bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced lower bounds and exact procedures for total completion time minimization in a two‐machine permutation flowshop with release dates
Authors: Mrad Mehdi , Chalghoumi Sabrine , Ladhari Talel , Gharbi Anis
Published: May 2017

We consider the problem of minimizing the sum of completion times in a two‐machine permutation flowshop subject to release dates. New procedures are proposed for effectively bounding the completion time of a given job that is processed at a given position. New assignment‐based lower bounds are derived as well as an enhanced mathematical programming formulation. Our computational analysis shows a consistent tightness of the proposed lower bounds and a high outperformance of the enhanced mathematical formulation with respect to the classical one.
Temperature dependence of field‐responsive mechanisms in lead zirconate titanate
Authors: Chung Ching‐Chang , Fancher Chris M. , Isaac Catherine , Nikkel Jason , Hennig Eberhard , Jones Jacob L.
Published: May 2017

An electric field loading stage was designed for use in a laboratory diffractometer that enables in situ investigations of the temperature dependence in the field response mechanisms of ferroelectric materials. The stage was demonstrated by measuring PbZr1−xTixO3 (PZT) based materials—a commercially available PZT and a 1% Nb‐doped PbZr0.56Ti0.44O3 (PZT 56/44)—over a temperature range of 25°C to 250°C. The degree of non‐180° domain alignment (η002) of the PZT as a function of temperature was quantified. η002 of the commercially available PZT increases exponentially with temperature, and was analyzed as a thermally activated process as described by the Arrhenius law. The activation energy for thermally activated domain wall depinning process in PZT was found to be 0.47 eV. Additionally, a field‐induced rhombohedral to tetragonal phase transition was observed 5°C below the rhombohedral‐tetragonal transition in PZT 56/44 ceramic. The field‐induced tetragonal phase fraction was increased 41.8% after electrical cycling. A large amount of domain switching (η002=0.45 at 1.75 kV/mm) was observed in the induced tetragonal phase.
Critical Thinking: Art Criticism as a Tool for Analysing and Evaluating Art, Instructional Practice and Social Justice Issues
Authors: Broome Jeffrey , Pereira Adriane , Anderson Tom
Published: May 2017

Recent educational initiatives have emphasised the importance of fostering critical thinking skills in today's students in order to provide strategies for becoming successful problem solvers throughout life. Other scholars advocate the use of critical thinking skills on the grounds that such tools can be used effectively when considering social justice issues. In this article we make the case that the teaching and learning strategies of analytic art criticism can serve as fundamental tools used not just for the study of art but can also centre critical thinking and analysis in all aspects of the art education curriculum. Our argument begins with a review of literature on the use of art criticism for critical thinking and meaning making. Then we describe our efforts to address critical thinking with our students by using the critical analysis model of art criticism and applying it to learning environments for forming reasoned judgments about teaching and learning, and also as springboard for examining social justice issues. We believe that promoting this form of affectively driven, intellectually guided critical thinking makes our students potentially more successful not just in their encounters with art and education, but also in their lives as human beings beyond school.
Design Education without Borders: How Students Can Engage with a Socially Conscious Pedagogy as Global Citizens
Authors: Macdonald Iain , MacLeod Myrna
Published: May 2017

This study examines the student experience of a third sector graphic design project in an international context. Inspired by a humanist and socially conscious perspective that was originally set out by Ken Garland's ‘First Things First’ manifesto in 1964, the project developed into a collaborative learning experience for African and European students. The aim of this project was to develop student global citizenship and mobility through a cultural learning experience in a very different environment with challenging resources and social conditions. Using student interviews and evidence from their reflective journals, this article analyses how UK design students participated and negotiated the implementation of live projects in an African context, specifically Mozambique. It also examines the wider impact on the cohort of students and friends who did not travel to Africa but followed the experience online. Risk taking, experimentation and an appetite for enquiry are attributes that students are encouraged to develop, but they can equally apply to teachers and lecturers as they develop their curricula. Within the framework of university learning, teaching and assessment strategies space can be found for design educators to look beyond corporate and conventional consumer outlets to a more socially conscious and community focus without borders.
Art Education and the Moral Injunction to be Oneself
Authors: Stabler Albert
Published: May 2017

A primary function of schooling is to impart moral discipline, and art education distills this role to its core imperative of mandated pleasure, summarised by Jacques Lacan as the ‘will to enjoy’. This manifests in the insistence that, despite producing similar outcomes, students come to recognise themselves as unique and creative. In the twentieth century, art education in the USA has developed methods for extracting supposedly intimate personal expressions from young people, albeit without demanding the technical versatility, historical knowledge and critical reflection required of mature artists – the exception to this, despite its many flaws, being so‐called Discipline‐Based Art Education, or DBAE. In this article, I begin with reflections on the untapped potential of DBAE to relate to contemporary art practices. My ideas on moral instruction are expanded upon in the second section, when I undertake a ‘backwards’ history of British and American art education, in which the ideal of art class as a site of intrinsic and authentic meaning‐making is challenged by the functional requirements of education. My last section takes up a critique of critical pedagogy, in which I use the example of a project my high school students did about Michael Jackson to challenge ways in which trauma and pleasure are seen by critical pedagogues as features of experience that conflict fatally with the educational ends of individualist autonomy.
Work climate and the mediating role of workplace bullying related to job performance, job satisfaction, and work ability: A study among hospital nurses
Authors: Olsen Espen , Bjaalid Gunhild , Mikkelsen Aslaug
Published: May 2017

Aim

To increase understanding of workplace bullying and its relation to work climate and different outcomes among nurses. Examine a proposed bullying model including both job resource and job demands, as well as nurse outcomes reflected in job performance, job satisfaction, and work ability.

