bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender, Dis‐/ability and Diversity Management: Unequal Dynamics of Inclusion?
Authors: Dobusch Laura
Published: December 2016

Although the body of diversity research has been growing steadily over recent decades, the impact of diversity management on the inclusion of historically disadvantaged groups is still in question. By jointly examining how gender and dis‐/ability are addressed, shaped and coconstituted by practices labelled as diversity management, this study aims to paint a finer‐grained picture of the inclusionary potential of the ‘diversity turn’. It offers a comparative analysis of two ‘diversity dimensions’ that are assumed to be opposing in terms of social desirability or economic exploitability. It thereby provides insight into the inclusionary and exclusionary dynamics of diversity management. Based on interviews in for‐profit and non‐profit organizations in Austria and Germany, the study reveals persistent, unequal dynamics of inclusion and exclusion: while the inclusion of supposedly non‐disabled women and men with ‘female‐associated living conditions’ revolves around a mostly undisputed gender‐equality norm, the inclusion of disabled people depends on specific conditions and is not taken for granted.
Preoperative platelet‐to‐lymphocyte ratio can predict recurrence beyond the Milan criteria after hepatectomy for patients with hepatocellular carcinoma
Authors: Kaida Takayoshi , Nitta Hidetoshi , Kitano Yuki , Yamamura Kensuke , Arima Kota , Higashi Takaaki , Taki Katsunobu , Nakagawa Shigeki , Okabe Hirohisa , Hayashi Hiromitsu , Imai Katsunori , Hashimoto Daisuke , Yamashita Yo‐ichi , Chikamoto Akira , Ishiko Takatoshi , Beppu Toru , Baba Hideo
Published: December 2016

Aim

Postoperative recurrence beyond the Milan criteria is a poor prognostic factor for patients with hepatocellular carcinoma (HCC) treated with various therapies. We investigated the most useful inflammation‐based prognostic score for predicting recurrence beyond the Milan criteria after initial liver resection.

Methods

From January 2007 to December 2012, 271 consecutive patients with HCC who underwent curative liver resection were enrolled. Patients were divided according to the initial recurrence pattern: recurrence beyond the Milan criteria; and recurrence within the Milan criteria, or no recurrence. The patients were classified into two groups, low platelet‐to‐lymphocyte ratio (PLR) (<150) and high PLR (≥150), additionally using other inflammation‐based prognostic scores. Then we analyzed the association between the recurrence patterns and the clinicopathological factors including PLR.

Results

Fifty‐five (20.2%) patients had recurrence beyond the Milan criteria. The 5‐year survival rate in patients with recurrence beyond the Milan criteria (41.6%) was significantly lower than in those with other recurrence patterns (79.7%). High PLR level was observed in 15.5% of the patients. Multivariate analysis revealed that PLR was the only independent predictive factor of recurrence patterns (odds ratio, 2.55; 95% confidence interval, 1.17–5.49; P = 0.018). The high PLR level was significantly associated with higher serum des‐γ‐carboxy prothrombin level, larger tumor size, and poor histological differentiation.

Conclusion

Among several inflammatory indices, PLR is a good indicator to predict recurrence beyond the Milan criteria after liver resection for patients with HCC.
Outcomes of treatment with daclatasvir and asunaprevir for recurrent hepatitis C after liver transplantation
Authors: Honda Masaki , Sugawara Yasuhiko , Watanabe Takehisa , Tateyama Masakuni , Tanaka Motohiko , Uchida Koushi , Kawabata Seiichi , Yoshii Daiki , Miura Kouhei , Isono Kaori , Hayashida Shintaro , Ohya Yuki , Yamamoto Hidekazu , Sasaki Yutaka , Inomata Yukihiro
Published: December 2016

Aim

The development of direct‐acting oral agents has dramatically changed the treatment strategy of hepatitis C virus (HCV) infection. Here we aimed to reveal the efficacy and safety of daclatasvir (DCV) and asunaprevir (ASV) for recurrent HCV genotype 1 infection after liver transplantation (LT).

Methods

A retrospective study was undertaken on nine patients who underwent a 24‐week DCV/ASV treatment regimen for recurrent HCV genotype 1 infection. Five of the patients were men; four had failed treatment with pegylated interferon (Peg‐IFN)/ribavirin, two had failed simeprevir/Peg‐IFN/ribavirin, one had the resistance‐associated variant Y93H in the NS5A region, and one underwent maintenance dialysis.

Results

Median time to treatment initiation following LT was 70 months. Of the nine patients treated with DCV/ASV, eight (88.9%) achieved a sustained viral response 12 weeks after completion of therapy (SVR12). The patient with virologic failure had failed simeprevir/Peg‐interferon/ribavirin therapy 4 months before undergoing the DCV/ASV treatment regimen. In addition, a resistance‐associated variant D168E in the NS3 region was detected in the patient after discontinuation of the DCV/ASV regimen. The trough level of tacrolimus tended to decrease, and renal function showed no significant changes during treatment. Adverse events occurred in two patients (22.2%), but no severe adverse events occurred during treatment.

