bluuebunny/crossref_metadata_2025 huggingface dataset:
“Am I a student or a Healthcare Assistant?” A qualitative evaluation of a programme of prenursing care experience
Authors: Whiffin Charlotte J. , Baker Denise , Henshaw Lorraine , Nichols Julia J. , Pyer Michelle
Published: July 2018

Aim

To examine the experiences of prenursing healthcare assistants (HCA) during a 6‐month programme of prenursing care experience.

Background

Care experience prior to commencing programmes of nurse education is broadly considered to be advantageous. However, it is not clear how formal care experience prior to nurse education has an impact on the values and behaviours of the aspirant nurse.

Design

A longitudinal prospective qualitative study using focus group discussions.

Methods

Data were collected from 23 prenursing HCA during September 2013–February 2014. Three focus groups were held at the beginning, middle, and end of the programme of care experience at each of the participating hospitals. A thematic analysis was used to analyse data sets from each hospital. Findings from each hospital were then compared to reach final themes.

Results

Five major themes were identified in the analysis of qualitative data: personal development; positioning of role in the healthcare team; support and supervision; perceived benefits; and advice and recommendations. These themes were underpinned by deep aspirations for better care and better nurses in the future.

Conclusions

Prenursing care experience can positively prepare aspirant nurses for programmes of nurse education. The benefits identified were confirmation of aspiration (or otherwise) to pursue nursing, learning opportunities, and aspiration to improve patient experience. Risks for the programme included poor supervision, role ambiguity or confusion, demotivation through a deteriorating view of nursing, and poor treatment by others. The longer term impact on values and behaviours of this cohort requires further evaluation.
The use of metaphors in non‐Hodgkin's lymphoma patients undergoing chemotherapy
Authors: Chircop Daren , Scerri Josianne
Published: July 2018

Aim

The aim of this study was to explore the use of metaphors by non‐Hodgkin's lymphoma (NHL) patients undergoing chemotherapy in a haematology ward setting.

Background

There is a dearth of literature exploring the use of metaphors in people with cancer undergoing aggressive treatment. Hence, this study aims to explore the use of metaphors in NHL patients undergoing chemotherapy and additionally, examining whether the use of such metaphors has an empowering/disempowering effect.

Design

A qualitative design was used.

Methods

The participants were six adult patients diagnosed with NHL and undergoing chemotherapy. Data collection was undertaken between July 2016–December 2016. Each participant was interviewed twice using semi‐structured interviews. The data were analysed using Pragglejaz method for finding metaphors.

Findings

The participants used metaphors 17 times per 1,000 words to describe their experience of undergoing chemotherapy for NHL. The metaphors cited focused on aspects relating to “war”, “prison” and a “journey”.

Conclusions

The findings demonstrate that certain metaphors used by the study participants, such as those pertaining to “war” or a “journey”, concur with those described in narratives of people with cancer in general. However, the use of the “prison” metaphor by NHL patients undergoing chemotherapy relates particularly to their context of being isolated while undergoing treatment for fear of infection. Consequently, there is the need to interpret metaphors in relation to the specific type of illness and context. Furthermore, the findings of this study suggest that the impact of metaphors in empowering/disempowering people with cancer depends on the unique interpretation of the individual patient.
Improving quality of care for perinatal and newborn care at district and subdistrict hospitals in Haryana, India: Implementation research protocol
Authors: Das Manoja Kumar , Arora Narendra Kumar , Dalpath Suresh , Kumar Saket , Qazi Shamim A. , Bahl Rajib
Published: July 2018

Aim

This implementation research aims to improve quality of care for mothers and newborns in three districts of Haryana, India at different public health facilities.

Background

The decline in key maternal and newborn health indicators in India is relatively slower than expected and missed the millennium development goals. The multifold rise in institutional delivery in last decade has limited impact on neonatal and maternal mortality. Despite investments in infrastructure, equipment, supplies, monitoring tools, and also manpower, suboptimal gains in indicators point towards potential challenge in quality of care.

Design

This study adopts pre‐post, quasi‐experimental study design with repeated observations using mixed research methods to document the impact of the plan‐do‐study‐act implementation cycles.

Methods

The quality improvement interventions shall be implemented at three district hospitals and six‐first referral unit hospitals in three districts of Haryana targeting the antenatal, delivery, newborn care services with nurses as the key partners. Formative research, situational analysis, and root‐cause analysis shall inform the contextualization, prioritization of interventions. Incremental plan‐do‐study‐act cycles over 15 months shall be implemented. The changes in adherence to protocols, appropriate documentation, reduction in delays, and client satisfaction shall be documented for 16 indicators across delivery, antenatal, and sick newborn care domains.

