bluuebunny/crossref_metadata_2025 huggingface dataset:
A Stochastic Joint Replenishment Problem with Dissimilar Items
Authors: Li Linda , Schmidt Charles P.
Published: June 2019

The classical stochastic joint replenishment problem (SJRP) often assumes uncapacitated batch size, and identical items. However, real problems encountered relate to the truck , or the container which has limited capacity. When the shipping capacity is limited, and the items are dissimilar in size, the problem becomes more challenging. By defining a class of order‐up‐to policies, we formulate the SJRP of this kind as a combinatorial optimization problem. To solve the problem, a data structure and an algorithm are developed. Based on the algorithm, we also suggest several heuristics including the (U, S) policy—a generalization of the well‐known (Q, S) policy for dissimilar items. The numerical study shows the (U, S) policy is robust and efficient. It performs well, especially when the items become more dissimilar, in terms of shipping size and inventory velocity.
Multilingual assessment of early child development: Analyses from repeated observations of children in Kenya
Authors: Knauer Heather A. , Kariger Patricia , Jakiela Pamela , Ozier Owen , Fernald Lia C.H.
Published: June 2019

In many low‐ and middle‐income countries, young children learn a mother tongue or indigenous language at home before entering the formal education system where they will need to understand and speak a country's official language(s). Thus, assessments of children before school age, conducted in a nation's official language, may not fully reflect a child's development, underscoring the importance of test translation and adaptation. To examine differences in vocabulary development by language of assessment, we adapted and validated instruments to measure developmental outcomes, including expressive and receptive vocabulary. We assessed 505 2‐to‐6‐year‐old children in rural communities in Western Kenya with comparable vocabulary tests in three languages: Luo (the local language or mother tongue), Swahili, and English (official languages) at two time points, 5–6 weeks apart, between September 2015 and October 2016. Younger children responded to the expressive vocabulary measure exclusively in Luo (44%–59% of 2‐to‐4‐year‐olds) much more frequently than did older children (20%–21% of 5‐to‐6‐year‐olds). Baseline receptive vocabulary scores in Luo (β = 0.26, SE = 0.05, p < 0.001) and Swahili (β = 0.10, SE = 0.05, p = 0.032) were strongly associated with receptive vocabulary in English at follow‐up, even after controlling for English vocabulary at baseline. Parental Luo literacy at baseline (β = 0.11, SE = 0.05, p = 0.045) was associated with child English vocabulary at follow‐up, while parental English literacy at baseline was not. Our findings suggest that multilingual testing is essential to understanding the developmental environment and cognitive growth of multilingual children.
Neural correlates of infant action processing relate to theory of mind in early childhood
Authors: Filippi Courtney , Choi Yeo Bi , Fox Nathan A. , Woodward Amanda L.
Published: June 2019

The mechanisms that support infant action processing are thought to be involved in the development of later social cognition. While a growing body of research demonstrates longitudinal links between action processing and explicit theory of mind (TOM), it remains unclear why this link emerges in some measures of action encoding and not others. In this paper, we recruit neural measures as a unique lens into which aspects of human infant action processing (i.e., action encoding and action execution; age 7 months) are related to preschool TOM (age 3 years;n = 31). We test whether individual differences in recruiting the sensorimotor system or attention processes during action encoding predict individual differences in TOM. Results indicate that reduced occipital alpha during action encoding predicts TOM at age 3. This finding converges with behavioral work and suggests that attentional processes involved in action encoding may support TOM. We also test whether neural processing during action execution draws on the proto‐substrates of effortful control (EC). Results indicate that frontal alpha oscillatory activity during action execution predicted EC at age 3—providing strong novel evidence that infant brain activity is longitudinally linked to EC. Further, we demonstrate that EC mediates the link between the frontal alpha response and TOM. This indirect effect is specific in terms of direction, neural response, and behavior. Together, these findings converge with behavioral research and demonstrate that domain general processes show strong links to early infant action processing and TOM.
A 24‐week, randomized, double‐blind, active‐controlled clinical trial comparing bexagliflozin with sitagliptin as an adjunct to metformin for the treatment of type 2 diabetes in adults
Authors: Halvorsen Yuan‐Di , Lock John P. , Zhou Wenjiong , Zhu Fang , Freeman Mason W.
Published: June 2019

Aim

To compare the relative safety and effectiveness of bexagliflozin and sitagliptin as adjuncts to metformin for the treatment of adults with type 2 diabetes.

Methods

Participants (n = 386) were randomized to receive bexagliflozin (20 mg) or sitagliptin (100 mg) in addition to their existing doses of metformin. The primary endpoint was the non‐inferiority of bexagliflozin to sitagliptin for change in HbA1c from baseline to week 24. Changes from baseline to week 24 in fasting plasma glucose (FPG), body mass (in subjects with baseline body mass index ≥25 kg m−2) and systolic blood pressure (SBP) were secondary endpoints.

