bluuebunny/crossref_metadata_2025 huggingface dataset:
Processes of Early Stroke Care and Hospital Costs
Authors: Svendsen Marie Louise , Ehlers Lars H. , Hundborg Heidi H. , Ingeman Annette , Johnsen Søren P.
Published: December 2013

Background

The relationship between processes of early stroke care and hospital costs remains unclear.

Aims

We therefore examined the association in a population-based cohort study.

Methods

We identified 5909 stroke patients who were admitted to stroke units in a Danish county between 2005 and 2010. The examined recommended processes of care included early admission to a stroke unit, early initiation of antiplatelet or anticoagulant therapy, early computed tomography/magnetic resonance imaging (CT/MRI) scan, early physiotherapy and occupational therapy, early assessment of nutritional risk, constipation risk and of swallowing function, early mobilization, early catheterization, and early thromboembolism prophylaxis. Hospital costs were assessed for each patient based on the number of days spent in different in-hospital facilities using local hospital charges.

Results

The mean costs of hospitalization were $23 352 (standard deviation 27 827). The relationship between receiving more relevant processes of early stroke care and lower hospital costs followed a dose–response relationship. The adjusted costs were $24 566 (95% confidence interval 19 364–29 769) lower for patients who received 75–100% of the relevant processes of care compared with patients receiving 0–24%. All processes of care were associated with potential cost savings, except for early catheterization and early thromboembolism prophylaxis.

Conclusions

Early care in agreement with key guidelines recommendations for the management of patients with stroke may be associated with hospital savings.
Tissue Kallikrein Preventing the Restenosis after Stenting of Symptomatic MCA Atherosclerotic Stenosis (KPRASS)
Authors: Lan Wenya , Yang Fang , Liu Ling , Yin Qin , Li Min , Li Zhuangli , Sang Hongfei , Xu Gelin , Ma Minmin , Zhang Zhizhong , Liu Zhenguo , Liu Xinfeng , Zhang Renliang
Published: December 2013

Rationale

Many recent studies suggest that the kallikrein-kinin system play a protective role in the impairment of vascular smooth muscle cells and vascular endothelial cell.

Aims

The study aims to determine whether tissue kallikrein is efficacy for preventing the long-term in-stent restenosis after stenting of symptomatic atherosclerotic stenosis of the middle cerebral artery M1 segment.

Design

This is a Phase II, randomized, single-blinded, controlled trial. In line with SAMMPRIS stenting indications, patients ( n = 90) with the symptomatic the middle cerebral artery M1 segment stenosis ⩾70% and successfully treated with stent will be enrolled. Eligible patients will be randomized using computer generated numbers, and allocated to receive tissue kallikrein treatment or not. Patients in tissue kallikrein treatment group will be prescribed with intravenous infusion of tissue kallikrein (0·15 PNAU/d, dissolved in 100 ml saline) for 7 days after stenting and then oral administration of pancreatic kallikrein enteric-coated tablet (240 U, 3/d) to the end of study. As the foundation treatment, all the enrolled patients will receive aspirin (100 mg/d), clopidogrel (75 mg/d), and atorvastatin (20 mg/d) for the first 6 months and continue with the combination of aspirin and atorvastatin at the previous dosage.

Study outcomes

Patients will be evaluated at 1, 6 and 12 months after stenting. The primary outcomes are the in-stent restenosis rate, new stroke or aggravation of the previous ischemic stroke ipsilateral to the severe stenotic artery. Secondary outcomes include stroke of other artery territories, myocardial infarction and vascular death. Modification of stroke knowledge, exercise and diet habit, smoking cessation and available laboratory data will also be recorded.

Conclusion

As our pilot study, tissue kallikrein would be expected to prevent the long-term in-stent restenosis after stenting of the symptomatic middle cerebral artery dramatically.
Why Do Some Toddlers Help A Stranger? Origins of Individual Differences in Prosocial Behavior
Authors: Newton Emily K. , Goodman Miranda , Thompson Ross A.
Published: December 2013

This study investigated the influence of emotion on toddlers' prosocial behavior in instrumental helping tasks with an unfamiliar adult. The goals were to examine whether early prosocial behavior was affected by (1) the adult's expressions of sadness (in contrast to a neutral expression) as a cue of need and (2) toddlers' emotion understanding. Thirty‐five 18‐ to 20‐month‐olds participated in eight trials in which an experimenter either indicated need for assistance (experimental condition) or did not (control). In addition, the experimenter expressed either sadness or neutral affect in each trial. Toddlers' emotion understanding was assessed using maternal reports of children's emotion words. The experimenter's emotional expression alone was not associated with prosocial behavior, but toddlers helped more in experimental than control conditions. However, toddlers with larger emotion word vocabularies were marginally more prosocial when the experimenter expressed sadness, and girls provided more assistance than boys in experimental conditions. These findings highlight the complex influences of emotion on early prosocial motivation.
A Unifying Framework for Marginalised Random‐Intercept Models of Correlated Binary Outcomes
Authors: Swihart Bruce J. , Caffo Brian S. , Crainiceanu Ciprian M.
Published: December 2013