Discussion

The successful implementation of the quality improvement processes has the potential of improving the pregnancy outcomes in terms of stillbirths, maternal, and newborn mortality and sick newborn outcomes. The feasibility and learning of coimplementation in the public health system shall inform integration into standards and scaling up.
The effects of biofeedback‐based stimulated recall on self‐regulated online learning: A gender and cognitive taxonomy perspective
Authors: Zhai Xuesong , Fang Qiansheng , Dong Yan , Wei Zhihui , Yuan Jing , Cacciolatti Luca , Yang Yalong
Published: July 2018

Previous studies posited the effectiveness of stimulated recall. However, few studies explored how SR is implemented in a relatively static context, for example, online self‐directed learning, or took human factors, for example, cognitive style and gender, into consideration in such a context. To fill this gap, the current study, aims to introduce biofeedback as a stimulus for learners to engage in retrospection regarding their learning behavior. A quasi‐experimental design study was carried out over a 12‐week set of EFL self‐regulated online reading activities. Pretest and posttest on reading performance and their cognitive taxonomy were assessed through a developed scale instrument, whereas physiological signals (e.g., gazing duration, verbal fixation, and brain wave) were captured via eye‐tracking and electroencephalograph (EEG) technology. The results emphasized that (a) students' reading ability and cognitive hierarchy significantly improved through biofeedback stimulation. Moreover, (b) learners in single level‐one cognitive hierarchic groups had significant improvements in both cognitive abilities and reading comprehension, whereas learners in multilevel hierarchic groups had no significant enhancements. Finally, (c) the optical data results and EEG reports showed that males favor procedural feedback and females have a preference for a conclusive assessment.
Diagnostic and therapeutic value of progastrin‐releasing peptide on small‐cell lung cancer: A Single‐Center Experience in China
Authors: Wu Xiao‐Yuan , Hu Yang‐Bo , Li Hui‐Juan , Wan Bing , Zhang Chen‐Xi , Zhang Bin , Hu Huan , Zhang Qun , Lv Tang‐Feng , Zhan Ping , Song Yong
Published: July 2018

We aimed to compare the diagnostic efficiency of proGRP and NSE on SCLC and to investigate whether the change of proGRP level would predict therapeutic response. Patients who were firstly diagnosed pathologically in Nanjing Chest Hospital and measured proGRP level consecutively were enrolled in the study. ProGRP level was detected using Elecsys ProGRP Assay. Totally 75 SCLC, 234 NSCLC and 264 benign lung diseases (BLD) were enrolled. Both proGRP and NSE levels in SCLC were significantly higher than those in NSCLC and BLD, and proGRP in extensive stage SCLC was higher than which in limited stage (P ≤ .001). The diagnostic efficiency of proGRP on SCLC was higher than that of NSE, but when the two biomarkers were bind together, the diagnostic efficiency was the best. When SCLC was differentiated from NSCLC and BLD, the cut‐off values were 114.35 pg/mL and 162.55 pg/mL respectively. For treatment responsive patients, proGRP level decreased markedly after the first cycle of therapy and kept a continued momentum of decline during treatment. But for unresponsive patients, no obvious decline was observed. ProGRP had higher diagnostic efficiency on SCLC when compared to NSE, and it could better predict therapeutic response of pulmonary target lesions on chemotherapy.
Comparison of insulin glargine 300 U/mL and insulin degludec using flash glucose monitoring: A randomized cross‐over study
Authors: Yamabe Mizuho , Kuroda Mami , Hirosawa Yasuyo , Kamino Hiromi , Ohno Haruya , Yoneda Masayasu
Published: July 2018

Aims/Introduction

We compared the efficacy and safety of insulin glargine 300 U/mL (Gla300) and insulin degludec U100 (Deg) using a flash glucose monitoring system.

Materials and Methods

A total of 24 Japanese patients with type 2 diabetes were randomized to receive once‐daily Gla300 (n = 12) or Deg (n = 12) in the morning. The primary end‐points were the mean percentage of time in the target glucose range (70–179 mg/dL) and hypoglycemia (<70 mg/dL), as measured using flash glucose monitoring during the last 7 days of each 14‐day period.

Results

The percentages of time with glucose levels <70 mg/dL were not significantly different between the two insulin treatments. No significant differences were observed in the percentages of time with glucose levels of 70–179 mg/dL or ≥180 mg/dL. The percentage of time with nocturnal hypoglycemia with Gla300 was significantly lower than that with Deg treatment (P = 0.021). This difference might be attributable to the difference in the duration of action between the two formulations, and the incidence of nocturnal hypoglycemia with Deg treatment was associated with the concomitant use of metformin (P = 0.035).

Conclusions

The two formulations were comparable in efficacy, whereas the incidence of nocturnal hypoglycemia was significantly lower with Gla300. Thus, the present study suggests that, although Gla300 and Deg are comparable long‐acting insulin analogs, Gla300 is safer with respect to the incidence of hypoglycemia.
Assessment of 16‐year retrospective cohort study of factors associated with non‐compliance with a tuberculosis contact tracing programme at a Spanish hospital
Authors: García Patricia , Sanchez José , Mora Juan , Ronda Elena
Published: July 2018

Rationale, aims, and objective

Contact tracing and screening is an essential strategy in tuberculosis (TB) control. Our aim is to assess factors associated with the degree of compliance with the main recommendations made to contacts of TB cases as part of the contact tracing programme, and to identify factors associated with non‐compliance.

