bluuebunny/crossref_metadata_2025 huggingface dataset:
Erysiphe australiana: the cause of powdery mildew onLagerstroemia speciosain Brazil
Authors: Fonseca N. R. , Guimarães L. M. S. , Pires R. P. , Alfenas A. C.
Published: June 2016

Powdery mildew symptoms and signs were observed on seedlings ofLagerstroemia speciosawithin an ornamental plant nursery in Viçosa, State of Minas Gerais, Brazil. Signs were most prominent as intense mycelial growth and sporulation on the shoots, new branches and leaves, which led to tissue necrosis. Based on morphological characteristics and phylogenetic analyses of ITS and 28S rDNA sequences, the powdery mildew pathogen ofL. speciosawas identified asErysiphe australiana, a well‐known powdery mildew pathogen infectingLagerstroemiaspp. worldwide. To our knowledge, this is the first report ofE. australianacausing powdery mildew onL. speciosain Brazil.
The couch grass rhizome with Heterobasidion annosum fruiting bodies in afforested post‐agricultural land
Authors: Sierota Z. , Damszel M. , Borys M. , Nowakowska J. A.
Published: June 2016

The pathogenic fungus Heterobasidion annosum was identified in the rhizome of a couch grass (Elymus repens) using genetic markers. The couch grass grew in the proximity of a Scots pine stand that was visibly affected by the pathogen. The rDNA analysis showed 100% sequence similarity between two H. annosum sequences of ITS1 and ITS2 obtained from fruiting bodies found on the couch grass rhizome and on the stem of the Scots pine. These results indicate a close relationship between the two isolates of H. annosum and that they are derived from a common ancestor. The results show that H. annosum mycelia can infect couch grass rhizomes and subsequently produce fruiting bodies. It also suggests that the known modes of infection of tree roots by this pathogen in coniferous stands should take into account couch grass rhizomes in the dispersal of the disease in afforested post‐agricultural soils.
Phytophthora species isolated from ash stands in Białowieża Forest nature reserve
Authors: Tkaczyk M. , Nowakowska J. A. , Oszako T.
Published: June 2016

Five Phytophthora species were isolated from the rhizosphere of ash‐dominated areas of the Białowieza European lowland forest nature reserve area. Morphological and DNA analyses identified Phytophthora fragariaefolia, P. plurivora, P. cactorum, P. lacustris and P. pseudosyringae. This is the first record of P. fragariaefolia in ash forests and demonstrates that several species in the potentially highly damaging Phytophthora genus are present within a near‐pristine ecosystem.
Extraction of maxillary teeth by dental students without palatal infiltration of local anaesthesia: a randomised controlled trial
Authors: Khan S. R. , Qazi S. R.
Published: June 2016

Objective

Palatal infiltration of local anaesthesia (LA) for maxillary tooth extractions is painful. One of the techniques for reducing the discomfort of this injection is to avoid it altogether. Given enough time, LA administered only as buccal infiltration diffuses to reach and anaesthetise the palatal tissues. The aim of this double‐blind randomised controlled trial was to test the hypothesis that buccal infiltration alone of LA by dental students should be adequate for maxillary tooth extractions.

Patients and methods

Fifty adult patients presenting for single‐tooth maxillary extractions were randomly allocated between two groups. The control group received palatal injections of 0.1 ml 2% lidocaine with 1:100,000 adrenaline, whilst the experimental group received a similar amount of saline (placebo). Extractions performed without further administration of LA were categorised as successful.

Results

Palatal infiltration of lidocaine with adrenaline was significantly more effective than saline (P = 0.002). Overall buccal infiltration alone was successful in 28% patients, with a 40% success rate in the posterior maxilla.

Conclusion

Results suggest that dental students should, as a matter of routine, extract maxillary teeth with both buccal and palatal infiltration of LA, whilst buccal infiltration alone may be considered in the posterior maxilla.
Circadian genes and lithium response in bipolar disorders: associations with PPARGC1A (PGC‐1α) and RORA
Authors: Geoffroy P. A. , Etain B. , Lajnef M. , Zerdazi E‐H. , Brichant‐Petitjean C. , Heilbronner U. , Hou L. , Degenhardt F. , Rietschel M. , McMahon F. J. , Schulze T. G. , Jamain S. , Marie‐Claire C. , Bellivier F.
Published: June 2016

Preliminary studies suggest that lithium (Li) response might be associated with some circadian gene polymorphisms, we therefore performed a pharmacogenetic study on the core clock genes in two independent samples suffering from bipolar disorder (BD) and thoroughly characterized for their Li response. Two independent Caucasian samples (165 and 58 bipolar patients) treated with Li were selected from samples recruited in a French multicenter study and assessed for their Li response using the Alda scale. The two samples were genotyped using the Human660 (H660) and OmniExpress (OE) BeadChips and gene‐based association analyses of 22 core clock genes were conducted. In the first sample (H660 chip), the RAR‐related orphan receptor‐a gene (RORA) and the Peroxisome Proliferator‐Activated Receptor Gamma, Coactivator 1 Alpha gene (PPARGC1A or PGC‐1α) were significantly associated with the Li response (empirical P‐value = 0.0015 and 0.04, respectively), and remained significant only for RORA after Bonferroni correction. In the second sample (OE chip), PPARGC1A was significantly associated with the Li response (empirical P‐value = 0.04), and did not remain significant after Bonferroni correction. PPARGC1A is a master regulator of mitochondrial function and a key component of the endogenous clock that stimulates the expression of Bmal1 and Rev‐erb‐alpha through coactivation of RORA. Although the observed associations deserve further replication and investigation, our results suggest genetic associations between Li response and these two close biological partners: PPARGC1A and RORA involved in circadian rhythms and bioenergetics processes in Li response.
Bi‐objective Model for Optimal Number and Size of Circular Facilities
Authors: Miyagawa Masashi
Published: June 2016