Background

Workplace bullying has been identified as some of the most damaging mechanisms in workplace settings. It is important to increase understanding of workplace bullying in relation to work climate and different outcomes among nurses.

Design

This study adopted a cross‐sectional web based survey design.

Method

A sample of 2946 Registered Nurses from four public Norwegian hospitals were collected during October 2014. We analysed data using descriptive statistics, correlations, Cronbach's alpa, confirmatory factor analyses, and structural equation modelling.

Results

The majority of work climate characteristics confirmed to influence workplace bullying, and additionally had direct influence on nurse outcomes; job performance, job satisfaction, and work ability. Bullying had a mediational role between most of the work climate dimensions and nurse outcomes.

Conclusion

This study increases our understanding of organizational antecedent of bullying among nurses. Workplace bullying among nurses functions as a mediator between the majority of work climate dimensions and outcomes related to job satisfaction and work ability. Strategies to reduce bullying should look at the study finding and specifically job resources and job demands that influence bullying and nurse outcomes.
The inter‐play between facilitation and context in the promoting action on research implementation in health services framework: A qualitative exploratory implementation study embedded in a cluster randomized controlled trial to reduce restraint in nursing homes
Authors: Mekki Tone Elin , Øye Christine , Kristensen Bodil , Dahl Helen , Haaland Astrid , Nordin Kristin Aas , Strandos Marta , Terum Toril Marie , Ydstebø Arnt Egil , McCormack Brendan
Published: May 2017

Aim

To explore the inter‐play between external facilitation and nursing home contexts relative to intervention outcomes.

Background

The Promoting Action on Research Implementation in Health Services framework is frequently used to theoretically inform implementation and research in nursing and recent reviews indicate high face validity for health services. However, the inter‐play and relationship between framework sub‐elements of evidence, context and facilitation and the prospective utility in non‐English speaking contexts warrant further illumination.

Design

In an overarching single‐blind cluster‐randomized controlled trial, we applied participatory action research and ethnography from August 2011–June 2015 to evaluate a standardized education intervention to reduce restraint and agitation in nursing home residents living with dementia. The trial results are published elsewhere.

Methods

Prospectively informed by the PARIHS framework, a research team and eight facilitators participating in dual roles as action researchers designed, implemented, and evaluated the intervention. How contextual factors influenced the facilitation processes were explored in focus group interviews (1), reflection notes (84) written by the facilitators’ after each education session, ethnographic field studies (6 homes), and co‐analysis workshops (5). Directed content analysis was used to analyse data.

Results

Clinical leaders taking roles of internal facilitator influenced the success of implementation, while complex and fluctuating context elements determined whether restraint use was reduced‐ or not. The PARIHS framework was found to be relevant in a non‐English nursing home setting, albeit some elements merit further conceptualization.

Conclusions

Our findings confirm the prospective utility of the PARIHS framework for implementation in a non‐English context, particularly the notion of implementation processes as dynamic and multifaceted.
Components and drivers of change in European freshwater fish faunas
Authors: Sommerwerk Nike , Wolter Christian , Freyhof Jörg , Tockner Klement
Published: May 2017

Aim

Human‐induced loss of native species and introduction of non‐native species have altered richness and composition of species assemblages world‐wide. During the past 15 years many studies have focused on changes in taxonomic similarity and identified numerous yet often contrasting reasons for these changes. This study aims to quantify taxonomic changes in freshwater fish assemblages between the mid‐19th century and today, while explicitly separating its different components and drivers.

Location

Geographic Europe, 251 river basins > 2500 km².

Methods

Pairwise catchment comparisons of historic and contemporary fish species inventories, with and without migratory fish, using Jaccard similarity; quantification of relative species turnover using a newly developed Reshuffling Index; determination of the threshold (here: number of catchments occupied) that displays how widespread a species must be to cause homogenization.

Results

The European freshwater fish fauna changed profoundly since the mid‐19th century. All river catchments exhibited an average net gain of 5.7 species, leading to an overall increase in faunal similarity across Europe of 3.1% (4.6% if migratory species are excluded). However, species turnover was much higher than indicated by the net gain. On average, 20% of the historic assemblages became reshuffled. The native catchment range size of an introduced species primarily determined its impact on taxonomic similarity change, irrespective whether it is translocated within or introduced from outside Europe and whether the species is of fisheries importance or not.

