bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of the Nurse Scientist as a Knowledge Broker
Authors: Thompson Marcella Remer , Schwartz Barcott Donna
Published: October 2018

Purpose

This article introduces the importance and nature of the role of the nurse scientist as a knowledge broker.

Design

A systematic literature review was completed using a modified version of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) appraisal tool to trace the emergence and characteristics of the knowledge broker role across disciplines internationally and in the United States.

Methods

Salient publications were identified using PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sociological Abstracts, and ProQuest Dissertations & Theses, as well as hand searches and searches of the grey literature. Authors used these resources to define the knowledge broker role and with their role‐related experiences developed the Thompson Knowledge Brokering Model.

Findings

A knowledge broker is one who connects science and society by building networks and facilitating opportunities among knowledge producers and knowledge users. The knowledge broker role includes three components: forming and sustaining partnerships; facilitating knowledge application; and creating new knowledge. There are five major strategies central to each role component: establish, engage, educate, empower, and evaluate.

Conclusions

The knowledge broker role has been increasingly recognized worldwide as key to translating science into practice and policy. The nurse scientist is ideally suited for this role and should be promoted worldwide. The Thompson Knowledge Brokering Model can be used as a guide for nurse scientists.

Clinical Relevance

The role of the knowledge broker is to facilitate translation of useful research to practice and policy by connecting stakeholders through meaningful engagement.
Integrating morphology andin vivoskeletal mobility with digital models to infer function in brittle star arms
Authors: Clark Elizabeth G. , Hutchinson John R. , Darroch Simon A. F. , Mongiardino Koch Nicolás , Brady Travis R. , Smith Sloane A. , Briggs Derek E. G.
Published: October 2018

Brittle stars (Phylum Echinodermata, Class Ophiuroidea) have evolved rapid locomotion employing muscle and skeletal elements within their (usually) five arms to apply forces in a manner analogous to that of vertebrates. Inferring the inner workings of the arm has been difficult as the skeleton is internal and many of the ossicles are sub‐millimeter in size. Advances in 3D visualization and technology have made the study of movement in ophiuroids possible. We developed six virtual 3D skeletal models to demonstrate the potential range of motion of the main arm ossicles, known as vertebrae, and six virtual 3D skeletal models of non‐vertebral ossicles. These models revealed the joint center and relative position of the arm ossicles during near‐maximal range of motion. The models also provide a platform for the comparative evaluation of functional capabilities between disparate ophiuroid arm morphologies. We made observations on specimens ofOphioderma brevispinaandOphiothrix angulata. As these two taxa exemplify two major morphological categories of ophiuroid vertebrae, they provide a basis for an initial assessment of the functional consequences of these disparate vertebral morphologies. These models suggest potential differences in the structure of the intervertebral articulations in these two species, implying disparities in arm flexion mechanics. We also evaluated the differences in the range of motion between segments in the proximal and distal halves of the arm length in a specimen ofO. brevispina, and found that the morphology of vertebrae in the distal portion of the arm allows for higher mobility than in the proximal portion. Our models of non‐vertebral ossicles show that they rotate further in the direction of movement than the vertebrae themselves in order to accommodate arm flexion. These findings raise doubts over previous hypotheses regarding the functional consequences of ophiuroid arm disparity. Our study demonstrates the value of integrating experimental data and visualization of articulated structures when making functional interpretations instead of relying on observations of vertebral or segmental morphology alone. This methodological framework can be applied to other ophiuroid taxa to enable comparative functional analyses. It will also facilitate biomechanical analyses of other invertebrate groups to illuminate how appendage or locomotor function evolved.
The effect of gender‐friendliness barriers on perceived image in nursing and caring behaviour among male nursing students
Authors: Hung Chao‐An , Wu Pei‐Ling , Liu Nai‐Yu , Hsu Wen‐Yi , Lee Bih‐O , Pai Hsiang‐Chu
Published: October 2018

Aims and objectives

To examine the relationships among nursing students’ perceived nursing image, caring behaviours and gender‐friendliness barriers to determine whether gender‐friendliness barriers affect nursing image and caring behaviour among male nursing students.

Background

Because caring is typically seen as a feminine trait, male nurses face gender‐role strains in the current nursing environment. Gender‐friendliness barriers may have an impact on the vital relationship between professional nursing image and caring behaviour.

Design

This study used a quantitative and cross‐sectional research design.

Methods

Participants were 141 male students who had obtained at least 1 month of clinical practice experience. We collected data using three instruments: The Caring Assessment Report Evaluation Q‐sort (CARE‐Q), Gender‐Friendliness Barriers in Nursing Programs (GFB‐NP), and Nursing Image—as a Profession Questionnaire (NIPQ). Data were collected from August 2016–July 2017. Partial least squares structural equation modelling (PLS‐SEM) with bootstrapping was used to test the hypothesis model.