Results

The mean change from baseline to week 24 in HbA1c was −0.74 (95% CI −0.86%, −0.62%) in the bexagliflozin arm and −0.82% (95% CI −0.93%, −0.71%) in the sitagliptin arm, establishing non‐inferiority. The changes from baseline FPG, body mass and SBP were −1.82 mmol L−1, −3.35 kg and −4.23 mmHg in the bexagliflozin arm and −1.45 mmol L−1, −0.81 kg and −1.90 mmHg in the sitagliptin arm, respectively. These differences were significant for the first two measures (one‐sided P = 0.0123, P < 0.0001 and P = 0.0276, respectively.) Adverse events were experienced by 47.1% of subjects in the bexagliflozin arm and 56.0% of subjects taking sitagliptin. Serious adverse events affected 3.7% of subjects in the bexagliflozin arm and 2.1% of subjects in the sitagliptin arm.

Conclusions

Bexagliflozin was non‐inferior to sitagliptin and provided benefits over sitagliptin in FPG and body mass. Adverse event incidences in the two arms were similar.
The first record of Botryodiplodia canker in Poland
Authors: Bartnik Czesław , Boroń Piotr , Michalcewicz Jakub , Ciach Michał
Published: June 2019

This study describes the first observation of Botryodiplodia canker in the Western Carpathians in south‐eastern Poland caused by Botryodiplodia hypodermia (Sacc.) Petr. (syn. Sphaeropsis hypodermia, S. ulmicola). The canker occurred on an approximately 17‐year‐old Ulmus glabra sapling in a mixed conifer/deciduous stand with elm trees severely damaged by Dutch elm disease. This paper describes disease symptoms and provides information on the macro‐ and micromorphology of the fungus isolated from the cankered tissues. The results of BLAST search using DNA sequences obtained for our cultures and subsequent phylogenetic positioning of the fungus among closely related Botryosphaeriaceae indicate that the species is much more closely related to Phaeobotryon than to the other Botryodiplodia or Sphaeropsis species. Moreover, a total of 16 polymorphisms within the ITS region were detected between S. ulmicola associated with Botryodiplodia canker in North America and B. hypodermia associated with the canker observed in Poland. Thus, the “European” variant of “Sphaeropsis” ulmicola can now be easily identified with our barcode sequences. The Botryodiplodia canker is much less prevalent in Europe than in North America. Differences in virulence of “American” and “European” linages and differences in susceptibility of various elm species may be the reason for the higher prevalence of the disease in North America.
Energy conservation in the gut microbe Methanomassiliicoccus luminyensis is based on membrane‐bound ferredoxin oxidation coupled to heterodisulfide reduction
Authors: Kröninger Lena , Steiniger Fabian , Berger Stefanie , Kraus Sebastian , Welte Cornelia U. , Deppenmeier Uwe
Published: June 2019

Methanomassiliicoccus luminyensis was originally isolated from human feces and belongs to the seventh order of methanogens, the Methanomassiliicoccales, which are only distantly related to other methanogenic archaea. The organism forms methane from the reduction of methylamines or methanol using molecular hydrogen as reductant. The energy‐conserving system in M. luminyensis is unique and the enzymes involved in this process are not found in this combination in members of the other methanogenic orders. In this context our central question was how the organism is able to generate ATP. Energy transduction was dependent on a membrane‐bound ferredoxin: heterodisulfide oxidoreductase composed of reduced ferredoxin as an electron donor, at least one protein in the membrane fraction and the heterodisulfide reductase HdrD, which reduced the electron acceptor CoM‐S‐S‐CoB. Electron transfer of this respiratory chain proceeded with a rate of 145 nmol reduced heterodisulfide min−1·mg−1 membrane protein. Methanomassiliicoccus luminyensis is the first example of a methanogenic archaeon that does not require Na+ ions for energy conservation. Only protons were used as coupling ions for the generation of the electrochemical ion gradient. The membrane‐bound F420H2:phenazine oxidoreductase complex (without the electron input module FpoF) probably catalyzed the oxidation of reduced ferredoxin and potentially acted as primary proton pump in this electron transport system. In summary, the energy‐conserving system of M. luminyensis possesses features found in the pathways of hydrogenotrophic and methylotrophic/aceticlastic methanogenesis. Consequently, the composition of the enzymes involved in ion translocation across the cytoplasmic membrane is different from all other methanogenic archaea.
DIC‐based J‐integral evaluation of laser repaired cracks with micro/nanomaterial addition
Authors: Li Yinyin , Jiang Wei
Published: June 2019

Cracks generated by a wire electric discharge machining on compact tension specimens are first repaired by high powered laser beam with different weight fractions of nano‐WC added at the crack tip. Digital image correlation method combined with J‐integral theory is used to measure and calculate J‐integrals of the repaired specimens. Fracture properties of the repaired specimens are compared and studied. The residual stress of specimens after being repaired by laser was also studied to analyze the feasibility of J‐integral to evaluate the fracture properties of the repaired parts. It is found that the influence of residual stress can be neglected when calculating J‐integral in a certain region in case of when the residual stress is small. The J‐integral obtained by the digital image correlation measurement is accurate and can effectively evaluate repairing effects. The paper provides guidance for laser repaired cracks with nanomaterial addition and an effective method for the evaluation of repairing effect.
Wild fledgling tits do not mob in response to conspecific or heterospecific mobbing calls
Authors: Carlson Nora V. , Healy Susan D. , Templeton Christopher N.
Published: June 2019

