bluuebunny/crossref_metadata_2025_split huggingface dataset:
A hermeneutical study of professional accountability in nursing
Authors: Chesterton Lorna , Tetley Josie , Cox Nigel , Jack Kirsten 
Published: October 2020

AbstractAims and ObjectivesThis paper presents findings from a hermeneutical study which sought to explore how registered nurses experienced and perceived their professional accountability in clinical settings.BackgroundProfessional accountability encompasses the ideals and standards of nursing practice. Nurses are accountable for their actions under civil, criminal and contract law to their; employing organisation, their regulatory body and the patients for whom they care.DesignThis paper reports on a Heideggerian hermeneutical study involving seven registered nurses, working in clinical practice in the National Health Service in the United Kingdom.MethodsThe study adopted purposive sampling, collecting data by means of in‐depth interviews. Data were analysed using the hermeneutic circle. COREQ checklist was used as a reporting guideline for this study.ResultsThe findings suggest that professional accountability in nursing practice is a complex phenomenon, which can be compromised by many factors which are historically, socially or politically drivenParticipants experienced challenges through a lack of resources and poor managerial support, which compromised their ability to deliver high‐quality patient care. However, collegiality strongly impacted upon resilience and positively influenced their well‐being.Relevance to clinical practiceAmid the challenges of the clinical workplace, a positive workplace culture with visible managerial support is a fundamental requirement in supporting professional accountability, development and retention of nurses. Findings highlight the view that leadership should be seen as a collective responsibility, which empowers staff to positively change the practice environment.
Predictors of burnout of health professionals in the departments of maternity and gynaecology, and its association with personality factors: A multicentre study
Authors: De la Fuente‐Solana Emilia I. , Suleiman‐Martos Nora , Velando‐Soriano Almudena , Cañadas‐De la Fuente Gustavo R. , Herrera‐Cabrerizo Blanca , Albendín‐García Luis 
Published: October 2020

AbstractAims and objectivesTo analyse the prevalence, levels and phases of burnout syndrome in midwives and obstetrics and gynaecology nurses, and to evaluate the relationship between burnout and sociodemographic, occupational and psychological factors.BackgroundBurnout syndrome is a major problem in occupational health, characterised by feelings of exhaustion, depersonalisation and a low sense of personal achievement that appears after long‐term occupational stress. Recent research has found that burnout harms the physical and mental well‐being of workers, and jeopardises the quality of care provided. The association between burnout and a risk profile in maternity wards has not previously been investigated but it deserves special attention since it is a highly stressful area to work in.DesignA cross‐sectional survey design was selected.MethodsA total of 150 nurses and midwives at 18 hospitals participated in this study. The data were collected using the Maslach Burnout Inventory, NEO Personality Inventory and the Educational‐Clinical Questionnaire: Anxiety and Depression. This study adhered to the STROBE guideline.Results17% of participants presented high levels of emotional exhaustion, 16.6% high depersonalisation and 55.1% a sense of low personal accomplishment. The sociodemographic and occupational variables related to burnout were gender, marital status and work shift. The three dimensions of the syndrome, emotional exhaustion, depersonalisation and personal accomplishment were predicted by depression, neuroticism, agreeableness and openness.ConclusionsOne third of the sample presented high levels of burnout, which was most strongly experienced as feelings of low personal accomplishment. Furthermore, personality factors play an important role in the development of burnout syndrome.Relevance to clinical practiceManagers and policy makers should promote strategies to reduce burnout. To prevent the syndrome, personality factors should be taken into account, for the early identification of a profile of professionals most at risk of developing burnout.
Thermocoagulation versus cryotherapy for the treatment of cervical precancers
Authors: Duan Lyufang , Du Hui , Belinson Jerome L. , Liu Zhihong , Xiao Aimin , Liu Shuangyan , Zhao Liwei , Wang Chun , Qu Xinfeng , Wu Ruifang 
Published: October 2020

