bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of power toothbrushing on periodontal inflammation in a Canadian nursing home population: A randomized controlled trial
Authors: Lavigne SE , Doupe MB , Iacopino AM , Mahmud S , Elliott L
Published: January 2017

Objectives

The aim of this study was to investigate whether twice‐daily use of a rotating‐oscillating power toothbrush (Oral‐B Professional Care 1000™) in nursing home (NH) residents over a 6‐week period, compared to usual care (UC), would reduce periodontal inflammation.

Methods

In this repeated measures single‐blinded randomized controlled trial, 59 residents of one NH in Winnipeg, Canada, were randomized to receive either twice‐daily tooth brushing with a rotating‐oscillating power toothbrush (PB) or UC by caregivers. Consent was obtained from residents or their proxies. Participants had some natural teeth, periodontal inflammation, non‐aggressive behaviour, no communicable diseases, were non‐smokers and non‐comatose. Outcomes were measured at baseline and 6 weeks, which included: inflammation (MGI, Lobene), bleeding (PBI, Loesche) and Plaque (Turesky). Comparisons of group changes in outcomes were analysed using an ANOVA with a repeated measure.

Results

Of 59 original study participants, one withdrew, one died prior to study commencement and three died before study completion. All oral parameters improved significantly for the remaining 54 residents over time (P<.0001), with no differences between groups.

Conclusions

These results demonstrate that it is possible for caregivers to improve periodontal inflammation of residents over a 6‐week period. Despite no significant group differences, periodontal inflammation of all study participants improved significantly, particularly in the reduction of bleeding, a direct measure of periodontal inflammation, which is a unique finding.
Longer‐lasting Al2O3‐SiCw‐TiC cutting tools obtained by spark plasma sintering
Authors: Gutiérrez‐González Carlos F , Pozhidaev Serghei , Rivera Sergio , Peretyagin Pavel , Solís Washington , Díaz Luis Antonio , Fernandez Adolfo , Torrecillas Ramón
Published: January 2017

In this work, an electrically conductive powder mixture of alumina, silicon carbide whiskers, and titanium carbide has been used to obtain cutting tools with a standard SNGN geometry after machining spark plasma sintered disks with 150 mm in diameter and 10 mm height. The obtained cutting inserts from the sintered blanks were used in real conditions in order to make a wear study of this composition compared to the alumina‐silicon carbide whiskers inserts available in the market. In parallel, pin on disk wear studies were performed. Results are discussed in terms of the different properties and microstructural features of the different ceramic composites.
Bronchial thermoplasty in severe asthma in Australia
Authors: Langton David , Sha Joy , Ing Alvin , Fielding David , Wood Erica
Published: January 2017

Background

Bronchial thermoplasty (BT) is an approved bronchoscopic intervention for the treatment of severe asthma. However, limited published experience exists outside of clinical trials regarding patient selection and outcomes achieved.

Aims

To evaluate the effectiveness and safety of BT in patients with severe asthma encountered in clinical practice.

Methods

This is a retrospective analysis of the first ‘real world’ data from Australia. The following outcomes were measured prior to, and 6 months following BT: spirometry, Asthma Control Questionnaire‐5 (ACQ‐5) score, reliever and preventer medication use and exacerbation history.

Results

Twenty patients were treated from June 2014 to December 2015 at three university teaching hospitals. All subjects met the European Respiratory Society/American Thoracic Society definition of severe asthma. Mean pre‐bronchodilator forced expiratory volume in 1 s was 62.8 ± 16.6% predicted (range: 33–95%). All patients were being treated with high dose inhaled corticosteroids, long‐acting beta2 agonists and long‐acting muscarinic antagonists. Ten patients (50%) were taking maintenance oral prednisolone. Most subjects also required at least one of montelukast (65%), omalizumab (30%) and methotrexate (20%). ACQ‐5 improved from 3.6 ± 1.1 at baseline to 1.6 ± 1.2 at 6 months, P < 0.001. Short‐acting reliever use decreased from a median of 8.0–0.25 puffs/day, P < 0.001, and exacerbations requiring corticosteroids also significantly reduced. Five of 10 patients completely discontinued maintenance oral corticosteroids. Ten patients with a baseline forced expiratory volume in 1 s of <60% predicted significantly improved from 49.2 ± 9.6% to 61.8 ± 17.6%, P < 0.05. Only two procedures required hospitalisation beyond the planned overnight admission.

Conclusion

BT is a safe procedure which can achieve clinical improvement in those with uncontrolled symptoms and severe airflow obstruction.
Developing a cultural competence inventory for nurses in China
Authors: Cai D. , Kunaviktikul W. , Klunklin A. , Sripusanapan A. , Avant P.K.
Published: January 2017

Aim

To develop and psychometrically test the Cultural Competence Inventory for Nurses in China.

Background

Cultural competence is expected worldwide from nurses due to the increasing cultural diversity of people in healthcare establishments. Yet, no cultural competence framework or instrument for nurses has been identified to guide nursing practice in China where the cultural diversity of the populations and the characteristics of the healthcare system are different from those of the West.

Methods

A review of literature and individual interviews among nurse experts generated 74 items, which were evaluated by six experts in transcultural nursing. A stratified random sampling technique was used to recruit 520 Chinese nurses for the field test. Construct validity and internal consistency reliability of the instrument were estimated by exploratory factor analysis and Cronbach's alpha, respectively. The data were collected from May 2015 to January 2016.