Conclusions

The DCV/ASV regimen was well tolerated, resulting in high rates of sustained viral response 12 weeks after completion of therapy for LT patients with recurrent HCV genotype 1 infection.
“Giving us hope”: Parent and neonatal staff views and expectations of a planned family‐centred discharge process (Train‐to‐Home)
Authors: Ingram Jenny , Redshaw Maggie , Manns Sarah , Beasant Lucy , Johnson Debbie , Fleming Peter , Pontin David
Published: December 2016

Background

Preparing families and preterm infants for discharge is relatively unstructured in many UK neonatal units (NNUs). Family‐centred neonatal care and discharge planning are recommended but variable.

Design and participants

Qualitative interviews with 37 parents of infants in NNUs, and 18 nursing staff and 5 neonatal consultants explored their views of discharge planning and perceptions of a planned family‐centred discharge process (Train‐to‐Home). Train‐to‐Home facilitates communication between staff and parents throughout the neonatal stay, using a laminated train and parent booklets.

Results

Parents were overwhelmingly positive about Train‐to‐Home. They described being given hope, feeling in control and having something visual to show their baby's progress. They reported positive involvement of fathers and families, how predicted discharge dates helped them prepare for home and ways staff engaged with Train‐to‐Home when communicating with them. Nursing staff reactions were mixed—some were uncertain about when to use it, but found the visual images powerful. Medical staff in all NNUs were positive about the intervention recognizing that it helped in communicating better with parents.

Conclusions

Using a parent‐centred approach to communication and informing parents about the needs and progress of their preterm infant in hospital is welcomed by parents and many staff. This approach meets the recommended prioritization of family‐centred care for such families. Predicted discharge dates helped parents prepare for home, and the ways staff engaged with Train‐to‐Home when communicating with them helped them feel more confident as well as having something visual to show their baby's progress.
Cytotoxic Epstein–Barr virus‐positive large B cell lymphoma: a regulatory B cell‐derived neoplasia?
Authors: Tabanelli Valentina , Santiago‐Pacheco Vanessa , Corbellino Mario , Calleri Angelica , Agostinelli Claudio , Parravicini Carlo , Pileri Stefano A
Published: December 2016

Aims

A new subtype of granzyme B (GrB)‐producing regulatory B cells (Bregs) has been described recently; these peculiar cytotoxic B cells are increased significantly in interleukin (IL)‐21‐rich settings, and in particular during HIV and Epstein–Barr virus (EBV) infection. Our aim is to report a unique case of an EBV‐positive diffuse large B cell lymphoma (DLBCL) with cytotoxic features arisen in an HIV+ patient, and to understand if this lesion may represent a proliferation of neoplastic cytotoxic Bregs.

Methods and results

We describe a 66‐year‐old male patient who presented with cervical lymph node enlargement and B symptoms; subsequently, HIV infection was diagnosed. Histopathological, immunohistochemical and molecular studies were performed, and revealed an EBV‐positive DLBCL with cytotoxic features. Considering the immunological setting and unconventional phenotype observed, we tried to evaluate further the expression of GrB and IL‐21 in another 150 aggressive B cell lymphomas (17 of 150 EBV+, two of 150 EBV+/HIV+). Minimal dot‐like expression of GrB was found in seven lymphomas (in fewer than 1% of tumour cells), three of which were EBV‐positive.

Conclusions

Breg origin has never been reported in B cell lymphomas. We describe an exceptional case of EBV‐positive DLBCL with aberrant expression of cytotoxic markers in a patient with a previously unknown HIV infection. We propose cytotoxic Bregs as a possible normal counterpart for this unusual tumour.
A feasibility study for a clinical decision support system prompting HIV testing
Authors: Chadwick DR , Hall C , Rae C , Rayment Ml , Branch M , Littlewood J , Sullivan A
Published: December 2016

Objectives

Levels of undiagnosed HIV infection and late presentation remain high globally despite attempts to increase testing. The objective of this study was to evaluate a risk‐based prototype application to prompt HIV testing when patients undergo routine blood tests.

Methods

Two computer physician order entry (CPOE) systems were modified using the application to prompt health care workers (HCWs) to add an HIV test when other tests selected suggested that the patient was at higher risk of HIV infection. The application was applied for a 3‐month period in two areas, in a large London hospital and in general practices in Teesside/North Yorkshire. At the end of the evaluation period, HCWs were interviewed to assess the usability and acceptability of the prompt. Numbers of HIV tests ordered in the general practice areas were also compared before and after the prompt's introduction.

Results

The system was found to be both useable and generally acceptable to hospital doctors, general practitioners and nurse practitioners, with little evidence of prompt/alert fatigue. The issue of the prompt appearing late in the patient consultation did lead to some difficulties, particularly around discussion of the test and consent. In the general practices, around 1 in 10 prompts were accepted and there was a 6% increase in testing rates over the 3‐month study period (P = 0.169).

