bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of journal clubs to teach evidence‐based medicine to health professionals: A systematic review and meta‐analysis
Authors: Ilic Dragan , de Voogt Annelies , Oldroyd John 
Published: January 2020

AbstractBackgroundJournal clubs are an educational activity in which individuals meet to critique and discuss research articles. They are an established part of the medical education system and are considered to be a practical way to improve the content knowledge of health professionals.AimsTo determine the effectiveness of journal clubs for increasing health professionals’ competency in EBM.MethodsA systematic review of randomized controlled trials (RCTs) was performed. Electronic searches were conducted in October 2019 across MEDLINE, ERIC and Scopus databases. Two authors independently reviewed articles, and extracted data. A risk‐of‐bias tool, based on the Cochrane Collaboration's tool for assessing risk of bias in RCTs, was used to assess internal validity.ResultsA total of 151 citations were returned, from which five studies (n = 378 individuals) were included in the final review. No overall statistical difference in knowledge scores was observed between health professionals participating in journal clubs compared to other professional education modes (SMD 0.15, 95% CI –0.09, 0.39). Similarly, no significant difference in attitudes or implementation of evidence‐based medicine practices was observed across studies.ConclusionsThere is insufficient evidence to support the effectiveness of journal clubs in improving the knowledge, attitudes, and implementation of evidence‐based skills by health professionals in clinical practice. Further research is needed to test the effectiveness of other interventions to increase uptake of EBM in real world settings. Such interventions may include interactive components with auditing and feedback to facilitate more effective learning.
Nurse managed patient focused assessment and care: A grounded theory of qualified nurses in acute and critical care settings assessing the mental capacity of adult patients
Authors: Jones Sian , Gill Paul , Kenkre Joyce 
Published: January 2020

AbstractAimsTo explore processes used by qualified nurses in assessing mental capacity of acutely and critically ill hospitalised adult patients.BackgroundMental capacity is the ability to understand, reason and make decisions. Acute and critical illness may impact upon the decision‐making abilities of hospitalised adult patients but little is known about how qualified nurses across a range of acute settings assess the capacity of such patients in their care.DesignA qualitative grounded theory approach informed by the Corbin and Strauss (Basics of Qualitative Research (Third Edition). London, UK: Sage, 2008) methodological pathway.MethodsData were collected through digitally recorded, semi‐structured interviews to explore assessment of capacity processes used by 13 registered nurses employed in acute and critical care environments in a district general hospital in South Wales, UK. Data were analysed using iterative constant comparative processes leading to a core category and grounded theory. The study is presented in accordance with the COREQ checklist.ResultsInformal, intuitive, holistic nurse‐led processes were used to assess the mental capacity of patients which combined processes for the assessment of their physiological and mental capacity status, recognising the need to support their rights, dignity and autonomy. The assessment of mental capacity was not a lone process but one that contributed to a cyclical process in which multi‐professional assessment was necessary and ongoing, and in which qualified nurses had a co‐ordinating role. This led to the development of the theory, Nurse Managed Patient Focused Assessment and Care.ConclusionThis theory provides a framework to explain processes and strategies used by qualified nurses in assessing mental capacity of, and caring for, adult patients with acute and/or critical illness.Relevance to clinical practiceThis framework may inform related clinical practice and can serve as a basis of an assessment tool in what has been identified as a fundamental role of the qualified nurse.
Health Literacy in Kidney Disease: Associations with Quality of Life and Adherence
Authors: Elisabeth Stømer Une , Klopstad Wahl Astrid , Gunnar Gøransson Lasse , Hjorthaug Urstad Kristin 
Published: January 2020