Results

The final instrument consists of 29 items in five dimensions, namely ‘cultural awareness, cultural respect, cultural knowledge, cultural understanding and cultural skills’. Cronbach's alpha for the instrument was 0.94, with a range of 0.79–0.92 for the individual dimensions. The evidence for contrast‐group validity (P < 0.001) was also obtained.

Conclusion

The study provides evidence that the Cultural Competence Inventory for Nurses in China is reliable, valid and culturally sensitive for measuring nurses’ cultural competence. The instrument development process facilitates the understanding of cultural competence globally.

Implications for nursing and nursing policy

Cultural competence of nurses can be evaluated for self‐development, workforce management and quality assurance. The instrument can also serve as the foundation to develop education curricula and nursing procedures or protocols to improve culturally competent nursing practice.
Solubility limits and LaGaO3 compatibility in the LaO1.5‐GaO1.5‐NiO ternary system
Authors: Duffy Patrick K. , Beal Rachel A. , Layton Carys E. , Barnett Scott A. , Mason Thomas O.
Published: January 2017

Phase compatibility and solubility limits in the LaO1.5‐GaO1.5‐NiO system at 1400°C were measured using phase analysis and disappearing phase methods, focusing on compatibility of LaGaO3 with NiO and Lan+1NinO3n+1 Ruddlesden‐Popper phases. For the first time, it was observed that, similar to La4Ni3O10, the incorporation of gallium stabilized La3Ni2O7 over a narrow composition range. The compositional limits of stability involving LaGaO3 were determined in detail, and the full quasiternary diagram is presented as a best estimation that is consistent with the observations of this study. LaGaO3 showed compatibility with NiO, with gallium and nickel substituting for each other in both phases. The lowest attainable amount of nickel in LaGaO3 in equilibrium with gallium‐saturated NiO was measured to be around 7% nickel on gallium sites. Of the Ruddlesden‐Popper phases, only La4Ni3O10 showed compatibility with LaGaO3, with the two‐phase region spanning between ~40%‐55% gallium on nickel sites in La4Ni3O10 and ~20%‐50% nickel on gallium sites in LaGaO3. The electrical conductivity of La4(Ni1−xGax)3O10 was also measured, and found to decrease monotonically with the addition of gallium. Implications relating to fabrication of solid oxide fuel cells with Sr‐ and Mg‐doped LaGaO3 electrolytes are discussed.
Editorial: Making clinical trials smarter (and more interesting)
Authors: Fearon R. M. Pasco
Published: January 2017

At its heart, the field of child psychology and psychiatry is geared towards using science to develop interventions that promote children's healthy development and treat behavioural and emotional difficulties when they arise. While there have been some successes (e.g. stimulant medication for ADHD, parent training for child conduct problems, Fonagy et al., ) serious challenges lie ahead if we are to achieve reliable and lasting improvements for a larger number of children, and for a broader spectrum of problems.
Summer co‐existence of small‐sized cyprinid and percid individuals in natural and impounded stretches of a lowland river: food niche partitioning among fishes
Authors: Lik J. , Dukowska M. , Grzybkowska M. , Leszczyńska J.
Published: January 2017

Due to changes of discharge regime downstream of a dam reservoir, an alluvial natural stretch of the Warta River changed to a macrophyte‐dominated ecosystem. Large patches of submersed, aquatic macrophytes appeared in summer and their effect is analysed in this study. These patches contained enriched macroinvertebrate assemblages (epiphyton and benthos) and they were refuge for both zooplankton and young fishes released from the reservoir. Despite these altered conditions in this stretch, roach Rutilus rutilus, perch Perca fluviatilis and ruffe Gymnocephalus cernua dominated, as they did in the natural backwater. Fishes were sampled every 2 weeks from June to August, together with their food resources to assess the partitioning of the diet among small individuals of the three species in both stretches (the natural and affected ones). The aim of the analysis was to answer how animal food associated with water plants was partitioned between the species. In both stretches, G. cernua were primarily benthivorous, but epiphytic fauna, zooplankton and large‐sized benthic chironomid larvae replaced lack of many large, benthic insects in the tailwater. Levins' food breath index decreased from 0·36 in the backwater to 0·29 in the tailwater. An opposite trend was observed for P. fluviatilis occurring among macrophytes. Perca fluviatilis were competitors of R. rutilus and took food not only in or on the river bed, but also in the water column. They ate zooplankton and epiphytic fauna and Levins' index increased from 0·32 to 0·44 in the tailwater. Rutilus rutilus fed on adult insects, algae and plant fragments in the natural stretch. In the tailwater, these food types were chiefly complemented by zooplankton. Despite this, the niche breadth of R. rutilus was similar at the two sites. Abundance of food associated with the macrophytes appeared to facilitate cohabitation in the abundant fish populations, but P. fluviatilis appeared to benefit the most in the altered river stretch.
Influence of the marine feeding area on the muscle and egg fatty‐acid composition of Atlantic salmonSalmo salarspawners estimated from the scale stable isotopes
Authors: Torniainen J. , Kainz M. J. , Jones R. I. , Keinänen M. , Vuorinen P. J. , Kiljunen M.
Published: January 2017

