bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of an Intensive Evidence‐Based Practice Educational and Skills Building Program on EBP Competency and Attributes
Authors: Gallagher‐Ford Lynn , Koshy Thomas Bindu , Connor Linda , Sinnott Loraine T. , Melnyk Bernadette Mazurek 
Published: February 2020

AbstractBackground and SignificanceEvidence‐based practice (EBP) is a systematic problem‐solving approach to the delivery of health care that improves quality and population health outcomes as well as reduces costs and empowers clinicians to fully engage in their role, otherwise known as the quadruple aim in health care. The Helene Fuld Health Trust National Institute for Evidence‐based Practice in Nursing and Healthcare at The Ohio State University College of Nursing has been offering 5‐day EBP immersion programs since 2012. The goal of the program is for the participants to acquire EBP competence (e.g., knowledge, skills, and attitude) and sustain it over time.Purpose and AimsThe purpose of this study was to evaluate the effects of the 5‐day EBP immersion (i.e., an education and skills building program) on EBP attributes and competence over time.Method and DesignA longitudinal pre‐experimental study was conducted that gathered data with an anonymous online survey from 400 program attendees who attended 16 5‐day immersions between September 2014 and May 2016. Participants completed five valid and reliable instruments at four points over 12 months, including EBP beliefs, implementation, competency, knowledge, and perception of organizational readiness and culture.ResultsFindings indicated statistically significant improvements in EBP attributes and competency over time. The results of this study support the hypotheses that EBP competency and attributes can be significantly improved and sustained by attending an intensive 5‐day EBP educational and skills building program such as the one described in this study. This study can help leaders and organizations to mitigate many of the traditional barriers to EBP.Linking Evidence to ActionThe results of this study indicate that EBP attributes and competencies can be improved and sustained by attending an intensive 5‐day EBP immersion, regardless of clinicians’ prior educational preparation.
Correction of z‐motion artefacts to allow population imaging of synaptic activity in behaving mice
Authors: Ryan Thomas Michael , Hinojosa Antonio Jesus , Vroman Rozan , Papasavvas Christoforos , Lagnado Leon 
Published: February 2020

Key points
Motion artefacts associated with motor behaviour are an inevitable problem of multiphoton imaging in awake behaving animals, particularly when imaging synapses.
Correction of axial motion artefacts usually requires volumetric imaging resulting in slower rates of acquisition.
We describe a method to correct z‐motion artefacts that is easy to implement and allows population imaging of synaptic activity while scanning a single plane in a standard multiphoton microscope.
The method uses a reference volume acquired in two colour channels – an activity reporter and an anatomical marker of blood vessels. The procedure estimates the z‐displacement in every frame and applies an intensity correction in which the z intensity profile for each synapse is modelled as a Moffat function.
We demonstrate that the method allows synaptic calcium signals to be collected from populations of synaptic boutons in mouse primary visual cortex during locomotion.
AbstractFunctional imaging of head‐fixed, behaving mice using two‐photon imaging of fluorescent activity reporters has become a powerful tool for studying the function of the brain. Motion artefacts are an inevitable problem during such experiments and are routinely corrected for in x and y dimensions. However, axial (z) shifts of several microns can also occur, leading to intensity fluctuations in structures such as synapses that are small compared to the axial point‐spread function of the microscope. Here we present a simple strategy to correct z‐motion artefacts arising over the course of a time‐series experiment in a single optical plane. Displacement in z was calculated using dye‐filled blood vessels as an anatomical marker, providing high contrast images and accuracy to within ∼0.1 µm. The axial profiles of ROIs corresponding to synapses were described using a Moffat function and this ‘ROI‐spread function’ used to correct activity traces on an ROI‐by‐ROI basis. We demonstrate the accuracy and utility of the procedures in simulation experiments using fluorescent beads and then apply them to correcting measurements of synaptic activity in populations of vasoactive‐intestinal peptide (VIP) interneurons expressing the synaptic reporter SyGCaMP6f. Correction of z‐motion artefacts had a substantial impact on the apparent correlation between synaptic activity and running speed, demonstrating the importance of correcting these when performing imaging experiments in awake mice.
Pyrolysis of Delonix Regia and Characterization of Its Pyrolytic Products: Effect of Pyrolysis Temperature
Authors: Kawale Harshal D. , Kishore Nanda 
Published: February 2020