Results

The full model results indicated a direct positive and significant path from professional nursing image to caring behaviour (β = 0.47, 95% CI = 0.32 to 0.61, t = 6.19, p < 0.001). Gender‐friendliness barriers had a direct and significant negative relationship between professional nursing image (β = −0.31, 95% CI = −0.49 to −0.12, t = 3.17, p < 0.01) and caring behaviour (β = −0.18, 95% CI = −0.35 to −0.02, t = 2.18, p < 0.05). In addition, the variable of student‐perceived barriers to gender‐friendliness was indirectly and significantly negatively related to caring behaviour (β = −0.15, 95% CI = −0.27 to −0.05, t = 2.57, p < 0.05) through professional nursing image.

Conclusion

Male nursing students with a higher nursing image engage in greater caring behaviour. Gender‐friendliness barriers, however, decrease students’ nursing image and caring behaviour.

Relevance to clinical practice

As applied to nursing education, the goal should be to improve male nursing students’ caring behaviours and professional nursing image and decrease gender‐friendliness barriers.
Patients’ experiences of nurses’ heartfelt hospitality as caring: A qualitative approach
Authors: Kelly Rosalind , Wright‐St Clair Valerie , Holroyd Eleanor
Published: October 2018

Aims and Objectives

To answer the question “What is the lived experience of hospitality during a patient's hospital stay for elective surgery?”

Background

Hospitality centres on a host offering comfort to others, as in a personal care context. Caring constitutes the essence of what it is to be human, having a profound effect on well‐being and recovery from surgery. Caring is one of the most elusive and diversely contested concepts in nursing; however, care provided by nurses seldom transcends as deep human connections and social utility. This study explored the nature, meaning and experience of hospitality as care from the perspective of elective surgery patients. Consolidated Criteria for Reporting Qualitative criteria were used.

Design

A hermeneutic phenomenological methodology.

Methods

Data were gathered through semi‐structured, face to face interviews with seven patients from both private and public hospitals, and from different cultural backgrounds.

Results

Three interpretative notions were as follows: experiences of hospitality as feeling “really” cared for, being at ease and being healed. Hospitality exists in the receiver's lived experience, evoking a special moment which leads to feelings of great comfort and feelings of being truly cared about. When hospitality is received, patients feel a connection; they begin to trust and their healing begins.

Conclusion

The offering of often small, yet heartfelt acts of hospitality, indicated that nurses can evoke powerful lived experiences which benefit patients undergoing elective surgery.

Relevance to clinical practice

The importance of prioritising emotional and social connections to the hospitality experience needs emphasis at all levels of the clinical structure. Hospitality as caring needs to form a part of all undergraduate and postgraduate nursing curricula, and ongoing professional development. The participant quotes presented in this article could form exemplars for the provision of hospitable nursing care practices, highlighting nurses getting to know and understand their patients, and being interested in their lives.
Nurses’ integrity and coping strategies: An integrative review
Authors: Sastrawan Sastrawan , Newton Jennifer Margaret , Malik Gulzar
Published: October 2018

Introduction

Integrity is one of the core values in nursing that needs to be maintained by nurses in practice. However, the complexity in the nursing milieu can pose threats to integrity. An understanding of the common threats and coping strategies might assist nurses in preserving integrity in everyday practice.

Aims and objectives

To review and synthesis the concept of integrity in nursing and identify common threats and coping strategies.

Methods

Whittemore and Knafl's integrative review method was implemented. A search was performed in Scopus, Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Proquest Health and Medical electronic databases published in English between 2000–2017. Two reviewers independently assessed eligibility for inclusion. Methodological appropriateness for the included studies was assessed using the critical appraisal skills programme. The constant comparative method of grounded theory was used to analyse and synthesise data from seven peer‐reviewed articles.

Results

Two major conceptions of integrity were identified. These included the sense of wholeness with regard to personal–professional concerns and ethical–moral conducts. Five entities, self, patients, teamwork and work culture, the nature of work, and organisation, were identified as interweaving elements that may induce threats to integrity. When integrity is threatened, nurses use two key strategies to survive: adjusting and compensating. An emergent framework to facilitate understanding of nurses’ threats to integrity is discussed.

Conclusions

A threat to nurses’ integrity takes form when there is an unmitigated gap between a nurse's expectation and reality. While the expectation comes from within the nurse, the reality materialises out of the complex interplays that occur in the healthcare workforce. Maintaining integrity demands a continual strive to balance personal expectations, professional concerns and nursing realities.
Interventions to increase hand hygiene compliance in a tertiary university hospital over a period of 5 years: An iterative process of information, training and feedback
Authors: Hoffmann Magdalena , Sendlhofer Gerald , Pregartner Gudrun , Gombotz Veronika , Tax Christa , Zierler Renate , Brunner Gernot
Published: October 2018

Aims and objective

To explore whether an iterative process of information and training paired with a feedback system to observed healthcare professionals and the respective management improves hand hygiene (HH) compliance.