Fatty acids in muscle tissue and eggs of female Atlantic salmonSalmo salarspawners were analysed to evaluate the dietary quality of their final feeding areas in the Baltic Sea. The final likely feeding area was identified by comparing stable carbon and nitrogen isotope composition of the outermost growth region (final annulus) of scales of returnedS. salarwith that of referenceS. salarcaught from different feeding areas. Some overlap of stable‐isotope reference values among the three areas, in addition to prespawning fasting, decreased the ability of muscle tri‐acylglycerols to discriminate the final likely feeding area and the area's dietary quality. Among three long‐chained polyunsaturated fatty acids, docosahexaenoic acid (DHA; 22:6n‐3), eicosapentaenoic acid (EPA; 20:5n‐3) and arachidonic acid (ARA; 20:4n‐6), the proportions ofARAin total lipids of spawningS. salarmuscle and eggs showed a significant negative correlation with increasing probability ofS. salarhaving returned from the Baltic Sea main basin (i.e.the Baltic Sea proper). The results suggest thatARAin muscle and eggs is the best dietary indicator for dietary characteristics of final marine feeding area dietary characteristics amongS. salarin the Baltic Sea.
American Geriatrics Society Policy Priorities for New Administration and 115th Congress
Authors: Lundebjerg Nancy E. , Hollmann Peter , Malone Michael L. ,   the AGS Board of Directors and Public Policy Committee
Published: January 2017

This paper is a statement of the American Geriatrics Society's (AGS) core policy priorities and the Society's positions on federal programs and policies that support older Americans as articulated to the new administration. Among the AGS priorities discussed in this paper are health reform, Medicare, and Medicaid. The AGS is committed to leveraging its expertise to inform regulatory and legislative policy proposals.
Medication administration errors and related deviations from safe practice: an observational study
Authors: Blignaut Alwiena J , Coetzee Siedine K , Klopper Hester C , Ellis Suria M
Published: January 2017

Aims and objectives

To determine the incidence of medication administration errors, medication administration‐related deviations from safe practice as well as factors associated with these errors in medical and surgical units of public hospitals in the Gauteng Province of South Africa.

Background

Several studies have been published on the incidence of medication administration errors, but only a few have studied the incidence of medication administration‐related deviations from safe practice. Context‐specific research on the incidence of medication administration errors and associated factors (patient acuity, bed occupancy, staffing levels, medication administrators’ qualifications, dose calculation skills, level of hospital, unit type, medication administration route and interruptions) within the continent of Africa is lacking.

Design

A cross‐sectional, observational design.

Methods

Direct observation was conducted incorporating a previously validated checklist based on basic medication guidelines including the five rights, asepsis and medication documentation. In addition, a knowledge test on dose calculations was performed. Medication administration to 315 patients (1847 medications administered) was observed between February–August 2015 in medical and surgical units from eight public hospitals. Twenty‐five medication administrators completed dose calculations.

Results

In total, 296 medication errors were identified, of which most were wrong‐time errors and omissions. Interruptions and patient acuity were significantly associated with wrong‐dose and wrong‐route errors, respectively. Most medication administration‐related deviations from safe practice were related to patient identification or asepsis. Sixteen of 50 dosage calculations were answered incorrectly. Incorrect answers most often occurred in the calculation of parenteral dosages.

Conclusions

Medication administration errors, especially wrong‐time errors and omissions, are prevalent in public hospitals in the Gauteng Province. Interruptions lower the risk of wrong‐dose errors, while patient acuity exacerbates this risk.

Relevance to clinical practice

Factors associated with wrong‐time errors and omissions should be addressed. Patient identification and asepsis protocols should be adhered to. Dosage calculation training is indicated.
ARE GREEN CAR DRIVERS FRIENDLY DRIVERS? A STUDYOF TAIWAN'S AUTOMOBILE INSURANCE MARKET
Authors: Huang Jerry S. , Wang Kili C.
Published: January 2017

ABSTRACT

By integrating claims data from Taiwan's compulsory liability insurance with a unique data set on driving mileage records for each car, this article examines whether green car drivers have lower accident risk. We find that after controlling for the mileage driven per car, the traffic accident risk of green car drivers is significantly lower. Our empirical evidence also confirms that green car drivers are, on average, high‐mileage drivers. Moreover, driving more results in a higher accident probability for green car drivers despite their being lower‐risk drivers. The policy implications are discussed.
Experiencing depression: women's perspectives in recovery
Authors: Chernomas W.M.
Published: January 2017

Depression, as perceived by 10 women, is presented in this descriptive study. Guided by symbolic interactionism and feminist theory this qualitative study used semistructured interviews, self‐report measures, observations and participant self‐reflective journals to elicit women's views on depression and its affect on, and meaning in, their lives. The theme of loss of self was the central feature in their experiences that characterized depression and, in turn, affected their efforts in recovery and healing. Six other themes reflected their experiences in living with depression including: the transformed self, wanting and monitoring, the self as healer, revealing vs. concealing, acceptance and belonging, and making sense of depression — meaning and understanding.
The Effects of Hospital Characteristics on Delays in Breast Cancer Diagnosis in Appalachian Communities: A Population‐Based Study
Authors: Louis Christopher J. , Clark Jonathan R. , Hillemeier Marianne M. , Camacho Fabian , Yao Nengliang , Anderson Roger T.
Published: January 2017

Purpose

Despite being generally accepted that delays in diagnosing breast cancer are of prognostic and psychological concern, the influence of hospital characteristics on such delays remains poorly understood, especially in rural and underserved areas. However, hospital characteristics have been tied to greater efficiency and warrant further investigation as they may have implications for breast cancer care in these areas.