Abstract
Pyrolysis of a rarely researched biomass feedstock, Delonix regia (DR), at different pyrolysis temperatures carried out in a tubular reactor at an atmospheric pressure of one bar. In addition to the fuel and physical properties of produced bio-oil and bio-char, extensive advanced characterization of these products, viz. Fourier transformation infrared (FTIR), GC-MS, proton (1H) nuclear magnetic resonance (1H NMR), X-ray diffraction (XRD), etc. is also performed as applicable to different products. The main emphasis of this work is on both quantitative and qualitative analysis of pyrolytic bio-oil and bio-char obtained from DR at 500–700 °C. In this range of temperature, higher heating value (HHV) of bio-oil found to be varying between 20.88 MJ/kg and 25.70 MJ/kg following increasing trend with the temperature. However, HHV of bio-char observed to be almost unaffected by pyrolysis temperature, and it is approximately 36 MJ/kg. The density of bio-oil found to be decreasing from 0.95 g/cc to 0.88 g/cc as the pyrolysis temperature increases from 500 to 700 °C; however, pH is found to be almost unaffected by the pyrolysis temperature changing only slightly from 3.4 to 3.3. Furthermore, the moisture content of bio-oil is also found to be unaffected by the temperature variations. From the GC-MS chromatograms of bio-oils, it is found that benzene is highest area % (with 14.6%) and phenol, 2,6-dimethoxy is the second-highest area % occupying component (with 10.5%) in bio-oil obtained at 600 °C of pyrolysis temperature. This result indicates that the DR feedstock is also an excellent resource for producing value-added green chemicals.
Effects of Seasonal Vitamin D3 Supplementation on Strength, Power, and Body Composition in College Swimmers
Authors: Rockwell Michelle S. , Frisard Madlyn I. , Rankin Janet W. , Zabinsky Jennifer S. , Mcmillan Ryan P. , You Wen , Davy Kevin P. , Hulver Matthew W. 
Published: February 2020

The purpose of this study was to evaluate the impact of fall season vitamin D3 supplementation on strength/power, body composition, and anabolic hormones in swimmers with optimal vitamin D status at summer’s end. Male and female National Collegiate Athletic Association Division I swimmers (N = 19) with optimal 25-hydroxyvitamin D [25(OH)D] randomly received 5,000 IU of vitamin D3 (VITD) or placebo (PLA) daily for 12 weeks while participating in swimming and strength and conditioning training (August–November). Before and after the intervention, the participants underwent blood sampling for analysis of serum 25(OH)D, parathyroid hormone, total testosterone, free testosterone, sex hormone-binding globulin, and insulin-like growth factor 1, dual-energy X-ray absorptiometry, and strength/power testing (bench press, squat, dead lift, standing broad jump, vertical jump, and dips and pull-ups). Sex was used as a covariate for analyses. The 25(OH)D was decreased by 44% in PLA (p < .05) and increased by 8% in VITD over the 12 weeks. Fat-free mass increased in VITD (56.4–59.1 kg; p < .05), but not PLA (59.4–59.7 kg; p < .01). Significant Group × Time interaction effects were observed for dead lift (F = 21.577, p < .01) and vertical jump (F = 11.219, p < .01), but no other strength/power tests. Total testosterone decreased similarly in both groups, but free testosterone decreased and sex hormone-binding globulin increased only in PLA (p < .01). There were no group differences or changes in insulin-like growth factor 1 with the intervention. The findings suggest that vitamin D supplementation is an efficacious strategy to maintain 25(OH)D during the fall season training and to enhance some aspects of strength/power and fat-free mass in swimmers. Further research on the relationship between vitamin D and anabolic hormones is needed.
Perception of Carbohydrate Availability Augments High-Intensity Intermittent Exercise Capacity Under Sleep-Low, Train-Low Conditions
Authors: Waterworth Sally P. , Spencer Connor C. , Porter Aaron L. , Morton James P. 
Published: February 2020