Main conclusions

The concurrent use of multiple indices allowed disentangling the main components and drivers of taxonomic change. It became evident that prevention of intended or unintended species introduction will not lower the rate of taxonomic homogenization per se. However, most species actually caused taxonomic differentiation despite their range gain. All introduced species still considerably contributed to taxonomic change with potential negative effects on ecosystem functions.
Web‐based integrated bipolar parenting intervention for parents with bipolar disorder: a randomised controlled pilot trial
Authors: Jones Steven H. , Jovanoska Jelena , Calam Rachel , Wainwright Laura D. , Vincent Helen , Asar Ozgur , Diggle Peter J. , Parker Rob , Long Rita , Sanders Matthew , Lobban Fiona
Published: May 2017

Background

People with bipolar disorder (BD) experience additional parenting challenges associated with mood driven fluctuations in communication, impulse control and motivation. This paper describes a novel web‐based self‐management approach (Integrated Bipolar Parenting Intervention; IBPI) to support parents with BD.

Method

Parents with BD with children aged 3–10 years randomised to IBPI plus treatment as usual (TAU) or waitlist control (WL). IBPI offered 16 weeks access to interactive self‐management information concerning BD and parenting issues. Feasibility was through recruitment, retention and web usage. Clinical outcomes were assessed at baseline, 16, 24, 36 and 48 weeks. Trial Registration Number: ISRCTN75279027.

Results

Ninety seven participants were recruited with 98% retention to end of intervention and 90% to final follow‐up (56%–94% data analysed of retained participants; higher rates for observer measures). 77% of IBPI participants accessed the website (53% accessed parenting modules). Child behaviour, parenting sense of competence and parenting stress improved significantly in IBPI compared to WL to end of intervention, sustained to 48 weeks. Impacts of IBPI on family functioning, parent mood and time to mood relapse were not significant.

Conclusions

Online self‐management support for parents with BD is feasible, with promising improvements in parenting and child behaviour outcomes. A definitive clinical and cost‐effectiveness trial is required to confirm and extend these findings.
Post‐harvest disinfestation of Bactrocera dorsalis (Hendel) (Diptera: Tephritidae) in mango using hot‐water treatments
Authors: Ndlela S. , Ekesi S. , Ndegwa P. N. , Ong'amo G. O. , Mohamed S. A.
Published: May 2017

Mango, Mangifera indica L. (Anacardiaceae), is one of the most important fruits in Africa, providing household nutrition and economic development opportunities for millions of growers across the continent. In Kenya, over 80% of mango production is carried out by smallholders who produce this crop for both the domestic and the export markets. Despite its importance, mango production is hampered by several constraints, including infestation by fruit flies, especially the exotic Bactrocera dorsalis. In addition to its direct damage to fruits, the high quarantine status of the pest restricts the export of fruits and limits access to lucrative markets, impacting negatively on export earnings. To facilitate access to export markets, post‐harvest management measures such as hot‐water treatment are required to ensure quarantine security. Internationally, this level has been set as either 99.99% (Probit 8.7) or 99.9968% (Probit 9). In developing a protocol, the development of immature life stages of B. dorsalis in ‘Apple’ mango was established. Using this information, infested mangoes harbouring the different immature life stages were subjected to a hot‐water treatment of 46.1°C for four different times, and the egg mortality and larval mortality were determined. The third‐instar life stage was the most heat tolerant, followed by second‐ and first‐instar larvae and the egg stage, respectively. The immersion time of 81.47 min (95% CL 75.77–87.18) was established as the time required to achieve 99.99% security level. In the validation experiment, there were no survivors from the 51,101 third‐instar individuals treated in ‘Apple’ mango weighing 400–500 g. Furthermore, there were no survivors from the 44,651 third instars exposed to 46.1°C for 68 min. These results provide sound evidence that the shorter treatment duration is an effective post‐harvest disinfestations treatment against B. dorsalis, and should facilitate access to export markets for mango fruits from Africa.
An audit of adherence to heart failure guidelines in an Australian hospital: A pharmacist perspective
Authors: Khalil Viviane , Danninger Melanie , Wang Wei , Khalil Hanan
Published: May 2017

Rationale, aims, and objectives

The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evidence‐based therapy (EBT) for CHF on discharge at this Australian metropolitan hospital and factors affecting its prescribing. The secondary aims are to examine the proportion of patients prescribed EBT on discharge on cardiac wards compared to medical wards and to explore the role of the pharmacist in the management of these patients.

Method

A retrospective audit of patients' medical notes who were admitted consecutively for CHF management was conducted over 6 months to examine their management.

Results

The results showed at discharge, a total of 52% of patients were discharged on angiotensin converting enzyme inhibitors/angiotensin receptor blockers, 49% were discharged on β‐blockers, 15% were on Aldosterone receptor antagonists, 90% were discharged on diuretics, and 29% were discharged on Digoxin. The main determinants of prescribing EBT on discharge were the presence of prescribing contraindications and patients' comorbidities. Patients discharged from cardiac wards were more likely to be prescribed EBT than if discharged on medical wards. Furthermore, in the subset of the cohort who was reviewed by a pharmacist during admission, a higher percentage of patients were discharged on EBT compared with those who did not have a pharmaceutical input.