Methods

Study data were derived from the Kentucky, North Carolina, Ohio, and Pennsylvania state central cancer registries (2006‐2008). We then linked Medicare enrollment files and claims data (2005‐2009), the Area Resource File (2006‐2008), and the American Hospital Association Annual Survey of Hospitals (2007) to create an integrated data set. Hierarchical linear modeling was used to regress the natural log of breast cancer diagnosis delay on a number of hospital‐level, demographic, and clinical characteristics.

Findings

The baseline study sample consisted of 4,547 breast cancer patients enrolled in Medicare that lived in Appalachian counties at the time of diagnosis. We found that hospitals with for‐profit ownership (P < .01) had shorter diagnosis delays than their counterparts. Estimates for comprehensive oncology services, system membership and size were not statistically significant at conventional levels.

Conclusions

Some structural characteristics of hospitals (eg, for‐profit ownership) in the Appalachian region are associated with having shorter delays in diagnosing breast cancer. Researchers and practitioners must go beyond examining patient‐level demographic and tumor characteristics to better understand the drivers of timely cancer diagnosis, especially in rural and underserved areas.
Lung microdialysis study of florfenicol in pigs after single intramuscular administration
Authors: Yang B. , Gao J. D. , Cao X. Y. , Wang Q. Y. , Sun G. Z. , Yang J. J.
Published: January 2017

For most bacterial lung infections, the concentration of unbound antimicrobial agent in lung interstitial fluid has been considered as the gold standard for estimating the antibacterial efficacy. In this study, the pharmacokinetics of florfenicol (FF) in porcine lung interstitial fluid was investigated after single intramuscular administration at two different doses (20 and 50 mg/kg). Twelve pigs underwent thoracotomy under general anesthesia. Then, the CMA/30 probe was implanted into the lung and perfused at 1 μL/min. The microdialysis (MD) samples were collected on a preset schedule and analyzed by high‐performance liquid chromatography (HPLC). Noncompartmental pharmacokinetic analysis was performed. FF exhibited rapid distribution and slow elimination in porcine lung interstitial fluid. The main pharmacokinetic parameters at 20 and 50 mg/kg were 4.88 ± 0.54 and 10.36 ± 2.52 μg/mL for the maximum concentration (Cmax), 3.25 ± 0.32 and 3.50 ± 0.27 h for the time to Cmax (Tmax), 9.47 ± 6.84 and 7.75 ± 3.23 h for the half‐life (t1/2), 0.10 ± 0.06 and 0.10 ± 0.04 1/h for the terminal elimination rate constant (λz), 13.85 ± 7.97 and 11.42 ± 2.79 h for the mean residence time (MRT), 37.77 ± 8.13 and 71.15 ± 16.99 h·μg/mL for the area under the curve from time 0 to 18.25 h (AUC0–18.25), and 51.18 ± 20.11 and 88.78 ± 27.58 h·μg/mL for the area under the curve from time 0 to infinity (AUC0–∞), respectively.
Ritualized fights among foraging cattle egrets following Père David's deer in Dafeng Nature Reserve
Authors: Fernandez E. V. , Shi X. , Li Z.
Published: January 2017

The outcome success of animals competing for food resources may be influenced by their differences in resource holding potential and motivation to acquire these resources. This study investigated the naturally occurring aggressive interactions during ritualized fights of the cattle egret (Bubulcus ibis) foraging with Père David's deer (Elaphurus davidianus). The study was conducted in the first core zone of Dafeng Père David's Deer National Nature Reserve, Jiangsu, China during the summers of 2012 and 2013. The foraging and vigilance variables of resident cattle egrets feeding with a deer with and without intrusion were calculated and compared. Cases of ritualized fights between residents and intruders were recorded in naturally occurring aggressive interactions. The prey capture success rate and the total foraging earnings of resident cattle egrets following a deer with intrusion were significantly higher than those of resident foragers without intrusion. The resident status did not affect the outcomes of the ritualized fights of the cattle egrets, although adult residents or intruders had more cases of winning in contesting ownership of the deer. Thus, age is the major resource holding factor in foraging cattle egrets competing for host ownership.
Reconstruction of the extinct Ezo wolf's diet
Authors: Matsubayashi J. , Ohta T. , Takahashi O. , Tayasu I.
Published: January 2017