Methods

We conducted a retrospective cohort study to assess the TB contact tracing programme at a Spanish hospital over the period 1998‐2013.

Results

A total 2269 contacts were identified corresponding to 644 active TB index cases, and initial screening indicated that 3.2% had active TB and 41.3% had latent TB infection (LTBI). Compliance with the recommendation for primary chemoprophylaxis increased significantly over the study period, rising from 76.5% in the period 1998 to 2002 to 82.7% in the period 2010 to 2013. A similar significant increase was also observed for latent tuberculosis infection treatment (46.1% in the first period to 68.0% in the latter period). Factors that were significantly associated with non‐compliance with the recommendations were: being of foreign origin, alcoholism, being recommended latent tuberculosis infection treatment, repeating the tuberculin skin test at 3 months, a smear‐positive index case, and an index case aged under 35 years old.

Conclusions

Although compliance levels have improved over the years, it remains necessary to adopt strategies that target contacts in groups identified as being at risk of non‐compliance.
Assessment of the flood hazard arising from land use change in a forested catchment in northern Iran
Authors: Hajian F. , Dykes A. P. , Cavanagh S.
Published: July 2018

The provinces of northern Iran that border the Caspian Sea are forested and may be prone to increased risks of flooding due to deforestation and other land use changes, in addition to climate change effects. This research investigated changes in runoff from a small forested catchment in northern Iran for several land use change scenarios and the effects of higher rainfall and high antecedent soil moisture. Peak discharges and total runoff volumes from the catchment were estimated using the U.S. Soil Conservation Service “Curve Number” (SCS‐CN) method and the SCS dimensionless unit hydrograph. This method was selected for reasons of data availability and operational simplicity for flood managers. A geographical information system (GIS) was used to manipulate spatial data for use in the catchment runoff modelling. The results show that runoff is predicted to increase as a result of deforestation, which is dependent on the proportion of the catchment area affected. However, climate change presents a significant flood hazard even in the absence of deforestation. Other land use changes may reduce the peak discharges of all return period floods. Therefore a future ban on timber extraction, combined with agricultural utilisation of rangeland, could prove effective as “nature‐based” flood reduction measures throughout northern Iran.
Room service in a public hospital improves nutritional intake and increases patient satisfaction while decreasing food waste and cost
Authors: McCray S. , Maunder K. , Barsha L. , Mackenzie‐Shalders K.
Published: July 2018

Background

Room service (RS) is a hospital foodservice model that is traditionally unique to the private sector. It allows patients to order meals compliant to their nutritional requirements from a single integrated menu at a time that suits them. Meals are prepared and delivered within 45 min of order. Following implementation in a private adult facility in 2013, Mater Group implemented the first RS in a public adult facility in Australia in 2016. In a pre–post study comparing RS with a traditional foodservice model (TM), key outcomes were measured and analysed.

Methods

A retrospective analysis of quality assurance data audits in a pre–post study design was undertaken to assess patient nutritional intake, plate waste, satisfaction and meal costs before and after RS implementation.

Results

Comparison of nutritional intake between TM (n = 84) and RS (n = 103) showed statistically significant increases with RS in both energy (5513 kJ day−1 versus 6379 kJ day−1, P = 0.020) and protein (53 g day−1 versus 74 g day−1, P < 0.001) intake, as well as energy and protein intake as a percentage of requirements (64% versus 78%, P = 0.002 and 70% versus 99%, P < 0.001, respectively). Total average plate waste decreased from 30% to 17% (P < 0.001). Patient satisfaction indicated an improvement with RS, with 98% of patients scoring the service good to very good, compared to 75% for TM (P < 0.04). Patient food costs decreased by 28% per annum with RS.

Conclusions

This research provides insight into the benefits achievable with RS in the public hospital setting, confirming that a patient‐centred food service model can cost‐effectively improve clinical outcomes.
The central circadian clock proteins CCA1 and LHY regulate iron homeostasis in Arabidopsis
Authors: Xu Gang , Jiang Zhimin , Wang Haiyang , Lin Rongcheng
Published: July 2018

Circadian clock is the endogenous time‐keeping machinery that synchronizes an organism's metabolism, behavior, and physiology to the daily light‐dark circles, thereby contributing to organismal fitness. Iron (Fe) is an essential micronutrient for all organisms and it plays important roles in diverse processes of plant growth and development. Here, we show that, in Arabidopsis thaliana, loss of the central clock genes, CIRCADIAN CLOCK ASSOCIATED 1 (CCA1) and LATE ELONGATED HYPOCOTYL (LHY), results in both reduced Fe uptake and photosynthetic efficiency, whereas CCA1 overexpression confers the opposite effects. We show that root Fe(III) reduction activity, and expression of FERRIC REDUCTION OXIDASE 2 (FRO2) and IRON‐REGULATED TRANSPORTER 1 (IRT1) exhibit circadian oscillations, which are disrupted in the cca1 lhy double mutant. Furthermore, CCA1 directly binds to the specific regulatory regions of multiple Fe homeostasis genes and activates their expression. Thus, this study established that, in plants, CCA1 and LHY function as master regulators that maintain cyclic Fe homeostasis.
Chronic, intermittent treatment with a cannabinoid receptor agonist impairs recognition memory and brain network functional connectivity
Authors: Mouro Francisco M. , Ribeiro Joaquim A. , Sebastião Ana M. , Dawson Neil
Published: July 2018