AbstractAimTo compare thermocoagulation and cryotherapy for treatment of high‐grade cervical intraepithelial neoplasia (CIN).MethodsFrom May 2017 to May 2018, women with CIN2/3 were randomized to thermocoagulation or cryotherapy at Peking University Shenzhen Hospital. Follow‐up at 4 and 8 months included cytology and human papillomavirus (HPV) testing. Women who were HPV‐positive or had atypical squamous cells of undetermined significance or higher‐grade disease underwent colposcopy/biopsy.ResultsAmong 149 women enrolled, 74 were randomized to thermocoagulation, and 75 to cryotherapy (excluded four were immediately referred for thermocoagulation due to large lesions). At follow‐up, there was no difference between the thermocoagulation and cryotherapy groups in HPV‐negative (4/8 months: 72.5%/86.2% vs 68.6%/80.6%) and pathology‐negative (97.1%/98.5% vs 94.3%/92.3%) rates (all P > 0.05). The cytology‐negative rate was similar for thermocoagulation and cryotherapy at 4 months (79.7% vs 78.9%, P > 0.05), but higher for thermocoagulation at 8 months (100% vs 88.7%, P < 0.05). No lesions were observed among the four referral women at follow‐up. As compared with cryotherapy, thermocoagulation was associated with shorter duration of treatment and less vaginal discharge, but higher pain during application and longer bleeding after treatment.ConclusionThermocoagulation was as effective and safe as cryotherapy and might be easily applied to treat high‐grade cervical lesions.
Adaptation, ancestral variation and gene flow in a ‘Sky Island’ Drosophila species
Authors: Hill Tom , Unckless Robert L. 
Published: October 2020

AbstractOver time, populations of species can expand, contract, fragment and become isolated, creating subpopulations that must adapt to local conditions. Understanding how species maintain variation after divergence as well as adapt to these changes in the face of gene flow is of great interest, especially as the current climate crisis has caused range shifts and frequent migrations for many species. Here, we characterize how a mycophageous fly species, Drosophila innubila, came to inhabit and adapt to its current range which includes mountain forests in south‐western USA separated by large expanses of desert. Using population genomic data from more than 300 wild‐caught individuals, we examine four populations to determine their population history in these mountain forests, looking for signatures of local adaptation. In this first extensive study, establishing D. innubila as a key genomic "Sky Island" model, we find D. innubila spread northwards during the previous glaciation period (30–100 KYA) and have recently expanded even further (0.2–2 KYA). D. innubila shows little evidence of population structure, consistent with a recent establishment and genetic variation maintained since before geographic stratification. We also find some signatures of recent selective sweeps in chorion proteins and population differentiation in antifungal immune genes suggesting differences in the environments to which flies are adapting. However, we find little support for long‐term recurrent selection in these genes. In contrast, we find evidence of long‐term recurrent positive selection in immune pathways such as the Toll signalling system and the Toll‐regulated antimicrobial peptides.
Role of H1 and DNA methylation in selective regulation of transposable elements during heat stress
Authors: Liu Shujing , de Jonge Jennifer , Trejo‐Arellano Minerva S. , Santos‐González Juan , Köhler Claudia , Hennig Lars 
Published: October 2020

Summary

Heat‐stressed Arabidopsis plants release heterochromatin‐associated transposable element (TE) silencing, yet it is not accompanied by major reductions of epigenetic repressive modifications. In this study, we explored the functional role of histone H1 in repressing heterochromatic TEs in response to heat stress.

We generated and analyzed RNA and bisulfite‐sequencing data of wild‐type and h1 mutant seedlings before and after heat stress.

Loss of H1 caused activation of pericentromeric Gypsy elements upon heat treatment, despite these elements remaining highly methylated. By contrast, nonpericentromeric Copia elements became activated concomitantly with loss of DNA methylation. The same Copia elements became activated in heat‐treated chromomethylase 2 (cmt2) mutants, indicating that H1 represses Copia elements through maintaining DNA methylation under heat.