This article presents a bi‐objective model for determining the number and size of finite size facilities. The objectives are to minimize both the average closest distance to facilities and the probability that a random line intersects facilities. The former represents the accessibility of customers, whereas the latter represents the interference to travelers. The average closest distance and the probability of intersecting facilities are derived for circular facilities randomly distributed in a circular city. The analytical expressions for the average closest distance and the probability of intersecting facilities demonstrate how the number and size of facilities affect the accessibility of customers and the interference to travelers. The model focuses on the tradeoff between the accessibility and interference, and the tradeoff curve provides planners with alternatives for the number and size of facilities.
Citrate vs. acetate dialysate on intradialytic heparin dose: A double blind randomized crossover study
Authors: Leung Kelvin C. W. , Tai Davina J. , Ravani Pietro , Quinn Rob R. , Scott‐Douglas Nairne , MacRae Jennifer M.
Published: June 2016

Introduction Citrate containing dialysate has a calcium‐binding anticoagulant effect compared to standard acetic acid containing dialysate. We performed a randomized, double‐blind, crossover trial in maintenance HD patients to determine if citrate dialysate (“citrate”) safely allows for a lower cumulative heparin dose (“heparin dose”).

Methods Intradialytic heparin was adjusted to the minimum during a 2‐week run‐in phase. Patients remaining on heparin at the end of the run‐in phase were then randomized to two weeks of HD with acetate dialysate (“acetate”) followed by two weeks of citrate (sequence 1) or two weeks of citrate followed by two weeks of acetate (sequence 2). We estimated a minimum of 14 patients are required to show a 30% reduction in heparin dose per HD session with citrate compared with acetate. Twenty‐five patients entered the run‐in phase, 20 were randomized, and 19 completed the study.

Findings The mean heparin dose was reduced by 19% (656 units, 95% CI −174 to −1139 units, P = 0.011) in the acetate group, and 30% (1046 units 95% CI −498 to 1594 units, P < 0.001) in the citrate group. There was no difference in the mean heparin dose reduction between the two dialysates (P > 0.05). The intradialytic ionized calcium in the citrate group was lowered by 0.10 mmol/L (95% CI 0.07 to 0.14 mmol/L, P < 0.001), and remained unchanged in the acetate group.

Discussion Although citrate is a safe alternative to acetate, it does not result in additional heparin dose reduction.
Moral Parochialism and the Limits of Impartiality
Authors: Thunder David
Published: June 2016

One of the central problems of contemporary political and moral thought is how to reconcile the cultural and social roots of morality with its objectivity or rational warrant, whether in the personal or political sphere. David Golemboski's reconstruction of Adam Smith's impartial spectator (European Journal of Political Theory, onlinefirst February 23rd 2015) provides a useful first approximation to this problem. What interests me is not whether Golemboski's critique of Smith's impartial spectator hits the mark, but rather, to what extent Golemboski's reconstruction of Smith's impartial spectator succeeds at addressing the problem of moral parochialism, as Golemboski claims. I shall argue in what follows that upon examination, Golemboski's reconstructed impartial spectator, far from resolving the problem of moral parochialism, actually exposes the limits of the value of impartiality as a resource for overcoming parochial prejudice, and the necessity of framing the problem of parochialism less as a matter of social and cultural bias than as a matter of the conditions of possibility of sound moral judgment.
Precisely Controlling Preparation of Ceria‐Stabilized Zirconia Microspheres of ~100 μm by External Gelation
Authors: Guogao Wang , Jingtao Ma , Yong Gao , Xingyu Zhao , Shaochang Hao , Changsheng Deng
Published: June 2016

Ceria‐stabilized zirconia (CSZ) microspheres of ~100 μm were prepared by external gelation process. The inner diameter of nozzle was 0.2 mm. The key process parameters including broth pH value, Zr concentration, flow rate, and vibration frequency were optimized for precise control of the diameter. The optimum parameters were found to be flow rate of 11.08 mL/min, Zr concentration of 0.72 mol/L, and vibration frequency of 2650 Hz. CSZ microspheres with an average diameter of 103.1 μm and standard deviation of 4.4 were prepared under these conditions. CSZ microspheres showed good monodispersity, good sphericity, and high density.
Inter‐country wage differences in the European Union
Authors: PEREIRA João , GALEGO Aurora
Published: June 2016