Elucidating how cannabinoids affect brain function is instrumental for the development of therapeutic tools aiming to mitigate ‘on target’ side effects of cannabinoid‐based therapies. A single treatment with the cannabinoid receptor agonist, WIN 55,212‐2, disrupts recognition memory in mice. Here, we evaluate how prolonged, intermittent (30 days) exposure to WIN 55,212‐2 (1 mg/kg) alters recognition memory and impacts on brain metabolism and functional connectivity. We show that chronic, intermittent treatment with WIN 55,212‐2 disrupts recognition memory (Novel Object Recognition Test) without affecting locomotion and anxiety‐like behaviour (Open Field and Elevated Plus Maze). Through 14C‐2‐deoxyglucose functional brain imaging we show that chronic, intermittent WIN 55,212‐2 exposure induces hypometabolism in the hippocampal dorsal subiculum and in the mediodorsal nucleus of the thalamus, two brain regions directly involved in recognition memory. In addition, WIN 55,212‐2 exposure induces hypometabolism in the habenula with a contrasting hypermetabolism in the globus pallidus. Through the application of the Partial Least Squares Regression (PLSR) algorithm to the brain imaging data, we observed that prolonged WIN 55,212‐2 administration alters functional connectivity in brain networks that underlie recognition memory, including that between the hippocampus and prefrontal cortex, the thalamus and prefrontal cortex, and between the hippocampus and the perirhinal cortex. In addition, our results support disturbed lateral habenula and serotonin system functional connectivity following WIN 55,212‐2 exposure. Overall, this study provides new insight into the functional mechanisms underlying the impact of chronic cannabinoid exposure on memory and highlights the serotonin system as a particularly vulnerable target.

image
A Chinese version of the Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale: Reliability and validity assessment in chronically ill patients
Authors: Zhou Chun‐Lan , Wang Si‐Qi , Wang Yan‐Fang , Ou Jie‐Xia , Wu Yan‐Ni
Published: July 2018

Aims and objectives

To translate the Patient Perceptions of Patient‐Empowering Nurse Behaviours Scale (PPPNBS) into Chinese and to psychometrically test the Chinese version of PPPNBS (PPPNBS‐C) in chronically ill patients.

Background

The growing prevalence and burden of chronic illnesses became the driving force for the need of empowerment as an approach to engage patients in self‐management. The PPPNBS was developed to assess patient perceptions of the process of empowerment during hospitalisation. Extending its application to different clinical context and ethnicities is worth pursuing.

Design

A cross‐sectional survey.

Methods

The PPPNBS was translated according to Brislin's translation guidelines and was culturally adapted. A questionnaire survey was carried out to determine the reliability and validity of the PPPNBS‐C among a total of 517 hospitalised patients with chronic illnesses.

Results

The content validity was found to be good with a content validity index of 0.94. Exploratory factor analysis identified six factors explaining 68.56% of the total variance and confirmatory factor analysis confirmed this six‐factor structure. The hypothesised differences were demonstrated through contrasted group comparisons by time since diagnosis and length of hospital stay. The score of the PPPNBS‐C was significantly and positively associated with that of the Client Satisfaction Questionnaire, as was the Self‐Efficacy for Managing Chronic Disease 6‐Item Scale score, providing evidence of convergent validity. The Cronbach's alpha coefficient was 0.960 and the intraclass correlation coefficient was 0.86 for the total scale, explaining good internal consistency and time stability.

Conclusions

The PPPNBS‐C has preliminary verification of the validity and reliability and could be useful in measuring patient perceptions of patient‐empowering nurse behaviours.

Relevance to clinical practice

The PPPNBS‐C can be applied to chronically ill patients as a metric of the implementation status of patient‐empowering nurse behaviours and can be used as a guide to encourage nurse's intentional utilisation of empowering behaviours.
“But this is a good cancer:” Patient perceptions of endometrial cancer in Denmark
Authors: Sidenius Anne , Manderson Lenore , Mogensen Ole , Rudnicki Martin , Møller Lars Mikael Alling , Hansen Helle Ploug
Published: July 2018

Aims and objectives

To explore endometrial cancer patients’ perceptions of the disease and the influence of favourable prognoses on their experiences.

Background

Endometrial cancer is associated with favourable prognoses, which may imply that patients experience distress to a lesser extent than other cancer patients with less positive treatment outcomes. However, most people with cancer report reduced quality of life and, despite endometrial cancer being prevalent worldwide, experiences of the disease have been little explored.

Design

Ethnographic fieldwork with participant observations and interviews.

Methods

Observations during clinical consultations at two Danish hospitals and interviews with women with endometrial cancer (n = 18) over a period of 6 months. The article adheres to the COREQ guidelines for reporting qualitative research.

