals were classified based on time of day in which foods were consumed (lunch: 11 pm–3 pm and dinner: 6 pm–9 pm). Crude and adjusted linear regression models were employed to verify the effect of watching TV during meals on dietary contribution of ultraprocessed foods (% of total energy intake). More than 70% of the children watched TV during meals, and 31.4% presented the behaviour on both “lunch and dinner.” Children's mean total energy intake was 1,532.3 kcal/day, of which 65.8% came from ultraprocessed foods. Findings indicated that children who watched TV whilst having both meals (lunch and dinner) consumed on average 85.5 kcal/day and 6.1% more energy from ultraprocessed foods than those who did not. Children who watched TV only during dinner consumed on average 37.1 kcal/day and 3.4% more energy from ultraprocessed foods than those who did not. The behaviour of watching TV whilst eating meals was associated with higher total daily consumption of ultraprocessed foods by children in the United Kingdom. Therefore, interventions designed to promote healthy eating habits should include aspects related to the context of meals.