Background

Healthcare‐associated infections are a major risk for patient safety, and adherence to the “My five moments” (M5M) for HH varies significantly within organisations as well as within healthcare professional groups. Identified barriers in a baseline survey revealed the need of more information, training, repetitive compliance measurements and feedback to all healthcare professionals.

Design

A quality improvement project using the method of direct observation of healthcare professionals in nonsurgical and surgical wards.

Methods

Between 2013 and 2017, 6,009 healthcare professionals were informed and trained, and HH compliance measurements were performed by hygiene experts. Compliance measurement results were documented in an online tool to give an immediate feedback to observed healthcare professionals. Additionally, a report was forwarded to the management of the respective department to raise awareness. Compliance rates per year were descriptively summarised. The research and reporting methodology followed SQUIRE 2.0.

Results

In total, 84 compliance measurements with 19,295 “M5M for HH” were observed in 49 wards. Overall, mean HH compliance increased from 81.9 ± 5.2% in 2013 to 94.0 ± 3.6% in 2017. Physicians’ HH compliance rate improved from 69.0 ± 16.6% to 89.3 ± 6.6%, that of nurses from 86.0 ± 6.9% to 96.4 ± 3.1%, and that of others from 60.5 ± 27.9% to 83.8 ± 20.2%. All M5M for HH (#1–#5) increased over the study period (#1: +16.9%; #2: +20.5%; #3: +7.6%; #4: +5.9%; #5: +12.7%).

Conclusions

Results demonstrated that an iterative process of information, training, observation and feedback over a period of 5 years can be successful in increasing HH compliance. Positive trends were observed for HH compliance rates across all healthcare professional groups as well as for all M5M for HH.
Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: a systematic guideline review and expert consensus
Authors: Muth C. , Blom J. W. , Smith S. M. , Johnell K. , Gonzalez‐Gonzalez A. I. , Nguyen T. S. , Brueckle M.‐S. , Cesari M. , Tinetti M. E. , Valderas J. M.
Published: October 2018

The complexity and heterogeneity of patients with multimorbidity and polypharmacy renders traditional disease‐oriented guidelines often inadequate and complicates clinical decision making. To address this challenge, guidelines have been developed on multimorbidity or polypharmacy. To systematically analyse their recommendations, we conducted a systematic guideline review using the Ariadne principles for managing multimorbidity as analytical framework. The information synthesis included a multistep consensus process involving 18 multidisciplinary experts from seven countries. We included eight guidelines (four each on multimorbidity and polypharmacy) and extracted about 250 recommendations. The guideline addressed (i) the identification of the target population (risk factors); (ii) the assessment of interacting conditions and treatments: medical history, clinical and psychosocial assessment including physiological status and frailty, reviews of medication and encounters with healthcare providers highlighting informational continuity; (iii) the need to incorporate patient preferences and goal setting: eliciting preferences and expectations, the process of shared decision making in relation to treatment options and the level of involvement of patients and carers; (iv) individualized management: guiding principles on optimization of treatment benefits over possible harms, treatment communication and the information content of medication/care plans; (v) monitoring and follow‐up: strategies in care planning, self‐management and medication‐related aspects, communication with patients including safety instructions and adherence, coordination of care regarding referral and discharge management, medication appropriateness and safety concerns. The spectrum of clinical and self‐management issues varied from guiding principles to specific recommendations and tools providing actionable support. The limited availability of reliable risk prediction models, feasible interventions of proven effectiveness and decision aids, and limited consensus on appropriate outcomes of care highlight major research deficits. An integrated approach to both multimorbidity and polypharmacy should be considered in future guidelines.
Multimorbidity and functional impairment–bidirectional interplay, synergistic effects and common pathways
Authors: Calderón‐Larrañaga A. , Vetrano D. L. , Ferrucci L. , Mercer S. W. , Marengoni A. , Onder G. , Eriksdotter M. , Fratiglioni L.
Published: October 2018

This review discusses the interplay between multimorbidity (i.e. co‐occurrence of more than one chronic health condition in an individual) and functional impairment (i.e. limitations in mobility, strength or cognition that may eventually hamper a person's ability to perform everyday tasks). On the one hand, diseases belonging to common patterns of multimorbidity may interact, curtailing compensatory mechanisms and resulting in physical and cognitive decline. On the other hand, physical and cognitive impairment impact the severity and burden of multimorbidity, contributing to the establishment of a vicious circle. The circle may be further exacerbated by people's reduced ability to cope with treatment and care burden and physicians’ fragmented view of health problems, which cause suboptimal use of health services and reduced quality of life and survival. Thus, the synergistic effects of medical diagnoses and functional status in adults, particularly older adults, emerge as central to assessing their health and care needs. Furthermore, common pathways seem to underlie multimorbidity, functional impairment and their interplay. For example, older age, obesity, involuntary weight loss and sedentarism can accelerate damage accumulation in organs and physiological systems by fostering inflammatory status. Inappropriate use or overuse of specific medications and drug–drug and drug–disease interactions also contribute to the bidirectional association between multimorbidity and functional impairment. Additionally, psychosocial factors such as low socioeconomic status and the direct or indirect effects of negative life events, weak social networks and an external locus of control may underlie the complex interactions between multimorbidity, functional decline and negative outcomes. Identifying modifiable risk factors and pathways common to multimorbidity and functional impairment could aid in the design of interventions to delay, prevent or alleviate age‐related health deterioration; this review provides an overview of knowledge gaps and future directions.
Synthetic surfactants with SP‐B and SP‐C analogues to enable worldwide treatment of neonatal respiratory distress syndrome and other lung diseases
Authors: Johansson J. , Curstedt T.
Published: October 2018