Conclusion

This study highlighted existing gaps between the National CHF Guidelines and clinical prescribing practice in this hospital. Patients who were discharged from cardiac wards were more likely to be prescribed medications concordant with the guidelines, and there is further opportunity for pharmacists to assist in closing gaps in prescribing practice by the promotion of adherence to these guidelines.
Different perspectives of validity in psychiatry
Authors: Telles Correia Diogo
Published: May 2017

It is important to improve our understanding about what might be the specific characteristics of mental disorders to strengthen the scientific credibility of psychiatry and to clarify its position among other medical and nonmedical sciences.

On the other hand, this issue has diagnostic, research, therapeutic, legal, financial, and moral implications.

Some authors defend a realistic and absolutist attitude towards validity and others an instrumental and relativistic stance. Regarding the organization of concepts, dimensional or categorical approaches have both advantages and disadvantages.

Regarding the methodology by which validity is sought, it can be oriented externally or internally to the concept in question. On the other hand, the validity can be expert driven or data driven, the research can be based on disorders or in symptoms and quantitative or qualitative methods may be used.

In this article, we review all these different kinds of perspectives that can be taken towards the definition of validity in psychiatry and the methodology to search for it.
Expanding the Field of Surgical Researchers: The Jahnigen Career Development Award
Authors: Deiner Stacie
Published: May 2017

Under a long‐standing collaboration with the John A. Hartford Foundation (JAHF), the Atlantic Philanthropies (AP), and specialty societies in 10 targeted specialties, the American Geriatrics Society (AGS) has been working to improve quality of care provided to older adults by surgical and related medical specialists. To support and nurture future academic leaders, the Geriatrics‐for‐Specialists Initiative (GSI) established the Dennis W. Jahnigen Career Development Scholar Award (JCDA) program in 2002, with AP joining JAHF as a core funder of the awards in 2003. Commencing in 2011, the National Institute on Aging (NIA) launched the Grants for Early Medical/Surgical Specialists’ Transition to Aging Research (GEMSSTAR) program, using an RO3 mechanism. Recipients of the JCDA and the GEMSSTAR are provided with 2 years of research support and networking opportunities with other scholars; 79 JCDA and 26 surgical and related medical specialty GEMSSTAR scholars have been funded through these award mechanisms, with AGS, JAHF, and surgical and related medical specialty societies providing matching support for 20 of the GEMSSTAR scholars for leadership development programs. One of the primary criteria for judging the overall success of the program was eventual transition of the award to a federally funded program, which was achieved when NIA launched the GEMSSTAR program in 2011.
Bank Capital Regulation of Trading Portfolios: An Assessment of the Basel Framework
Authors: ALEXANDER GORDON J. , BAPTISTA ALEXANDRE M.
Published: May 2017

In setting minimum capital requirements for trading portfolios, the Basel Committee on Banking Supervision (1996, 2011a, 2013) initially used Value‐at‐Risk (VaR), then both VaR and stressed VaR (SVaR), and most recently, stressed Conditional VaR (SCVaR). Accordingly, we examine the use of SCVaR to measure risk and set these requirements. Assuming elliptically distributed asset returns, we show that portfolios on the mean‐SCVaR frontier generally lie away from the mean‐variance (M‐V) frontier. In a plausible numerical example, we find that such portfolios tend to have considerablyhigherratios of risk (measured by, e.g., standard deviation) to minimum capital requirement than those of portfolios on the M‐V frontier. Also, we find that requirements based on SCVaR are smaller than those based on both VaR and SVaR but exceed those based on just VaR. Finally, we find that requirements based on SCVaR are less procyclical than those based on either VaR or both VaR and SVaR. Overall, our paper suggests that the use of SCVaR to measure risk and set requirements is not a panacea.
Unstable Inflation Targets
Authors: BRANCH WILLIAM A. , EVANS GEORGE W.
Published: May 2017

This paper studies long‐run inflation targets and stability in an imperfect information environment. When central banks set an inflation target that is not fully communicated, agents draw inferences about inflation from recent data and remain alert to structural change by forming expectations from a forecasting model that is estimated via discounted least squares. Inflation targets can lead agents' beliefs to depart from rational expectations through two channels. First, implementing a higher inflation target can lead to overshooting. Second, there can be nearly self‐fulfilling inflation, disinflation, or deflation that arises as an endogenous response to shocks. Policy implications for implementing a higher target without deanchoring expectations are discussed.
Structural and functional characteristics of oestrogen receptor β splice variants: Implications for the ageing brain
Authors: Kim C. K. , Torcaso A. , Asimes A. , Chung W. C. J. , Pak T. R.
Published: May 2017