SUMMARYBackgroundHealth literacy (HL) is a multidimensional concept with significance for self‐management and health outcomes in patients with chronic kidney disease (CKD); however, research with a multidimensional perspective on HL is scarce.ObjectivesThis study aimed to explore the relationship between multidimensional HL, quality of life (QoL) and adherence to long‐term therapy in CKD patients.DesignA descriptive single‐centre cross‐sectional study.ParticipantsPatients with CKD in stages 3–5 were recruited from the nephrology unit in a Norwegian hospital.MeasurementsThe Health Literacy Questionnaire (HLQ) was used to assess HL, QoL was measured by the Short Form‐12 (SF‐12) and a Visual Analogue Scale (VAS‐QoL). Adherence to long‐term therapy was measured by the Medical Adherence Rating Scale 5 (MARS‐5), participants' prescription withdrawals from pharmacies, and a VAS (VAS‐adherence). Hierarchical cluster analysis was performed to group patients with similar HLQ scores, and multiple linear regression analysis was performed to identify the HL dimensions that were associated with QoL and adherence to long‐term therapy.ResultsA total of 187 patients were included, 65% were male, and the mean (SD) age was 67 (13) years. The high‐level HL group (N = 52) had significantly better QoL than patients in the mid‐level (N = 106) and low‐level (N = 27) HL groups. The HL dimensions “actively managing health,” “actively engage with healthcare providers,” “ability to find good health information” and “ability to understand health information” were predictive of QoL and adherence to long‐term therapy.ConclusionHL seems to be important for both QoL and adherence to long‐term therapy.
Do Australian children carry out recommended preventive child health behaviours? Insights from an online parent survey
Authors: Baker Sabine , Morawska Alina , Mitchell Amy E 
Published: January 2020

AimTo investigate (i) the proportion of Australian children who do not adhere to preventive child health behaviours, (ii) clustering of child health behaviours, (iii) the proportion of parents who are concerned about not meeting recommendations and (iv) parents' access to and interest in information on ways to establish healthy habits in their child.MethodsA cross‐sectional online survey of 477 Australian parents of 0–4‐year‐old children assessed the degree to which children meet key child health recommendations (diet, physical activity, oral health, sleep, pedestrian/vehicle safety, screen use, sun safety, personal hygiene, medical care), examined clustering of health behaviours and identified parents' greatest concerns.ResultsA significant proportion of children do not meet recommendations for many preventive child health behaviours. More than half of the parents report infrequent toothbrushing and dentist check‐ups, less than the recommended vegetable consumption, excessive consumption of treats, not wearing safety equipment, excessive screen time and screen time during meals, child inactivity, insufficient sleep, not covering coughs and sneezes, insufficient hand and nail hygiene and inadequate sun protection. No clustering of life‐style risk behaviours was found. Areas of greatest concern to parents are vegetable consumption, toothbrushing, covering coughs and sneezes, screen time and wearing sunglasses.ConclusionsWhile the majority of Australian parents have accessed child health recommendations, relatively few consistently implement health‐protective practices with their children. Parents are concerned about this and interested in receiving information. Future research should investigate barriers to following guidelines and how parents can best be supported in establishing healthy habits.
Characteristics associated with bacterial growth in urine in 451 proteinuric dogs (2008‐2018)
Authors: Grimes Millie , Heseltine Johanna C. , Nabity Mary B. , Lawhon Sara D. , Wheeler Lance , Cigarroa Annalis , Lidbury Jonathan A. 
Published: January 2020

AbstractBackgroundUrine cultures are frequently recommended to rule out infection as a postrenal cause of proteinuria.ObjectiveIdentify characteristics associated with bacterial growth in urine in proteinuric dogs.AnimalsFour hundred and fifty‐one dogs admitted to a teaching hospital between January 2008 and January 2018 with urine protein‐to‐creatinine ratios (UPCs) >0.5.MethodsRetrospective study included dogs with a UPC, urinalysis, and quantitative urine culture (QUC) performed within a 72‐hour period by searching electronic records. Dogs with recent antimicrobial therapy, urine collected by methods other than cystocentesis, or UPC ≤0.5 were excluded. Signalment, comorbidities, serum BUN and creatinine concentrations, urinalysis findings, and QUC results were recorded. The association between these characteristics and presence of bacterial growth in urine was assessed by univariable and multivariable analysis.ResultsThirty of four hundred fifty‐one dogs (6.7%) had bacterial growth in urine. Of these, 18 (60.0%) had active urine sediment. Bacterial growth in urine was associated with pyuria (odd ratio [OR] 25.1, 95% confidence interval [CI] 7.9‐79.6, P < .001), bacteriuria (OR 11.1, 95% CI 3.2‐39.1, P < .001), and lower urinary tract disease (OR 6.7, 95% CI 1.9‐23.0; P = .0028). If QUC was prompted based on these criteria, 8/451 (1.8%) of proteinuric dogs would have had undetected bacterial growth.Conclusions and Clinical ImportanceThe proportion of proteinuric dogs with both inactive urine sediment and bacterial growth in urine was low, suggesting that QUC might not be necessary in the evaluation of all proteinuric dogs. An active urine sediment or lower urinary tract disease should prompt QUC for proteinuric dogs.
Electoral Externalities in Federations – Evidence from German Opinion Polls
Authors: Frei Xenia , Langer Sebastian , Lehmann Robert , Roesel Felix 
Published: January 2020