On Hokkaido, Japan, the Ezo wolfCanis lupus hattai, an apex predator, became extinct at the end of the 19th century owing to human activities. Top predators often have an important role in their ecosystems, yet we have no scientific information on the feeding habits of the Ezo wolf. We performed carbon and nitrogen stable isotope analysis and radiocarbon dating of specimens of the wolf (n = 7) and its prey species and estimated the components of the wolves’ diet using an isotope mixing model. Radiocarbon dating suggested that most of the wolves examined came from different populations or generations. The mean stable isotope ratios of the wolves were −19.5 ‰ (±1.9 ‰sd) forδ13C and 8.7 ‰ (±2.6 ‰sd) forδ15N. The discrimination‐corrected isotopic ratios of five of the seven wolves were almost the same as those of Sika deer at the same sites. In contrast, those of two wolves had clearly higher isotopic values than those of deer, suggesting that these wolves depended partly on marine prey such as salmon and marine mammals. Thus, Ezo wolves had similar ecological roles to Canadian grey wolves, and were a second subspecies shown to have fed on a marine diet, in addition to the ‘coastal wolves’ of British Columbia.
The genus Anthopsis and its phylogenetic position in Chaetothyriales
Authors: Moussa Tarek A. A. , Gerrits van den Ende Bert H. G. , Al Zahrani Hassan S. , Kadasa Naif M. S. , de Hoog Sybren G. , Dolatabadi Somayeh
Published: January 2017

The genus Anthopsis was introduced for a black fungus with peculiar, inverted phialides and triangular conidia. The genus accommodates, in addition to the type species Anthopsis deltoidea, which once was reported as a cause of human phaeohyphomycosis, two further taxa: A. catenata and A. microspora. Current taxonomy is mainly based on microscopic structures of phialides. To assess the phylogenetic position of the genus, sequences of the internal transcribed spacer region and partial LSU rDNA were obtained for Anthopsis spp. and compared with sequences from public databases. Phylogenetic analyses based on both loci were used to assess the evolutionary relationships of Anthopsis spp. at the family and ordinal levels. Anthopsis s.str. was found to cluster in Chaetothyriales, while A. catenata proved to be of helotialean affinity. Thermotolerance and morphology of each species were recorded.
Detection of neonatal unit clusters of Candida parapsilosis fungaemia by microsatellite genotyping: Results from laboratory‐based sentinel surveillance, South Africa, 2009‐2010
Authors: Magobo Rindidzani E. , Naicker Serisha D. , Wadula Jeannette , Nchabeleng Maphoshane , Coovadia Yacoob , Hoosen Anwar , Lockhart Shawn R. , Govender Nelesh P. ,   the TRAC‐South Africa group
Published: January 2017

Neonatal candidaemia is a common, deadly and costly hospital‐associated disease. To determine the genetic diversity of Candida parapsilosis causing fungaemia in South African neonatal intensive care units (NICUs). From February 2009 through to August 2010, cases of candidaemia were reported through laboratory‐based surveillance. C. parapsilosis isolates from neonatal cases were submitted for identification by internal transcribed spacer (ITS) region sequencing, antifungal susceptibility testing and microsatellite genotyping. Cluster analysis was performed using Unweighted Pair Group Method with Arithmetic Mean (UPGMA). Of 1671 cases with a viable Candida isolate, 393 (24%) occurred among neonates. Isolates from 143 neonatal cases were confirmed as C. parapsilosis sensu stricto. Many isolates were resistant to fluconazole (77/143; 54%) and voriconazole (20/143; 14%). Of 79 closely‐related genotypes, 18 were represented by ≥2 isolates; 61 genotypes had a single isolate each. Seven clusters, comprised of 82 isolates, were identified at five hospitals in three provinces. Isolates belonging to certain clusters were significantly more likely to be fluconazole resistant: all cluster 7 isolates and the majority of cluster 4 (78%), 5 (89%) and 6 (67%) isolates (P<.001). Candida parapsilosis‐associated candidaemia in public‐sector NICUs was caused by closely related genotypes and there was molecular evidence of undetected outbreaks as well as intra‐hospital transmission.
Cardiovascular disease and prediabetes as complex illness: People's perspectives
Authors: van Wissen Kim , Thunders Michelle , Mcbride‐Henry Karen , Ward Margaret , Krebs Jeremy , Page Rachel
Published: January 2017

Cardiovascular disease (CVD) and sustained high blood glucose as prediabetes are an established comorbidity. People's experience in reconciling these long‐term conditions requires deeper appreciation if nurses are to more effectively support person‐centred care for people who have them. Our analysis explores the initial experience of people admitted to hospital with CVD who then find they also have sustained high blood glucose. Our methodology is informed by the philosophy of Gadamer and applies interpretive description to develop an interpretation of participant experiences. The major theme emerging from participant interviews was the ‘invisible disequilibrium’ characterised by three subthemes: ‘losing equilibrium’, ‘becoming embattled’ and ‘evolving illness’. This study examines CVD and prediabetes in conjunction with the Gadamerian notion of the ‘whole’, as being in a social and emotional world in which illness is also a component part. We explore how participants lived within an ‘invisible disequilibrium’, with prediabetes frequently remaining unnoticed, while CVD was manifest. To identify multiple conditions and support effective intervention to manage them as part of person‐centric care, nursing practice should explore the ‘whole’ of the person's experience, value people’s knowledge as potential indicators of complex illness, thereby reducing the risk of accelerating complex illness.
Missed nursing care as an ‘art form’: The contradictions of nurses as carers
Authors: Harvey Clare , Thompson Shona , Pearson Maria , Willis Eileen , Toffoli Luisa
Published: January 2017

This article draws on the free‐text commentaries from trans‐Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self‐effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms.
The effect of potassium diclofenac and dexamethasone on MMP‐1 gene transcript levels during experimental tooth movement in rats
Authors: Molina Da Silva G. P. , Tanaka O. M. , Campos Navarro D. F. , Repeke C. E. , Garlet G. P. , Guariza‐Filho O. , Trevilatto P. C.
Published: January 2017

Structured Abstract

Objectives

The aim of this study was to analyze MMP‐1 transcript levels in periodontal tissues of rats that underwent orthodontic treatment using potassium diclofenac and dexamethasone at different stages of tooth movement.