Mobbing, where birds harass a predator through a combination of vocalizations and stereotyped behaviours, is an effective anti‐predator behaviour for many species. Mobbing may be particularly important for juveniles, as these individuals are often more vulnerable than adults. Although the component behaviours of mobbing are often considered to be un‐learned, there are few confirmatory data, and the developmental trajectory of mobbing is unknown. In this study, we tested whether conspecific or heterospecific mobbing calls initiated mobbing behaviour in juvenile Blue Tits Cyanistes caeruleus. We located wild adult and recently fledged juvenile Blue Tits and presented them with playback recordings of adult conspecific (Blue Tit) and heterospecific (Great Tit Parus major) mobbing alarm calls. Although adult birds readily mob in response to these types of playbacks, juveniles did not exhibit characteristic mobbing behaviour. Some juveniles did, however, exhibit individual components of mobbing behaviour found in mobbing, despite not producing adult‐like mobbing behaviour in response to either conspecific or heterospecific playback. These results suggest that, although birds might be capable of mobbing as juveniles, the associations between the non‐vocal stereotyped mobbing behaviours and mobbing calls may be learned.
Blast flagging of the Sysmex XN‐10 hematology analyzer with supervised cell image analysis: Impact on quality parameters
Authors: Petrone Jessica , Jackups Ronald , Eby Charles S. , Shimer Gail , Anderson Jeanne , Frater John L.
Published: June 2019

Introduction

The Sysmex XN‐10 automated hematology analyzer (Sysmex Corporation) is routinely used in hematology laboratories to perform complete blood cell count with differential (CBC w/ diff). The sensitivity of this system for blast detection is unclear, since many prior studies evaluating the blast flagging capabilities of Sysmex XN series used the white precursor cell (WPC) channel, which is not cleared for use in the United States.

Methods

We assessed the blast flagging capabilities of the Sysmex XN‐10 compared with CellaVision (a cell image analyzer)‐assisted visual hematology results. We evaluated the following flags: “blasts?/abnormal lymph?” and “immature granulocytes present” and compared differences in turnaround time between methods.

Results

We collected data on 2239 CBC w/ diff Sysmex automated analyzer differential and CellaVision‐assisted visual differential from the inpatient hematology‐oncology population of a tertiary care medical center. Solely analyzing the first CBC/diff from each unique patient, both flags had a combined sensitivity of 100%, specificity of 50.2%, PPV of 21.7%, and NPV of 100%. The mean turnaround time for the automated differential was 19.5 minutes (SD 35.9 minutes) compared with 66.4 minutes for the CellaVision‐assisted visual differential (SD 68.5 minutes; P < 0.001; Figure 1).

Conclusion

The Sysmex XN‐10 abnormal lymphocyte/blast and immature granulocytes flags had excellent sensitivity and acceptable specificity in detecting circulating blasts with shorter turnaround time than the CellaVision‐assisted visual differential. Our study suggests that automated differentials performed on Sysmex XN‐10 can replace visual differentials as a first‐line screening method for blast detection with improved turnaround time in hematology‐oncology populations.
The applicability of multiparameter flow cytometry for the detection of minimal residual disease using different‐from‐normal panels to predict relapse in patients with acute myeloid leukemia after allogeneic transplantation
Authors: Wang Ziwei , Guo Mengqiao , Zhang Yuesheng , Xu Sheng , Cheng Hui , Wu Jiawei , Zhang Weiping , Hu Xiaoxia , Yang Jianmin , Wang Jianmin , Tang Gusheng
Published: June 2019

Background

The MRD status detected using multiparameter flow cytometry (MFC) before allogeneic hematopoietic stem cell transplantation (allo‐HSCT) has crucial prognostic value for patients with acute myeloid leukemia (AML) in morphologic complete remission (CR). We designed a novel panel of antibodies to identify aberrant differentiation/maturation profiles of residual leukemia cells in patients who were not diagnosed at our institution, relapsed with an antigenic shift, or lack leukemia‐associated immunophenotypes.

Methods

We compared the MRD status detected using MFC and real‐time quantitative polymerase chain reaction (RT‐qPCR) in the same 158 bone marrow samples collected from 44 AML patients carrying leukemia‐specific fusion genes. The clinical performance of the MFC‐based MRD status was analyzed in 168 AML patients who exhibited morphologic CR (135) or active disease (33) before HSCT.

Results

Strong concordance was found between MFC‐based and RT‐qPCR‐based MRD status (κ = 0.868). Among the patients displaying CR, the positive MRD status detected using MFC was correlated with a worse prognosis [HRs (P values) for relapse, event‐free survival, and overall survival: 4.83 (<0.001), 2.23 (0.003), and 1.79 (0.049), respectively]; the prognosis was similar to patients with an active disease before HSCT. Patients with a positive MRD before HSCT might experience a benefit from developing chronic graft‐vs‐host disease.