Conclusions

Using a CPOE‐based clinical decision support application to prompt HIV testing appears both feasible and acceptable to HCWs. Refining the application to provide more accurate risk stratification is likely to make it more effective.
In situ synthesis of Al2O3‐supported ZnCr2O4 nanoparticles for application as an activated photocatalyst
Authors: Tajizadegan Hamid , Naghibi Sanaz , Jamshidi Amin , Torabi Omid , Golabgir Mohammad‐Hossein
Published: December 2016

Zincochromite nanoparticles (NPs) were precipitated on surfaces of the as‐prepared Al2O3 micron‐sized particles by a heterogeneous precipitation technique using urea as a homogeneous precipitation agent. This procedure leads to decrease the pore diameter and increase the pore volume and specific surface area (as), realizing the potential access to ZnCr2O4 catalytic sites. Although the obtained band gap energy (Eg) of Al2O3‐ZnCr2O4 composite is about 2.3 eV (more than ZnCr2O4), the absorbance is enhanced about 1.5 orders of magnitude. These characteristics make it an effective photocatalyst of inorganic dyes from an aqueous media. Dye removal performance of the nanocomposite powder is higher than that of pure ZnCr2O4, which is attributed to an increase in the photocatalytic sites and the absorbance intensity. It was believed that the surface area created from Al2O3 support realized the potential access to ZnCr2O4 catalytic sites. To confirm these assertions, X‐ray diffractometry (XRD), scanning electron microscopy (SEM), diffuse reflectance spectroscopy (DRS), and N2 adsorption‐desorption analysis were applied.
Secondary analysis of data can inform care delivery for Indigenous women in an acute mental health inpatient unit
Authors: Bradley Pat , Cunningham Teresa , Lowell Anne , Nagel Tricia , Dunn Sandra
Published: December 2016

There is a paucity of research exploring Indigenous women's experiences in acute mental health inpatient services in Australia. Even less is known of Indigenous women's experience of seclusion events, as published data are rarely disaggregated by both indigeneity and gender. This research used secondary analysis of pre‐existing datasets to identify any quantifiable difference in recorded experience between Indigenous and non‐Indigenous women, and between Indigenous women and Indigenous men in an acute mental health inpatient unit. Standard separation data of age, length of stay, legal status, and discharge diagnosis were analysed, as were seclusion register data of age, seclusion grounds, and number of seclusion events. Descriptive statistics were used to summarize the data, and where warranted, inferential statistical methods used SPSS software to apply analysis of variance/multivariate analysis of variance testing. The results showed evidence that secondary analysis of existing datasets can provide a rich source of information to describe the experience of target groups, and to guide service planning and delivery of individualized, culturally‐secure mental health care at a local level. The results are discussed, service and policy development implications are explored, and suggestions for further research are offered.
Randomized, controlled trial of a brief family‐centred care programme for hospitalized patients with bipolar disorder and their family caregivers
Authors: Lee Hsiu‐Ju , Lin Esther Ching‐Lan , Chen Mei‐Bih , Su Tung‐Ping , Chiang Li‐Chi
Published: December 2016

Family interventions have been emphasized in the treatment of bipolar disorder (BPD) due to the bidirectional and entangled relationships between patients and the family system, and have benefits for patients’ symptoms and health; however, the effects of family interventions on family function and caregivers’ health‐related outcomes have not been well investigated. This randomized, controlled trial with 47 hospitalized patients with BPD/family caregiver dyads at a medical centre in northern Taiwan compared the effects of a brief family‐centred care (BFCC) programme with treatment as usual (TAU). All of the family caregivers in two groups were invited to attend a routine 60‐min family discussion group about violence and suicide prevention. The TAU group without specific family interview for patient and family caregiver dyad. In the BFCC group, four 90‐min BFCC programme sessions were additionally provided twice a week for each hospitalized family dyad. We hypothesized that, first, family caregivers in the BFCC group could increase their family function, and second, improve perceived health status and reduce caregiver's burdens compared to the TAU. The results showed that family caregivers in the BFCC group significant interaction effects in overall family function (P = 0.03) and subscale conflict (P = 0.04), communication (P = 0.01), and problem‐solving (P = 0.04), but there were no significant interaction effects on the caregivers’ perceived health status and caregivers’ burdens. Our findings support both the feasibility of using the BFCC programme for inpatients and its specific benefits for family function. An intensive family intervention during hospitalization has been suggested in psychiatric practice to support patients with BPD and family caregivers.
Particle refinement of ZrB2 by the combination of borothermal reduction and solid solution
Authors: Guo Wei‐Ming , Wu Li‐Xiang , Sun Shi‐Kuan , Lin Hua‐Tay
Published: December 2016

Flexible synthesis of ultra‐fine ZrB2 powders was achieved by borothermal reduction in a mixture of ZrO2, boron, and TiO2. Without TiO2 additive, coarse ZrB2 powders with particle size of 0.81 μm were obtained, presumably due to good wettability and solubility of ZrB2 in the byproduct B2O3. It was found that the particle growth of ZrB2 was effectively inhibited by the solid solution of TiB2 (≥1 mol%). The refinement mechanism was that the solid solution of in situ formed TiB2 presumably lowered the wettability and solubility of ZrB2 in the B2O3 liquid and significantly inhibited the coarsening of ZrB2. The average particle size of resulting powders decreased to 0.37 μm with the addition of 10 mol% TiO2.
Nurse‐perceived quality of care in intensive care units and associations with work environment characteristics: a multicentre survey study
Authors: Stalpers Dewi , Van Der Linden Dimitri , Kaljouw Marian J. , Schuurmans Marieke J.
Published: December 2016

Aims

To examine nurse‐perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics.