We demonstrate that many current approaches for marginal modelling of correlated binary outcomes produce likelihoods that are equivalent to the copula‐based models herein. These general copula models of underlying latent threshold random variables yield likelihood‐based models for marginal fixed effects estimation and interpretation in the analysis of correlated binary data with exchangeable correlation structures. Moreover, we propose a nomenclature and set of model relationships that substantially elucidates the complex area of marginalised random‐intercept models for binary data. A diverse collection of didactic mathematical and numerical examples are given to illustrate concepts. Copyright © 2013 John Wiley & Sons, Ltd.
Couverture et respect de la législation sur le salaire minimum dans les pays en développement
Authors: RANI Uma , BELSER Patrick , OELZ Martin , RANJBAR Setareh
Published: December 2013

Les auteurs observent la couverture et le respect de la législation sur le salaire minimum dans onze pays en développement. Ils mettent en relation l'étendue de cette couverture et le degré de ce respect avec le niveau du salaire minimum, l'existence d'un taux unique ou de taux multiples et la façon dont il est fixé et mis en application. La couverture et le respect sont supérieurs, et le niveau optimal atteint, lorsque le système est simple et bien connu, et que les travailleurs et les employeurs sont associés à la fixation du salaire minimum et à son application.
Rémunération «de la main à la main» dans l'Union européenne
Authors: WILLIAMS Colin C. , PADMORE Jo
Published: December 2013

Les auteurs révèlent le nombre de salariés qui, dans l'Union européenne, perçoivent de leur employeur non seulement un salaire déclaré, mais aussi une rémunération non déclarée. Exploitant les résultats d'une enquête de 2007 fondés sur 26659 entretiens, les auteurs montrent que 1 salarié déclaré sur 18 est rémunéré de la main à la main par son employeur à hauteur de 25 pour cent de son salaire brut, en moyenne. Ces arrangements salariaux hybrides sont très répandus, mais touchent plus certains pays, catégories de salariés et types d'entreprises. Les auteurs concluent par les implications théoriques et politiques de ces résultats.
Modèle théorique du choix de l'emploi et de la mobilité sur un marché du travail à plusieurs secteurs: l'exemple du Ghana
Authors: TAIWO Olumide
Published: December 2013

L'auteur élabore un modèle de marché du travail divisé en trois secteurs: emploi salarié, travail indépendant et entreprises familiales, à partir duquel il étudie le choix de l'emploi et la mobilité entre ces secteurs, au moyen des données d'une enquête auprès des ménages du Ghana. Les résultats montrent que les travailleurs indépendants sont les moins mobiles et les travailleurs familiaux, les plus mobiles. Ils font apparaître l'importance de la prime à l'instruction dans l'emploi salarié, celle de la taille et de la richesse de la famille sur le choix de l'emploi et celle du caractère transférable des compétences d'un secteur à l'autre.
Revision and typification of names in Canarian Sonchus (Asteraceae: Cichorieae) published by or based on material from E. R. Sventenius
Authors: Mejías José A. , Santos‐Guerra Arnoldo , Kim Seung‐Chul
Published: December 2013

In the present paper we analyse the validity and nomenclatural status of the names of 16 taxa (eight species, four interspecific hybrids, one subspecies and three varieties) in Macaronesian Sonchus described or collected by E. R. Sventenius. As there is much controversy regarding their validity, mainly concerning the proper indication of the types and their location, we conducted a general revision of exsiccata, collected by Sventenius and kept at ORT, GB and BC, in order to locate possible type material. As a result, we located five holotypes, designated six lectotypes (four of which are illustrations), two neotypes and two epitypes, and located six isotypes and one paratype. We propose accepting the validity of most of Sventenius's names in the group with the exception of those whose protologue includes more than one gathering. Because except for S. ortunoi Svent. the taxa have valid names subsequently published by L. Boulos, we introduce a valid name for S. ortunoi here. Furthermore, we indicate legitimate names in the more widely circumscribed Sonchus that is now recognized based on recent phylogenetic reconstructions; in addition, we introduce the new combinations S.×rupicola (Svent.) A. Santos & Mejías and S.×decipiens (Svent.) A. Santos & Mejías.
The Negative Impact of Additional Legislation on Corporate Stewardship
Authors: O'Leary Conor , Boolaky Pran , Copp Richard
Published: December 2013

Many jurisdictions worldwide have reacted to the global financial crisis by implementing new or improved corporate legislative requirements. These would impact upon company directors and audit committee members. This study examines the attitudes of Australian members of these two groups to nine United Kingdom proposed amendments to corporate legislation.