Setting and Sample Population

The sample comprised of ninety male Wistar rats.

Material and Methods

A closed nickel‐titanium coil spring was used to apply a force of 50 cN to move the maxillary right first molars mesially. One group received daily doses of 0.9% saline solution, the second group received daily doses of 5 mg/kg potassium diclofenac, and the third group received daily doses of 0.5 mg/kg dexamethasone. Tooth movement was observed on days 0, 1, 3, 7, and 14. MMP‐1 transcript levels were evaluated by real‐time polymerase chain reaction and the results were compared between groups by three‐way ANOVA, with a significance level of 0.05.

Results

Transcript levels increased in groups that received the coil spring treatment on all days of the experiment. MMP‐1 expression was found to be decreased in groups treated with potassium diclofenac and dexamethasone compared to that in the control group, on days 1, 3, 5, and 7.

Conclusions

The application of orthodontic forces significantly increased MMP‐1 transcript levels. The use of anti‐inflammatory drugs may have an inhibitory effect on MMP‐1 expression.
Effects of Antegrade Accessory Pathway Conduction on QRS Terminal Vector in Patients with Preexcitation Syndrome
Authors: LIU RENGUANG , CHEN QI , CHEN YANG , ZHANG YINGJIE , XU ZHAOLONG , WANG GAOPIN
Published: January 2017

Background

Ventricle preexcitation through accessory pathway changes QRS initial vector, and manifests as delta wave on electrocardiogram (ECG). However, QRS terminal vector can also be affected.

Methods

A total of 158 patients who had single accessory pathway (AP) with antegrade conduction capacity were included and divided into two groups according to the ECG with or without delta wave. Note that 150 patients had delta wave (overt AP group) on ECG; classical preexcitation syndrome was diagnosed before radiofrequency ablation. Eight patients had no delta wave on ECG (unapparent AP group); preexcitation was induced by transesophageal atrial pacing. ECGs and intracardiac electrogram (IEGM) before and after ablation and during atrioventricular reentrant tachycardia were analyzed.

Results

(1) In the overt AP group: QRS terminal vector amplitude and polarity changes were observed in all the 150 patients, and were related to AP location and delta wave polarity. (2) In the unapparent AP group: QRS terminal vector changes were found in two out of eight patients, and the initial activation of ventricle myocardium via AP on IEGM was almost simultaneous with the onset of QRS complex on ECG.

Conclusions

It is not only the QRS initial vector, but also the QRS terminal vector that can be changed by the antegrade accessory pathway conduction in patients with preexcitation syndrome. The change of QRS terminal vector is valuable for the diagnosis of atypical preexcitation.
Role of root disease in the poor establishment of Medicago pastures after cereal cropping in South Australia
Authors: Pankhurst C. E. , Hawke B. G. , McDonald H. J.
Published: January 2017

Field experiments were conducted in 1991, 1992 and 1994 at three locations in South Australia to investigate the involvement of root pathogenic fungi in the poor establishment and growth of annual medics (Medicago spp.) in naturally regenerating pastures. The severity of root disease across the three sites, rated on a 0–4 scale, was 2·4 (1991), 2·7 (1992) and 1·7 (1994). Medicago emergence and/or herbage production increased in the presence of potassium phosphonate applied as a soil drench or as a postemergence spray at 1·0 kg to 3·0 kg a.i. ha−1 in every year and with metalaxyl applied as a postemergence spray (0·83 kg a.i. ha−1) in 1992 and as a soil drench (5 kg a.i. ha−1) in 1994. The severity of root disease was reduced in the presence of both fungicides. Metalaxyl specifically reduced root infection of Medicago by Pythium spp. whilst potassium phosphonate showed a broader spectrum activity, reducing infection by Fusarium spp., Phoma spp., Pythium spp. and Rhizoctonia solani. Fungal isolates showing pathogenicity towards Medicago littoralis cv. Harbinger in growth cabinet experiments included Fusarium acuminatum, F. avenaceum, F. culmorum, F. crookwellense, F. equiseti, F. graminearum, Phoma medicaginis, Pythium irregulare and Rhizoctonia solani.
Evaluating the efficacy of seasonal grazing and livestock exclusion as restoration tools for birds in riparian habitat of the Okanagan Valley, British Columbia, Canada
Authors: Forrester Timothy R. , Green David J. , McKibbin René , Bishop Christine A.
Published: January 2017