Background

Nurse‐perceived quality of care and job satisfaction have been positively linked to quality outcomes for nurses and patients. Much evidence exists on factors contributing to job satisfaction. Understanding specific factors that affect nurse‐perceived quality potentially enables for improvements of nursing care quality.

Design

A multicentre survey study was conducted in three Dutch intensive care units.

Methods

The Dutch version of the Essentials of Magnetism II questionnaire was used; including the single‐item indicators: (i) nurse‐perceived quality of care; (ii) overall job satisfaction; and (iii) 58 statements on work environments. Data were collected between October 2013 – June 2014.

Results

The majority of 123 responding nurses (response rate 45%) were more than satisfied with quality of care (55%) and with their job (66%). No associations were found with nurse characteristics, besides differences in job satisfaction between the units. After controlling for job satisfaction, nurse‐perceived quality was positively associated with the work environment characteristics: adequacy of staffing, patient‐centeredness, competent peers and support for education. Patient‐centeredness and autonomy were the most important predictors for overall job satisfaction.

Conclusion

Factors that contribute to nurse‐perceived quality of care in intensive care units, independent from the effects of overall job satisfaction, were identified. Hereby, offering opportunities to maximize high quality of care to critically ill patients. Research in a larger sample is needed to confirm our findings.
The concept of exposure in environmental health for nursing
Authors: Thompson Marcella Remer , Schwartz Barcott Donna
Published: December 2016

Aim

To report an analysis of the concept of exposure in environmental health for nursing.

Background

The importance of the environment has long been recognized in nursing, although the nature and scope of the concept and how it influences health have varied over time. Exposure is the sufficient and necessary link between environment and health. In nursing practice, the word ‘exposure’ has been used frequently with no clear standard definition.

Design

Concept analysis using Kim's first‐level analytics.

Data sources

Chronological review (1980–2015) of the nursing science literature was conducted through ProQuest Dissertations and Theses and CINAHL, followed by a multi‐disciplinary search through PubMed (1980–2015), texts and the Internet to compare definitions and measurements of exposure and related concepts.

Methods

Explicit and implicit conceptual definitions and measurements of exposure were identified, categorized and analysed.

Results

The newly defined concept of ‘exposure’ is a process involves three phases: 1, contact is made between a target and one or more agents in the same environment; 2, the agent accesses the target by one or more routes of entry; and 3, the agent enters the target by crossing a barrier or boundary. Existing measurements related to each phase are identified and discussed. Definitions of ‘target’ and ‘agent’ were refined for congruency.

Conclusion

Consistent use of terms as defined is critical to development of nursing knowledge. These concepts should be incorporated into nursing‐related research to evaluate their usefulness to nursing. Alignment of this concept with relevant theories should be critically examined.
Aggressive Behaviour Risk Assessment Tool for newly admitted residents of long‐term care homes
Authors: Kim Son Chae , Young Lori , Berry Brigette
Published: December 2016

Aim

The aim of this study was to revise the 10‐item Aggressive Behaviour Risk Assessment Tool for predicting aggressive events among residents newly admitted to long‐term care homes.

Background

The original tool had acceptable sensitivity and specificity for identifying potentially aggressive patients in acute care medical‐surgical units, but its usefulness in long‐term care homes is unknown.

Design

A retrospective cohort study design was used.

Methods

All residents admitted to 25 long‐term care homes in western Canada were assessed for the risk of aggression using the original tool within 24 hours of admission from January 2014 ‐ December 2014 (n = 724). Incident reports of aggressive events occurring within 30 days of admission were collected. Multiple logistic regression and receiver operating characteristics analyses were performed.

Results

Fifty‐three residents of 724 exhibited aggressive behaviours. The demographic variable of age less than 85 years was found to be a positive predictor of aggressive events in multivariate logistic regression model and was added to the tool. The revised six‐item Aggressive Behaviour Risk Assessment Tool for Long‐Term Care consists of one new item, age less than 85 years and five items from the original tool: History of physical aggression, physically aggressive/threatening, anxiety, confusion/cognitive impairment and threatening to leave. The receiver operating characteristics of the revised tool with weighted scoring showed a good discriminant ability with satisfactory sensitivity and specificity at the recommended cut‐off score of 4.

Conclusion

The revised six‐item tool may be useful in identifying potentially aggressive residents newly admitted to long‐term care homes.
Child protection services and parents with intellectual and developmental disabilities
Authors: LaLiberte Traci , Piescher Kristine , Mickelson Nicole , Lee Mi Hwa
Published: December 2016

Background

Information about parents with intellectual and developmental disabilities (IDD) in the child protection system (CPS) continues to evolve. This study examined characteristics, experiences and representation of parents with IDD across three CPS decision points, as compared to parents with other disabilities and parents without disabilities in the United States.