Treatment of neonatal respiratory distress syndrome (RDS) using animal‐derived lung surfactant preparations has reduced the mortality of handling premature infants with RDS to a 50th of that in the 1960s. The supply of animal‐derived lung surfactants is limited and only a part of the preterm babies is treated. Thus, there is a need to develop well‐defined synthetic replicas based on key components of natural surfactant. A synthetic product that equals natural‐derived surfactants would enable cost‐efficient production and could also facilitate the development of the treatments of other lung diseases than neonatal RDS. Recently the first synthetic surfactant that contains analogues of the two hydrophobic surfactant proteins B (SP‐B) and SP‐C entered clinical trials for the treatment of neonatal RDS. The development of functional synthetic analogues of SP‐B and SP‐C, however, is considerably more challenging than anticipated 30 years ago when the first structural information of the native proteins became available. For SP‐B, a complex three‐dimensional dimeric structure stabilized by several disulphides has necessitated the design of miniaturized analogues. The main challenge for SP‐C has been the pronounced amyloid aggregation propensity of its transmembrane region. The development of a functional non‐aggregating SP‐C analogue that can be produced synthetically was achieved by designing the amyloidogenic native sequence so that it spontaneously forms a stable transmembrane α‐helix.
Association between tongue muscle strength and masticatory muscle strength
Authors: Hara Koji , Tohara Haruka , Kenichiro Kobayashi , Yamaguchi Kohei , Ariya Chantaramanee , Yoshimi Kanako , Nakane Ayako , Minakuchi Shunsuke
Published: October 2018

Background

The tongue is responsible for compressing food against the palate and squeezing it into the pharynx during the oral preparatory phase of swallowing. Tongue pressure (TP), an indicator of tongue muscle strength, has been observed to decline with age; maximum occlusal force (MOF), an indicator of chewing ability, is correlated with TP. However, no study has investigated the relationship between TP and MOF.

Objective

To investigate the correlation between TP and MOF according to age in healthy individuals.

Methods

We retrospectively collected handgrip strength (HGS), body mass index (BMI), TP, MOF and tooth loss data for 785 healthy participants (305 men, 480 women). All subjects had either unilateral or bilateral occlusal support, regardless of the presence of dentures or natural teeth. The participants were divided into two groups: an adult (20s‐50s, n = 497) group and an elderly (60s‐80s, n = 288) group. Multivariate linear regression analysis was performed to determine significant independent variables associated with TP in both groups.

Results

Multivariate analysis revealed that TP was significantly associated with age (β = −0.153), BMI (β = 0.205), HGS (β = 0.298) and MOF (β = 0.239) in the adult group (all P < 0.001) and with age (β = −0.266, P < 0.001), BMI (β = 0.160, P = 0.005), MOF (β = 0.217, P = 0.001) and tooth loss (β = 0.156, P = 0.011) in the elderly group.

Conclusions

As age and MOF are each associated with TP in both elderly and adult patients, age‐related TP decline can be prevented with routine lingual exercises, even before the onset of old age. Additionally, MOF deterioration may indicate a decline in TP for elderly.
Effect of Nanodiamond Addition on Flexural Strength, Impact Strength, and Surface Roughness of PMMA Denture Base
Authors: Al‐Harbi Fahad A. , Abdel‐Halim Mohamed S. , Gad Mohammed M. , Fouda Shaimaa M. , Baba Nadim Z. , AlRumaih Hamad S. , Akhtar Sultan
Published: October 2018

Purpose

To assess the effect of addition of different concentrations of nanodiamonds (NDs) on flexural strength, impact strength, and surface roughness of heat‐polymerized acrylic resin.

Materials and Methods

120 specimens were fabricated from heat‐polymerized acrylic resin. They were divided into a control group of pure polymethylmethacrylate (PMMA; Major.Base.20) and three tested groups (PMMA‐ND) with 0.5%wt, 1%wt, and 1.5%wt of added ND to PMMA. Flexural strength was determined using the three‐point bending test. Impact strength was recorded by using a Charpy type impact test. Surface roughness test was performed using a Contour GT machine. One‐way ANOVA and Tukey's post‐hoc analysis (p ≤ 0.05) were used for statistical analysis.