Conclusions

The assessment of MRD using our self‐built different‐from‐normal AML‐MRD detection panel exhibited reliable sensitivity, specificity, and accuracy. In addition, patients with a positive MRD status before transplantation may have higher risk of relapse and worse survival.
Exploring patient preferences for involvement in medication management in hospitals
Authors: Bucknall Tracey , Digby Robin , Fossum Mariann , Hutchinson Alison M. , Considine Julie , Dunning Trisha , Hughes Lee , Weir‐Phyland Janet , Manias Elizabeth
Published: June 2019

Aim

The aim of this study was to identify patient preferences for involvement in medication management during hospitalization.

Design

A qualitative descriptive study.

Methods

This is a study of 20 inpatients in two medical and two surgical wards at an academic health science centre in Melbourne, Australia. Semi‐structured interviews were recorded and analysed using content analysis.

Findings

Three themes were identified: (a) ‘understanding the medication’ established large variation in participants’ understanding of their pre‐admission medication and current medication; (b) ‘ownership of medication administration’ showed that few patients had considered an alternative to their current regimen; only some were interested in taking more control; and (c) ‘supporting discharge from hospital’ showed that most patients desired written medication instructions to be explained by a health professional. Family involvement was important for many.

Conclusion

There was significant diversity of opinion from participants about their involvement in medication management in hospital. Patient preferences for inclusion need to be identified on admission where appropriate. Education about roles and responsibilities of medication management is required for health professionals, patients and families to increase inclusion and engagement across the health continuum and support transition to discharge.

Impact statement

Little is known about patient preferences for participation in medication administration and hospital discharge planning. Individual patient understanding of and interest in participation in medication administration varies. In accordance with individual patient preferences, patients need to be included more effectively and consistently in their own medication management when in hospital.
The effectivness of a strengths‐oriented therapeutic conversation intervention on perceived support, well‐being and burden among family caregivers in palliative home‐care
Authors: Petursdottir Asta B. , Svavarsdottir Erla Kolbrun
Published: June 2019

Aims

To evaluate the effectiveness of a two‐session multicomponent family strengths‐ oriented therapeutic conversation intervention among family caregivers of an individual with advanced/final stage cancer during ongoing palliative home‐care.

Background

Family caregivers of patients in the advanced/final phases of cancer, experience multifaceted psychological distress and morbidity. Psychosocial interventions improve the well‐being of family members who are caring for their close relative.

Design

A pre‐experimental design with a one‐group pre‐test/posttests measurements.

Methods

Forty‐eight family caregivers were assigned to receive two 60–90 min sessions of the intervention. The primary outcome was perceived emotional and cognitive support and psychological well‐being, measured at baseline (T1). Then the participants were offered the first session of the intervention. About 1 week later, the second session was administered. The participants answered the same questionnaires again (T2) and then 2–4 weeks later (T3). The guideline; Criteria for Reporting Development and Evaluation of Complex Interventions 2, guided the reporting of the study.

Results

Family caregivers reported significantly higher emotional and cognitive support post‐intervention (T2) and at (T3). They also reported significantly reduced stress symptoms at (T3) and reduced caregiver burden post‐intervention (T2) and at (T3).

Conclusion

The provision of the intervention contributed to extending knowledge about the usefulness of family conversations in the context of advanced/final stage cancer care.

Impact

There is a lack of knowledge about the benefit of therapeutic conversation interventions for family caregivers. The therapeutic conversation intervention offered, resulted in perceived support, decreased stress, and decreased caregiving demands among caregivers in palliative home‐care. Trial registration number: ISRCTN 21786830.
Lipidomic characteristics and clinical findings of epileptic patients treated with valproic acid
Authors: Li Rong , Qin Xingyue , Liang Xiaoliu , Liu Meizhen , Zhang Xiaoxi
Published: June 2019

Our early study has found valproic acid (VPA)‐induced lipid dysmetabolism in animal model, however, the details of lipid profiling of VPA‐treated epileptic patients remain unknown. Therefore, in this study, the blood samples of VPA‐treated epileptic patients and VPA‐free controls were collected for lipidomic and biochemical assays. As results, clinical data showed the changes of some blood lipid molecules in VPA‐treated epileptic patients. In lipidomic assays, all 3797 annotated positive ions were identified prior to the data validation. In addition, the number of differentially expressed lipids were identified. And the 133 lipid molecules in VPA‐treated cases were significantly up‐regulated when compared to those in controls, while other 250 lipid metabolites were down‐regulated. Further, these lipid metabolites were mainly constituted with glycerolipids, glycerophopholipids, fatty acyls, sterol lipids. In addition, the most significant elevations of metabolite molecules of triglyceride, sphingomyelin, phosphorylcholine, ceramides, phenolic phthiocerol, as well as topped reductions of phosphoethanolamines, diradylglycerols, 1α,25‐dihydroxy‐24‐oxo‐22‐oxavitamin D3, 2‐deoxy‐20‐hydroxy‐5alpha‐ecdysone 3‐acetate, dolichyl‐4 phosphate were identified respectively. Taken together, these clinical findings demonstrate that negative impacts of exposure to VPA on expression of lipid mediators, progressively disrupting the functions of lipid molecules. Interestingly, these differentially expressed metabolites may be potential biomarkers for screening VPA‐induced dyslipidemia.
Little to no inbreeding depression in a tapeworm with mixed mating
Authors: Caballero Isabel C. , Criscione Charles D.
Published: June 2019