We discovered that H1 is required for TE repression in response to heat stress, but its functional role differs depending on TE location. Strikingly, H1‐deficient plants treated with the DNA methyltransferase inhibitor zebularine were highly tolerant to heat stress, suggesting that both H1 and DNA methylation redundantly suppress the plant response to heat stress.
Foetal exposure to heavy metals and risk of atopic diseases in early childhood
Authors: Pesce Giancarlo , Sesé Lucile , Calciano Lucia , Travert Benoit , Dessimond Boris , Maesano Cara Nichole , Ferrante Giuliana , Huel Guy , Prud’homme Julie , Guinot Martine , Soomro Munawar Hussain , Baloch Ramen Munir , Lhote Raphael , Annesi‐Maesano Isabella 
Published: October 2020

AbstractBackgroundAccumulating evidence suggests that in utero exposures can influence the development of the immune system and thus contribute to disease development. Studies investigating the association between prenatal exposures to heavy metals and atopic diseases, however, are scarce.MethodsChildren from the EDEN birth cohort were prospectively followed up using parental questionnaires with validated questions on asthma, allergic rhinitis, eczema, and food allergy symptoms. The questionnaires were administered every 4 months during the children's first year, and then every year until the age of 5, with a final survey at the age of 8. Serum concentrations of lead (Pb), cadmium (Cd), and manganese (Mn) were assessed in maternal blood samples collected during mid‐pregnancy and in cord blood of 651 mother‐children pairs. Hazard ratios (HR) for the incidence of each atopic disease in relation to the exposure to metals were calculated using Cox proportional hazard models.ResultsLevels of Cd in cord blood were associated with greater risk of asthma (hazard ratio [95% confidence interval] for upper vs lower quartile: 1.81 [1.00‐3.29]), eczema (1.60 [1.09‐2.35]), and food allergy (3.17 [1.36‐7.38]), while Mn levels in maternal serum were associated with eczema (1.55 [1.05‐2.28]). These associations were similar in males and females and were confirmed using log concentrations of metals as exposures.ConclusionsOur results support the hypothesis that fetal exposure to heavy metals may affect the development of asthma, eczema, and food allergy in childhood and suggest that timing of exposure in utero may have a role in these associations.
Undertaking responsibility and a new role as a relative: a qualitative focus group interview study
Authors: Larsen Malene Kaas , Birkelund Regner , Mortensen Michael Bau , Schultz Helen 
Published: October 2020

BackgroundBeing a relative of a patient with oesophageal cancer can evoke strong emotions and uncertainty about the future. As a consequence of the treatment course for oesophageal cancer and an increase in outpatient treatment, relatives are becoming increasingly responsible for patients’ physical and emotional care. There is a lack of research exploring relatives’ experiences with illness, treatment and decision‐making.Aims and objectivesTo explore relatives’ experiences with illness, treatment of the patient and decision‐making in the context of oesophageal cancer.DesignA qualitative explorative design was chosen.MethodsWe conducted two focus group interviews with 11 relatives. The analysis was based on Ricoeur’s theory of interpretation.ResultsThroughout illness and treatment, relatives faced the fear of loss, leading to distress and anxiety. Relatives were simultaneously taking responsibility and asserting a new role during treatment as they regarded treatment as a joint affair. Regarding decision‐making, relatives positioned themselves on the sidelines, awaiting the authority of the patients and healthcare professionals to give them space for participation.ConclusionRelatives of patients with oesophageal cancer undergoing treatment are suppressing their anxiety and doubt about the future. As they are undertaking responsibility during treatment, they are claiming control in new areas, which leads to changing roles within the family. However, they do not feel empowered in decision‐making because they recognise patients’ decision‐making authority. This study highlights the complexity of balancing patients’ authority with acknowledgement of relatives’ role as active collaborators.
Immigration status and end‐stage kidney disease: Role of policy and access to care
Authors: Rizzolo Katherine , Cervantes Lilia 
Published: October 2020

AbstractImmigration status is an important mitigating factor in determining the provision of dialysis and kidney‐related care. Immigrants make up the largest uninsured group in the country. For immigrants with end‐stage kidney disease (ESKD), dialysis access varies by insurance type and by state, leading to great variability in the availability of kidney care. In some states, undocumented immigrants may only qualify for hemodialysis when critically ill (emergency hemodialysis), which is associated with higher mortality, hospital length of stay, and cost, in addition to an emotional burden on patients, their caregivers, and healthcare professionals. Barriers to effective care for immigrants with ESKD include immigration status, insurance access, and availability of pre‐end stage kidney disease care, vascular access, and transplant. Effective strategies for improving dialysis care for immigrants include advocacy at the state and federal level, broadening definitions under Emergency Medicaid, and improving benefits for home therapies and transplantation options.
Contourite characterization and its discrimination from other deep‐water deposits in the Gulf of Cadiz contourite depositional system
Authors: de Castro Sandra , Hernández‐Molina Francisco Javier , de Weger Wouter , Jiménez‐Espejo Francisco José , Rodríguez‐Tovar Francisco Javier , Mena Anxo , Llave Estefanía , Sierro Francisco Javier 
Published: October 2020