Results

Acrylic resin reinforced with 0.5% ND displayed significantly higher flexural strength than the unreinforced heat‐polymerized specimens, acrylic resin reinforced with 1% ND and the 1.5% ND (p < 0.0001). The impact strength of unreinforced heat‐polymerized specimens was significantly higher than all nano‐composite materials (p < 0.0001) with no significant difference between 1% ND and the 1.5% ND (p > 0.05). The addition of 0.5% ND and 1% ND significantly decreased the surface roughness in comparison to both control and the 1.5% ND groups (p < 0.0001) while no significant differences between 0.5% ND and 1% ND (p > 0.05) were reported. Nano‐composite material (0.5% ND) showed significantly lower surface roughness when compared to other specimens.

Conclusions

The addition of NDs to acrylic denture base improved the flexural strength and surface roughness at low concentrations (0.5%), while the impact strength was decreased with ND addition.
A pilot study on in vitro solubility of phosphorus from mineral sources, feed ingredients and compound feed for pigs, poultry, dogs and cats
Authors: Lineva Anna , Kirchner Robert , Kienzle Ellen , Kamphues Josef , Dobenecker Britta
Published: October 2018

Excess phosphorus (P) as seen in cat foods can have a negative effect on health (Dobenecker, Webel, Reese, & Kienzle, ; Pastoor, Klooster, Mathot, & Beynen, ). P surpluses may affect the environment, and economics in food producing animals, whereas marginal supply may impair performance and health. P can only be absorbed if it is soluble. Solubility of feed P in water and weak acid solution—as a precondition for absorption—was investigated in feed for dogs, cats, pigs and poultry. Different P containing mineral compounds (Ca(H2PO4)2, CaHPO4•2H2O, Ca4Na(PO4)3, KH2PO4, K4P2O7, NaH2PO4, Na5P3O10 (29 samples), as well as eight different ingredients such as wheat or meat, 64 compound feeds for pig and poultry, eight complete dry and 13 complete moist dog foods, 25 complete moist cat foods and 29 experimental diets were analysed for P solubility. Finely ground feeds were soaked in water or hydrochloric acid (0.4%) for 1 and 90 min. The samples were centrifuged and the supernatant was analysed for P (photometric vanadate molybdate method after wet ashing). The solubility of P from inorganic sources reflected the solubility of the main compound of the feed grade material. “organic” ingredients, such as fish meal or meat, showed a lower P solubility than inorganic sources. Most ingredients from animal origin (exception fish meal) had a higher P solubility than those from plant origin. When inorganic and “organic” P sources were mixed, the P solubility of the mixture reflected the P solubility and percentages of its compounds. In chicken, turkey and pig compound feed the percentage of acid soluble P increased with increasing P content. Pet moist food showed high percentages of water‐soluble P. The results show that the method is suitable to obtain data on water and acid solubility of P in feed and ingredients.
Influence of various concentrate‐to‐roughage ratios on dietary intake and nutrient digestibilities of weanling horses
Authors: Turcott‐White Susan K. , Nielsen Brian D. , Robison Cara I. , Skelly Christine D. , Rosenstein Diane S. , Pritchard Abby , Herdt Thomas
Published: October 2018

The objective of this study was to compare the feed intake and the apparent digestibilities of three different diets varying in concentrate‐to‐roughage ratios in weanling horses (n = 24) at 5 and 8 months of age. Horses were stratified by breed, gender, birth date and body weight and assigned to one of three dietary treatments containing the following concentrate‐to‐roughage ratios on an as‐fed basis: 70:30 (High Con), 50:50 (Equal) and 30:70 (Low Con). All horses were fed their respective diets for a 10‐day adaptation period and a 4‐day collection period at 5 and 8 months. There were no differences in BW or daily feed intake among treatments during both trials. The horses consuming Low Con had a greater amount of faecal output than High Con at both 5 and 8 months (p < 0.01). At 5 months, High Con had the highest crude protein (CP) digestibility (p < 0.05). At 8 months, High Con had a higher CP digestibility than Low Con (p < 0.01) and tended to be higher than Equal (p = 0.07). Acid detergent fibre (ADF) digestibility did not differ among treatments; however, horses fed the Low Con tended to digest a higher percentage of neutral detergent fibre (NDF) than both the Equal and High Con treatments (p = 0.09). Horses in the High Con treatment tended to digest a higher percentage of energy than those in the Low Con treatment (p = 0.06). Weanlings seem to digest protein more thoroughly when fed high‐concentrate diets and may digest fibre more efficiently when fed diets higher in fibre.
Geographic Expansion of Federally Qualified Health Centers 2007–2014
Authors: Chang Chiang‐Hua , P.W. Bynum Julie , Lurie Jon D.
Published: October 2018

Purpose

Federally Qualified Health Centers (FQHCs), which were expanded under the Affordable Care Act, are federally funded health centers that aim to improve access to primary care in underserved areas. With continued federal support, the number of FQHCs in the United States has increased >80% within a decade. However, the expansion patterns and their impact on the population served are unknown.