The authors tested the hypothesis that perception of carbohydrate (CHO) availability augments exercise capacity in conditions of reduced CHO availability. Nine males completed a sleep-low train model comprising evening glycogen-depleting cycling followed by an exhaustive cycling protocol the next morning in the fasted state (30 min steady state at 95% lactate threshold followed by 1-min intervals at 80% peak power output until exhaustion). After the evening depletion protocol and prior to sleeping, subjects consumed (a) a known CHO intake of 6 g/kg body mass (TRAIN HIGH) or (b) a perceived comparable CHO intake but 0 g/kg body mass (PERCEPTION) or a known train-low condition of 0 g/kg body mass (TRAIN LOW). The TRAIN HIGH and PERCEPTION trials were conducted double blind. During steady state, average blood glucose and CHO oxidation were significantly higher in TRAIN HIGH (4.01 ± 0.56 mmol/L; 2.17 ± 0.70 g/min) versus both PERCEPTION (3.30 ± 0.57 mmol/L; 1.69 ± 0.64 g/min, p < .05) and TRAIN LOW (3.41 ± 0.74 mmol/L; 1.61 ± 0.59 g/min, p < .05). Exercise capacity was significantly different between all pairwise comparisons (p < .05), where TRAIN LOW (8 ± 8 min) < PERCEPTION (12 ± 6 min) < TRAIN HIGH (22 ± 9 min). Data demonstrate that perception of CHO availability augments high-intensity intermittent exercise capacity under sleep-low, train-low conditions, though this perception does not restore exercise capacity to that of CHO consumption. Such data have methodological implications for future research designs and may also have practical applications for athletes who deliberately practice elements of training in CHO-restricted states.
Insights for Blood Flow Restriction and Hypoxia in Leg Versus Arm Submaximal Exercise
Authors: Willis Sarah J. , Millet Grégoire P. , Borrani Fabio 
Published: February 2020

Purpose: To assess tissue oxygenation, along with metabolic and physiological responses during blood flow restriction (BFR, bilateral vascular occlusion) and systemic hypoxia conditions during submaximal leg- versus arm-cycling exercise. Methods: In both legs and arms, 4 randomized sessions were performed (normoxia 400 m, fraction of inspired oxygen [FIO2] 20.9% and normobaric hypoxia 3800 m, FIO2 13.1% [0.1%]; combined with BFR at 0% and 45% of resting pulse elimination pressure). During each session, a single 6-minute steady-state submaximal exercise was performed to measure physiological changes and oxygenation (near-infrared spectroscopy) of the muscle tissue in both the vastus lateralis (legs) and biceps brachii (arms). Results: Total hemoglobin concentration ([tHb]) was 65% higher (P < .001) in arms versus legs, suggesting that arms had a greater blood perfusion capacity than legs. Furthermore, there were greater changes in tissue blood volume [tHb] during BFR compared with control conditions (P = .017, F = 5.45). The arms elicited 7% lower tissue saturation (P < .001) and were thus more sensitive to the hypoxia-induced reduction in oxygen supply than legs, no matter the condition. This indicates that legs and arms may elicit different regulatory hemodynamic mechanisms (ie, greater blood flow in arms) for limiting the decreased oxygen delivery during exercise with altered arterial oxygen content. Conclusions: The combination of BFR and/or hypoxia led to increased [tHb] in both limbs likely due to greater vascular resistance; further, arms were more responsive than legs. This possibly influences the maintenance of oxygen delivery and enhances perfusion pressure, suggesting greater vascular reactivity in arms than in legs.
Inequalities in early childhood care and development in low/middle-income countries: 2010–2018
Authors: Lu Chunling , Cuartas Jorge , Fink Günther , McCoy Dana , Liu Kai , Li Zhihui , Daelmans Bernadette , Richter Linda 
Published: February 2020