AbstractDespite numerous efforts to properly differentiate between contourites and other deep‐water deposits in cores and outcrops, reliable diagnostic criteria are still lacking. The co‐occurrence of downslope and along‐slope sedimentary processes makes it particularly difficult to differentiate these relatively homogeneous deposits. The main aim of this paper is to identify differences in deep‐water sediments based on Principal Component Analysis of grain size and geochemistry, sedimentary facies, and reinforced by microfacies and ichnofacies. The sediments studied were obtained from two International Ocean Drilling Program Expedition 339 sites in mounded and sheeted drifts in the Gulf of Cadiz. The statistical approach led to the discernment of hemipelagites, silty contourites, sandy contourites, bottom current reworked sands, fine‐grained turbidites and debrites over a range of depositional and physiographic elements. These elements are linked to contourite drifts, the drift‐channel transition, the contourite channel and distal upper slope. When bottom currents or gravity‐driven flows are not the dominant depositional process, marine productivity and continental input settling forms the main depositional mechanism in deep‐water environments. This is reflected by a high variability of the first principal component in hemipelagic deposits. The stacked principal component variability of these deposits evidences that the contourite drift and the adjacent contourite channel were influenced by the interrelation of hemipelagic, gravitational and bottom current induced depositional processes. This interrelation questions the paradigm that a drift is made up solely of muddy sediments. The interrelation of sedimentary processes is a consequence of the precession‐driven changes in the intensity of the Mediterranean Outflow Water related to Mediterranean climate variability, which are punctuated by millennial‐scale variability. Associated vertical and lateral shifts of the Mediterranean Outflow Water, and therefore of its interface with the East North Atlantic Central Water, controlled sediment input and favoured turbulent sediment transport in the middle slope. During the interglacial precession maxima/insolation minima, a more vigorous upper core of the Mediterranean Outflow Water and the enhanced impact of the East North Atlantic Central Water – Mediterranean Outflow Water interface allowed for the development of the sandier contourite deposits.
The utility of a monocyte monolayer assay in the assessment of intravenous immunoglobulin–associated hemolysis
Authors: Tong Tik Nga , Blacquiere Megan , Sakac Darinka , Burke‐Murphy Emeralda , Yi Qilong , Callum Jeannie , Cserti‐Gazdewich Christine , Parmar Nagina , Shehata Nadine , Pavenski Katerina , Lau Wendy , Lin Yulia , Lieberman Lani , Branch Donald R. , Pendergrast Jacob 
Published: October 2020

AbstractBackgroundHemolysis following the administration of intravenous immunoglobulin (IVIG) is an important adverse event (AE). While the monocyte monolayer assay (MMA) has been used to predict in vivo hemolysis when serologically incompatible blood may be transfused, it has also been shown to correlate with IVIG‐associated hemolysis. In this study, the MMA was examined for its utility in assessing the risk of hemolysis after IVIG.Study Design and MethodsForty‐two non–blood group O patients receiving high‐dose IVIG (≥2 g/kg) were examined using an autologous and allogeneic MMA. Hemolysis was defined by a drop in hemoglobin of ≥1 g/L, a positive direct antiglobulin test (DAT) and eluate, and a decrease in haptoglobin or increase in lactate dehydrogenase and/or reticulocytes.ResultsForty‐two patients provided 50 assessable postinfusion samples, with hemolysis observed in 20 (40%) of cases. Autologous MMA using post‐IVIG red blood cells significantly correlated with clinical outcomes when compared to allogeneic MMA (P = .0320 vs .5806, t test). No significant difference in receiver operating characteristics was observed when comparing autologous MMA testing against DAT for the diagnosis of IVIG‐associated hemolysis. However, when using samples collected 5 to 10 days after receipt of high‐dose IVIG, the autologous MMA had higher sensitivity than the DAT.ConclusionMMA testing with autologous monocytes collected 5 to 10 days after receipt of high‐dose IVIG can be used for the diagnosis of IVIG‐associated hemolysis and may be of particular value in cases in which the Day 5 to 10 DAT is negative.
Effect of Ground Boundary Condition on Near-Field Wingtip Vortex Flow and Lift-Induced Drag
Authors: Lu A. , Lee T. 
Published: October 2020