SUMMARYThe performance of parties at the national level is likely to influence election results at the local level, and vice versa. However, researchers have not yet quantified those electoral externalities. We apply vector autoregressions with predetermined variables to new high‐frequency opinion poll data for the German state of Berlin, measuring voting intentions of Berlin voters for the state parliament and for the national parliament. Our results show that the impact of local politics on national elections has been drastically underestimated so far. Shocks in state parliament voting intentions influence national parliament voting intentions to the very same extent as vice versa. Externalities account for around 10% to 40% of the variation at the other level of government. Left‐wing parties interact somewhat more strongly between different levels of government than right‐wing parties, and effects are more persistent.
Claims, confusion, and status: Which city is New Zealand's oldest?
Authors: Brett André 
Published: January 2020

AbstractThere is little clarity as to which city is New Zealand's “oldest” or “first.” Scholars, journalists, and websites make competing claims. This article examines various categories by which cities can claim to be oldest, and reveals that Auckland, Christchurch, and Wellington have valid claims but Dunedin and Nelson do not. Most claims are bound up in the inconsistent development of New Zealand's municipal authorities and representative institutions. I conclude that although the status of “oldest city” has no legal significance, this detail provides an accessible entry point to important historical narratives and to understanding urban life in colonial New Zealand.
Feasibility and acceptability of a future‐oriented empowerment program to prevent substance use and school dropout among school‐disengaged youth
Authors: Stoddard Sarah A. , Hughesdon Kathryn , Khan Angubeen , Zimmerman Marc A. 
Published: January 2020

AbstractObjectiveTo evaluate the feasibility and acceptability of a health promotion program to prevent school dropout and substance use among middle school‐aged youth who display early warning signs of school disengagement.InterventionYouth Empowerment Solutions for Positive Futures (YES‐PF), an intensive, theoretically driven, 5‐week summer enrichment program, aims to prevent school dropout and substance use by promoting youth empowerment, school engagement, and future orientation.Design and SampleUsing a pre–post‐intervention design, we test feasibility and acceptability with 6th and 7th grade students (n = 43) who exhibited early warning signs for school disengagement (e.g., chronic absenteeism) in two school districts.MeasuresProgram evaluation components included: (a) program session forms completed by facilitators; (b) post‐program interviews with facilitators; (c) post‐intervention program evaluation surveys with youth; (d) attendance; and (e) baseline and post‐intervention surveys with youth to assess behavioral and psychosocial outcomes.ResultsFacilitators routinely delivered core component lesson activities. Acceptability and program satisfaction were evidenced in strong program attendance by youth. Youth participants reported higher levels of leadership efficacy (p < .05) and a greater sense of control over their lives and potential problems (p < .01).ConclusionsYES‐PF was feasible and acceptable to school personnel and youth. Program refinement, based on implementation findings, is discussed.
Validation of criteria to identify severe maternal morbidity
Authors: Himes Katherine P. , Bodnar Lisa M. 
Published: January 2020