Methods

The sample consisted of 303,039 individuals: 2,081 were individuals identified as parents in a CPS investigation; 1,101 had children in out‐of‐home care (OHC); and 308 experienced termination of parental rights (TPR). Descriptive statistics, chi‐square analysis, disparity indices and logistic regression were employed.

Results

Parents with IDD were significantly more likely than parents without disabilities (but not significantly more likely than parents with other types of disabilities) to experience disproportionately representation.

Conclusions

Parents with IDD are generally over‐represented within CPS; however, this representation is dependent upon the comparison group utilized and other risk factors. CPS system‐level changes are necessary.
New insight on vertebral anomalies in cultured Senegalese sole (Solea senegalensis, Kaup) at early stages of development
Authors: de Azevedo A M , Losada A P , Ferreiro I , Riaza A , Vázquez S , Quiroga M I
Published: December 2016

Senegalese sole (Solea senegalensis, Kaup) is a promising flatfish species in aquaculture. However, skeletal anomalies are still a great concern in sole farming. Investigation of this issue is crucial to improving larval quality and optimizing production. The aim of this study was to thoroughly assess anomalies in the rachis of reared sole at early developmental stages. Sole (n = 507) were sampled at 31 or 32 days after hatching (dah). The specimens were stained with alcian blue and alizarin red and evaluated for the detection of vertebral deformities. Most fish presented 9:34:3 vertebrae in abdominal, caudal and caudal complex regions, respectively. Remarkably, all specimens showed at least one spinal anomaly. Alterations of neural/haemal elements, as well as deformities of hypurals, parhypural and epural, were recurrent. Vertebral body anomalies and/or vertebral column deviations were identified in 52% of the individuals. Vertebral deformations and fusions were common, especially in caudal complex. ‘Minor’ anomalies were predominant, and some of the detected disorders might be a result of non‐/low‐pathological processes. These results contribute a new insight into the main skeletal anomalies affecting cultured sole larvae. Further research is required to determine their impact on fish welfare and external appearances at commercial stages.
Assessing the clinical and economic impact of increasing treatment uptake in chronic hepatitis B infection using a Markov model
Authors: Chinnaratha Mohamed A , Kaambwa Billingsley , Woodman Richard J , Fraser Robert J , Wigg Alan J
Published: December 2016

Treatment uptake in chronic hepatitis B virus (HBV) infection is low in South Australia, and the cost‐effectiveness of increasing treatment uptake rates in this population has not been assessed.

Aims and Methods

Using a cohort Markov model, cost‐effectiveness was assessed for three different treatment uptake scenarios: 2.9% (current level—scenario 1), 10% (scenario 2), and 15% (scenario 3). The initial HBV population included 2550 treatment eligible patients who transitioned between six different health states over a 10‐year period. Treatment transition probabilities were based on tenofovir therapy, while those not assigned to treatment followed the natural history transition probabilities. We estimated the incremental cost per quality adjusted life year gained using the prevented number of deaths, hepatocellular carcinoma, and liver transplants.

Results

Scenario 3 was associated with the lowest mean cost/person over 10 years (AU$60 133), compared with scenario 2 (AU$61 964) and scenario 1 (AU$64 597). Scenario 3 was also associated with the highest quality adjusted life year gained (8.196) compared with scenario 2 (7.985) and scenario 1 (7.684). Scenario 3 would result in 50% reduction in hepatocellular carcinoma and 30% reduction in HBV‐related mortality compared with scenario 1, over a 10‐year period. Higher treatment uptake was found to be cost‐effective with at least 2 years of treatment at either 10% or 15% of the target population.

Conclusion

Maximizing the treatment uptake in the existing HBV population from 2.9% to 15% was cost‐effective for periods of 2 years or more. This was due to a reduction in the number of expected clinical events.
Comparative evaluation of performance measures for shading correction in time‐lapse fluorescence microscopy
Authors: LIU L. , KAN A. , LECKIE C. , HODGKIN P.D.
Published: December 2016

Time‐lapse fluorescence microscopy is a valuable technology in cell biology, but it suffers from the inherent problem of intensity inhomogeneity due to uneven illumination or camera nonlinearity, known as shading artefacts. This will lead to inaccurate estimates of single‐cell features such as average and total intensity. Numerous shading correction methods have been proposed to remove this effect. In order to compare the performance of different methods, many quantitative performance measures have been developed. However, there is little discussion about which performance measure should be generally applied for evaluation on real data, where the ground truth is absent. In this paper, the state‐of‐the‐art shading correction methods and performance evaluation methods are reviewed. We implement 10 popular shading correction methods on two artificial datasets and four real ones. In order to make an objective comparison between those methods, we employ a number of quantitative performance measures. Extensive validation demonstrates that the coefficient of joint variation (CJV) is the most applicable measure in time‐lapse fluorescence images. Based on this measure, we have proposed a novel shading correction method that performs better compared to well‐established methods for a range of real data tested.
Primary care nursing activities with patients affected by physical chronic disease and common mental disorders: a qualitative descriptive study
Authors: Girard Ariane , Hudon Catherine , Poitras Marie‐Eve , Roberge Pasquale , Chouinard Maud‐Christine
Published: December 2016

Aims and objectives

To describe nursing activities in primary care with patients affected by physical chronic disease and common mental disorders.