Results

We identify how patients consider cancer in general very likely to be fatal, while clinicians in contrast characterise endometrial cancer specifically as “good” because of favourable prognoses. We employ the concept of bricolage to illustrate how bits and pieces of biomedical knowledge and statistical evidence become intertwined with patients’ past experiences and subjective ways of knowing, suggesting that patients’ perceptions of endometrial cancer as a disease are somewhat dynamic.

Conclusions

Public stories and everyday life experiences of cancer provide a central framework for illness perceptions. As a result, patients retain the idea of a close connection between cancer and death, while also adopting the notion of endometrial cancer as “good”. This influenced how women responded to treatment and care. Framing endometrial cancer as “good” is not always helpful, as the impact of a cancer diagnosis per se is rarely favourable.

Relevance to clinical practice

In providing women with endometrial cancer with optimal support through diagnosis and treatment, clinicians should attend to the complexity of patients’ illness understandings and be aware that assuring patients of a good prognosis not always has the expected impact.
Living with my small stomach: The experiences of post‐bariatric surgery patients within 1 year after discharge
Authors: Lin Hsiu‐Chin , Tsao Lee‐Ing
Published: July 2018

Aims and objectives

To explore how patients adapt to their changed body and life within the first year of receiving bariatric surgery.

Background

Bariatric surgery is used to treat severely obese patients. Most studies investigating the postsurgery period are about weight loss related issues. However, few studies have investigated these patients’ subjective live experiences within the first year after discharge.

Design

A qualitative research using grounded theory method was applied.

Methods

In‐depth interviews were conducted with 17 participants with a mean age of 34.5 years. The constant comparative method was used to analyse the interview data.

Findings

The core concept of “living with my small stomach” indicates that postbariatric patients are confronted with multidimensional challenges over time in their live experiences. Post‐bariatric surgery patients felt “unexpected body discomforts” in the initial period after discharge. Qualitative analysis generated two different types of living processes—either in the “life modification” process or a “suffering” process. The associated categories and subcategories delineated the living process after discharge. In the life modification process, five categories were identified: “being forced to change meal habits,” “bad feelings due to unsatisfied eating desires,” “choosing food for quality rather than quantity,” “persisting and confronting” and “getting support from family members.” In the suffering process, three categories were identified: “health becoming worse due to loss of albumin,” “suffering from bad health” and “emotional disturbances.” Finally, most participants would engage in “valuing my changed body” by “doing the right things and maintaining my new life.”

Conclusions

How to modify one's life is the main concern of postbariatric patients. These patients need to either engage in the process of making life modifications or suffer from complications.

Relevance to clinical practice

Patients need support and health education regarding living with their small stomach. In addition, we should be more sensitive about the need to detect malabsorption early.
Functional recovery of older stroke patients discharged from hospital to home: The effects of cognitive status and different levels of therapy intensity
Authors: Liu Huiying , Lou Vivian W. Q.
Published: July 2018

Aims and objectives

To determine whether and how cognitive impairment interacts with therapy intensity to affect functional improvements in older stroke patients over an 8‐week postdischarge intervention delivered in a community setting.

Background

Cognitive status is an important predictor of success of community‐based rehabilitation, but little has been known as to how cognitive impairment may affect outcomes through its interaction with the rehabilitation process.

Design

A prospective follow‐up evaluation was conducted in Hong Kong of older stroke patients (n = 384) who were admitted to an 8‐week home‐based rehabilitation intervention after discharge in Hong Kong between 2012–2014.

Methods

Cognitive screening was conducted among patients at the time of discharge from hospital. The intervention process was monitored, and individuals’ therapy intensity was assessed and recorded by physical or occupational therapists independently in each therapy session. Outcomes were measured using the 10‐item Barthel ADL index at discharge and after the intervention.

Results

Therapy intensity significantly moderated the relationship between cognitive impairment and functional recovery. Cognitively impaired stroke patients with moderate‐intensity rehabilitation reported significantly higher increase in functional performance than that of patients with low‐ and high‐intensity rehabilitation. In patients with no cognitive impairment, those who received high‐intensity treatment showed significantly more functional gains than that of patients being treated with less intensive rehabilitation.

Conclusion

Cognitive impairment affected functional outcomes through its interaction with different levels of therapy intensity among poststroke older patients.

Relevance to clinical practice

Increasing therapy intensity from moderate to high benefitted cognitively intact but not cognitively impaired patients. These results should inform decisions about community‐based rehabilitation and be used to identify the most cost‐effective service delivery model.
Caring Interaction with stroke survivors' family members—Family members' and nurses' perspectives
Authors: Lehto Birgitta , Kylmä Jari , Åstedt‐Kurki Päivi
Published: July 2018

Aims and objectives

To examine emotional support given by nurses to family members in the acute phase after a working‐aged patient's stroke based on nurses’ and family members’ experiences.

Background

The number of patients with stroke is increasing globally. There is a lack of knowledge about the emotional support of family members during the acute phase of working‐aged stroke victims. To be able to provide high‐quality nursing care during this phase, we need information about emotional support from family members’ and nurses’ perspective.