AbstractBackgroundEpidemiologic research on severe maternal morbidity often relies on a screening definition of the outcome because a gold standard approach requires medical record review.ObjectiveTo determine the validity of screening or identification criteria to classify cases of severe maternal morbidity using the definition of severe maternal morbidity proposed by the American College of Obstetricians and Gynecologists (ACOG).MethodsFrom all singleton deliveries at Magee‐Womens Hospital in Pittsburgh, Pennsylvania (2010‐2011; n = 19 307), we selected all deliveries that had at least one screening or identification criteria for severe maternal morbidity (n = 349) and a random sample of deliveries with no case identification criteria (n = 349). Screen‐positive deliveries were a delivery with any of the following: Centers for Disease Control and Prevention International Classification of Diseases 9th Revision diagnosis and procedure codes for the identification of severe maternal morbidity; prolonged post‐partum length of stay; or maternal intensive care unit admission. We identified true cases through detailed chart review using the suggested diagnoses in the 2016 ACOG and SMFM Obstetric Care Consensus on severe maternal morbidity. We calculated the positive and negative predictive values of the screening criteria.ResultsApproximately 1.8% of deliveries screened positive for severe maternal morbidity. After medical record review, 166 screen‐positive deliveries were true cases (48% positive predictive value), and 347 screen‐negative cases were true negatives (99% negative predictive value). Two screen‐negative cases were false negatives. If we applied the negative predictive value to the population, 109 true cases would be missed with these criteria.ConclusionThe criteria we used to identify potential cases of severe acute maternal morbidity had poor performance in our cohort. In the absence of resources to apply the gold standard outcome definition to a large population, validation data and analytic strategies that incorporate measurement error are essential to estimate the direction and magnitude of the resulting bias.
Reflectance confocal microscopy may be included as part of the diagnostic algorithm of early‐stage mycosis fungoides
Authors: Zhu Mengyan , Yu Wenzhong , Wang Ping , Liu Jiao , Li Zhao , Dai Hui , Xu Ai‐E 
Published: January 2020

AbstractIntroductionReflectance confocal microscopy (RCM), a noninvasive, real‐time technique of computed tomography, has been widely used for pigmentary, inflammatory, and tumor diseases of the skin.AimOur main purpose was to analyze the consistency between pathological and RCM characteristics of early‐stage mycosis fungoides (MF) and the utility of RCM in the diagnosis of early‐stage MF.MethodsAccording to the RCM features of MF in the early stage, the biopsy sites of 40 cases of suspected MF and 20 cases of chronic inflammatory skin diseases clinically were preliminarily located. Histopathologic and immunohistochemical examinations were performed to make a diagnosis based on the diagnostic algorithm proposed by the International Society for Cutaneous Lymphomas.ResultsAmong the 60 patients observed, there were 12 confirming cases of MF, 14 suspecting cases, 6 not completely excluding cases, and 28 eliminating cases according to the diagnostic algorithm, as well as characteristics of RCM were typical in 8 cases, suspected in 16 cases, not excluded in 3 cases, and excluded in 33 cases. The kappa value was 0.769 (P < .01), which means there is a strong consistency between the classification by RCM and the diagnosis algorithm. MF in patch stage and plaque stage (IA to IIB) has typical characteristics of RCM, respectively.ConclusionsRCM can be used as an objective and convenient auxiliary means to diagnose early‐stage MF and may be included as part of the diagnostic algorithm of early‐stage MF.
SUMOylation of MYB30 enhances salt tolerance by elevating alternative respiration via transcriptionally upregulating AOX1a in Arabidopsis
Authors: Gong Qianyuan , Li Sha , Zheng Yuan , Duan Hongqin , Xiao Fei , Zhuang Yufen , He Jiaxian , Wu Guochun , Zhao Shuangshuang , Zhou Huapeng , Lin Honghui 
Published: January 2020