Background

Patients in primary care who are affected by physical chronic disease and common mental disorders such as anxiety and depression require care and follow‐up based on their physical and mental health condition. Primary care nurses are increasingly expected to contribute to the care and follow‐up of this growing clientele. However, little is known about the actual activities carried out by primary care nurses in providing this service in the Province of Quebec (Canada).

Methods

A qualitative descriptive study was conducted. Data were obtained through semistructured individual interviews with 13 nurses practising among patients with physical chronic disease in seven Family Medicine Groups in Quebec (Canada).

Results

Participants described five activity domains: assessment of physical and mental health condition, care planning, interprofessional collaboration, therapeutic relationship and health promotion.

Conclusion

The full potential of primary care nurses is not always exploited, and some activities could be improved. Evidence for including nurses in collaborative care for patients affected by physical chronic disease and common mental disorders has been shown but is not fully implemented in Family Medicine Groups. Future research should emphasise collaboration among mental health professionals, primary care nurses and family physicians in the care of patients with physical chronic disease and common mental disorders.

Relevance to clinical practice

Primary care nurses would benefit from gaining more knowledge about common mental disorders and from identifying the resources they need to contribute to managing them in an interdisciplinary team.
Peanut allergy as a family project: social relations and transitions in adolescence
Authors: Stensgaard Anette , Bindslev‐Jensen Carsten , Nielsen Dorthe
Published: December 2016

Aims and objectives

To explore and better understand the impact that peanut allergy can have on family experiences in everyday life through interviews with individual family members.

Background

Peanut allergy affects adolescents' quality of life through the need to avoid eating peanut‐containing food and the risk of anaphylaxis. Adolescence is a period of increasing separation from parents and has the highest risk of food fatalities.

Design

A qualitative interview study taking a phenomenological‐hermeneutical approach.

Methods

Data were generated through semi‐structured individual interviews with the adolescent with peanut allergy, and both parents and a sibling. Five families were interviewed, with 20 participants in total. The theoretical foundation was the family as an interactive system, and data were analysed with Ricoeur's theory of interpretation.

Results

The consequences of peanut allergy appeared to affect all family members and required knowledge and understanding, especially in the social network. Siblings took responsibility and had concerns for the well‐being of the adolescent with allergy, while parents expressed difficulties with their child's transition to independence and their subsequent loss of control. Social relations with new family members or friends were challenged by lack of knowledge about the potential seriousness of peanut allergy.

Conclusions

Risk and uncertainty were permanent companions for the adolescents with peanut allergy and their families. It takes time to acquire the necessary understanding about peanut allergy and the risk of anaphylaxis. The adolescent's social network also needs this knowledge during the transition to independent living.

Relevance to clinical practice

In the management of peanut allergy in adolescence, it is important to consider not only the smaller biological family unit (mothers, fathers and siblings) but to also take a wider perspective to include others such as stepfamily and friends.
Breast‐related stereotype threat contributes to a symptom cluster in women with breast cancer
Authors: Li Jie , Gao Wei , Yu Li‐Xiang , Zhu Song‐Ying , Cao Feng‐Lin
Published: December 2016

Aims and objectives

To investigate the prevalence of breast‐related stereotype threat and its effects on a symptom cluster consisting of anxiety, depression and fatigue and on each symptom.

Background

The stereotype that breasts are a sign of women's femininity results in patients with breast cancer fearing diminished femininity and rejection, which may induce psychological problems that co‐occur as a symptom cluster.

Design

Cross‐sectional study.

Methods

A total of 131 patients with breast cancer postmastectomy completed the study. A question measuring breast‐related stereotype threat, the Hospital Anxiety and Depression Scale and the Functional Assessment of Chronic Illness Therapy‐Fatigue Scale were used to assess their breast‐related stereotype threat and symptoms of anxiety, depression and fatigue.

Results

Of the 131 patients who answered the breast‐related stereotype threat question, 86 (65·6%) reported breast‐related stereotype threat. They did not differ significantly in social and clinical characteristics compared with those without the stereotype, but did report significantly higher levels of the symptom cluster and each symptom (anxiety, depression and fatigue). The odds ratios of the stereotype were significant for the symptom cluster, depression and fatigue (odds ratios = 2·52–3·98, p < 0·05).

Conclusion

The breast‐related stereotype threat was common in patients with breast cancer. There was about a twofold increase in their risk of experiencing the symptom cluster and symptoms of depression and fatigue.