Methods

A pre (2007)‐post (2014) study of FQHC locations. FQHC locations were identified from the Provider of Services Files then linked to primary care service areas (PCSAs), which represent the service markets that FQHCs served. Road‐based travel time was estimated from each 2007 FQHC to the nearest new FQHC as an indicator of geographic expansion in access. PCSA‐level characteristics were used to compare 2007 and 2014 FQHC service markets.

Findings

Between 2007 and 2014, there was greater expansion in the number of FQHCs (3,489 vs 6,376; 82.7%) than in the number of service markets (1,835 vs 2,695; 46.9%). Nearly half of 2007 FQHCs (47%) had at least one new FQHC within 30 minutes travel time. Most newly certified FQHCs (81%) were located in urban areas. Compared to 2007 service markets, the new 2014 markets (N = 174) were much less likely to be in areas with >20% of the population below poverty (31.4% vs 14.9%, P < .001).

Conclusions

The latest expansion of FQHCs was less likely to be in rural or high poverty areas, suggesting the impact of expansion may have limitations in improving access to care among the most financially disadvantaged populations.
Virulence of Agrobacteriumtumefaciens requires lipid homeostasis mediated by the lysyl‐phosphatidylglycerol hydrolase AcvB
Authors: Groenewold Maike K. , Hebecker Stefanie , Fritz Christiane , Czolkoss Simon , Wiesselmann Milan , Heinz Dirk W. , Jahn Dieter , Narberhaus Franz , Aktas Meriyem , Moser Jürgen
Published: October 2018

Agrobacterium tumefaciens transfers oncogenic T‐DNA via the type IV secretion system (T4SS) into plants causing tumor formation. The acvB gene encodes a virulence factor of unknown function required for plant transformation. Here we specify AcvB as a periplasmic lysyl‐phosphatidylglycerol (L‐PG) hydrolase, which modulates L‐PG homeostasis. Through functional characterization of recombinant AcvB variants, we showed that the C‐terminal domain of AcvB (residues 232–456) is sufficient for full enzymatic activity and defined key residues for catalysis. Absence of the hydrolase resulted in ~10‐fold increase in L‐PG in Agrobacterium membranes and abolished T‐DNA transfer and tumor formation. Overproduction of the L‐PG synthase gene (lpiA) in wild‐type A. tumefaciens resulted in a similar increase in the L‐PG content (~7‐fold) and a virulence defect even in the presence of intact AcvB. These results suggest that elevated L‐PG amounts (either by overproduction of the synthase or absence of the hydrolase) are responsible for the virulence phenotype. Gradually increasing the L‐PG content by complementation with different acvB variants revealed that cellular L‐PG levels above 3% of total phospholipids interfere with T‐DNA transfer. Cumulatively, this study identified AcvB as a novel virulence factor required for membrane lipid homeostasis and T‐DNA transfer.
Efficacy of Additional Corticosteroid in a Multimodal Cocktail for Postoperative Analgesia Following Total Knee Arthroplasty: A Meta‐Analysis of Randomized Controlled Trials
Authors: Chai Xiping , Liu Haiping , You Congxin , Wang Changde
Published: October 2018

Background

Local injection of a multimodal cocktail including corticosteroid is commonly used for postoperative pain following total knee arthroplasty (TKA). However, it is inconclusive whether additional corticosteroid is beneficial. This meta‐analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy of an additional, local injection of corticosteroid in terms of pain relief and knee function recovery after TKA.

Methods

RCTs in electronic literature databases including PubMed, Web of Science, Embase, and Cochrane Library were systematically searched. Of 1,628 records identified, 9 RCTs involving 727 knees were eligible for data extraction and meta‐analysis.

Results

Local injection of a multimodal cocktail including corticosteroid did not contribute to pain relief within 12 hours postoperatively (P > 0.05). However, from 24 hours to 72 hours, it significantly decreased pain scores (P < 0.05, all) at rest and reduced total rescue opioid consumption postoperatively (P < 0.05). Knee range of motion (ROM) was improved at postoperative day 1 (POD1) and POD2 (P < 0.05), and hospital stay (P < 0.05) was shortened after local injection of corticosteroid. However, the other outcomes, including knee ROM after POD2, C‐reactive protein level, Knee Society score, postoperative nausea and vomiting, and wound complication occurrences, were not significantly different (P > 0.05, all).