Both groups were predominantly opposed to additional legislation (failing to see how it could improve current stewardship) and indicated they would be less comfortable in their current roles. The implications are significant. Additional legislation, although well intentioned, may have negative impacts on stewardship, as requirements may deter good corporate citizens from retaining or seeking office.
EAA/EMQN best practice guidelines for molecular diagnosis of Y‐chromosomal microdeletions: state‐of‐the‐art 2013
Authors: Krausz C. , Hoefsloot L. , Simoni M. , Tüttelmann F.
Published: December 2013

The molecular diagnosis of Y‐chromosomal microdeletions is a common routine genetic test which is part of the diagnostic workup of azoospermic and severe oligozoospermic men. Since 1999, the European Academy of Andrology (EAA) and the European Molecular Genetics Quality Network (EMQN) have been actively involved in supporting the improvement of the quality of the diagnostic assays by publication of the laboratory guidelines for molecular diagnosis of Y‐chromosomal microdeletions and by offering external quality assessment trials. The present revision of the 2004 laboratory guidelines summarizes all the clinical novelties related to the Y chromosome (classic, partial and gene‐specific deletions, genotype–phenotype correlations, methodological issues) and provides an update on the results of the quality control programme. These aspects also reflect the consensus of a large group of specialists present at a round table session during the recent Florence‐Utah‐Symposium on ‘Genetics of male infertility’ (Florence, 19–21 September, 2013). During the last 10 years the gr/gr deletion has been demonstrated as a significant risk factor for impaired sperm production. However, the screening for this deletion type in the routine diagnostic setting is still a debated issue among experts. The original basic protocol based on two multiplex polymerase chain reactions remains fully valid and appropriate for accurate diagnosis of complete AZF deletions and it requires only a minor modification in populations with a specific Y chromosome background. However, in light of novel data on genotype–phenotype correlations, the extension analysis for the AZFa and AZFb deletions is now routinely recommended. Novel methods and kits with excessively high number of markers do not improve the sensitivity of the test, may even complicate the interpretation of the results and are not recommended. Annual participation in an external quality control programme is strongly encouraged. The 12‐year experience with the EMQN/EAA scheme has shown a steep decline in diagnostic (genotyping) error rate and a simultaneous improvement on reporting practice.
Cellular evidence for selfish spermatogonial selection in aged human testes
Authors: Maher G. J. , Goriely A. , Wilkie A. O. M.
Published: December 2013

Owing to a recent trend for delayed paternity, the genomic integrity of spermatozoa of older men has become a focus of increased interest. Older fathers are at higher risk for their children to be born with several monogenic conditions collectively termed paternal age effect (PAE) disorders, which include achondroplasia, Apert syndrome and Costello syndrome. These disorders are caused by specific mutations originating almost exclusively from the male germline, in genes encoding components of the tyrosine kinase receptor/RAS/MAPK signalling pathway. These particular mutations, occurring randomly during mitotic divisions of spermatogonial stem cells (SSCs), are predicted to confer a selective/growth advantage on the mutant SSC. This selective advantage leads to a clonal expansion of the mutant cells over time, which generates mutant spermatozoa at levels significantly above the background mutation rate. This phenomenon, termed selfish spermatogonial selection, is likely to occur in all men. In rare cases, probably because of additional mutational events, selfish spermatogonial selection may lead to spermatocytic seminoma. The studies that initially predicted the clonal nature of selfish spermatogonial selection were based on DNA analysis, rather than the visualization of mutant clones in intact testes. In a recent study that aimed to identify these clones directly, we stained serial sections of fixed testes for expression of melanoma antigen family A4 (MAGEA4), a marker of spermatogonia. A subset of seminiferous tubules with an appearance and distribution compatible with the predicted mutant clones were identified. In these tubules, termed ‘immunopositive tubules’, there is an increased density of spermatogonia positive for markers related to selfish selection (FGFR3) and SSC self‐renewal (phosphorylated AKT). Here we detail the properties of the immunopositive tubules and how they relate to the predicted mutant clones, as well as discussing the utility of identifying the potential cellular source of PAE mutations.
Suppressing thoughts of evaluation while being evaluated
Authors: Slepian Michael L. , Oikawa Masanori , Smyth Joshua M.
Published: December 2013

Thought suppression can cause ironic increases in the occurrence of intrusive thoughts. Intrusive thoughts of evaluation could be especially disruptive while undergoing evaluation. Such a context, however, could help suppression efforts as the context provides an external source for which to attribute suppression failures. When suppressing thoughts of evaluation in a non‐evaluative context (a context‐content mismatch), typical ironic effects of thought suppression occurred. There was no increased accessibility of evaluation, however, when suppressing evaluation in an evaluative context (a context‐content match), which allowed for attributing intrusive thoughts to the context, rather than the self, making suppression easier. Suppressing thoughts of evaluation may be beneficial in an evaluative context, suggesting that the consequences of willful suppression are moderated by context.
Different perceptions of self‐handicapping across college and work contexts
Authors: Park Sun W. , Brown Christina M.
Published: December 2013