BackgroundInequalities in early childhood development (ECD) tend to persist into adulthood and amplify across the life course. To date, little research on inequalities in early childhood care and development in low/middle-income countries has been available to guide governments, donors and civil society in identifying which young children and families should be targeted by policies and programmes to improve nurturing care that could prevent them from being left behind.MethodsUsing data from 135 Demographic and Health Surveys and Multiple Indicator Cluster Surveys between 2010 and 2018, we assessed levels and trends of inequalities in exposure to risks of stunting or extreme poverty (under age 5; levels in 85 and trends in 40 countries), early attendance of early care and education programmes (36–59 months; 65 and 17 countries), home stimulation (36–59 months; 62 and 14 countries) and child development according to the Early Childhood Development Index (36–59 months; 60 and 13 countries). Inequalities within countries were measured as the absolute gap in three domains—child gender, household wealth and residential area—and compared across regions and country income groups.Results63% of children were not exposed to stunting or extreme poverty; 39% of 3–4-year olds attended early care and education; and 69% received a level of reported home stimulation defined as adequate. Sub-Saharan Africa had the lowest proportion of children not exposed to stunting or extreme poverty (45%), attending early care and education (24%) and receiving adequate home stimulation (47%). Substantial gaps in all indicators were found across country income groups, residential areas and household wealth categories. There were no significant reductions in gaps over time for a subset of countries with available data in two survey rounds.ConclusionsAvailable data indicate large inequalities in early experiences and outcomes. Efforts of reducing these inequalities must focus on the poorest families and those living in rural areas in the poorest countries. Improving and applying population-level measurements on ECD in more countries over time are important for ensuring equal opportunities for young children globally.
Development and implementation of a standardised emergency department intershift handover tool to improve physician communication
Authors: Kwok Edmund S H , Clapham Glenda , White Shannon , Austin Michael , Calder Lisa A 
Published: February 2020

BackgroundStructured handover can reduce communication breakdowns and potential medical errors. In our emergency department (ED) we identified a safety risk due to variation in quality and content of overnight handovers between physicians.AimOur goal was to develop and implement a standardised ED-specific handover tool using quality improvement (QI) methodology. We aimed to increase the proportion of patients having adequate handover information conveyed at overnight shift change from a baseline of 50%–75% in 4 months.MethodsWe used published best practices, stakeholder input and local data to develop a tool customised for intershift ED handovers. Implementation methods included education, cognitive aids, policy change and plan-do-study-act cycles informed by end-user feedback. We monitored progress using direct observation convenience sampling.MeasuresOur outcome measure was proportion of adequate patient handovers (defined as >50% of handover components communicated per patient) per overnight handover session. Tool utilisation characteristics were used for process measurement, and time metrics for balancing measures. We report changes using statistical process control charts and descriptive statistics.ResultsWe observed 49 overnight handover sessions from 2017 to 2019, evaluating handovers of 850 patients. Our improvement target was met in 10 months (median=76.1%) and proportion of adequate handovers continued to improve to median=83.0% at the postimprovement audit. Written communication of handover information increased from a median of 19.2% to 68.7%. Handover time increased by median=31 s per patient. End-users subjectively reported improved communication quality and value for resident education.ConclusionsWe achieved sustained improvements in the amount of information communicated during physician ED handovers using established QI methodologies. Engaging stakeholders in handover tool customisation for local context was an important success factor. We believe this approach can be easily adopted by any ED.
Checklist for Head Injury Management Evaluation Study (CHIMES): a quality improvement initiative to reduce imaging utilisation for head injuries in the emergency department
Authors: Masood Sameer , Woolner Victoria , Yoon Joo Hyung , Chartier Lucas B 
Published: February 2020