Oestrogen receptor (ER)β is a multifunctional nuclear receptor that mediates the actions of oestrogenic compounds. Despite its well defined role in mediating the actions of oestrogens, a substantial body of evidence demonstrates that ERβ has a broad range of physiological functions independent of those normally attributed to oestrogen signalling. These functions can partly be achieved by the activity of several alternatively spliced isoforms that have been identified for ERβ. This short review describes structural differences between the ERβ splice variants that are known to be translated into proteins. Moreover, we discuss how these alternative structures contribute to functional differences in the context of both healthy and pathological conditions. Our review also describes the principal factors that regulate alternative RNA splicing. The alternatively spliced isoforms of ERβ are differentially expressed according to brain region, age and hormonal milieu, emphasising the likelihood that there are precise cell‐specific mechanisms regulating ERβ alternative splicing. However, despite these correlative data, the molecular factors regulating alternative ERβ splicing in the brain remain unknown. We also review the basic mechanisms that regulate alternative RNA splicing and use that framework to make logical predictions about ERβ alternative splicing in the brain.
Payday Loan Marketing in Social Media Networks
Authors: Hao Jianqiang , Dai Hongying
Published: May 2017

The payday lending industry has grown dramatically over the past two decades, with lenders increasingly marketing their products on the Internet. However, little is known about payday loan (PDL) marketing through social media networks. Our study is the first to report the PDL promotions on Twitter. Out of 23,276 tweets related to PDLs from June 29, 2015 to October 2, 2015, 71% were commercial tweets, most of which came from a small percentage of users. The overall impact to the general public was large and we observed a range of opinions in our sentiment analysis. Commercial tweets had an average sentiment score of 34.9 while noncommercial had a total average sentiment score of 50.7. Commercial tweets were more concentrated in states with restrictive or hybrid regulations on PDL. Our findings provide evidence for enhancing online PDL regulations and using social media data for real‐time monitoring of PDL lending.
Assessment of the efficacy and safety of a new complex skin cream in Asian women: A controlled clinical trial
Authors: Jung Yu Seok , Lee Ji Hae , Bae Jung Min , Lee Dong Won , Kim Gyong Moon
Published: May 2017

Background

Medical products such as hydroquinone and tretinoin have been widely used to treat various types of skin hyperpigmentation. However, these products are limited in daily use given their adverse effects. Other alternative agents with fewer adverse side effects have been developed. However, single agents often do not produce satisfactory results.

Aims

To evaluate the efficacy and safety of a new brightening complex cream containing niacinamide, tranexamic acid, oxyresveratrol, glutathione disulfide, and linoleic acid.

Patients and Methods

A total of 26 Korean women seeking to lighten their skin were enrolled. The product was applied on the face two times per day for 12 weeks. Standardized photographs were taken at baseline, 4 weeks, 8 weeks, and 12 weeks. Efficacy was assessed using melanin index (MI), erythema index (EI), and chromatic aberration values (L*, a*, and b*). Improvement perceived by investigators and patients was measured as well.

Results

The L*‐value was increased at 8 weeks (0.7±2.5, P<.05) and at 12 weeks (0.8±2.5, P<.05). The MI was significantly decreased at 8 weeks (−4.2±4.5, P<.05) and at 12 weeks (−3.8±4.8, P<.001). The EI was significantly improved at 12 weeks (−3.2±2.2, P<.001). More than 80% of patients were considered improved at 12 weeks based on the view of the investigators and patients.

Conclusions

The new brightening complex cream was proved to be effective and safe in Asian women.
The views of older people and health professionals about dignity in acute hospital care
Authors: Tauber‐Gilmore Marcelle , Addis Gulen , Zahran Zainab , Black Sally , Baillie Lesley , Procter Sue , Norton Christine
Published: May 2017

Aims and objectives

To report the findings from interviews conducted as part of a wider study on interventions to support dignified care in older people in acute hospital care. The data in this study present the interview data.

Background

Dignity is a complex concept. Despite a plethora of recommendations on how to achieve dignified care, it remains unclear how to attain this in practice and what the priorities of patients and staff are in relation to dignity.

Design

A purposive sample of older patients and staff took part in semi‐structured interviews and gave their insight on the meaning of dignity and examples of what sustains and breaches a patient's dignity in acute hospital care.

Method

Thirteen patients and 38 healthcare professionals in a single metropolitan hospital in the UK interviewed. Interviews were transcribed verbatim and underwent a thematic analysis.

Results

The meaning of dignity was broadly agreed on by patients and staff. Three broad themes were identified: the meaning of dignity, staffing level and its impact on dignity, and organisational culture and dignity. Registered staff of all healthcare discipline and student nurses report very little training on dignity or care of the older person.

Conclusion

There remain inconsistencies in the application of dignified care. Staff behaviour, a lack of training and the organisational processes continue to result in breaches to dignity of older people. Clinical nurses have a major role in ensuring dignified care for older people in hospital.

Relevance to clinical practice

There needs to be systematic dignity‐related training with regular refreshers. This education coupled with measures to change the cultural attitudes in an organisation towards older peoples’ care should result in long‐term improvements in the level of dignified care. Hospital managers have an important role in changing system to ensure that staff deliver the levels of care they aspire to.
Curious, thoughtful and affirmative—Young children's meanings of participation in healthcare situations when using an interactive communication tool
Authors: Stålberg Anna , Sandberg Anette , Larsson Thomas , Coyne Imelda , Söderbäck Maja
Published: May 2017

Aims and objectives

To describe young children's demonstrated participation in healthcare situations while using an interactive communication tool.