Meta‐studies on hermaphrodites have found a negative relationship between primary selfing rates and levels of inbreeding depression (ID) and, thus, generally support purging in inbred systems. However, in plants, high among‐taxa variance in ID results in no difference in the mean ID between outcrossing and mixed‐mating taxa. Selective interference likely explains high ID among mixed‐mating taxa, whereas low levels of ID among mixed‐mating taxa are not as stressed. Among animal hermaphrodites, primarily molluscs, there are little data on mixed‐mating systems. To fill a taxonomic and mating system gap, we tested for ID in a mixed‐mating tapeworm, Oochoristica javaensis. We provide a direct estimate of ID across infection of an intermediate host by comparing selfing rates at two life history stages. We found little to no evidence for ID, and the level of ID falls in line with what is reported for highly selfing species even though O. javaensis has mixed mating. We discuss this result within the context of kin mating in O. javaensis. Our results emphasize that primary selfing rates alone may be insufficient to classify the inbreeding history in all species when testing for a relationship to ID. Mixed‐mating taxa, and possibly some outcrossing taxa, may exhibit low levels of ID if biparental inbreeding is also driving purging. We advocate that ID studies report estimates of inbreeding history (e.g. FIS or identity disequilibrium) from nature‐derived adult samples to provide context rather than relying on primary selfing rates alone.
Factors Associated With Deprescribing Acetylcholinesterase Inhibitors in Older Nursing Home Residents With Severe Dementia
Authors: Niznik Joshua D. , Zhao Xinhua , He Meiqi , Aspinall Sherrie L. , Hanlon Joseph T. , Nace David , Thorpe Joshua M. , Thorpe Carolyn T.
Published: June 2019

BACKGROUND/OBJECTIVE

Uncertainty regarding benefits and risks associated with acetylcholinesterase inhibitors (AChEIs) in severe dementia means providers do not know if and when to deprescribe. We sought to identify which patient‐, provider‐, and system‐level characteristics are associated with AChEI discontinuation.

DESIGN

Analysis of 2015 to 2016 data from Medicare claims, Part D prescriptions, Minimum Data Set (MDS), version 3.0, Area Health Resource File, and Nursing Home Compare. Cox‐proportional hazards models with time‐varying covariates were used to identify patient‐, provider‐, and system‐level factors associated with AChEI discontinuation (30‐day or more gap in supply).

SETTING

US Medicare–certified nursing homes (NHs).

PARTICIPANTS

Nonskilled NH residents, aged 65 years and older, with severe dementia receiving AChEIs within the first 14 days of an MDS assessment in 2016 (n = 37 106).

RESULTS

The sample was primarily white (78.7%), female (75.5%), and aged 80 years or older (77.4%). The most commonly prescribed AChEIs were donepezil (77.8%), followed by transdermal rivastigmine (14.6%). The cumulative incidence of AChEI discontinuation was 29.7% at the end of follow‐up (330 days), with mean follow‐up times of 194 days for continuous users of AChEIs and 105 days for those who discontinued. Factors associated with increased likelihood of discontinuation were new admission, older age, difficulty being understood, aggressive behavior, poor appetite, weight loss, mechanically altered diet, limited prognosis designation, hospitalization in 90 days prior, and northeastern region. Factors associated with decreased likelihood of discontinuation included memantine use, use of strong anticholinergics, polypharmacy, rurality, and primary care prescriber vs geriatric specialist.

CONCLUSION

Among NH residents with severe dementia being treated with AChEIs, the cumulative incidence of AChEI discontinuation was just under 30% at 1 year of follow‐up. Our findings provide insight into potential drivers of deprescribing AChEIs, identify system‐level barriers to deprescribing, and help to inform covariates that are needed to address potential confounding in studies evaluating the potential risks and benefits associated with deprescribing. J Am Geriatr Soc 67:1871–1879, 2019
The effect of an educational program based on Roy's adaptation model on the quality of life of patients suffering from heart failure: A clinical trial study
Authors: Mansouri Akram , Baraz Shahram , Elahi Nasrin , Malehi Amal S. , Saberipour Bayan
Published: June 2019

Aim

Heart failure is a progressive, debilitating disease with exacerbated physical and psychological symptoms that reduces the quality of life of patients. Nursing intervention based on nursing theories could help in the adaptation of patients to the disease and improving quality of life. The aim of this study was to determine the effect of an educational program based on Roy's adaptation model on the quality of life of patients with heart failure.

Methods and Material

In this randomized controlled trial, 76 patients with heart failure were allocated to either the intervention or control group through a blocked randomization method. The data were collected between May and October 2017. The intervention group received oral and written educational programs for 4 weeks. Minnesota quality‐of‐life questionnaire and Roy's adaptation model‐based evaluation form was completed at the beginning of the trial, and 1 month after the completion of the study.

Results

Intervention patients showed statistically significantly improved scores on the physiologic, role function, independence‐interdependence dimensions and the total score of Roy's adaptation model over time compared with control patients (p < .05). The mean score of all of the three quality‐of‐life dimensions and total score of quality of life increased significantly (p < .05).