We investigated the effectiveness of self‐handicapping as an impression management strategy in college and work contexts. In contrast to past research in which college students are both targets and perceivers, we tested whether target status and perceiver status moderate perceptions of self‐handicappers. To this end, we manipulated whether the target was a college student or an adult worker, and we recruited as perceivers both college students (Study 1) and adult workers (Study 2). We additionally manipulated the target's behavior (self‐handicapping vs. control) and outcome (success vs. failure). The results revealed that self‐handicapping protected a student target (but not a worker) from negative evaluations (e.g., ability attributions) in the eyes of college students, particularly males. However, adult workers consistently judged self‐handicapping negatively.
Permanent maxillary canines – review of eruption pattern and local etiological factors leading to impaction
Authors: Sajnani Anand K.
Published: December 2013

The position of the permanent maxillary canine at the angle of the mouth is strategically significant in maintaining the harmony and symmetry of the occlusal relationship. However, the maxillary canine is the second most frequently impacted tooth, with prevalence reported to be between 1% and 2%. Moreover, treatment of this condition is often complex and involves substantial time and financial cost. Hence, it is only prudent to monitor the eruption and identify the etiological factors that lead to impaction of the maxillary canine. Numerous researchers have tried to identify specific and nonspecific etiological factors responsible for displacement of canines. The purpose of this review was to track the development processes of maxillary canines and determine the hindrances that affect the eruption at different ages. Awareness of the eruption process and etiology of noneruption will help to reduce the incidence of impacted canines by allowing for early recognition and interceptive treatment.
Diagnostic dilemma of unicystic ameloblastoma: novel parameters to differentiate unicystic ameloblastoma from common odontogenic cysts
Authors: Gunawardhana Kuda Singappulige Niluka Darshani , Jayasooriya Primali Rukmal , Tilakaratne Wanninayake Mudiyanselage
Published: December 2013

Aim

Diagnostic criteria that have been specified for unicystic ameloblastomas (UAs) are not always helpful to differentiate these cystic tumors from common odontogenic cysts. The aim of this study therefore was to identify additional histopathological features (other than the features considered for the diagnosis of UA at present) that would be helpful to differentiate UA from odontogenic cysts.

Methods

One hundred histopathologically confirmed unicystic ameloblastomas and 20 cases each of radicular, inflamed dentigerous and non‐inflamed dentigerous cysts were selected. Histopathological features of the UAs that are not used as diagnostic criteria at present were identified.

Results

Hyperplastic arcading epithelial proliferations with stellate‐reticulum‐like and vacuolated cells were always seen associated with inflammation in odontogenic cysts, while in UA plexiform‐like areas were also seen without inflammation (P < 0.001). In addition, a spiky rete pattern was observed in non‐inflamed UA while this pattern was observed only in inflamed odontogenic cysts. Furthermore, spiky retes together with subepithelial hyalinization were usually observed in UAs while only subepithelial hyalinization was observed in non‐inflamed dentigerous cysts.

Conclusions

Combinations of histopathological features were identified to differentiate non‐inflamed UA from common odontogenic cysts. However, presence of inflammatory changes in UA precludes the use of features identified in the present study for diagnostic purposes.
Effect of phase 1 periodontal therapy on gingival crevicular fluid levels of matrix metalloproteinases‐3 and ‐13 in chronic periodontitis patients
Authors: Pawar Deepali D. , Mehta Dhoom S.
Published: December 2013

Aim

The aim of the present study was to estimate the gingival crevicular fluid (GCF) levels of matrix metalloproteinases (MMP)‐3 and ‐13 in periodontally‐healthy controls and chronic periodontitis (CP) patients, and also to investigate the effect of phase 1 periodontal therapy on MMP‐3 and ‐13 levels in CP patients.

Methods

Fifty‐five systemically‐healthy patients were divided into two groups: group 1 (healthy) and group 2 (CP). The recording of clinical parameters and GCF sampling was done at baseline for both groups and again at 6 weeks post‐therapy for group 2. The MMP level was determined by ELISA.

Results

A significant increase in the mean MMP‐3 and ‐13 was found between healthy and CP patients. There was a statistically‐significant reduction of GCF MMP‐3 and ‐13 concentration after periodontal therapy in the CP group. A positive correlation was found between clinical parameters and GCF MMP‐3 and ‐13 levels.

Conclusions

A lower concentration of GCF MMP‐3 and ‐13 was found in healthy patients, and a higher concentration was noted for CP patients, which was reduced after periodontal therapy. This indicates the important role played by these MMP in periodontal destruction. Thus, MMP‐3 and ‐13 could be used as inflammatory biomarkers in diagnosing periodontal disease severity.
Efficacy of tooth bleaching with the prior application of a desensitizing agent
Authors: do Carmo Públio Juliana , D'Arce Maria B. F. , Ambrosano Gláucia M. B. , Aguiar Flávio H. B. , Lovadino José R. , Paulillo Luís A. M. S. , Lima Débora A. N. L.
Published: December 2013

Aim

In the present study, we evaluated the efficacy of bleaching on enamel and opposite dentin surfaces using 35% hydrogen peroxide (HP) with the prior application of a desensitizing agent.