This article investigates the determinants of wage gaps between European Union countries along the wage distribution, applying the methodology proposed by Firpo, Fortin and Lemieux (2009) and Fortin, Lemieux and Firpo (2011). The authors conclude that both wage structure and composition effects contribute to explaining wage differentials, but that the wage structure effect is more important. This latter effect would appear to derive from differences between unknown factors, while the composition effect can largely be explained by differences in the following areas: education, proportion of workers with supervisory responsibilities, occupational structure, and, to a lesser extent, industrial structure.
A Comparison of Two Methods for Recruiting Children with an Intellectual Disability
Authors: Adams Dawn , Handley Louise , Heald Mary , Simkiss Doug , Jones Alison , Walls Emily , Oliver Chris
Published: June 2016

Background

Recruitment is a widely cited barrier of representative intellectual disability research, yet it is rarely studied. This study aims to document the rates of recruiting children with intellectual disabilities using two methods and discuss the impact of such methods on sample characteristics.

Methods

Questionnaire completion rates are compared between (i) participants being approached in child development centre waiting rooms and (ii), one year later, the same participants being invited to take part by phone, email and/or post.

Results

The face‐to‐face recruitment method resulted in a better recruitment rate (58.5% compared to 18.5%) and a larger sample (n = 438) than the telephone/email/post sample (n = 40). It also required less hours of researcher time per completed questionnaire.

Conclusions

In‐line with previous research, recruitment of participants with intellectual disabilities (or their parents/carers) requires significant time and resources to get a sample of an acceptable size.
Characterization, Mapping, and Ablation of Complex Atrial Tachycardia: Initial Experience With a Novel Method of Ultra High‐Density 3D Mapping
Authors: SCHAEFFER BENJAMIN , HOFFMANN BORIS A. , MEYER CHRISTIAN , AKBULAK RUKEN Ö. , MOSER JULIA , JULARIC MARIO , EICKHOLT CHRISTIAN , NÜHRICH JANA M. , KUKLIK PAWEL , WILLEMS STEPHAN
Published: June 2016

Ultra High‐Density Mapping of Complex AT

Introduction

Conventional mapping of complex atrial tachycardias (ATs) can be challenging. Thus, we evaluated feasibility and utility of a novel, ultra high‐density 3D mapping approach to characterize and map AT in these cases.

Methods and Results

Overall, 21 patients (67.4 ± 7.6 years; male: 52.4%, 1.9 ± 1.4 previous ablation procedures) with documented AT referred to our center underwent catheter ablation including ultra high‐density mapping using a novel 64‐electrode mini‐basket catheter and an adjunctive 3D mapping system. A total of 24 AT (20 left atrial, 4 right atrial AT) were analyzed in 19 cases. In 2 patients, map acquisition failed due to scarce local electrograms and unstable AT cycle length, respectively. Underlying mechanisms were focal (n = 3), as well as local (n = 8) and macro (n = 13) reentry tachycardias with a mean cycle length of 311.8 ± 67.7 milliseconds. The analysis of propagation waves, activation and voltage revealed complex activation patterns and allowed for the identification of critical sites of AT initiation or maintenance without the need for further mapping techniques. In all cases critical sites could be verified by successful consecutive ablation. Mean mapping time was 19.4 ± 7.6 minutes, mean number of mapping points was 19,217 ± 10,270. Radiofrequency application until first effect was 165.1 ± 374.2 seconds; total procedure time was 157.6 ± 51.4 minutes, fluoroscopy time 21.7 ± 13.8 minutes, and total radiofrequency duration 1,016 ± 951.9 seconds, respectively. No severe complications occurred.

Conclusion

Ultra high‐density mapping of complex AT is safe and feasible. Further, it enables detailed insight into AT mechanisms. Critical AT sites can be identified precisely in order to guide successful catheter ablation.
Feelings of stigmatization in patients with rosacea
Authors: Halioua B. , Cribier B. , Frey M. , Tan J.
Published: June 2016

Background

Rosacea is a chronic facial disease that may lead to feelings of stigmatization, which can negatively impact psychological and social well‐being.

Objective

The aim of this study was to evaluate different aspects of rosacea that could contribute to feelings of stigmatization.

Methods

An online survey of a representative sample of the adult population in the UK, France, Germany and US was conducted to identify patients with rosacea based on presence of three or more clinical features.

Results

Among the patients who completed the survey (n = 807), mean age at first sign/symptom of rosacea was 31.3 ± 14.5 years; mean duration of disease was 102 ± 119 months. One‐third of patients reported feelings of stigmatization (FS; n = 275). Male patients were more likely to experience FS (49% vs. 37.2% in non‐FS population; P = 0.0037). Those with FS were more likely to avoid social situations (54.2% vs. 2.0%, P < 1.00E‐10) and had a higher rate of depression (36.7% vs. 21.1%, P < 1.00E‐10).

Conclusions

Stigmatization is important in the daily lives of those with rosacea and should be taken into consideration in the management of these patients.
Epidemiology of cutaneous sarcoidosis, 1976–2013: a population‐based study from Olmsted County, Minnesota
Authors: Ungprasert P. , Wetter D.A. , Crowson C.S. , Matteson E.L.
Published: June 2016

Background

The epidemiology of cutaneous sarcoidosis is not well‐characterized as only referral‐based studies are available.