Background

Participation is a multidimensional concept influenced by situational and contextual issues. In child participation, verbal and nonverbal communicative expressions are of interest, as both demonstrate the child's perspective. Children have a right to participate in all situations that matter to them, for instance healthcare situations. Children, understood as social actors, express a wish and a need to participate in these situations to get information and to enable preparation.

Design/method

In a pilot study, video observations were used to capture the children's use of the interactive communication tool in healthcare situations. A hermeneutic analysis was conducted to achieve a deeper understanding of the children's demonstrated cues of participation.

Results

The expressed cues of participation were understood as having either a curious, thoughtful or affirmative meaning of participation and there was a continuous movement between them. Curious cues were expressed when introducing or reintroducing the tool in the situation and demonstrated a wish to get knowledge of the things shown on the screen or to perform the virtual tasks. Thoughtful cues slowed down the progression of the situation when the children needed time to think or adapt to the virtual procedures. Affirmative cues were self‐rewarding and demonstrated at successful task performance.

Conclusion

An interactive communication tool used in healthcare situations can promote young children's understanding and facilitate their situated participation, which potentially reduces feelings of distress or anxiety. This innovative use of interactive technology within paediatric health care provides new ways of revealing the child's perspective in the situation.

Relevance to clinical practice

Interactive technology improves understanding and participation of children in healthcare situations, which impact them positively, both in the present and for the future. A communication tool enhances professionals’ opportunities to adopt a child‐centred approach by responding sensitively to the children's expressions.
The trajectory of experience of critical care nurses in providing end‐of‐life care: A qualitative descriptive study
Authors: Ong Keh Kiong , Ting Kit Cheng , Chow Yeow Leng
Published: May 2017

Aims and objectives

To understand the perceptions of critical care nurses towards providing end‐of‐life care.

Background

There has been an increasing interest in end‐of‐life care in the critical care setting. In Singapore, approximately half of deaths in the hospital occur during critical care. While nurses are well positioned to provide end‐of‐life care to patients and their family members, they faced barriers to providing end‐of‐life care. Also, providing end‐of‐life care has profound positive and negative psychological effects on nurses, with the latter being more prominent.

Design

Qualitative descriptive design.

Method

Data collection was performed in a medical intensive care unit of a public tertiary hospital in Singapore. Ten registered nurses were purposively sampled and interviewed individually using a semi‐structured interview guide. A codebook was developed to guide coding, and data were thematically analysed. Rigour was maintained.

Results

Nurses went through a trajectory of experience. They experienced the culture of care and developed dissatisfaction with it. The tension shaped their perception and meaning of life and death, and they developed mechanisms to reach resolution.

Conclusion

This study provides insight on nurses’ perception as a trajectory of experience and raised several implications on clinical practice, policy and research. There is a need to alleviate the tension nurses face and to facilitate coming to terms with the tension by improving the culture of care and supporting nurses.

Relevance to clinical practice

Nurses could be involved more in decision‐making and empowered to start end‐of‐life care conversations within the team and with family members. Communication with family members and between nurses and doctors could be improved. Support for nurses providing end‐of‐life care could be enhanced through promoting social networks, education and bereavement support. Further research is needed to explore ways to support and empower nurses to provide end‐of‐life care in critical care.
Antecedents and consequences of workplace violence against nurses: A qualitative study
Authors: Najafi Fereshteh , Fallahi‐Khoshknab Masoud , Ahmadi Fazlollah , Dalvandi Asghar , Rahgozar Mehdi
Published: May 2017

Aims and objectives

To explore Iranian nurses’ perceptions of and experiences with the antecedents and consequences of workplace violence perpetrated by patients, patients’ relatives, colleagues and superiors.

Background

Workplace violence against nurses is a common problem worldwide, including in Iran. Although many studies have reviewed the antecedents and consequences of workplace violence, limited information is available on this topic. An understanding of the predisposing factors for violence and the consequences of violence is essential to developing programs to prevent and manage workplace violence.

Design

Qualitative descriptive design.

Methods

In this qualitative study, 22 unstructured, in‐depth interviews were conducted with registered nurses who had experienced workplace violence and who were selecting using purposive sampling in nine hospitals. Inductive content analysis was used to analyse the data.

Results

Five categories emerged as predisposing factors: unmet expectations of patients/relatives, inefficient organisational management, inappropriate professional communication, factors related to nurses and factors related to patients, patients’ relatives and colleagues. Individual, familial and professional consequences were identified as outcomes of workplace violence against nurses.

Conclusions

Workplace violence by patients/their relatives and colleagues/superiors is affected by various complicated factors at the individual and organisational levels. In addition to negatively affecting nurses’ individual and family lives, workplace violence may lead to a lower quality of patient care and negative attitudes towards the nursing profession.