Methods

Thirty bovine dental fragments, with thicknesses of 1 mm enamel and 1.75 mm dentin, were stained in a solution of black tea. The fragments were randomly divided into three groups (n = 10) according to the following protocols: (a) 2% neutral fluoride + bleaching; (b) desensitizing agent + bleaching; and (c) without desensitizer + bleaching. The bleaching efficacy was evaluated four times: after staining with tea (baseline) and after each of the 3 weeks of bleaching, by means of the CIE Lab method using a reflectance spectrophotometer. The data coordinate L* was evaluated by an analysis of repeated measures with PROC MIXED and Tukey–Kramer's test. The ΔE values were subjected to anova and Tukey's test (α = 0.05).

Results

The 35% HP treatment showed greater efficacy on deep dentin after removal of the enamel stains, with increasing means during all times in all treatments.

Conclusion

The use of a desensitizing agent prior to the bleaching session did not affect the mechanism of action of 35% HP with regard to tooth depth.
Physical well‐being in postoperative period: a survey in patients, nurses and physicians
Authors: Andión Óscar , Cañellas Montserrat , Baños Josep‐E
Published: December 2013

Aims and objectives

To determine which unpleasant conditions might contribute to postoperative physical well‐being, as judged by patients, nurses and physicians.

Background

Healthcare professionals have rarely assessed holistic postoperative well‐being. Most studies have focused on specific symptoms, and a broader survey is lacking.

Design

A prospective study, which collected information on the causes of decreased physical well‐being in the postoperative period.

Methods

The study was carried out in 101 patients who subsequently underwent elective surgery, in 82 physicians and in 40 nurses, all from the same hospital. A questionnaire was used for each sample, which included an inventory of 12 items, which have been associated with the worsening of postoperative physical well‐being in the literature. Patients were asked to fill out the questionnaire on the second or third postoperative day and score each item from 0–10.

Results

Physicians rated pain (8·45), vomiting (6·68) and nausea (6·55) the highest. Nurses scored pain (8·48), nasogastric tube (7·13) and nausea (7·10) at the top. Insomnia and oxygen mask were scored significantly higher by nurses than by physicians. Patients scored pain (5·41) and movement restriction (4·62) the highest. When departments were compared, statistical differences were seen in nausea, vomiting, intravenous drips, nasogastric tube and oxygen mask.

Conclusions

This survey shows that there is a general agreement between nurses and physicians regarding what contributes to decreased postoperative physical well‐being, with few exceptions. However, healthcare professionals may differently rate some items that patients find as the most troubling.

Relevance to clinical practice

This survey shows that, besides pain, other symptoms can affect the physical well‐being of patients during the postoperative period. Alleviation of some symptoms and the use of medical devices only when they are really needed may help to improve the well‐being of patients.
Exploring interference from analgesia in patients with cancer pain: a longitudinal qualitative study
Authors: Manzano Ana , Ziegler Lucy , Bennett Mike
Published: December 2013

Aims and objectives

To increase understanding of the impact of analgesic side effects in patients with cancer pain.

Background

Studies in the area of cancer pain often refer to the need to find a satisfactory balance between analgesics and side effects as the key to cancer pain management. We explore how patients achieve this balance, its components and how it affects pain treatment adherence.

Design

An exploratory longitudinal study using qualitative research methodology.

Methods

Twenty‐five semi‐structured face‐to‐face interviews with patients with advanced cancer and their caregivers. Longitudinal interviews were conducted with patients (n = 11) at six‐week intervals over three months. Eleven first interviews, eight second interviews and six third interviews were completed with attrition due to death or ill health. Ten of the 25 interviews included caregivers.

Results

How cancer pain analgesics interfere with patients' life determines their adherence to the prescribed treatment. Compromises were made to manage three elements: pain, cognitive adverse effects of analgesics and physical activity. Negotiations and choices within this triad fluctuated and were determined by multiple psychosocial circumstances affecting patients and their caregivers varying from simple to complex. Patients with cancer and their caregivers actively managed the interference of analgesic drugs in their cognitive abilities and displayed a variety of nonadherence behaviours.

Conclusion

Further understanding of the role of analgesic side effects in the success of cancer pain management in patients is needed. This would enable clinicians to frame an optimal pain management plan.

Relevance to clinical practice

Clinicians should advise their patients about side effects of analgesic drugs, specifically the impact that cognitive alterations might have on their lives and subsequent adherence behaviour. Helping patients to achieve a balance between pain, adverse effects and physical function should have a key place in pain management strategies with advanced cancer.
Intensive care survivors' experiences of ward‐based care: Meleis' theory of nursing transitions and role development among critical care outreach services
Authors: Ramsay Pam , Huby Guro , Thompson Andrew , Walsh Tim
Published: December 2013

Aims and objectives

To explore the psychosocial needs of patients discharged from intensive care, the extent to which they are captured using existing theory on transitions in care and the potential role development of critical care outreach, follow‐up and liaison services.

Background

Intensive care patients are at an increased risk of adverse events, deterioration or death following ward transfer. Nurse‐led critical care outreach, follow‐up or liaison services have been adopted internationally to prevent these potentially avoidable sequelae. The need to provide patients with psychosocial support during the transition to ward‐based care has also been identified, but the evidence base for role development is currently limited.