Conclusion

The study results help nursing staff detect the stimuli and the behaviors of patients with heart failure. Roy's adaptation model can be used as a standard practice to increase adaptation to the disease and improving quality of life.
Age‐related macular degeneration among the elderly: The 5th National Health and Nutrition Examination Survey, 2010 through 2012
Authors: Kim Chul‐Gyu , Park Seungmi , Kim Youngji
Published: June 2019

Aim

This study was conducted to identify the prevalence and factors associated with age‐related macular degeneration (AMD) in Korean elderly.

Methods

The study population of this cross‐sectional survey was the Korean Health and Nutrition Examination Survey (KHANES) 2010 through 2012, the fifth population‐based study.

Results

Analysis of 2,767 elderly (above age 65) from 23,376 participants showed the prevalence of any AMD to be 17.6% in the Korean elderly. Factors that were significantly positively associated with AMD included age, sex, occupation, low socioeconomic status, liver cirrhosis and physical activity (p < .01). Significantly negatively associated with AMD were cardiovascular disease, obesity, and beta‐carotene intake (p < .05).

Conclusions

This study estimated the prevalence rate and assessed factors associated with AMD in the elderly. This can be used to build a strategy for elderly eye health, and provides valuable information for screening for putative risks in the elderly.
Effect of triage nurse‐led application of the Ottawa Ankle Rules on number of radiographic tests and length of stay in selected emergency departments in Oman
Authors: Al Abri Fatema H. , Muliira Joshua K. , Al Awaisi Huda
Published: June 2019

Aim

Ankle injuries are commonly seen in the emergency department (ED) and contribute to overcrowding. In Oman, injuries are a leading cause of years of life lost, disability‐adjusted life years, and pose a burden to the healthcare system. This study aimed to evaluate the effectiveness of ED triage nurse‐led application of the Ottawa Ankle Rules (OARs) toward improving the healthcare outcomes of ankle injury patients.

Methods

A quasi‐experimental design was used to collect data (demographic characteristics, waiting time, length of stay, and number of radiographic tests) from 96 patients. The intervention group (n = 46) received ED triage nurse‐led assessment and initiation of radiographic tests based on the OARs. The control group (n = 50) received usual care.

Results

The participants' mean age was 26.4 ± 7.90 years. The main causes of ankle injuries were football (36%), falls (31%) and twisting while walking (24%). There was a significant difference in number of ankle X‐rays (t = 6.19; p < .001); length of stay (U = 549; p < .001); and waiting time (U = 167; p < .001) between the control and intervention group. The intervention reduced the mean waiting time and length of stay by 25.09 and 41.01 min, respectively.

Conclusion

Application of the OARs by the ED triage nurse can decrease the number of unnecessary radiographic tests, waiting time and length of stay in the ED. Nurses' utilization of evidence‐based clinical decision‐making tools can improve ED care outcomes of common acute conditions such as ankle injuries.
Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery
Authors: Guo Min , Wang Cui , Yin Xiumin , Nie Liting , Wang Gongchao
Published: June 2019

Aim

To explore symptom clusters experienced by patients with oesophageal cancer 3 months after surgery and examine whether symptom clusters are related to demographic, clinical and quality of life variables.

Background

There are multiple symptoms in patients with oesophageal cancer after surgery, which seriously affect their quality of life. Exploring the mechanics of concurrent symptoms such as symptom clusters may facilitate the development of strategies to reduce the impact of these symptoms and improve quality of life.

Design

Cross‐sectional survey. The STROBE Statement was chosen as the EQUATOR checklist.

Methods

A convenience sample of 128 oesophageal cancer patients was followed up at 3 months after surgery. Participants completed the demographic questionnaire, the M. D. Anderson Symptom Inventory for Gastrointestinal Cancer, the Functional Assessment of Cancer Therapy‐General and the Connor‐Davidson Resilience Scale. Exploratory factor analysis, stepwise regression and correlation analysis were applied.

Results

Four symptom clusters were identified: dysphagia–psychological, chemoradiotherapy side‐effect, digestive tract reconstruction and fatigue–sleep. Gender, stage of disease and resilience influenced the dysphagia–psychological symptom cluster. Gender, stage of disease, resilience and treatment were significant factors affecting the chemoradiotherapy side‐effect and fatigue–sleep symptom clusters. Gender, stage of disease, resilience and anastomotic position were significant factors influencing the digestive tract reconstruction symptom cluster. The correlations between symptom clusters and quality of life were significant, with the highest correlation between the dysphagia–psychological cluster and quality of life.

Conclusions

Nurses should pay more attention to symptom management in patients with oesophageal cancer 3 months after surgery by focusing on four symptom clusters. It is necessary to implement individualised care depending on the influence factors including gender, stage of disease, resilience, treatment and anastomotic position.

Relevance to clinical practice

These findings will help develop targeted interventions to facilitate further symptom management for transitional nursing from the peri‐operative phase to long‐term rehabilitation.
The experience of advance care planning discussion among older residents in a long‐term care institution: A qualitative study
Authors: Fan Sheng‐Yu , Sung Huei‐Chuan , Wang Shu‐Chen
Published: June 2019

Aims and objectives

To explore the experiences and processes of advance care planning (ACP) discussions in older residents of a long‐term care institution.