Method

Using a Glaserian grounded theory approach, the study was conducted using open interviews with family members and group interviews with nurses. Data were collected between 2012–2013.

Results

In this study, emotional support is identified as Caring Interaction. The changed life situation and diverse feelings aroused by the stroke are the starting point of providing emotional support to family members. It is important that the nurses notice family members’ need for support at the right time, use their intuition and respond appropriately.

Conclusions

The patient's family members are important when providing holistic nursing care for the whole family. As well as providing emotional support, high‐quality nursing interventions enhance the care of family members. This study provides an explanation of the interaction process between family members and nurses. It helps family members and nurses to better understand each other. Although the data were collected 5 years ago, it is assumed that the interaction between family members and nurses has not changed during these years remarkably.

Relevance to clinical practice

According to the experiences of family members and nurses who participated in this research, emotional support manifests in Caring Interaction. Being aware of body language and behaviour of family members, nurses can better interact with them.
Health‐promoting leadership: A qualitative study from experienced nurses’ perspective
Authors: Furunes Trude , Kaltveit Anita , Akerjordet Kristin
Published: July 2018

Aims and objectives

To increase knowledge about experienced nurses’ understanding of a health‐promoting work environment, health‐promoting leadership and its role in retention of staff in the nursing workplace.

Background

The quality of leadership is imperative in creating supportive and health‐promoting work environments to ensure workforce productivity and ethically sustainable caring cultures. More knowledge on how leaders can promote health and sustainable careers among nurses is needed. At a time of current and projected nursing shortage, it is important to understand the reasons why nurses intend to remain in their jobs.

Design

Qualitative descriptive.

Method

Twelve experienced registered nurses participated in an individual, digitally recorded, semi‐structured interview. Data were transcribed verbatim and subjected to qualitative content analysis of manifest and latent content.

Results

A health‐promoting work environment should provide autonomy, participation in decision‐making, skills development and social support. Health‐promoting leaders should be attentive and take action.

Conclusion

Health‐promoting work environments enable nurses to flourish. Having ample autonomy is therefore important to nurses so that when they face new challenges, they see them as a way of using and developing their competencies. Although most nurses claim their own leaders are not health promoting, they have a clear understanding of how a health‐promoting leader should act. The health‐promoting leader should not only be attentive and promote skills development, but also cater for nurses’ meaningfulness.

Relevance to clinical practice

Nurses in primary health care understand a health‐promoting work environment to be a workplace where they can develop, not only clinical skills, but also flourish as human beings. Further, nurses find it health promoting to have a meaningful job, using their competence to make a difference for patients and their families. Nurse Managers have an important role in facilitating meaningfulness in nurses’ jobs to retain nurses as a valuable asset for the organisation.
Expert in nursing care but sometimes disrespected—Telenurses’ reflections on their work environment and nursing care
Authors: Wahlberg Anna Carin , Bjorkman Annica
Published: July 2018

Aims and objectives

To describe telenurses’ reflections on their work environment and how it impacts on their nursing care.

Background

Telenursing is one of the largest healthcare settings in Sweden today; approximately 5.5 million care‐seekers call the designated number—1177—each year. Telenursing is regarded as highly qualified nursing care, and providing care over the telephone is considered a complex form of nursing. Within other fields of nursing, the work environment has been shown to affect the outcome of care, patient safety, nurse job satisfaction and burnout.

Design

The study used a descriptive design and followed the COREQ checklist.

Methods

Twenty‐four interviews were performed and analysed using qualitative content analysis.

Results

The main theme concerned “feeling like a nursing care expert but sometimes being disrespected.” The telenurses reported that their work environment supported their work as nursing care experts via the telephone in some respects, but also hindered them. Appreciation and respect they received from the vast majority of callers positively impacted the work environment and contributed to work satisfaction. However, they also felt disrespected by both their employers and healthcare staff; they sometimes felt like a dumping ground. Receiving support from colleagues seemed invaluable in helping them feel like and be a nursing care expert.

Conclusion

Work was perceived as cognitively demanding and sometimes exhausting, but appreciation from care‐seekers and the feeling of being able to provide qualified nursing care made working as a telenurse worthwhile.

Relevance to clinical practice

If telenurses are to perform good nursing care over the telephone, managers must provide them with resources, for example, support, education and opportunities for recovery during shifts. It seems that the role of the 1177 service has not been properly implemented and accepted within the healthcare system, and politicians need to anchor its mission within the healthcare organisation.
The psychic readiness for destruction among contemporary adolescents
Authors: Sitnik‐Warchulska Katarzyna , Izydorczyk Bernadetta
Published: July 2018

Aims and objectives

To verify the existence of psychic readiness for destruction among adolescent girls and to determine how psychic readiness for destruction is related to suicidal or violent behaviour in adolescence.

Background

The psychic readiness for destruction can be treated as a generalised tendency (personality disposition) to behave in a way that increases the probability of negative consequences which directly and indirectly threaten one's life, health and its quality.

Design

A retrospective cross‐sectional study.