Design and methods

Twenty participants were invited to discuss their experiences of ward‐based care as part of a broader study on recovery following prolonged critical illness. Psychosocial distress was a prominent feature of their accounts, prompting secondary data analysis using Meleis et al.'s mid‐range theory on experiencing transitions.

Results

Participants described a sense of disconnection in relation to profound debilitation and dependency and were often distressed by a perceived lack of understanding, indifference or insensitivity among ward staff to their basic care needs. Negotiating the transition between dependence and independence was identified as a significant source of distress following ward transfer. Participants varied in the extent to which they were able to express their needs and negotiate recovery within professionally mediated boundaries.

Conclusion

These data provide new insights into the putative origins of the psychosocial distress that patients experience following ward transfer.

Relevance to clinical practice

Meleis et al.'s work has resonance in terms of explicating intensive care patients' experiences of psychosocial distress throughout the transition to general ward–based care, such that the future role development of critical care outreach, follow‐up and liaison services may be more theoretically informed.
Valuing narrative in the care of older people: a framework of narrative practice for older adult residential care settings
Authors: Buckley Catherine , McCormack Brendan , Ryan Assumpta
Published: December 2013

Aims and objectives

To report on the development of a framework of narrative practice, in residential care settings for older people.

Background

Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework.

Design

A hermeneutic approach incorporating narrative methods was used.

Methods

Forty‐six narrative interviews with older people in residential care were secondary‐analysed for key themes through a three‐stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person‐centredness and narrative. Finally, the combined findings were used to derive a single set of themes.

Results

The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person‐centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to ‘work in a storied way’ and provide person‐centred outcomes and a narrative informed philosophy of care for older adults in residential care.

Conclusion

This framework provides nurses with a template that confirms the identity of the older person taking account of their biography.

Relevance to clinical practice

The framework outlines an approach that provides staff with a template on how to provide person‐centred care in a narrative way.
Nurses' knowledge of evidence‐based guidelines on the prevention of peripheral venous catheter‐related infections: a multicentre survey
Authors: Cicolini Giancarlo , Simonetti Valentina , Comparcini Dania , Labeau Sonia , Blot Stijn , Pelusi Gilda , Di Giovanni Pamela
Published: December 2013

Aims and objectives

To evaluate nurses' knowledge of guidelines for preventing infections associated with peripheral venous catheters.

Background

Guidelines for the prevention of intravascular catheter‐related infections are an important tool to help healthcare professionals minimise the risk of infection. However, they are not always applied by nurses. The literature on this topic is limited, and no study examined this matter for peripheral venous catheters.

Design

This cross‐sectional study was carried out from November 2011–June 2012.

Methods

The nurses' knowledge of peripheral venous catheter guidelines and its association with gender, experience, education and the ward membership was assessed using a validated questionnaire.

Results

Sixteen hospitals from six regions of Italy participated, and 933 questionnaires were collected. Most participants were female (70·1%), undergraduate (51·8%), worked in medical (35·8%) and surgical departments (28·0%), and had >10 years of experience (55·0%). The median score on 10 questions was 6 of 10.

A majority of nurses knew it is recommended to replace peripheral venous catheters routinely (90·0%), to perform an aseptic technique during connecting/disconnecting the infusive lines (55·2%), and to replace the administration set <24 hour when lipid emulsions have been infused (88·4%). Of note, 52·6% of nurses advocated the use of steel needles, a potentially dangerous practice.

In multivariate analysis, a higher level of education and the area of work were associated with better test scores.

Conclusion

The sample of nurses' knowledge to some recommendations is frequently low. This could be a potential risk factor for patient safety. The results should sensitise healthcare managers to improve nursing training and education, according to clinical risk management perspectives.

Relevance to clinical practice

These data request for more emphasis on international guidelines in infection prevention initiatives.
Wound care practices: a survey of acute care nurses
Authors: Gillespie Brigid M , Chaboyer Wendy , Allen Pamela , Morely Nicola , Nieuwenhoven Paul
Published: December 2013

Aims and objectives

To describe the self‐reported wound care practices of acute care nurses practising in a large metropolitan hospital in Queensland, Australia.

Background

Wound infections occur in up to 30% of surgical procedures and are the third most commonly reported hospital‐acquired infection. The growing complexity and cost of wound care demand that nurses use wound care knowledge based on best practice guidelines.

Design

Descriptive cross‐sectional survey design.

Methods

A convenience sample of 250 medical and surgical nurses working in an acute care facility was invited to complete a 42‐item survey. The survey was based on an extensive literature review and an environmental scan of wound care issues in major hospitals, Australia.

Results

The survey was completed by 120 acute care nurses with a response rate of 48%. Ninety (75·6%) respondents reported that ‘wound appearance’ was the most important factor guiding their choice of dressing product. Only 6 (5·0%) respondents considered the cost of a dressing product ‘highly important’. Fifty‐nine (50·4%) respondents reported being ‘unaware’ of the national standards pertaining to wound management, and only 41 (34·7%) respondents reported that their knowledge of wound products was ‘good’ or ‘excellent’. The majority (n = 89, 75·4%) of respondents used the hospital's wound care specialist nurses as the primary source of information in regard to managing acute wounds.