Background

Advance care planning can facilitate discussion about end‐of‐life care and help to identify individual's views, wishes and beliefs about dying at a time when they have the cognitive capacity to reflect on and/or make such decisions.

Design

A qualitative study was conducted.

Methods

Twenty‐eight older adults in a long‐term care institution participated in person‐to‐person interviews using an ACP booklet, which included topics such as life review, healthy habits and behaviours, and end‐of‐life care issues and information. The discussions were recorded, and thematic analysis was used to analyse the qualitative data. The Standards for Reporting Qualitative Research (SRQR) checklist was followed.

Results

Three themes were identified. First, participants identified that ACP could help to ensure that they achieved their view of a “good death.” Second, the process of ACP bought up difficult decisions that many participants expressed uncertainty about making. Third, participants' ability and willingness to plan for end of life were shaped by considerations about their family members' needs, views and potential role as their future carer.

Conclusions

The ACP process involved not only personal ideas about good death but also families' concerns. Uncertainty and lack of information created difficult barriers.

Relevance to clinical practice

Healthcare professionals could address the concept of good death, deliver information for their concerns and promote communication with family members.
Exploring women's health care experiences through an equity lens: Findings from a community clinic serving marginalised women
Authors: Prodan‐Bhalla Natasha , Browne Annette J.
Published: June 2019

Aims and objectives

To explore how marginalised women perceive and rate equity‐oriented health care at a primary care clinic using items that evaluate patients' experiences of care.

Background

Despite an increased recognition of the importance of health care that is equity‐oriented, and that understands the patient within the context of the broader social determinants of health, inequities in health remain prevalent around the world.

Design

Items from the “EQUIP Primary Health Care" research programme were used to explore patients' experiences of equity‐oriented health care. Women were invited to complete the questionnaire with the explicit aim of gaining their input to improve quality of care at the clinic. The Strengthening the Reporting of Observational Studies in Epidemiology Statement was followed for the study.

Methods

Sixty‐seven women who experienced significant health and social inequities, and were seeking care at a women's only nurse practitioner primary health care clinic in Canada, were invited to complete the questionnaire. For quality improvement purposes, correlational analyses were used to explore women's experiences of care.

Results

Women's responses showed that Promote Emotional Safety and Trust and Overall Quality of Care were the most highly correlated domains, indicating the importance of the health care team in establishing trusting relationships, particularly for women who experience stigma and negative judgement when seeking care.

Conclusion

Seeking feedback from patients on their experiences of care using items developed to explicitly tap into equity issues is useful in understanding how patients experience equity‐oriented health care. Responses from the women highlight the importance of understanding not only the what of equity‐oriented care but also the how.

Relevance to clinical practice

The results of this study illustrate the importance of establishing trusting relationships, tailoring care, and using a nondiscriminatory approach when working with women who experience negative judgements when seeking care.
Prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders
Authors: dos Santos Treichel Carlos Alberto , da Rosa Jardim Vanda Maria , Prado Kantorski Luciane , Guimarães Lima Margareth
Published: June 2019

Aims and objectives

This study aimed to analyse the prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders.

Background

Studies conducted with family caregivers of people with dementia and cancer point out a high prevalence of suicidal ideation among these subjects; however, this aspect has not yet been investigated among family caregivers of people with mental disorders.

Design

This is a cross‐sectional study, conducted with 537 family caregivers of patients from 16 Psychosocial Care Centers (CAPS) of the 21st Health Region of the state of Rio Grande do Sul, Brazil.

Methods

Question 17 of the Self‐Reporting Questionnaire (SRQ‐20) was used for suicidal ideation screening. The prevalence of suicidal ideation was calculated according to sociodemographic and care variables, with confidence interval estimate (95% CI). Crude and adjusted odds ratios were calculated by logistic regression. The Guidelines to Reporting of Observational Studies in Epidemiology (STROBE Statement) was adhered in this study (See File S1).

Results

The prevalence of suicidal ideation found in this study for the 30 days preceding the interview was 12.5% (95% CI: 10–15). The factors associated with the outcome were lower age, lower schooling, feeling of burden, self‐report of stress problem and dissatisfaction with family relationships.

Conclusion

The prevalence of suicidal ideation among the studied family caregivers was high and strongly associated with issues regarding care, showing the need for interventions that provide support.

Relevance for clinical practice

Nurses are a large part of the workforce of the community mental health services. The careful characterisation of the subjects who show suicidal ideation, as performed in this study, may reveal specificities capable of refining the diagnostic potential for establishment of action plans in a timely manner, avoiding possible attempts or even the consummation of suicide.
“You only have time for so much in 12 hours” unmet social needs of hospitalised patients: A qualitative study of acute care nurses
Authors: Brooks Carthon J. Margo , Hedgeland Taylor , Brom Heather , Hounshell Danielle , Cacchione Pamela Z.
Published: June 2019

Aims and objectives

To explore the experiences of nurses caring for socially at‐risk patients and gain an understanding of the challenges nurses face when providing care.