Methods

The study involved 140 participants, aged 13–17, including 40 girls after suicide attempts (GS group), 40 girls using violence against others (GA group) and 60 girls without destructive behaviour at all (CG group). To measure psychic readiness for destruction, the polish adaptation of the Chronic Self‐Destructiveness Scale (CS‐DS) by Kelly was used.

Results

No significant differences were found between the GS group and GA group. A significant difference was found between the girls who engage in interpersonal violence (GA) and the control group (CG). In this case, the results showed a significantly higher score among those participants who were involved in extremely aggressive behaviours. A similar trend was also observed when comparing the group of girls who attempted suicide (GS) with the CG.

Conclusions

Based on the conducted analyses, a clear trend was observed in consistency of destructive behaviours (tendency for destruction)—both active (seeking to violate norms, risky behaviours) and passive (omission, neglect) among the girls from both groups indicating even a single act of this kind (no significant differences between the groups).

Relevance to clinical practice

Due to the complex nature of readiness for destruction and its negative consequences on health, it is imperative to investigate the risk factors for the tendency for destruction and to conduct health education among adolescents.
FDG‐PET/CT in the management of lymphomas: current status and future directions
Authors: El‐Galaly T. C. , Villa D. , Gormsen L. C. , Baech J. , Lo A. , Cheah C. Y.
Published: July 2018

FDG‐PET/CT is the current state‐of‐the‐art imaging in lymphoma and plays a central role in treatment decisions. At diagnosis, accurate staging is crucial for appropriate therapy selection: FDG‐PET/CT can identify areas of lymphoma missed by CT alone and avoid under‐treatment of patients with advanced disease stage who would have been misclassified as having limited stage disease by CT. Particularly in Hodgkin lymphoma, positive interim FDG‐PET/CT scans are adversely prognostic for clinical outcomes and can inform PET‐adapted treatment strategies, but such data are less consistent in diffuse large B‐cell lymphoma. The use of quantitative FDG‐PET/CT metrics using metabolic tumour volume, possibly in combination with other biomarkers, may better define prognostic subgroups and thus facilitate better treatment selection. After chemotherapy, FDG‐PET/CT response is predictive of outcome and may identify a subgroup who benefit from consolidative radiotherapy. Novel therapies, in particular immunotherapies, exhibit different response patterns than conventional chemotherapy, which has led to modified response criteria that take into account the risk of transient pseudo‐progression. In relapsed lymphoma, FDG‐PET/CT after second‐line therapy and prior to high‐dose therapy is also strongly associated with outcome and may be used to guide intensity of salvage therapy in relapsed Hodgkin lymphoma. Currently, FDG‐PET/CT has no role in the routine follow‐up after complete metabolic response to therapy, but it remains a powerful tool for excluding relapse if patients develop clinical features suggestive of disease relapse. In conclusion, FDG‐PET/CT plays major roles in the various phases of management of lymphoma and constitutes a step towards the pursuit of personalized treatment.
Organellar genomics: a useful tool to study evolutionary relationships and molecular evolution in Gracilariaceae (Rhodophyta)
Authors: Iha Cintia , Grassa Christopher J. , Lyra Goia de M. , Davis Charles C. , Verbruggen Heroen , Oliveira Mariana C.
Published: July 2018

Gracilariaceae has a worldwide distribution including numerous economically important species. We applied high‐throughput sequencing to obtain organellar genomes (mitochondria and chloroplast) from 10 species of Gracilariaceae and, combined with published genomes, to infer phylogenies and compare genome architecture among species representing main lineages. We obtained similar topologies between chloroplast and mitochondrial genomes phylogenies. However, the chloroplast phylogeny was better resolved with full support. In this phylogeny, Melanthalia intermedia is sister to a monophyletic clade including Gracilaria and Gracilariopsis, which were both resolved as monophyletic genera. Mitochondrial and chloroplast genomes were highly conserved in gene synteny, and variation mainly occurred in regions where insertions of plasmid‐derived sequences (PDS) were found. In mitochondrial genomes, PDS insertions were observed in two regions where the transcription direction changes: between the genes cob and trnL, and trnA and trnN. In chloroplast genomes, PDS insertions were in different positions, but generally found between psdD and rrs genes. Gracilariaceae is a good model system to study the impact of PDS in genome evolution due to the frequent presence of these insertions in organellar genomes. Furthermore, the bacterial leuC/leuD operon was found in chloroplast genomes of Gracilaria tenuistipitata, G. chilensis, and M. intermedia, and in extrachromosomal plasmid of G. vermiculophylla. Phylogenetic trees show two different origins of leuC/leuD: genes found in chloroplast and plasmid were placed with proteobacteria, and genes encoded in the nucleus were close to Viridiplantae and cyanobacteria.
Sham sleep feedback delivered via actigraphy biases daytime symptom reports in people with insomnia: Implications for insomnia disorder and wearable devices
Authors: Gavriloff Dimitri , Sheaves Bryony , Juss Amender , Espie Colin A. , Miller Christopher B. , Kyle Simon D.
Published: July 2018