Relevance to clinical practice

In clinical practice, breast‐related stereotype threat should be measured together with prevalent symptoms (e.g. anxiety, depression and fatigue) in patients with breast cancer. Our findings will aid the development of interventions for improving the mental health of women with breast cancer.
Coping strategies of Taiwanese children with autism spectrum disorders
Authors: Chin Wei‐Chih , Chao Kuo‐Yu , Chang Hsueh‐Ling , Li Hsin‐Mei , Chen Sue‐Hsien
Published: December 2016

Aims and Objectives

To explore and describe the coping experiences of children with autism spectrum disorders in Taiwan.

Background

Children with autism spectrum disorders are faced with daily social and living challenges, which can cause stress. Chinese culture emphasises discipline and obedience, which may influence coping strategies of children with autism spectrum disorders in Taiwan.

Design

This qualitative study employed an exploratory descriptive design.

Method

Data were collected from in‐depth, face‐to‐face structured interviews. Interviews explored coping strategies of Taiwanese school‐aged children (aged 6–19) with autism spectrum disorders. Children (N = 17) and their caregivers were recruited by purposive sampling. Transcribed interview data were thematically analysed using the procedure of Miles and Huberman.

Result

Five themes emerged from the analysis of the data, which described the coping strategies of the children: (1) problem‐solving, (2) acting‐out, (3) avoidance, (4) seeking help and (5) self‐regulation. These themes included multiple coping strategies, which employed the concepts of engagement and disengagement.

Conclusions

The children with autism spectrum disorder used many strategies to cope with the stresses resulting from behaviours and symptoms associated with the disorder. Most of the Taiwanese children use both problem‐solving and emotional‐focused coping strategies.

Relevance to Clinical Practice

Understanding coping strategies of children with autism spectrum disorder could help caregivers (parents, teachers) and medical professionals develop interventions to reduce these challenges, which could alleviate stress and improve social functioning for these children.
An integrative literature review to examine the provision of self‐management support following transient ischaemic attack
Authors: Kessler Dorothy , Liddy Clare
Published: December 2016

Aims and objectives

To identify the types of self‐management support that have been provided to persons with transient ischaemic attack and the evidence for the effectiveness of these programmes.

Background

Self‐management is a key element for the effective management of chronic conditions. For persons with transient ischaemic attack, secondary stroke prevention is a recognised standard of care. Best practice guidelines indicate that persons who have experienced transient ischaemic attack should be supported to develop self‐management skills. However, it is not clear how best to support the development of these skills.

Design

An integrative literature review was conducted.

Methods

A search was conducted using Medline, Embase, HealthSTAR, CINAHL and PsycINFO. Published quantitative and qualitative studies, abstracts or dissertations describing the provision, experience or outcomes of self‐management interventions for people with transient ischaemic attack, and published in English before March 2016, were included. Articles were selected and rated separately by two reviewers. The American Academy for Cerebral Palsy and Developmental Medicine Level of Evidence and Conduct Rating tools were used for rating. Interventions were described and compared, and evidence was presented using the traffic lighting system.

Results

Sixteen interventions representing a variety of group‐ and individual‐based interventions were identified. Interventions differed in target population, content, structure, duration and outcomes. Only four interventions were specifically designed for persons with transient ischaemic attack. While evidence to support self‐management interventions is promising, there is limited evidence to support any one intervention. However, one good‐quality randomised controlled trial supports the provision of a group self‐management programme for improving blood pressure control.

Conclusions

There are numerous interventions to support self‐management by persons with transient ischaemic attack. More research is needed to determine which approaches are most effective. Given the limited evidence to support any one program for persons with TIA, clinicians and programs that provide self‐management support should evaluate and monitor outcomes to ensure client needs are being met.
Patients experiences of negative pressure wound therapy at home for the treatment of deep perivascular groin infection after vascular surgery
Authors: Monsen Christina , Acosta Stefan , Kumlien Christine
Published: December 2016

Aims and objectives

To explore experiences of negative pressure wound therapy at home, in patients with deep perivascular groin infection after vascular surgery and management in daily life.

Background

Deep surgical site infection after vascular surgery with exposed vessels often requires long‐term treatment with negative pressure wound therapy, and continued therapy at home has become routine.

Design

An explorative qualitative study.

Methods

Nine men and six women with a deep surgical site infection in the groin after vascular surgery, treated in their home with negative pressure wound therapy, were interviewed. The interviews were analysed using manifest and latent content analysis.

Results

Undergoing negative pressure wound therapy at home meant a transition from being a dependent patient to a person who must have self‐care competence and be involved in their own care. A need to feel prepared for this before discharge from hospital was expressed. Lack of information and feelings of uncertainty prolonged the time before feeling confident in managing the treatment. The informants gradually accepted the need to be tied up to a machine, became competent in its management and found solutions to perform everyday tasks. Overall, it was a relief to be treated at home.

Conclusions

Several benefits of negative pressure wound therapy at home were expressed. However, unnecessary stress and anxiety were experienced due to a lack of information on the treatment and instruction concerning the equipment. Adequate information and education must therefore be provided to facilitate the transition from a patient to a person with self‐care competence and ability to manage this treatment at home.