Background

Nurses play a pivotal role in caring for hospitalised patients with social risk factors and preparing them for discharge. Few studies have explored whether acute care nurses are adequately supported in their practice environments to address the unique needs of socially at‐risk patients as they transition back into community settings.

Design

A qualitative descriptive study of nurses working in a large urban academic medical centre.

Methods

We conducted six semi‐structured focus groups of nurses (n = 21). Thematic content analysis was performed to analyse the transcripts from the focus groups. We adhered to COREQ guidelines for reporting this qualitative study.

Results

Six key themes emerged: (a) nurses’ assessments of social risk factors, (b) experiences providing care, (c) barriers to care, (d) fear of “labelling” socially at‐risk patients, (e) unmet social care needs and (f) recommendations to improve care.

Conclusions

Our findings suggest that nurses are able to identify social risk factors. However, prioritisation of medical needs during acute care hospitalisation and lack of organisational supports may deter nurses from fully addressing social concerns.

Relevance to clinical practice

Acute care nurses should be involved in the development of future efforts to address the needs of socially at‐risk patients and be provided with additional supports in their practice environments. This could include continuing education to build nursing competencies in community‐based care and social vulnerability.
Psychosocial behaviour reactions, psychosocial needs, anxiety and depression among patients with rectal cancer before and after colostomy surgery: A longitudinal study
Authors: Jin Ying , Zhang Jing , Zheng Mei‐Chun , Bu Xiu‐Qing , Zhang Jun‐E
Published: June 2019

Aims and objectives

To compare the differences in psychosocial behaviour reactions, psychosocial needs, anxiety and depression before and after colostomy surgery and to explore the predictors of psychosocial behaviour reactions.

Background

Colorectal cancer is increasing worldwide. Abdominoperineal resection accompanied by permanent colostomy can cause complicated psychosocial reactions and needs. However, colostomy patients' trajectories of psychosocial adjustment at different time points must be discussed.

Design

A longitudinal study.

Methods

Using a convenience sampling method, 67 patients planning to undergo colostomy surgery were recruited from a tertiary cancer centre in southern China from January 2013–January 2014. Data collection consisted of two phases, conducted 1–2 days before surgery and 1–2 days prior to discharge. The Ostomy Psychosocial Behaviour Reaction Questionnaire, the Ostomy Psychosocial Needs Questionnaire, the Hospital Anxiety and Depression Scale and a self‐designed demographic questionnaire were used to collect data. STROBE guidelines were followed.

Results

The participants had a moderate level of psychosocial behaviour reactions, a deep and wide range of psychosocial needs and a high incidence of anxiety and depression before and after surgery. Anxiety before surgery was significantly higher than that after surgery. Psychosocial needs and anxiety were significant predictors of psychosocial behaviour reactions.

Conclusions

Patients' anxiety was alleviated after surgery. The combination of ascertaining and meeting various psychosocial needs and managing negative emotions was helpful in alleviating patients' stress responses before and after surgery.

Relevance to clinical practice

An increased focus on the relationships among psychosocial behaviour reactions, psychosocial needs, anxiety and depression at different time points in colostomy patients is necessary for future research and practice.
Instruments measuring behavioural aspects of the nurse–patient relationship: A scoping review
Authors: Feo Rebecca , Conroy Tiffany , Wiechula Rick , Rasmussen Philippa , Kitson Alison
Published: June 2019

Aims and objectives

To identify and map tools measuring behavioural aspects of the nurse–patient relationship.

Background

The behaviours nurses employ to develop relationships with patients form a key part of nursing practice. Systematically measuring these behaviours provides an objective means of assessing and evaluating how nurses establish and maintain relationships with patients in a variety of settings. Whilst tools exist to measure these behaviours, little is known about their aims/scope, structure, method of development and contexts of use. Such knowledge is crucial for understanding the nature of the literature, including in which contexts and for which patient groups existing tools are suited.

Design

Scoping review informed by Joanna Briggs Institute methodology.

Methods

A database search was undertaken using CINAHL, PsycINFO, Pubmed and Embase. Primary research articles, theses and methodological papers that developed, refined and/or administered tools measuring behavioural aspects of the nurse–patient relationship, in any setting and for any patient group, were included. Tools had to measure actual not hypothetical behaviour (e.g., perceptions regarding importance). Data from included studies and tools were mapped. Results are reported in accordance with PRISMA‐ScR guidelines.

Results

One hundred and twenty‐seven studies, containing 35 tools, were included. The literature was characterised by substantial variability, stemming from the continued refinement of tools (e.g., reduction to short forms) but also the development of new tools that appeared to duplicate existing work and the inconsistent use of tools across studies.

Conclusions

The volume of tools available demonstrates the importance of measuring the nurse–patient relationship. However, the existing duplication and variability create challenges in choosing amongst the tools available and show that, as a concept, the nurse–patient relationship remains poorly understood.

Relevance to clinical practice

Research is required to synthesise, and assess the quality of, existing tools, enabling clinicians, leaders/managers, educators and researchers to administer appropriate tools to evaluate the nurse–patient relationship.