This study investigated whether providing sham feedback about sleep to individuals with insomnia influenced daytime symptom reports, sleep‐related attentional bias and psychomotor vigilance. Sixty‐three participants meeting DSM‐5 criteria for insomnia disorder were recruited from the community. Following baseline assessments and actigraphy briefing, participants were randomised to receive next‐day sham feedback on sleep quality (“positive” vs. “negative” sleep efficiency condition). Feedback was delivered at habitual rise‐time using an integrated actigraphy‐diary watch to simulate wearable device behaviour. Participants completed symptom reports immediately before receiving feedback, and at 12:00 and 15:00 hr, using the experience sampling method. Following this they returned to the laboratory in the evening to complete symptom reports and computerised tests of sleep‐related attentional bias and basic psychomotor vigilance. Participants randomised to negative feedback (n = 32) evidenced impaired daytime function (decreased alert cognition [d = 0.79], increased sleepiness/fatigue [d = 0.55]) in the evening compared with those given positive feedback (n = 31). Within‐day trajectories revealed that the positive‐feedback group, relative to the negative‐feedback group, displayed a significantly greater increase in positive mood and alert cognition (from rise‐time to 12:00 hr), and significantly greater decrease in sleepiness/fatigue. There were no significant between‐group differences on measures of sleep‐related attentional bias [d = 0.20] or psychomotor vigilance [d = 0.12]. This controlled experiment shows that sham feedback about sleep biases appraisal of daytime symptoms, highlighting a pathway connecting sleep misperception with daytime features of insomnia. Findings have important implications for wearable devices that claim to measure “objective” sleep yet may provide inaccurate data relative to gold‐standard measurement.
Simple parametric tests for trait–environment association
Authors: ter Braak Cajo J. F. , Peres‐Neto Pedro R. , Dray Stéphane
Published: July 2018

Question

The CWM approach is an easy way of analysing trait–environment association by regressing (or correlating) the mean trait per plot against an environmental variable and assessing the statistical significance of the slope or the associated correlation coefficient. However, the CWM approach does not yield valid tests, as random traits (or random indicator values) are far too often judged significantly related to the environmental variable, even when the trait and environmental variable are extrinsic to (not derived from) the community data. Existing solutions are the ZS‐modified test (Zelený & Schaffers,) and the max (or sequential) test based on the fourth‐corner correlation. Both tests are based on permutations which become cumbersome when many tests need to be carried out and many permutations are required, as in methods that correct for multiple testing. The main goal of this study was to compare these existing permutation‐based solutions and to develop a quick and easy parametric test that can replace them.

Methods

This study decomposes the fourth‐corner correlation in two ways, which suggests a simple parametric approach consisting of assessing the significances of two linear regressions, one plot‐level test as in the CWM approach and one species‐level test, the reverse of the CWM approach, that regresses the environmental mean per species (i.e. the species niche centroid) on to the trait. The tests are combined by taking the maximum p‐value. The type I error rates and power of this parametric max test are examined by simulation of one‐ and two‐dimensional Gaussian models and log‐linear models.

Results

The ZS‐modified test and the fourth‐corner max test are conservative in different scenarios, the ZS‐modified test being even more conservative than the fourth‐corner. The new parametric max test is shown to control the type I error and has equal or even higher power than permutation tests based on the fourth‐corner, the ZS‐modified test and variants thereof. A weighted version of the new test showed inflated type I error.

Conclusion

The combination of two simple regressions is a good alternative to the fourth‐corner and the ZS‐modified test. This combination is also applicable when multiple trait measurements are made per plot.
Monitoring age‐related trends in genomic diversity of Australian lungfish
Authors: Schmidt Daniel J. , Fallon Stewart , Roberts David T. , Espinoza Thomas , McDougall Andrew , Brooks Steven G. , Kind Peter K. , Bond Nick R. , Kennard Mark J. , Hughes Jane M.
Published: July 2018

An important challenge for conservation science is to detect declines in intraspecific diversity so that management action can be guided towards populations or species at risk. The lifespan of Australian lungfish (Neoceratodus forsteri) exceeds 80 years, and human impacts on breeding habitat over the last half century may have impeded recruitment, leaving populations dominated by old postreproductive individuals, potentially resulting in a small and declining breeding population. Here, we conduct a “single‐sample” evaluation of genetic erosion within contemporary populations of the Australian lungfish. Genetic erosion is a temporal decline in intraspecific diversity due to factors such as reduced population size and inbreeding. We examined whether young individuals showed signs of reduced genetic diversity and/or inbreeding using a novel bomb radiocarbon dating method to age lungfish nonlethally, based on 14C ratios of scales. A total of 15,201 single nucleotide polymorphic (SNP) loci were genotyped in 92 individuals ranging in age from 2 to 77 years old. Standardized individual heterozygosity and individual inbreeding coefficients varied widely within and between riverine populations, but neither was associated with age, so perceived problems with recruitment have not translated into genetic erosion that could be considered a proximate threat to lungfish populations. Conservation concern has surrounded Australian lungfish for over a century. However, our results suggest that long‐lived threatened species can maintain stable levels of intraspecific variability when sufficient reproductive opportunities exist over the course of a long lifespan.