Objectives

To characterize the epidemiology of cutaneous sarcoidosis, with emphasis on annual incidence and clinical characteristics, from 1976 to 2013.

Methods

Inception cohorts of patients with incident isolated cutaneous sarcoidosis and incident systemic sarcoidosis with cutaneous involvement in 1976–2013 in Olmsted County, Minnesota, United States were identified based on comprehensive individual medical record review. Inclusion in the isolated cutaneous sarcoidosis cohort required physician diagnosis and skin biopsy showing non‐necrotizing granuloma. Inclusion in the systemic sarcoidosis with cutaneous involvement cohort required presence of systemic sarcoidosis and cutaneous lesions. Presence of systemic sarcoidosis was determined by physician diagnosis supported by histopathology of non‐necrotizing granuloma, characteristic radiologic features of intrathoracic sarcoidosis and exclusion of other granulomatous diseases. Cutaneous lesions were defined as either sarcoidosis‐specific or non‐specific.

Results

There were 62 cases with sarcoidosis‐specific cutaneous lesions (36 cases of sarcoidosis‐specific cutaneous lesions and 26 cases of isolated cutaneous sarcoidosis) which corresponded to an incidence of 1.9 per 100 000 population. The female to male ratio was 2.1 : 1. Plaques, papules and subcutaneous nodules were the most commonly observed cutaneous lesions. There was no significant difference in cutaneous presentation between those who had isolated skin disease and those who had skin disease in association with systemic sarcoidosis. Prognosis of cutaneous sarcoidosis was favourable, as over 90% of patients had a good response to either glucocorticoids, hydroxychloroquine or tetracycline antibiotics. This study has a significant limitation, in that the studied population was predominantly Caucasians who generally have a lower prevalence of skin disease.

Conclusions

The incidence of sarcoidosis‐specific cutaneous lesions was about 1.9 per 100 000 population with female predominance. The cutaneous presentations were similar among those with and without systemic sarcoidosis.
No association of psoriasis with autoimmune thyroiditis
Authors: Vassilatou E. , Papadavid E. , Papastamatakis P. , Alexakos D. , Koumaki D. , Katsimbri P. , Hadjidakis D. , Dimitriadis G. , Rigopoulos D.
Published: June 2016

Background

Common autoimmune diseases tend to coexist in the same patients. Few studies have examined the possible association between autoimmune thyroiditis and psoriasis or psoriatic arthritis (PsA), with inconsistent results.

Objective

To investigate the prevalence of autoimmune thyroiditis in psoriatic patients with or without PsA, living in an iodine‐sufficient area.

Methods

We studied prospectively, 114 psoriatic patients with disease duration of 5–38 years, 30 of them with PsA, and 286 age‐ and body mass index (BMI)‐matched subjects without psoriasis or known thyroid disease or autoimmune disease. A detailed medical history was obtained from all participants and clinical examination and laboratory evaluation was performed. Psoriasis severity was assessed with Psoriasis Area and Severity Index (PASI). Autoimmune thyroiditis was defined by the presence of positive autoantibodies to thyroid peroxidase and/or thyroglobulin.

Results

There was no difference in the prevalence of autoimmune thyroiditis between psoriatic patients and controls (20.2% vs. 19.6%). The prevalence of autoimmune thyroiditis in male and female psoriatic patients was similar (9.6% and 10.5% respectively), in contrast to the increased, as expected, prevalence in female vs. male controls (14.7% vs. 4.9%, P < 0.01). Detected cases with hypothyroidism due to autoimmune thyroiditis were similar in psoriatic patients and controls (7.9% and 7.0% respectively). Autoimmune thyroiditis in psoriatic patients was not related with age of psoriasis onset, psoriasis duration, PASI score, PsA and obesity.

Conclusion

These data support that psoriatic patients with or without PsA do not have an increased risk for autoimmune thyroiditis.
Efficacy of topical chamomile management vs. placebo in patients with oral lichen planus: a randomized double‐blind study
Authors: Lopez Jornet P. , Aznar‐Cayuela C.
Published: June 2016

Background

The purpose of this study was to compare the clinical therapeutic efficacy of topical applications of chamomile vs. a placebo for treating oral lichen planus (OLP).

Methods

This double‐blind study, randomly divided 60 patients with OLP into two groups, 30 treated with 2% Chamaemelum nobile gel (0.5 mL/3 times a day) and 30 treated with a placebo (Trial Registration NCT02421770). A visual analogue scale was used to rate pain, itching and burning sensation, and Thongprasom Index, the Oral Health Impact Profile 14 (OHIP‐14) and the Hospital Anxiety‐Depression Scale. Patients were evaluated at baseline and after 4 weeks of treatment.

Results

Patients treated with chamomile showed significant improvements after 4 weeks for pain (P < 0.001), burning sensation (P < 0.001), itching (P = 0.011), OHIP‐14 (P < 0.001) and Thongprasom index (P = 0.001); 92% of patients treated with chamomile showed a partial or total response, while only five subjects (17%) in the placebo group showed any improvement.