Riparian habitat supports the highest density and diversity of songbirds in Western North America despite covering less than 1% of the land area. Widespread destruction and degradation of riparian habitat, especially by livestock grazing, has led to habitat restoration efforts. In 2000, restoration activities in the form of permanent and seasonal exclusion of livestock from riparian areas were initiated to improve habitat for the endangered Western Yellow‐breasted Chat (Icteria virens auricollis) population, which is dependent on early successional shrub habitat for nesting, in the Okanagan Valley of British Columbia, Canada. We assessed the effectiveness of livestock exclusion by examining temporal changes in the abundance, richness, and breeding performance of birds in restoration and reference sites. The abundance of W. Yellow‐breasted Chats significantly increased between 2002 and 2013 in areas where restoration activities occurred. However, restoration did not have significant effects on the abundance, richness, or breeding performance of other riparian birds at the restoration sites independent of temporal changes that occurred at reference sites. Our results provide evidence that limiting livestock grazing in temperate riparian areas can lead to recovery of endangered riparian songbirds that rely on early successional shrub habitat but may have limited effects on common species that are not strictly reliant on this habitat.
Fifteen Years after the Bellingham ISSRM: An Empirical Evaluation of Frederick Buttel's Differentiating Criteria for Environmental and Resource Sociology
Authors: Qin Hua , Bent Elizabeth , Brock Caroline , Dguidegue Yassine , Achuff Elizabeth , Hatcher Meghan , Ojewola Ojetunde
Published: January 2017

The sociology of natural resources and the environment constitutes a major field of inquiry in the research on human–environmental interactions. A constructive debate and dialogue on the relationships between environmental sociology (ES) and the sociology of natural resources (SNR) began at the 2000 International Symposium on Society and Resource Management (ISSRM) in Bellingham, Washington. Frederick Buttel argued that the two subdisciplines had different subject matters, levels of analysis, spatial focuses, theoretical orientations, policy relevance, and interdisciplinary commitments. These distinctive tendencies have been widely accepted in environmental and natural resource social science but have not been systematically analyzed. The primary objective of this research is to conduct an empirical test of Buttel's differentiating criteria through a systematic review of sample American sociological journal articles published in 2000 and 2014. The multivalue qualitative comparative analysis revealed that there was no clear‐cut divide between the two subfields regarding the combinations of empirical research characteristics, while the general tendencies within both of them became more diverse over time. The overall lack of empirical research evidence for rigid ES–SNR distinctions also indicates that there is more potential than typically realized to build an integrative environmental and resource sociology in the American context and beyond.
Does Institutional Linkage of Bank‐MFI Foster Inclusive Financial Development Even in the Presence of MFI Frauds?
Authors: Ho Shirley J. , Mallick Sushanta K.
Published: January 2017

Growing reports indicate the presence of frauds in microfinance institutions (MFIs), as it can occur in any organization in countries where there are weak institutions, weak rule of law, and fraudulent behavior of MFI officers for personal gain. While there are increasing calls to launch financial governance of these NGO MFIs, there are concerns as to whether frauds of this nature can damage MFIs’ contributions to the credit market, particularly in the bank‐linkage program where the NGO MFIs act as third party intermediary. The purpose of this study was to analyze the collusion decisions faced by MFIs and their impact on the bank‐linkage program, which has been offered as a solution to help overcome adverse selection and moral hazard problems in the credit market by harnessing local information via MFIs. Our results show that even when there is a chance of collusion between MFI and the borrower, the linkage between MFI and bank can still increase the probability that the borrower puts in full effort, and therefore decreases the probabilities of both credit rationing and strategic default. Such linkage in financing viable projects can make micro‐financing more effective in achieving inclusive financial development and thereby poverty reduction in rural areas.
Resolving evolutionary relationships in closely related nonmodel organisms: a case study using chromosomally distinct members of a black fly species complex
Authors: CONFLITTI IDA M. , SHIELDS GERALD F. , MURPHY ROBERT W. , CURRIE DOUGLAS C.
Published: January 2017

Coalescent‐based analyses have been recommended for species delimitation and tree reconstruction. Yet, despite recent advances in molecular methods, acquiring sufficient genetic data often precludes coalescent‐based analyses in nonmodel organisms. We show that these methods are accessible to questions in nonmodel systems. Specifically, we use coalescent‐based analyses to investigate evolutionary independence and relationships among chromosomally distinct members (sibling species) of a black fly (Diptera: Simuliidae) species complex. Our dataset consists of nuclear DNA (nuDNA) and mitochondrial DNA (mtDNA) markers – the former developed using the black fly transcriptome and available genomes from model relatives. We show that individual gene trees exhibit considerable discordance among one another and reveal little about potential species limits. Consistent species tree topologies are obtained from analyses of nuDNA, both with and without the inclusion of mtDNA data. Nodes on the tree receive robust support with the addition of mtDNA. Coalescent‐based species validation approaches recognize all sibling species. However, unlike species tree analyses, the addition of mtDNA data does not improve or alter the results. Thus, analyses of nuDNA alone can validate sibling species. Contrary to these results, population genetic patterns of neutral diversity, within‐locus recombination, and linkage disequilibrium suggest that sibling species represent a single species with high levels of nucleotide polymorphism, large effective population sizes, and extensive gene flow. Demographic patterns inferred from neutrality tests integrate seemingly disparate results by showing signatures of gene flow among structured populations that are expanding in size. Thus, admixture associated with geographic range expansions may be assimilating sibling species into a single genetic lineage.
Identification of a 10/10 matched donor for patients with an uncommon haplotype is unlikely
Authors: Olson J. A. , Gibbens Y. , Tram K. , Kempenich J. , Novakovich J. , Buck K. , Dehn J.
Published: January 2017

Background

Despite over 6 million subjects contributing to the National Marrow Donor Program human leukocyte antigen (HLA) haplotype frequency reference data (HFD), haplotypes cannot be predicted from the HLA assignments of some patients searching for an unrelated donor (URD) in the Be The Match Registry®. We aimed to determine the incidence of these patient searches and whether haplotypes lacking from the HFD can be found among the low‐resolution typed URD pool.