Relevance to clinical practice

Identifying factors, which lead to workplace violence, could help facilitate documenting and reporting such incidents as well as developing the necessary interventions to reduce them. Furthermore, native instruments must be developed to predict and monitor violence.
Weight loss and improved metabolic outcomes amongst rural African American women in the Deep South: six‐month outcomes from a community‐based randomized trial
Authors: Ard J. D. , Carson T. L. , Shikany J. M. , Li Y. , Hardy C. M. , Robinson J. C. , Williams A. G. , Baskin M. L.
Published: May 2017

Background

Obesity is highly prevalent in African American women, especially those in the rural southern USA, resulting in persistent health disparities.

Objective

To test the effectiveness of an evidence‐based behavioural weight loss intervention delivered by community health advisors to African American women in the rural south.

Design and Methods

Overweight or obese African American women (30–70 years) from eight counties in Mississippi and Alabama participated in a 24‐month randomized controlled trial of an evidence‐based behavioural weight loss programme augmented with community strategies to support healthy lifestyles (Weight Loss Plus, N = 154) compared to the weight loss programme alone (Weight Loss Only, N = 255). This study reports on 6‐month outcomes on primary (weight change) and secondary (waist circumference, blood pressure, lipids, fasting blood glucose) outcomes, coinciding with the completion of the intensive weight loss phase.

Results

Weight Loss Only participants lost an average of 2.2 kg (P < 0.001). Weight Loss Plus participants lost an average of 3.2 kg (P < 0.001). The proportion of the total sample that lost at least 5% of their body weight was 27.1% with no difference between treatment groups. Similarly, we observed statistically significant reductions in blood pressure, waist circumference and triglycerides in each treatment group, with no statistical differences between groups.

Conclusion

Trained lay health staff and volunteers from the rural southern USA were able to deliver a translation of a high‐intensity behavioural intervention targeted to African American women, resulting in clinically meaningful weight loss and improvement in other metabolic outcomes in a significant proportion of participants.
Contrast Extravasation versus Hemorrhage after Thrombectomy in Patients with Acute Stroke
Authors: Yedavalli Vivek , Sammet Steffen
Published: May 2017

BACKGROUND AND PURPOSE

Intra‐arterial recanalization postprocedural imaging in stroke patients can result in diagnostic complications due to hyperdensities on noncontrast computed tomography (CT), which may represent either contrast extravasation or intracranial hemorrhage. If these lesions are hemorrhage, then they are risk factors becoming symptomatic, which, if not distinguished, can alter clinical management. We investigate the effects of iodinated contrast on postprocedural magnetic resonance imaging (MRI) and prevalence of equivocal imaging interpretations of postprocedural extravasated contrast versus hemorrhage while identifying protocol pitfalls.

METHODS

We identified 10 patients diagnosed with ischemic stroke who underwent intra‐arterial recanalization in a 5‐year period. These patients demonstrated a hyperdensity on a postprocedural CT within 24 hours, underwent an MRI within 48 hours, and an additional confirmatory noncontrast CT at least 72 hours postprocedure.

RESULTS

Postprocedural MRI in all 10 stroke patients demonstrated T1‐ and T2‐relaxation time changes due to residual iodine contrast agents. This lead to false positive postprocedural hemorrhage MRI interpretations in 2/10 patients, 3/10 false negative interpretations of contrast extravasation, and 5/10 equivocal interpretations suggesting extravasation or hemorrhage. Of these five cases, two were performed with gadolinium.

CONCLUSION

MRI done within 48 hours postprocedure can lead to false positive hemorrhage or false negative contrast extravasation interpretations in stroke patients possibly due to effects from the administered angiographic contrast. Additionally, MRI should be done both after 72 hours for confirmation and without gadolinium contrast as the effects of the gadolinium contrast and residual angiographic contrast could lead to misdiagnosis.
A Simplified Approach for Fabrication of a Lightweight Individualized Impression Tray with the Aid of Existing Obturator Prosthesis Using Lost Salt Technique
Authors: Bhochhibhoya Amar , Acharya Binod , Rana Samskar Bickram , Sharma Rinu , Maskey Brijesh
Published: May 2017

Maxillary defects resulting from ablative oncologic surgery can be extensive and usually have complex contours. Impression procedures for such defects can be time consuming and cumbersome, challenging the skills of even the most‐experienced clinician. A well‐oriented impression tray with proper extension and adequate contour is essential for successfully capturing the relevant details in impression. This article describes a method using the patient's existing obturator prosthesis to simplify and expedite the fabrication of a lightweight individualized impression tray directly on an irreversible hydrocolloid impression, thus avoiding the preliminary impression procedure for the patient.
Systemic inflammation and alterations to cerebral blood flow in obstructive sleep apnea
Authors: Chen Hsiu‐Ling , Lin Hsin‐Ching , Lu Cheng‐Hsien , Chen Pei‐Chin , Huang Chih‐Cheng , Chou Kun‐Hsien , Su Mao‐Chang , Friedman Michael , Chen Yi‐Wen , Lin Wei‐Che
Published: May 2017