Conclusion

The topical application of 2% chamomile gel is an effective treatment for OLP.
Ability to home in small site‐attached coral reef fishes
Authors: Booth D. J.
Published: June 2016

The ability of two common, site‐attached coral‐reef fishes to return to their home corals after displacement was investigated in a series of field experiments at One Tree Island, southern Great Barrier Reef. The humbug Dascyllus aruanus was displaced up to 250 m, with 42% of individuals returning home, irrespective of body size, displacement, direction (up or across currents) and route complexity, while for the lemon damselfish Pomacentrus moluccensis 35% of individuals returned overall, with 33% from the greatest displacement, 100 m along a reef edge. Given that the home range of both species is <1 m2, over their 10+ year life span, the mechanisms and motivations for such homing ability are unclear but it may allow resilience if fishes are displaced by storm events, allowing rapid return to home corals.
Oxytetracycline age validation of an adult shortfin mako shark Isurus oxyrinchus after 6 years at liberty
Authors: Kinney M. J. , Wells R. J. D. , Kohin S.
Published: June 2016

This study presents findings on an oxytetracycline injected adult male shortfin mako Isurus oxyrinchus recaptured in waters off of southern California after 6 years at liberty. During the period at liberty, the vertebral band‐pair deposition rate was validated at one per year. This result indicates that from a time at or near sexual maturity, male I. oxyrinchus in the north‐east Pacific Ocean exhibit a band‐pair deposition rate of one band pair per year, while deposition rates for juveniles in the area have been validated at two band pairs per year.
BeyondZar: the use and abuse of classification statistics for otolith chemistry
Authors: Jones C. M. , Palmer M. , Schaffler J. J.
Published: June 2016

Classification method performance was evaluated using otolith chemistry of juvenile Atlantic menhadenBrevoortia tyrannuswhen assumptions of data normality were met and were violated. Four methods were tested [linear discriminant function analysis (LDFA), quadratic discriminant function analysis (QDFA), random forest (RF) and artificial neural networks (ANN)] using computer simulation to determine their performance when variable‐group means ranged from small to large and their performance under conditions of typical skewness to double the amount of skewness typically observed. Using the kappa index, the parametric methods performed best after applying appropriate data transformation, gaining 2% better performance withLDFAperforming slightly better thanQDFA.RFperformed as well asQDFAand showed no difference in performance between raw and transformed data while the performance ofANNwas the poorest and worse with raw data. All methods performed well when group differences were large, but parametric methods outperformed machine‐learning methods. When data were skewed the performance of all methods declined and worsened with greater skewness, butRFperformed consistently as well or better than the other methods in the presence of skewness. The parametric methods were found to be more powerful when assumptions of normality can be met and can be used confidently when skewness and kurtosis are minimized. When these assumptions cannot be minimized, then machine‐algorithm methods should also be tried.
Assessing Space Heating Demandon a Regional Level: Evaluation of a Bottom‐Up Model in the Scope of a Case Study
Authors: Froemelt Andreas , Hellweg Stefanie
Published: June 2016

The residential sector constitutes a major energy consumer, particularly on account of its needs for space heating. Offering a high leverage potential, this sector is a suitable starting point for greenhouse gas mitigation policies. By providing predictions of the energy demand of building stocks, bottom‐up building energy models represent a first step toward deriving strategies for abatement of detrimental effects related to housing energy use.

This article aims at evaluating the performance of a simplified bottom‐up housing energy model. A global sensitivity analysis was performed to study the model's structure and the impact of individual model parameters. Moreover, an extensive final energy consumption data set allowed for an in‐depth comparison of this model with primary data in the scope of a case study in a Swiss municipality.

On an individual building scale, the model fails to accurately simulate the energy demand. Deviations can be attributed to a range of factors, such as variability in occupants’ behavior and problems of representativeness in the underlying statistical database. Nevertheless, such under‐ or overestimations level off on an aggregated scale. In particular, the model reproduces the overall characteristics of the residential building stock's heating demand well. It is therefore well suited as a building stock model and provides a promising basis for an extended assessment of housing energy demands. In future research work, we will apply this model to a larger region in order to study various types of settlements from a life cycle perspective and to derive targeted measures aimed at reducing environmental impacts.
Effects of topical application of B‐Resorcinol and Glycyrrhetinic acid monotherapy and in combination with fractional CO2 laser treatment for benign hand hyperpigmentation treatment
Authors: Grippaudo Francesca Romana , Di Russo Pier Paolo
Published: June 2016

Background

Hand solar lentigines are frequent benign lesions of elderly population, requiring longtime treatments with topical agents or laser to lighten.

Aims

The aim of this study was to evaluate and compare the efficacy of CO2 fractional laser photothermolysis followed by topical application of B‐Resorcinol and Glycyrrhetinic acid vs. only topical B‐Resorcinol and Glycyrrhetinic acid application for hand solar lentigines treatment.

Methods

Hand solar lentigines of eleven volunteers were divided into two groups: Group A spots received CO2 fractional laser photothermolysis followed by 4 weeks topical application of B‐Resorcinol and Glycyrrhetinic acid, and Group B spots received only 4 weeks topical treatments. All hands were photographed, and hand solar lentigines scanned with dermatoscope at the beginning of the study (T0), 1 month after laser treatment (T1), and at the end of the study (T2) to document spots dimensions and color. A blinded dermatologist evaluated dermoscopic T0 and T2 images. The considered variables were assessed for significance by the nonparametric Mann–Whitney U‐test.