Materials and Methods

New NMDP searches with uncommon patient haplotypes (UPH), defined as a lack of haplotype pairs in any single ethnic group in the HFD based upon HLA‐A˜C˜B˜DRB1˜DQB1, were identified. Each search had up to 20 potential 10/10 or 8/8 URDs typed to determine the likelihood of an allele match.

Results

The incidence of patient searches without haplotype pairs in a single ethnic group in the HFD was 1.2% (N=144 out of 12,172) and a majority of these patients (117; 81%) had one uncommon haplotype previously uncharacterized in the HFD. Non‐White patients had the highest incidence of UPH. Importantly, no patients with UPH had a 10/10 URD identified. The transplant rate among UPH patients was 15%, and a majority of these patients utilized cord blood units as their transplant stem cell source.

Conclusion

Therefore, the HLA HFD that informs the HapLogic matching algorithm is thorough as UPH patient searches were infrequent. Since such patients are highly unlikely to have a fully 10/10 matched URD identified, this study supports the identification of alternative stem cell sources including cord blood or a mismatched URD early in the search process.
Combining one‐step Sanger sequencing with phasing probe hybridization for HLA class I typing yields rapid, G‐group resolution predicting 99% of unique full length protein sequences
Authors: Tu Bin , Masaberg Carly , Hou Lihua , Behm Daniel , Brescia Peter , Cha Nuri , Kariyawasam Kanthi , Lee Jar How , Nong Thoa , Sells John , Tausch Paul , Yang Ruyan , Ng Jennifer , Hurley Carolyn Katovich
Published: January 2017

Background

Sanger‐based DNA sequencing of exons 2+3 of HLA class I alleles from a heterozygote frequently results in two or more alternative genotypes. This study was undertaken to reduce the time and effort required to produce a single high resolution HLA genotype.

Materials and methods

Samples were typed in parallel by Sanger sequencing and oligonucleotide probe hybridization. This workflow, together with optimization of analysis software, was tested and refined during the typing of over 42,000 volunteers for an unrelated hematopoietic progenitor cell donor registry. Next generation DNA sequencing (NGS) was applied to over 1000 of these samples to identify the alleles present within the G group designations.

Results

Single genotypes at G level resolution were obtained for over 95% of the loci without additional assays. The vast majority of alleles identified (>99%) were the primary allele giving the G groups their name. Only 0.7% of the alleles identified encoded protein variants that were not detected by a focus on the antigen recognition domain (ARD)‐encoding exons.

Conclusion

Our combined method routinely provides biologically relevant typing resolution at the level of the ARD. It can be applied to both single samples or to large volume typing supporting either bone marrow or solid organ transplantation using technologies currently available in many HLA laboratories.
In celebration of Ruggero Ceppellini: HLA in transplantation
Authors: Petersdorf E. W.
Published: January 2017

The availability of hematopoietic cell transplantation as curative therapy for blood disorders has been dramatically improved through a better understanding of the human leukocyte antigen (HLA) barrier. Although a fully compatible unrelated donor is preferable, transplantation from donors with a limited degree of HLA mismatching is associated with acceptable outcomes in many cases. Research on the limits of HLA mismatching, and the features that define permissible HLA mismatches will continue to enable transplantation to be more broadly available to patients in need.
Patient engagement in HIV care and treatment in Zambia, 2004–2014
Authors: Chung Neo Christopher , Bolton‐Moore Carolyn , Chilengi Roma , Kasaro Margaret P. , Stringer Jeffrey S. A. , Chi Benjamin H.
Published: January 2017

Objective

To describe engagement along the HIV continuum of care using a large network of clinics in Zambia.

Methods

We employed a practical framework to describe retention along the HIV treatment cascade, using routinely collected clinical data available in resource‐constrained settings. We included health facilities in four Zambian provinces with more than 300 enrolled patients over the age of 5 years. We described attrition at each step, from HIV enrolment to 720 days after ART initiation. The population was further stratified by year of enrolment to describe temporal trends in patient engagement.

Results

From January 2004 to December 2014, 444 439 individuals over the age of 5 years sought HIV care at 75 eligible health facilities. Among those enrolled into HIV care, 82.1% (95% confidence interval [CI]: 79.4–84.5%) were fully assessed for ART eligibility within 180 days of enrolment and 63.6% (95% CI: 61.7–65.3) were found to be eligible for ART based on the HIV treatment guidelines at the time. Of those patients eligible for ART, 81.1% (95% CI: 79.5–82.7%) initiated ART within 180 days. Patient retention in ART programme was 81.2% (95% CI: 80.4–81.9%) at 90 days, 70.0% (95% CI: 68.7–71.2%) at 360 days and 61.6% (95% CI: 60.0–63.2%) at 720 days. We noted a steady decline in proportions assessed for ART eligibility and deemed eligible for ART in the time frame. Proportions that started ART and remained in care remained relatively consistent.

Conclusion

We describe a simple approach for assessing patient engagement after enrolment into HIV care. Using limited types of data routinely available, we demonstrate an important and replicable approach to monitoring programmes in resource‐constrained settings.