SummarySalt stress reduces crop growth and productivity globally. Here we report that a R2R3‐MYB transcription factor MYB30 participates in salt tolerance in Arabidopsis. MYB30 can be SUMOylated by SIZ1 in response to salt stress and the lysine (K)283 of MYB30 is essential for its SUMOylation. In contrast to wild‐type MYB30, the MYB30K283R mutant failed to rescue the salt‐sensitive phenotype of the myb30‐2 mutant, indicating that SUMOylation of MYB30 is required for the salt‐stress response. Through transcriptomic analysis, we identified a MYB30 target, alternative oxidase 1a (AOX1a). MYB30 binds the promoter of AOX1a and upregulates its expression in response to salt stress; however, MYB30K283R cannot bind the promoter of AOX1a. The cyanide (CN)‐resistant alternative respiration (Alt) mediated by AOX is significantly reduced in the myb30‐2 mutant through the loss of function of MYB30. As a result, the redox homeostasis is disrupted in the myb30‐2 mutant compared with that in wild‐type seedlings (WT) under salt conditions. The artificial elimination of excess reactive oxygen species partially rescues the salt‐sensitive phenotype of the myb30‐2 mutant, whereas after the exogenous application of SHAM, an inhibitor of AOXs and Alt respiration, the salt tolerance of Col‐0 and the complemented plants decreased to a level similar to that observed in myb30‐2. Finally, overexpression of AOX1a in myb30‐2 confers WT‐like salt tolerance compared with that of the myb30‐2 mutant. Taken together, our results revealed a functional link between MYB30 and AOX1a, and indicated that SIZ1‐mediated SUMOylation of MYB30 enhances salt tolerance by regulating Alt respiration and cellular redox homeostasis via AOX1a in Arabidopsis.
Labour market adjustment to third‐party competition: Evidence from Mexico
Authors: Robertson Raymond , Halliday Timothy J. , Vasireddy Sindhu 
Published: January 2020

AbstractChina's exports reduce wages in importing countries, but few studies have looked at competition in third‐party markets. We examine labour market outcomes in Mexico's apparel and textile sectors associated with US apparel and textile imports from China. Using data on US imports in conjunction with quarterly Mexican labour force surveys, we show that US imports from China are associated with a reduction of employment in Mexico's apparel and textile sectors. These effects are the most pronounced for the least educated. Wages were not impacted on net except for possibly the poorest which would indicate stronger local labour market ties in the left tail of the wage distribution. Finally, the effects of trade‐induced demand shocks dissipate after about two quarters indicating low firm‐level adjustment costs.
Clinical features of canine nodal T‐cell lymphomas classified as CD8+ or CD4−CD8− by flow cytometry
Authors: Harris Lauren J. , Rout Emily D. , Labadie Julia D. , Avery Paul R. , Fernandez Monica , Yoshimoto Janna , Avery Anne C. 
Published: January 2020

AbstractCanine T‐cell lymphoma (TCL) encompasses a heterogeneous group of diseases with variable clinical presentation, cytomorphology, immunophenotype, and biologic behaviour. The most common types of TCL in dogs involving peripheral lymph nodes include indolent T‐zone lymphoma (TZL) and biologically aggressive peripheral T‐cell lymphoma (PTCL). TCL phenotypes can be categorized by expression of the surface antigen molecules CD4 and CD8. The majority of TCL cases are CD4+, with far fewer cases being CD8+ or CD4− CD8−. The clinical features of CD4+ TCLs have been previously described. The less common TCL phenotypes, however, are poorly characterized with little to no information about prognosis. In this retrospective study, we describe and correlate the presenting clinical signs, flow cytometry, and outcomes of 119 dogs diagnosed with nodal, non‐TZL, CD8+ or CD4− CD8− TCL by flow cytometry. Skin lesions present at the time of diagnosis were more commonly observed in the CD8+ TCL group. Mediastinal enlargement and/or hypercalcemia were more commonly seen in the CD4− CD8− TCL group. Dogs with either CD8+ or CD4− CD8− TCLs had aggressive clinical disease with median overall survival (OS) times of 198 days and 145 days, respectively. In both groups, neoplastic cell size determined by flow cytometry ranged from small to large, and large cell size was associated with shorter OS times (median OS = 61 days). Cases classified as small cell had a median OS of 257 days. Expression levels of major histocompatibility complex (MHC) class II and CD5 were highly variable among cases but were not prognostically significant in this group of patients.