Systemic inflammation and alterations to regional cerebral blood flow (CBF) have been reported previously in obstructive sleep apnea (OSA). This study utilized arterial spin labelling (ASL) perfusion magnetic resonance imaging (MRI) to evaluate CBF in OSA patients and determine its relationship with systemic inflammation. Twenty male patients with moderate and severe OSA [apnea–hypopnea index (AHI) >15] and 16 healthy male volunteers (AHI <5) were recruited. Early‐ or late‐phase changes in leucocyte apoptosis and its subsets were determined by flow cytometry. Perfusion MRI data were acquired with a pulsed continuous ASL technique. The CBF maps were compared using voxel‐based statistics to determine differences between the OSA and control groups. The differences in CBF, clinical severity and leucocyte apoptosis were correlated. Exploratory groupwise comparison between the two groups revealed that the OSA patients exhibited low CBF values in the vulnerable regions. The lower regional CBF values were correlated with higher clinical disease severity and leucocyte apoptosis. OSA impairs cerebral perfusion in vulnerable regions, and this deficit is associated with increased disease severity. The apparent correlation between systemic inflammation and cerebral perfusion may be indicative of haemodynamic alterations and their consequences in OSA.
Canine Cutaneous Plasmacytosis: 21 Cases (2005–2015)
Authors: Boostrom B.O. , Moore A.S. , DeRegis C.J. , Robat C. , Freeman K. , Thamm D.H.
Published: May 2017

Background

Cutaneous plasmacytosis (CP) is a syndrome of multiple cutaneous plasma cell tumors, in the absence of multiple myeloma. Although rare in both humans and dogs, treatment recommendations are usually extrapolated from multiple myeloma protocols. To date, no case series of CP have been described in the veterinary literature.

Hypothesis/Objectives

To describe clinical presentation, determine treatment response rates and duration, and report overall survival of dogs with CP.

Animals

Twenty‐one client‐owned dogs with CP.

Methods

Medical records of 21 dogs with CP were reviewed. Diagnosis was based on histopathologic evaluation of at least 1 representative cutaneous or subcutaneous lesion in dogs with ≥3 lesions. Dogs with suspicion of multiple myeloma were excluded.

Results

The most commonly affected breeds were the golden (5/21) and Labrador retriever (3/21). Fourteen of 21 dogs had >10 lesions, with some having >100. Lesions commonly were described as round, raised, pink‐to‐red, and variably alopecic or ulcerated. The most commonly used drug protocol was combined melphalan and prednisone, with an overall response rate (ORR) of 73.7% (14/19 dogs). Single‐agent lomustine was associated with a similar ORR of 71.4% (5/7 dogs). For all treatments combined, the median progression‐free interval after the first treatment was 153 days. The median survival time from the first treatment was 542 days.

Conclusions and Clinical Importance

Alkylating agents were effective in inducing remission of CP; corticosteroids, melphalan, and lomustine were the most commonly used drugs. Survival times were similar to those reported in dogs with multiple myeloma treated with alkylating agents.
A ‘good faith’ interpretation of the right to manifest religion? The diverging approaches of the European Court of Human Rights and the UN Human Rights Committee
Authors: Berry Stephanie E.
Published: May 2017

The European Court of Human Rights (ECtHR) and UN Human Rights Committee have reached contradictory decisions in cases concerning the right to manifest religion. This discrepancy calls into question the universality of the right and is problematic from the perspective of legal certainty. Consequently, this article explores the extent to which the diverging decisions of these two bodies are compatible with a good faith interpretation of the right to manifest religion. A good faith interpretation of the right is identified by utilising the travaux préparatoires and subsequent interpretations. It is argued that by failing to scrutinise the necessity of restrictions and the role of secularism, the ECtHR has undermined this good faith interpretation and, in so doing, is not fulfilling its role as ‘the conscience of Europe’.
Visual predation during springtime foraging of the North Atlantic right whale (Eubalaena glacialis)
Authors: Fasick Jeffry I. , Baumgartner Mark F. , Cronin Thomas W. , Nickle Benjamin , Kezmoh Lorren J.
Published: May 2017

To assess the role that vision plays in the ability of the North Atlantic right whale (Eubalaena glacialis) to detect its primary prey species, the calanoid copepod Calanus finmarchicus, we have compared the absorbance spectrum of the E. glacialis rod visual pigment, the transmittance spectra of C. finmarchicus carotenoid pigments, as well as the downwelling irradiance and horizontal radiance spectra collected during springtime at three locations in the western Gulf of Maine. The E. glacialis rod visual pigment absorbs light maximally at 493 nm, while microspectrophotometric measurements of the C. finmarchicus carotenoid pigments reveal transmission spectra with minima matching very well with the E. glacialis rod visual pigment absorbance spectra maximum. Springtime spectral downwelling irradiance and horizontal radiance values from the surface waters of Cape Cod Bay and at all depths in Great South Channel overlap the E. glacialis rod absorbance spectrum, allowing C. finmarchicus to appear as a high‐contrast dark silhouette against a bright background spacelight, thus facilitating visually guided contrast foraging. In contrast, spectral downwelling irradiance and horizontal radiance at depth in Cape Cod Bay, and all depths in Wilkinson Basin, do not overlap the E. glacialis rod absorbance spectrum, providing little if any useful light for contrast vision.