Conclusions

Although acute care nurses have a sound knowledge of wound healing processes, it appears that many do not use the recommended clinical guideline pertaining to wound care.

Relevance to clinical practice

While it is important for nurses to detect early wound complications, treatment plans based on wound assessments need to be informed by current clinical guidelines. In implementing the guideline, it is essential to first identify barriers and facilitators to knowledge transfer.
Managing medications: the role of informal caregivers of older adults and people living with dementia. A review of the literature
Authors: Gillespie Robyn , Mullan Judy , Harrison Lindsey
Published: December 2013

Aims and objectives

To explore published literature that describes what is known about the role of informal caregivers as they manage medications for older adults and/or people living with dementia residing in the community.

Background

The number of informal caregivers of older adults, including people living with dementia, is growing worldwide. Good medication management by informal caregivers contributes to improved health outcomes and reduced institutionalisations for the care recipient; however, little is known about this domain of care.

Design

Narrative review.

Methods

A literature search was conducted to identify relevant research articles written in English between January 2000–April 2013, sourced from online database searches using multiple keywords, reviewing reference lists and citations of key articles and Internet searches. Articles were included if they described informal caregiver medication management for older adults and/or people living with dementia.

Results

Ten articles were found that described this role from the perspective of the informal caregiver. The evidence suggests that this role is complex and is often made more difficult because of increasing medication regimen complexities, aspects of the relationship between the caregiver and the care recipient, healthcare system practices and a lack of information and/or training available to the informal caregiver, especially when caring for people living with dementia.

Conclusion

Responsibility for managing medications for older adults and/or people living with dementia in the community often falls to informal caregivers. More information resources are required for this role, which requires specific medication management skills and knowledge and is further complicated by the cognitive decline of the care recipient.

Relevance to clinical practice

Informal caregivers are often expected to manage medications in a safe and effective manner for their older care recipient, who may also have cognitive impairment. Nurses, who may be in frequent contact with community‐living older adults/people living with dementia, can be an important source of information, training and support for informal caregivers.
DOES EDUCATION REDUCE INCOME INEQUALITY? A META‐REGRESSION ANALYSIS
Authors: Abdullah Abdul , Doucouliagos Hristos , Manning Elizabeth
Published: December 2013

This paper reexamines the effects of education on inequality through a comprehensive meta‐regression analysis of the extant empirical literature. We find that education affects the two tails of the distribution of income: Education reduces the income share of top earners and increases the share of the bottom earners. Education has been particularly effective in reducing inequality in Africa. Some of the results suggest that secondary schooling appears to have a stronger effect than primary schooling, though this finding is not always robust. The heterogeneity in reported estimates can be largely explained by differences in the specification of the econometric model and measure of inequality and education.
The influence of resilient liner and clip attachments for bar‐implant‐retained mandibular overdentures on opposing maxillary ridge. A 5‐year randomised clinical trial
Authors: ELsyad M. A. , Ashmawy T. M. , Faramawy A. G.
Published: December 2013

This study aimed to compare the influence of resilient liner and clip attachments for bar‐implant‐retained mandibular overdentures on opposing maxillary ridge after 5 years of denture wearing. Thirty edentulous male patients (mean age 62·5 years) received two implants in the anterior mandible after being allocated into two equal groups using balanced randomisation. After 3 months, implants were connected with resilient bars. New maxillary complete dentures were then constructed, and mandibular overdentures were retained to the bars with either clips (group I, GI) or silicone resilient liners (group II, GII). The prosthetic and soft tissue complications of the maxillary dentures were recorded 6 months (T6 m), 1 year (T1), 3 years (T3) and 5 years (T5) after overdenture insertion. Traced rotational tomograms were used for measurements of maxillary alveolar bone loss. The proportional value between bone areas and areas of reference not subject to resorption was expressed as a ratio (R). Change in R immediately before (T0) and after 5 years (T5) of overdenture insertion was calculated. Maxillary denture relining times and frequency of flabby anterior maxillary ridge occurred significantly more often in GI compared with GII. The change of R in anterior part of maxilla was significantly higher than change of R in posterior part in both groups. GI showed significant resorption of anterior residual ridge compared with GII. Relining times and frequencies of flabby ridge were significantly correlated with change in R. Within the limitations of this study, resilient liner attachments for bar‐implant‐retained mandibular overdentures are associated with decreased resorption and flabbiness of maxillary anterior residual ridge and fewer maxillary denture relining times when compared with clip attachments.
Detection of Grapevine Viruses in Poland
Authors: Komorowska Beata , Berniak Hanna , Golis Tomasz
Published: December 2013