Over 90% of patients with head trauma seen in emergency departments (EDs) are diagnosed with minor head injuries. Over-utilisation of CT scans results in unnecessary exposure to radiation and increases healthcare utilisation. Using recommendations from the Choosing Wisely Canada (CWC) campaign and quality improvement (QI) methodology, we aimed to reduce the CT scan rate for head injuries by 10% over a 6-month period.Baseline CT scan rates were determined through a 27-month retrospective cohort review. We used stakeholder engagement and provider surveys to develop our driver diagram and Plan-Do-Study-Act (PDSA) cycles, which included (1) improving provider knowledge about the CWC campaign recommendations; (2) testing, refining and implementing a modified Canadian CT Head Rule checklist; (3) developing CWC-themed head injury–specific patient handouts; and (4) feedback on CT scan group ordering rates to providers. Our primary outcome measure was the number of CT scans performed for patients with head injuries. Process measures included the number of checklists completed and ED length of stay (LOS). Our balancing measure was return ED visits within 72 hours (with or without admission).Baseline CT scan rates prior to our interventions was 46.1%. Our QI initiative resulted in a ‘shift’ in the Statistical Process Control chart of the weekly CT scan rates, associated with the first and second PDSA cycles, resulting in a 13.9% reduction in CT rates during the initial 3 months, and a sustained reduction of 8% at 16 months (p<0.05). Mean ED LOS for all patients with head injuries decreased by 1.5 min (p=0.74). 33% of checklists were completed. 72-hour return visits did not change significantly (p=0.68).Through provider and patient education, and the creation of a user-friendly evidence-based tool, our local QI initiative was successful in achieving long-term reduction in CT rates for patients presenting to EDs with head injuries.
What benefits do healthcare organisations receive from leadership and management development programmes? A systematic review of the evidence
Authors: Seidman Gabriel , Pascal Laurie , McDonough John 
Published: February 2020

IntroductionLeadership and management training/development programmes have gained increasing institutional attention in healthcare organisations, and they have a wide variety of formats and approaches. However, limited evidence exists about effects of these programmes for the organisations that sponsor them. A minority of healthcare systems in the USA measure the impact of these programmes on organisational metrics such as staff turnover or cost savings. This systematic review sought to answer the question, ‘What evidence exists that leadership and/or management development and training programs yield benefits for health care organizations?’ These benefits could include return on investment, improved productivity/cohesion/teaming, or increased use of specific management skills (eg, strategic planning) that would directly benefit the organisation.MethodsWe followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct a systematic review of the relevant literature. We conducted two searches in PubMed and one in ABI/Inform, a business literature database. All articles included for the study were further categorised according to their relevance for answering the research questions, using predefined criteria based on their methodology and reported findings.ResultsOur search included 2462 studies, of which 55 met criteria for inclusion. We identified four potential organisation-level benefits to leadership and management training programmes: benefits to other staff (besides those who participate in the programmes), improved patient safety and satisfaction, tangible benefits from projects that were part of the programme and improved ability/confidence using leadership-related skills by programme participants. However, the research base on this topic is limited.ConclusionAlthough this research identified potential benefits of leadership and management programmes at the organisation level, additional research is needed to make definitive conclusions about their impact.
Role of nocturnal light intensity on adaptation to three consecutive night shifts: a counterbalanced crossover study
Authors: Sunde Erlend , Mrdalj Jelena , Pedersen Torhild , Thun Eirunn , Bjorvatn Bjørn , Grønli Janne , Harris Anette , Waage Siri , Pallesen Ståle 
Published: February 2020

ObjectivesTo investigate how a standard ceiling mounted light-emitting diode (LED)-based bright light intervention affected alertness and neurobehavioural performance during three consecutive simulated night shifts, and timing of circadian rhythm after the shifts.MethodsTwenty seven participants (20 females, 21.4±2.1 years; mean±SD) worked three consecutive night shifts (23:00–07:00) under a full-spectrum (4000 K) bright light (900 lx) and a standard light (90 lx) condition in a counterbalanced crossover design (separated by 4 weeks). Subjective alertness (Karolinska Sleepiness Scale) and neurobehavioural performance (Psychomotor Vigilance Task and Digit Symbol Substitution Test) were assessed five times during each shift. Salivary dim-light melatonin onset (DLMO) was assessed before and after the shifts. The simulated night shifts were conducted in a laboratory while the participants slept at home.ResultsSubjective alertness and neurobehavioural performance deteriorated during the night shifts in both light conditions. However, bright light significantly reduced alertness and performance decrements as compared with standard light. For a subset of the participants, DLMO was delayed by a mean of 3:17±0:23 (mean±SEM) hours after three night shifts in bright light and by 2:06±0:15 hours in standard light, indicating that bright light causes larger phase delay.ConclusionBright light improved performance and alertness during simulated night shifts and improved adaptation to night work. Bright light administered by ceiling mounted LED luminaires has the potential to improve adaptation to night work and reduce the risk of accidents and injuries among night workers.Trial registration numberNCT03203538.