Results

In all volunteers, investigators and blinded dermatologist's evaluation hand solar lentigines features improved, with no statistical differences in the two groups.

Conclusion

Topical application of B‐Resorcinol and Glycyrrhetinic acid is effective to lighten hand solar lentigines after 4 weeks of treatment, with or without a previous fractional laser photothermolysis.
Quality survey on efficacy of carboxytherapy for localized lipolysis
Authors: Lee Georgia S. K.
Published: June 2016

Background

A survey was conducted to ascertain the efficacy of carboxytherapy for localized lipolysis.

Methods

Patients on physical, dietary, or drug concurrent therapy were excluded. Paired measurements (initial versus 8th course) between treated (right) and untreated (left) sides were compared for braline, upper arm, abdomen, and thigh.

Results

Ten women, age range 23–37 years, were reviewed. Weight and body mass index were unchanged. Significant reductions (P < 0.01) were obtained for braline and abdominal caliper and ultrasound measurements. Mean (SD) decreases in caliper braline and abdomen measurements were 6.9 (5.9) and 4.3 (3.0) mm, respectively. Mean (SD) changes in ultrasound abdominal readings were −6.6 (3.8), −7.4 (3.2), and −6.8 (3.5) mm for upper, lower, and flank, respectively.

Limb girth measurements were significant for the thigh (−1.3 [0.8] mm) but not for the upper limb.

Conclusion

These results are in agreement with those reported originally and demonstrate that carboxytherapy is locally effective in reduction of subcutaneous fat.
Bridging the gap in sexual healthcare in nursing practice: implementing a sexual healthcare training programme to improve outcomes
Authors: Sung Su‐Ching , Jiang Huey‐Hwa , Chen Ru‐Rong , Chao Jian‐Kang
Published: June 2016

Aims and objectives

This study aimed to evaluate the effectiveness of a sexual healthcare training programme for clinical nurses, with respect to knowledge, attitudes and self‐efficacy concerning sexual healthcare.

Background

Inadequate sexual healthcare can result in poor treatment and quality of life for patients. Few studies have examined the development of sexual healthcare and related interventions from nurses' perspectives.

Design

The study included two stages involving focus groups and a quasi‐experimental design.

Methods

The first stage consisted of an exploratory, descriptive session to assess nurses' perceptions and educational needs concerning sexual healthcare via two focus groups (N = 16). The second stage involved a quasi‐experimental session to evaluate the training programme, based on the results of the first stage. In total, 117 nurses were recruited from a Taiwanese hospital; the experimental group (n = 59) completed a four‐week (16 hours) training programme, and the control group (n = 58) did not participate in a training programme. Data were collected at four time points over 17 weeks. Longitudinal changes that occurred over time were examined using hierarchical linear models.

Results

The experimental group demonstrated significant improvements in knowledge (β = 0·16, p < 0·01), attitude (β = 0·18, p < 0·05), and self‐efficacy (β = 0·73, p < 0·001) scores. Relative to that of the control group, the experimental group showed significantly greater improvement in knowledge (β = −0·12, p < 0·01) and attitudes regarding sexual healthcare (β = −0·25, p < 0·05), but their improvement in self‐efficacy concerning sexual healthcare was limited (p = 0·179).

Conclusions

The training programme for sexual healthcare could exert positive and beneficial effects on nurses' development of knowledge regarding sexual healthcare and clarify their values and attitudes.

Relevance to clinical practice

The training programme could reduce challenges related to sexual healthcare issues in nursing care.
Nurses' experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study
Authors: De Witt Jansen Bannin , Brazil Kevin , Passmore Peter , Buchanan Hilary , Maxwell Doreen , McIlfactrick Sonja J , Morgan Sharon M , Watson Max , Parsons Carole
Published: June 2016

Aims and objectives

To explore hospice, acute care and nursing home nurses' experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support.

Background

Pain management in end‐stage dementia is a fundamental aspect of end‐of‐life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether training needs to be tailored to the context of care.

Design

A qualitative study using semi‐structured interviews and thematic analysis to examine data.

Methods

Twenty‐four registered nurses caring for people dying with advanced dementia were recruited from 10 nursing homes, three hospices and two acute hospitals across a region of the UK. Interviews were conducted between June 2014–September 2015.

Results

Three core themes were identified: challenges administering analgesia, the nurse–physician relationship, and interactive learning and practice development. Patient‐related challenges to pain management were universal across care settings; nurse‐ and organisation‐related barriers differed between settings. A need for interactive learning and practice development, particularly in pharmacology, was identified.

Conclusions

Achieving pain management in practice was highly challenging. A number of barriers were identified; however, the manner and extent to which these impacted on nurses differed across hospice, nursing home and acute care settings. Needs‐based training to support and promote practice development in pain management in end‐stage dementia is required.