Conclusions

Additional corticosteroid added to a multimodal cocktail improved postoperative pain, enhanced knee functional recovery, and shortened hospital stays following TKA, but local injection of corticosteroids had no effect on reducing nausea and vomiting based on our outcomes.
A systematic review of nurse‐led interventions with populations experiencing homelessness
Authors: Weber Jillian J.
Published: October 2018

Homelessness is associated with poorer health status, and affects men, women, children, and veterans alike across the United States. With over half a million‐people suffering from homelessness on any given night, it is imperative that the health care delivery system step in to help this vulnerable group. Registered nurses encounter people experiencing homelessness in hospitals, clinics, shelters, and across the public health sector. They have the necessary skills to help make positive health‐related changes for homeless populations and improve their overall quality of life. Therefore, the purpose of this systematic review was to (a) assess existing nurse‐led interventional studies with homeless populations, (b) highlight effective methods that nurses used to impact care, and (c) make recommendations about future research needed. PRISMA guidelines were used and multiple databases were searched for nurse‐led interventional research with those experiencing homelessness. Recommendations include using a holistic nursing approach when working to improve outcomes for homeless populations to ensure optimal treatment for their complex physical, mental, and social health problems.
Comparison of seed and seedling functional traits in native Helianthus species and the crop H. annuus (sunflower)
Authors: Castillo‐Lorenzo E. , Pritchard H. W. , Finch‐Savage W. E. , Seal C. E.
Published: October 2018

Seed functional traits of native Helianthus species contribute towards ecosystem services but limitations to their use in managed programmes exist. Many perennial Helianthus possess seed dormancy. The ability for germination to occur under different temperature and drought conditions, as well as the capacity of germinated seeds to convert into normal seedlings is rarely considered. Our aim was to identify and quantify these constraints through functional trait analyses.

In five seed lots of native Helianthus (four perennial and one annual) and five genotypes of sunflower (H. annuus) for comparison, dormancy, thermal and hydro thresholds and times, morphology, mass, oil content and conversion into normal seedlings were quantified. The influence of the seed collection site environment on these traits was also explored.

Seed dormancy of the perennial species was overcome by scarification followed by germination in 5 mm GA3. Thermal and hydro‐time analyses revealed slower germination for the native seed lots (>1350 °Ch) in comparison to the sunflower genotypes (<829.9 °Ch). However, native seed lots had a higher capacity to convert into normal seedlings at high temperatures and low water potentials than sunflower genotypes. For the native seed lots, the average monthly temperature of the collection site was negatively correlated with thermal time.

Variability in seed functional traits of native Helianthus and greater capacity for germinated seeds to convert into normal seedlings suggests they are better equipped to cope with high temperature and drought scenarios than sunflower. Effective dormancy alleviation is required to facilitate the use of native Helianthus species.
Intuitive Political Theory: People's Judgments About How Groups Should Decide
Authors: DeScioli Peter , Bokemper Scott E.
Published: October 2018

Societies must make collective decisions even when citizens disagree, and they use many different political processes to do so. But how do people choose one way to make a group decision over another? We propose that the human mind contains an intuitive political theory about how to make collective decisions, analogous to people's intuitive theories about language, physics, number, minds, and morality. We outline a simple method for studying people's intuitive political theory using scenarios about group decisions, and we begin to apply this approach in three experiments. Participants read scenarios in which individuals in a group have conflicting information (Experiment 1), conflicting interests (Experiment 2), and conflicting interests between a majority and a vulnerable minority who have more at stake (Experiment 3). Participants judged whether the group should decide by voting, consensus, leadership, or chance. Overall, we find that participants prefer majority‐rule voting over consensus, leadership, and chance when a group has conflicting interests or information. However, participants' support for voting is considerably diminished when the group includes a vulnerable minority. Hence, participants showed an intuitive understanding of Madison's concerns about tyranny of the majority.
Comparative acetylomic analysis reveals differentially acetylated proteins regulating anther and pollen development in kenaf cytoplasmic male sterility line
Authors: Chen Peng , Wei Fan , Li Ru , Li Zeng‐Qiang , Kashif Muhammad H. , Zhou Rui‐Yang
Published: October 2018

Cytoplasmic male sterility (CMS) is widely used in plant breeding and represents a perfect model to understand cyto‐nuclear interactions and pollen development research. Lysine acetylation in proteins is a dynamic and reversible posttranslational modification (PTM) that plays an important roles in diverse cell processes and signaling. However, studies addressing acetylation PTM regarding to anther and pollen development in CMS background are largely lacking. To reveal the possible mechanism of kenaf (Hibiscus cannabinus L.) CMS and pollen development, we performed a label‐free‐based comparative acetylome analysis in kenaf anther of a CMS line and wild‐type (Wt). Using whole transcriptome unigenes of kenaf as the reference genome, we identified a total of 1204 Kac (lysin acetylation) sites on 1110 peptides corresponding to 672 unique proteins. Futher analysis showed 56 out of 672 proteins were differentially acetylated between CMS and Wt line, with 13 and 43 of those characterized up‐ and downregulated, respectively. Thirty‐eight and 82 proteins were detected distinctively acetylated in CMS and Wt lines, respectively. And evaluation of the acetylomic and proteomic results indicated that the most significantly acetylated proteins were not associated with abundant changes at the protein level. Bioinformatics analysis demonstrated that many of these proteins were involved in various biological processes which may play key roles in pollen development, inculding tricarboxylic acid (TCA) cycle and energy metabolism, protein folding, protein metabolism, cell signaling, gene expression regulation. Taken together, our results provide insight into the CMS molecular mechanism and pollen development in kenaf from a protein acetylation perspective.
Gradualism in the GATT: Strategic tariff bargaining and forward manipulation
Authors: Chan Jackie M. L.
Published: October 2018