During a 3‐year study, grapevines from 23 vineyards in Poland were surveyed for virus diseases and tested to determine the prevalence of the most economically important viruses by RT‐PCR. The rate of positive samples was 2.2% for grapevine leafroll‐associated virus 1 (GLRaV‐1), 1.9% for grapevine leafroll‐associated virus 2 (GLRaV‐2), 1.5% grapevine leafroll‐associated virus 3 (GLRaV‐3), 1.9% for grapevine virus A (GVA), 0.2% for grapevine virus B (GVB), 0.2% for grapevine virus E (GVE), 0.65% for grapevine fanleaf virus (GFLV), 20.4% for grapevine fleck virus (GFkV) and 71.9% for grapevine rupestris stem pitting‐associated virus (GRSPaV). These viruses were found to occur as single or mixed infections of different combinations in individual grapevines. The overall viral infection rate in the surveyed grapevines was 82.6%. GRSPaV is the most widely distributed virus of all the viruses currently detected in the region. DNA sequencing confirmed the identification of the viruses in selected samples, and analysis indicated that the Polish isolates shared a close molecular identity with the corresponding isolates in GenBank. To our knowledge, this is the first detection of GLRaV‐1, ‐2, ‐3, GVA, GVB, GVE, GFLV, GFkV and GRSPaV in Poland.
Chronic Stress Influences Sexual Motivation and Causes Damage to Testicular Cells in Male Rats
Authors: Hou Gonglin , Xiong Wei , Wang Mingming , Chen Xiangming , Yuan Ti-Fei
Published: December 2013

Introduction

The suppressing effects of chronic stress on sexual desire have long been noted. Yet the biological mechanisms underlying such effects, especially at the level of cellular biology of testicular cells, have not been fully investigated.

Aim

In the present study, we used a chronic unpredictable mild stress model to examine the association between chronic stress and structural alterations in the male reproductive system.

Main Outcome Measures

The main outcome measures were the structural changes in sperm cells and Leydig cells of male rats. We used Agmo and Ellingsen's procedure to study partner preference behavior and observed the morphology of Leydig cells and germ cells in the control and stress groups.

Methods

Our methods included histology, electron microscopy, and animal behavior tests.

Results

The results showed that after 5 weeks of chronic stress exposure, partner preference behavior was impaired, the total surface area of Leydig cells and the number and diameter of seminiferous tubules decreased significantly, and the number and size of Leydig cells, as well as the number and the short-axis diameter of spermatogenic cells, also decreased. At the ultrastructural level, transmission electron microscopy revealed that the basement membranes of seminiferous tubules in stressed rats was far thinner, had a low density, and was uneven in thickness compared with the normal group, with enhanced apoptosis in germ cells.

Conclusion

We conclude that chronic stress can trigger organic damage to testicular cells in male rats.
Evaluation of the safety of a combination of oral administration of phenylbutazone and firocoxib in horses
Authors: Kivett L. , Taintor J. , Wright J.
Published: December 2013

Simultaneous administration of a nonselectiveCOXinhibitor and aCOX‐2 specificNSAIDhas not been previously reported in horses. The goal of this study was to determine the safety of a 10‐day dosage regimen of phenylbutazone and firocoxib, both at their standard dosages, in horses. Six horses were administered 2.2 mg/kg of phenylbutazone and 0.1 mg/kg of firocoxib by mouth, daily for 10 days. Horses were assessed daily for changes in behavior, appetite, fecal consistency, signs of abdominal pain, and oral mucous membrane ulceration. Horses were assessed prior to and on the last day of treatment for changes in serum creatinine, albumin, total protein, and urine‐specific gravity. Horses underwent endoscopic examination of the esophagus, stomach, and pylorus prior to and 24 hours after the last treatment. A significant change in serum creatinine and total protein was observed on day 10 of treatment. No other significant findings were noted during the experiment. Results indicated that co‐administration of phenylbutazone and firocoxib may cause renal disease.
A novel siderophore‐independent strategy of iron uptake in the genus Burkholderia
Authors: Mathew Anugraha , Eberl Leo , Carlier Aurelien L.
Published: December 2013

Like many other bacteria, Burkholderia sp. take up iron in its ferric form via siderophore‐dependent transporters. We observed that mutant strains of B. cenocepacia H111 unable to synthesize siderophores did not exhibit any growth defect under iron limited conditions. This finding suggested that this opportunistic pathogen can adopt an alternative iron uptake strategy to compensate for the loss of siderophores. We identified a putative iron uptake locus, ftrBccABCD, in the genome of B. cenocepacia H111, which is also conserved in other members of the genus Burkholderia. Mutants deficient in both siderophore‐dependent and FtrBccABCD systems failed to grow under iron‐limited conditions and radiolabelled iron transport assays showed that these mutants were impaired in iron uptake. In addition, expression of ftrBccABCD can restore growth of an E. coli strain lacking all known high‐affinity iron transport systems under iron‐limited conditions. We show that all four proteins encoded by ftrBccABCD are essential for iron uptake. Furthermore, our results indicate that the expression of ftrBccABCD is regulated at the transcriptional level by iron concentration. This study provides evidence of an alternative, siderophore‐independent, iron uptake system in Burkholderia species.