Relevance to clinical practice

Nurses considered pain management fundamental to end‐of‐life care provision; however, nurses working in acute care and nursing home settings may be undersupported and under‐resourced to adequately manage pain in people dying with advanced dementia. Nurse‐to‐nurse mentoring and ongoing needs‐assessed interactive case‐based learning could help promote practice development in this area. Nurses require continuing professional development in pharmacology.
From screening to synthesis: using nvivo to enhance transparency in qualitative evidence synthesis
Authors: Houghton Catherine , Murphy Kathy , Meehan Ben , Thomas James , Brooker Dawn , Casey Dympna
Published: June 2016

Aims and objectives

To explore the experiences and perceptions of healthcare staff caring for people with dementia in the acute setting. This article focuses on the methodological process of conducting framework synthesis using nvivo for each stage of the review: screening, data extraction, synthesis and critical appraisal.

Background

Qualitative evidence synthesis brings together many research findings in a meaningful way that can be used to guide practice and policy development. For this purpose, synthesis must be conducted in a comprehensive and rigorous way. There has been previous discussion on how using nvivo can assist in enhancing and illustrate the rigorous processes involved.

Design

Qualitative framework synthesis.

Methods

Twelve documents, or research reports, based on nine studies, were included for synthesis.

Conclusion

The benefits of using nvivo are outlined in terms of facilitating teams of researchers to systematically and rigorously synthesise findings. nvivo functions were used to conduct a sensitivity analysis. Some valuable lessons were learned, and these are presented to assist and guide researchers who wish to use similar methods in future.

Relevance to clinical practice

Ultimately, good qualitative evidence synthesis will provide practitioners and policymakers with significant information that will guide decision‐making on many aspects of clinical practice. The example provided explored how people with dementia are cared for acute settings.
The documentation practice of perioperative nurses: a literature review
Authors: Søndergaard Susanne Friis , Lorentzen Vibeke , Sørensen Erik Elgaard , Frederiksen Kirsten
Published: June 2016

Aims and objective

To explore and present the existing knowledge of the documentation practices of perioperative nurses in the operating room.

Background

Studies demonstrate that the documentation of nursing care provided is important for the continuity of patient care as well as patient safety. Nurses find that documenting their perioperative services is important to the surgical pathway; however, a number of studies indicate that the documentation practices of perioperative nurses are characterised by subjectivity, randomness and poor quality.

Design

A literature review with a systematic search of scientific material.

Method

The content of the studies included was analysed using content analysis as suggested by Krippendorff. The materials were acquired by searching electronic databases. The search was performed for the period 1995–2015 and resulted in 12 studies.

Results

Three general themes were found to be important for perioperative nurses’ documentation practices: (1) the documentation tool must be adapted to the clinical practice; (2) nurses document to improve patient safety and protect themselves legally; and (3) traditions and conditions for documentation.

Conclusion

Nurses considered documenting their perioperative practices very important. It was of vital importance that the tool used be adapted to the actual clinical practice and to relevant regulations regarding form and content. Nurses’ subjective perceptions of and opinions on the effect of documentation influenced their documentation practices, which were widely governed by habits and traditions. Nurses document to safeguard patients against errors but also to protect their own legal status. Nurses also use documentation as proof of their nursing and as ‘a window’ to gain recognition for their professional practice.

Relevance to clinical practice

Our review demonstrates that a focus on the documentation traditions of perioperative nurses combined with training, structure and improved technical tools may facilitate the documentation and thereby improve patient safety.
Managing parental groups: personal impact of a group leadership course for child healthcare nurses
Authors: Lefèvre Åsa , Lundqvist Pia , Drevenhorn Eva , Hallström Inger
Published: June 2016

Aims and objectives

To investigate the experience and personal impact of a group leadership course for child healthcare nurses.

Background

During their child's first year, all parents in Sweden are invited to participate in parental groups within the child health service; however, only 49% choose to participate. Despite extensive experience, child healthcare nurses find managing parental groups challenging and express a need for training in group dynamics and group leadership.

Design

The study was designed as a controlled study with a pretest/post‐test design where the participants form their own control group.

Methods

A group leadership course was given to 56 child healthcare nurses and evaluated in a pre‐ and postintervention questionnaire, a course evaluation and an interview with the course leaders.

Results

The child healthcare nurses felt their group leadership skills were strengthened and the majority (96%) felt that the course had changed their way of leading parental groups. They felt that the group leader role had been clarified and that they had obtained several new tools to use in their groups.

Conclusions and relevance to clinical practice

Clarifying the role of group leader and adding knowledge about group leadership and dynamics seems to have increased the self‐confidence for child healthcare nurses in group leadership. Improved confidence in group management might motivate the child healthcare nurses to further develop parental groups to attract the parents who currently choose not to participate.
An integrative review of a preoperative nursing care structure
Authors: Turunen Elina , Miettinen Merja , Setälä Leena , Vehviläinen‐Julkunen Katri
Published: June 2016

Aims and objectives

The aims of this integrative literature review are to define the role of a preoperative nurse and to describe the main components and hypothetical outcomes of a preoperative nursing care structure before a surgical patient arrives to an elective procedure.

Background

The development of medical care has impacted surgical processes, and patients are now spending less time in hospital settings. Patients often enter the hospital on the day of a procedure and are discharged as soon as it is medically safe, creating challenges for nursing care. Preoperative clinics have been opened, and the importance of preoperative nursing care has been widely understood. Previous literature has provided descriptions about the roles, tasks and outcomes of preoperative nurses; however, the terminology is heterogeneous, and the optimal model remains unknown.