This paper examines strategic bargaining in a non‐cooperative game of tariff negotiation in the General Agreement on Tariffs and Trade (GATT). In the model, a country bargains sequentially and bilaterally with multiple trading partners under the MFN principle, making take‐it‐or‐leave‐it offers consisting of tariffs and transfers. A dynamic bargaining inefficiency arises in which the country strategically delays the reduction of its tariff until the final stage, and extensions to the model demonstrate gradual trade liberalization over multiple stages. Based on this idea of forward manipulation, the theory provides an explanation for gradualism in tariff reduction during the early GATT rounds.
Moment Conditions and Bayesian Non-Parametrics
Authors: Bornn Luke , Shephard Neil , Solgi Reza
Published: October 2018

Models phrased through moment conditions are central to much of modern inference. Here these moment conditions are embedded within a non-parametric Bayesian set-up. Handling such a model is not probabilistically straightforward as the posterior has support on a manifold. We solve the relevant issues, building new probability and computational tools by using Hausdorff measures to analyse them on real and simulated data. These new methods, which involve simulating on a manifold, can be applied widely, including providing Bayesian analysis of quasi-likelihoods, linear and non-linear regression, missing data and hierarchical models.
What brings meaning to life in a highly secular society? A study on sources of meaning among Danes
Authors: Pedersen Heidi Frølund , Birkeland Marit Handegard , Jensen Jens Søndergaard , Schnell Tatjana , Hvidt Niels Christian , Sørensen Torgeir , la Cour Peter
Published: October 2018

This study presents psychometric properties of the Danish version of the Sources of Meaning and Meaning in Life Scale (SoMe‐Da) and associations to socio‐demographic and religious characteristics. Participants were 554 Danes, 66% women ranging in age between 15 and 91 years. Exploratory factor analysis (EFA) suggested a five factor structure for the 26 sources if meaning. Construct validity within the SoMe‐Da and between mental health variables were established. Generativity associated most strongly with meaningfulness followed by spirituality, attentiveness, and explicit religiosity. We found religious characteristics to be more strongly associated with meaningfulness than socio‐demographic variables. Finally, we found distinct patterns of preferred sources of meaning between Christians, agnostics, and atheists. Christians and agnostics seemed to be more motivated by self‐transcendance, whereas atheists may be more motivated by self‐actualization. Results indicate that the SoMe‐Da appears to be a valid instrument for measuring the content and degree of personal meaning in life.
Gender, disaster, and women's access to contraception and reproductive health care
Authors: Berndt Virginia Kuulei
Published: October 2018

Despite an increasing focus on health in disasters and the intersection of gender and disaster, there are few studies on women's health and access to essential reproductive health care during and after disasters. Even though contraceptives have an objective importance in maintaining reproductive health, there have been policy changes in the United States that run counter to this need, leading some to perceive women's health care as superfluous or morally wrong. With such a negative perception of women's reproductive health care, how are state‐level contraceptive policies and emergency refill laws constructed in a way that compromises women's ability to maintain an emergency supply of contraceptives and/or hinders their contraceptive access in disasters? In this review, I describe literature that answers this question while highlighting the lack of literature on this specific intersection. Additionally, I describe current policies that address this question. I then present a discussion and directions for future research to conclude this paper.
Creating a math‐talk learning community with preservice teachers
Authors: Saylor Laura Lackner , Walton Janet B.
Published: October 2018

In order to explore the potential for math‐talk learning communities (utilizing interactive discussions of mathematics principles) as a framework for preservice teacher learning, a math‐talk learning community framework was adopted in a methods of teaching mathematics course for preservice early elementary teachers. A case study of the co‐created math‐talk learning community revealed that the use of this framework enhanced individual learning about mathematical concepts and the use of math‐talk learning communities, resulted in a prioritization of sense making, engaged learners, and created a safe space for mathematical discourse. The study has implications for teacher educators and for future research.
Just a Little Respect: Differences in Job Satisfaction Among Individuals With and Without Disabilities*
Authors: Brooks Jennifer D.
Published: October 2018

Objective

While scholars have documented high unemployment rates of individuals with disabilities, few studies address how workers with disabilities feel about their jobs. This study uses nationally representative data to explore the relationship between disability and job satisfaction; and examines how differences in job satisfaction between workers with and without disabilities may reflect educational attainment and perceived workplace respect.

Methods

Data come from the 2006 U.S. General Social Survey (N = 1,613). I estimated a series of ordinal logit regression models, controlling for gender, age, and race.

Results

Controlling for demographic and workplace characteristics, workers with disabilities had 49 percent lower odds of reporting high job satisfaction than their nondisabled counterparts. Differences in workplace respect accounted for 38 percent of this difference.

Conclusion

Given these results, one policy recommendation would be to implement disability awareness training for all employees, which may increase the amount of respect experienced by disabled workers.