Relevance to clinical practice

The findings revealed a need for more support and knowledge in their transition from hospital care to home care with negative pressure wound therapy. Routines must be established that ensure patient safety and security in treatment at home.
Safety and Tolerability of SonoVue® in Patients with Large Artery Anterior Circulation Acute Stroke
Authors: Baracchini Claudio , Viaro Federica , Favaretto Silvia , Palmieri Anna , Kulyk Caterina , Causin Francesco , Farina Filippo , Ballotta Enzo
Published: December 2016

BACKGROUND AND PURPOSE

Ultrasound contrast agents (UCAs) are routinely used to improve the visualization of intracranial arteries. Since a higher rate of intracranial hemorrhage (ICH) has been observed in patients undergoing sonothrombolysis in combination with UCAs, we conducted this study with the aim of assessing safety and tolerability of SonoVue® in patients with acute ischemic stroke due to anterior circulation large artery occlusion (LAO) and eligible to intravenous thrombolysis and/or mechanical thrombectomy.

METHODS

Among 474 patients consecutively admitted to our Stroke Unit with anterior circulation ischemic stroke, SonoVue® was administered during transcranial ultrasound evaluation to 48 patients with suspected LAO for diagnostic confirmation (group I) and to 44 patients with inadequate temporal bone window. Forty‐eight stroke patients with LAO diagnosed only by computed tomography (CT) angiography /magnetic resonance (MR) angiography and matched for age, gender, and National Institutes of Health Stroke Scale score with group I represented the control group (group II). Thrombolysis, thrombectomy, or combined treatment were offered to all eligible patients. Brain MR imaging/CT was performed in both groups in case of neurological deterioration or after 1 week to check for ICH.

RESULTS

SonoVue® did not cause any serious adverse event; only mild and transient side effects were reported in six cases (6.5%). Among patients in groups I and II, there were 31 (32.3%) secondary cerebral bleedings with no statistically significant difference between the groups, but only 2 (2.1%) were symptomatic.

CONCLUSIONS

According to our study, SonoVue® can be safely administered to acute ischemic stroke patients with suspected anterior circulation LAO and/or inadequate temporal bone window.
Prolonged-release minitablets with carbamazepine – preliminary observations in vitro
Authors: Dzajkowska Magdalena , Hanna Kotlowska , Anna Madanecka , Maja Szczepanska , Dagmara Doniza , Anna Sosnowicz , Malgorzata Sznitowska
Published: December 2016

Objective

The aim was to develop prolonged-release minitablets (MT) with carbamazepine (CBZ).

Methods

Matrix-type 3-mm MT (5 mg CBZ) were prepared by direct compression using hydrophilic (hypromellose) or hydrophobic polymers (ethylcellulose, Kollidon SR, glyceryl behenate). Coated prolonged-release MT (2.5 mm/3 mg of CBZ) were produced using ethylcellulose or Eudragit RL/RS. The release tests were performed in a basket apparatus with water or 1% sodium lauryl sulphate solution as dissolution media.

Key findings

High-viscosity hypromellose used as a matrix polymer resulted in slow release of CBZ (80% released during 12 h). Dissolution was slower from hydrophobic matrices. Non-swelling MT cores were successfully coated with Eudragit RL/RS, which resulted in the prolonged release of CBZ (80%/14 h), depending on the film thickness and Eudragit composition. Careful choice of pore formers in the coating film allowed to reduce lag time. Ethylcellulose was unsuitable as coating polymer due to low permeability to CBZ and unsatisfying mechanical resistance of the films modified with hypromellose.

Conclusion

Prolonged release of CBZ was obtained from both matrix-type and coated MT. Further development of MT as a single unit or multicompartment prolonged-release new dosage form especially suitable for children has been justified.
Proposed mechanisms of Terminalia catappa in hyperglycaemia and associated diabetic complications
Authors: Behl Tapan , Kotwani Anita
Published: December 2016

Objectives

Terminalia catappa has shown potent antidiabetic activity in the past; however, the exact molecular mechanisms by which it acts have not been elucidated. This review aims at exploring several hypotheses which have been proposed to explain its mechanism of action, including reduction in oxidative stress, inflammation, angiogenesis, lipid profile correction and direct hypoglycaemic actions.

Methods

A thorough review of all the articles, research as well as reviews, available regarding the concerned topic was performed. MEDLINE databases were searched using keywords (and their combinations), such as T. catappa, renin oxidative stress, inflammation, angiogenesis, diabetic retinopathy, α-glucosidase and α-amylase, among several others. English-language articles were preferably selected.

Key findings

Apart from metabolic dysfunctions, several hyperglycaemia-induced pathological conditions come into scene as the after-effects of diabetes. These mainly include inflammation, oxidative stress, angiogenesis and lipid profile alteration, which ultimately result in vascular endothelial dysfunction, hepatic steatosis, lipid peroxidation and apoptosis of endothelial, hepatic and neuronal cells. Terminalia catappa effectively attenuates the progression of diabetic retinopathy and shows significant hypoglycaemic actions. The mechanisms behind these effects were explained.

Conclusion

Terminalia catappa may provide an effective natural product to treat hyperglycaemia and prevent subsequent diabetic complications.