Design

A systematic procedure for searching, selecting, and evaluating the literature was followed. The data were collected from PubMed and CINAHL between 1 January 2004 and 20 September 2014. In total, 41 articles were included in the study and were analysed by qualitative inductive content analysis.

Results

The data provided seven main tasks of a preoperative nurse, tools to support preoperative nursing and outcomes of structured preoperative nursing care.

Conclusion

A preoperative nurse is a specialised coordinator of patient care, and the main purposes of this role are to meet the patient's and the family's needs individually and to prepare them for the scheduled procedure and postoperative recovery. By following the structure of the seven main tasks and using different supportive tools, preoperative nursing can positively impact patient and provider satisfaction, patient safety, quality of care and cost savings.

Relevance to clinical practice

A preoperative nursing care structure should be implemented in clinical practice and then evaluated to measure whether the hypothetical outcomes reported in this literature review can be achieved.
Correlates and predictors of missed nursing care in hospitals
Authors: Bragadóttir Helga , Kalisch Beatrice J , Tryggvadóttir Gudný Bergthora
Published: June 2016

Aims and objectives

To identify the contribution of hospital, unit, staff characteristics, staffing adequacy and teamwork to missed nursing care in Iceland hospitals.

Background

A recently identified quality indicator for nursing care and patient safety is missed nursing care defined as any standard, required nursing care omitted or significantly delayed, indicating an error of omission. Former studies point to contributing factors to missed nursing care regarding hospital, unit and staff characteristics, perceptions of staffing adequacy as well as nursing teamwork, displayed in the Missed Nursing Care Model.

Design

This was a quantitative cross‐sectional survey study.

Methods

The samples were all registered nurses and practical nurses (n = 864) working on 27 medical, surgical and intensive care inpatient units in eight hospitals throughout Iceland. Response rate was 69·3%. Data were collected in March–April 2012 using the combined MISSCARE Survey‐Icelandic and the Nursing Teamwork Survey‐Icelandic. Descriptive, correlational and regression statistics were used for data analysis.

Results

Missed nursing care was significantly related to hospital and unit type, participants’ age and role and their perception of adequate staffing and level of teamwork. The multiple regression testing of Model 1 indicated unit type, role, age and staffing adequacy to predict 16% of the variance in missed nursing care. Controlling for unit type, role, age and perceptions of staffing adequacy, the multiple regression testing of Model 2 showed that nursing teamwork predicted an additional 14% of the variance in missed nursing care.

Conclusions

The results shed light on the correlates and predictors of missed nursing care in hospitals. This study gives direction as to the development of strategies for decreasing missed nursing care, including ensuring appropriate staffing levels and enhanced teamwork.

Relevance to clinical practice

By identifying contributing factors to missed nursing care, appropriate interventions can be developed and tested.
The effect of transcutaneous electrical nerve stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease: randomised controlled trial
Authors: Öncü Emine , Zincir Handan
Published: June 2016

Aims and objectives

The aim of the present study was to assess the efficacy of transcutaneous electrical nerve stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease.

Background

In patients with stable chronic obstructive pulmonary disease, transcutaneous electrical nerve stimulation has been known to attain improvement in forced expiratory volume in 1 seconds, physical activity, and quality of life. However, information about the effects of transcutaneous electrical nerve stimulation on acute exacerbation of chronic obstructive pulmonary disease is quite limited.

Design

A single‐blind, randomised controlled trial.

Methods

Data were collected between August 2013–May 2014. Eighty‐two patients who were hospitalised with a diagnosis of acute exacerbation of chronic obstructive pulmonary disease were randomly assigned to a transcutaneous electrical nerve stimulation group receiving transcutaneous electrical nerve stimulation treatment for 20 seance over the acupuncture points with pharmacotherapy or placebo group receiving the same treatment without electrical current output from the transcutaneous electrical nerve stimulation device. Pulmonary functional test, six‐minute walking distance, dyspnoea and fatigue scale, and St. George's Respiratory Questionnaire scores were assessed pre‐ and postprogram. The program started at the hospital by the researcher was sustained in the patient's home by the caregiver.

Results

All patients were able to complete the program, despite the exacerbation. The 20 seance transcutaneous electrical nerve stimulation program provided clinically significant improvement in forced expiratory volume in 1 seconds 21 ml, 19·51% but when compared with the placebo group, the difference was insignificant (p > 0·05). The six‐minute walking distance increased by 48·10 m more in the placebo group (p < 0·05). There were no significant differences between the two groups' St. George's Respiratory Questionnaire, dyspnoea and fatigue score (p > 0·05).

Conclusion

Adding transcutaneous electrical nerve stimulation therapy to pharmacotherapy in patients with acute exacerbation of chronic obstructive pulmonary disease provided clinical improvement in forced expiratory volume in 1 seconds and add benefit in exercise capacity, but no significant effect on the other outcomes measured.

Relevance to clinical practice

Transcutaneous electrical nerve stimulation can be used as a non‐invasive complementary therapy due to its beneficial effects on forced expiratory volume in 1 seconds and exercise capacity in patients with acute exacerbation of chronic obstructive pulmonary disease.