Abstract
The ground proximity is known to induce an outboard movement and suppression of the wingtip vortices, leading to a reduced lift-induced drag. Depending on the ground boundary condition, a large scatter exists in the published lift-induced drag and vortex trajectory. In this experiment, the ground boundary condition-produced disparity in the vortex strength and induced drag were evaluated. No significant discrepancy appeared for a ground distance or clearance larger than 30% chord. As the stationary ground was further approached, there was the appearance of a corotating ground vortex (GV), originated from the downstream progression of a spanwise ground vortex filament, which added vorticity to the tip vortex, leading to a stronger tip vortex and a larger lift-induced drag compared to the moving ground. For the moving ground, the ground vortex was absent. In close ground proximity, the rollup of the high-pressure fluid flow escaped from the wing's tip always caused the formation of a counter-rotating secondary vortex, which dramatically weakened the tip vortex strength and produced a large induced-drag reduction. The moving ground effect, however, induced a stronger secondary vortex, leading to a smaller lift-induced drag and a larger outboard movement of the tip vortex as compared to the stationary ground effect.
Motives for and Experiences of Expatriation to Coach
Authors: Felber Charbonneau Evelyne , Camiré Martin , Lemyre Pierre-Nicolas 
Published: October 2020

Coaching is a global profession and coaches play a central role in enhancing the performance of millions of athletes worldwide. In the 21st century, the global mobility of coaches has increased, with many coaches taking advantage of opportunities to coach abroad. Norway leads the all-time Winter Olympics medals table (i.e., 368 medals), and with most of these medals coming from skiing disciplines, Norway represents a skiing hotbed that attracts ski coaches from other parts of the world. The purpose of the study was to examine ski coaches’ motives for and experiences of expatriation to coach in Norway. Five North American alpine ski coaches (four males and one female) were individually interviewed (M = 77 min, SD = 24.94), with the data examined using interpretative phenomenological analysis. Motives for expatriation included having a passion for skiing, challenging oneself, experiencing a new sport culture, and maintaining relationships. Upon arriving in Norway, coaches mentioned experiencing challenges with the Norwegian sport system, language, pressure from parents and the media, and being far from friends and family. Once acclimated, coaches discussed the benefits of expatriation that included the Norwegian work ethic, family-centric lifestyle, and popularity of skiing.
Intercostal chest drain fixation strength: comparison of techniques and sutures
Authors: Ringel Yaniv , Haberfeld O , Kremer R , Kroll E , Steinberg R , Lehavi A 
Published: October 2020

ObjectiveThe accidental removal of an intercostal chest drain (ICD) is common and may result in serious complications. A number of fixation techniques and suture material are in use, and the selection is often based on personal preferences and equipment availability. This study is designed to determine which of the common techniques provides the strongest ICD fixation.MethodsThis study compared the mechanical strength of eight different ICD fixation techniques (purse string, ‘Roman sandal’, ‘Jo’burg’ (JO) technique, a suture through the tube, one and two passes through a locking plastic tie, tape fixation and a commercial disposable drainage tube holder) and two silk suture sizes using porcine cadavers and a digital push–pull dynamometer to simulate accidental removal of an ICD. A total of 14 different experimental set-ups produced 280 measurements.ResultsSignificant differences in ICD fixation strength were observed. A modified JO technique using a size 1 silk suture was nearly three times stronger than a purse-string fixation using a size 0 silk and 10 times stronger from a commercial, adhesive-based device (180, 70 and 22, respectively).ConclusionIn situations where the mechanical strength of ICD fixation is important, using a size 1 silk and a modified JO technique may provide the strongest fixation.