bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer: A phenomenological hermeneutical study
Authors: Karlsson Jonas , Eriksson Thomas , Lindahl Berit , Fridh Isabell 
Published: July 2020

AbstractAims and objectivesTo reveal meanings of family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer.BackgroundInterhospital intensive care unit‐to‐unit transfers take place between different hospitals and their respective intensive care units (ICUs). These types of transfers are an increasing phenomenon but are sparsely studied from the family members' perspective. Indeed, the patient's critical illness and care can have a major impact on family members. During the transfer process, there is a demand for the involved intensive care health personnel to make family members feel safe and cared for.DesignA qualitative design based on phenomenological hermeneutics.MethodsThe study was conducted at two Swedish general ICUs. Data were generated through individual in‐depth interviews with seven family members and analysed using a phenomenological hermeneutical approach. The Criteria for Reporting Qualitative Research principles were applied in the conduct and reporting of this study.ResultsFour themes that reveal meanings of family members' lived experiences were developed: losing your safe haven, dealing with uncertainty, carrying your own and others' burdens and a wish to be close.ConclusionsThe study reveals that an interhospital intensive care unit‐to‐unit transfer affects the whole family and is characterised by family members experiencing many negative feelings. The findings also illustrate that being a family member when a loved one is transferred means being exposed to the core existential elements of being human, such as loneliness and searching for meaning.Relevance to clinical practiceThe study highlights the importance of maintaining a family‐centred approach during the transfer process. Our findings can provide deeper knowledge for intensive care health personnel, better preparing them for the delicate task of providing family‐centred care during the interhospital intensive care unit‐to‐unit transfer process.
Influences of the culture of science on nursing knowledge development: Using conceptual frameworks as nursing philosophy in critical care nursing
Authors: Burns Margie , Bally Jill , Burles Meridith , Holtslander Lorraine , Peacock Shelley 
Published: July 2020

AbstractNursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand the patients and families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person‐centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions.
Parenting problems postpartum can be detected early in pregnancy in patients with rheumatoid arthritis
Authors: Smeele Hieronymus T W , de Man Yael A , Röder Esther , Wintjes Hetty , Hazes J M W , Dolhain Radboud J E M 
Published: July 2020

ObjectiveTo describe parenting disability postpartum in patients with rheumatoid arthritis (RA) using the Parenting Disability Index and to determine early in pregnancy which patients will face parenting problems postpartum.MethodsData were collected from a prospective study on pregnancy and RA (Pregnancy induced Amelioration of Rheumatoid Arthritis study). Postpartum visits were performed at 6, 12 and 26 weeks after delivery. Domains causing parenting difficulties were identified. A multivariate logistic regression model to identify which patients develop parenting disabilities postpartum with patient characteristics in the first trimester as covariates was performed.Results148 patients were eligible for this study. The domains carrying, hygiene, feeding, getting up and down, and household/shopping were frequently scored as difficult. Maintaining discipline, taking care of the children when sick, listening and having other children over caused the least problems. 30.1% of patients with RA report low parenting disability, 30.9% reports intermediate disability and 39.0% reports high disability. Patients with a low Health Assessment Questionnaire (HAQ)-score in the first trimester (OR 9.2, 95% CI 3.0 to 27.7, p<0.001) and low disease activity in the first trimester (Disease Activity Score 28-joint count C reactive protein<3.2) (OR 4.8, 95% CI 1.8 to 12.9, p=0.002) were likely to report low parenting disability postpartum. Patients with a longer disease duration (OR 0.87, 95% CI 0.79 to 0.95, p=0.003) were less likely to report low parenting disability postpartum. A high HAQ-score in the first trimester (OR 4.54, 95% CI 1.99 to 10.34, p<0.001) and erosive disease (OR 2.32, 95% CI 1.00 to 5.35, p=0.049) increased the risk of high parenting disability postpartum.ConclusionPhysical domains of parenting postpartum are most commonly affected in patients with RA. When counselling patients with RA, a HAQ-score in the first trimester is the most reliable marker to identify patients that develop parenting disability after delivery.
Injury Length and Arteriole Constriction Shape Clot Growth and Blood-Flow Acceleration in a Mouse Model of Thrombosis
Authors: Mitrophanov Alexander Y. , Merrill-Skoloff Glenn , Grover Steven P. , Govindarajan Vijay , Kolanjiyil Arun , Hariprasad Daniel S. , Unnikrishnan Ginu , Flaumenhaft Robert , Reifman Jaques 
Published: July 2020

Objective:
Quantitative relationships between the extent of injury and thrombus formation in vivo are not well understood. Moreover, it has not been investigated how increased injury severity translates to blood-flow modulation. Here, we investigated interconnections between injury length, clot growth, and blood flow in a mouse model of laser-induced thrombosis.

Approach and Results:
Using intravital microscopy, we analyzed 59 clotting events collected from the cremaster arteriole of 14 adult mice. We regarded injury length as a measure of injury severity. The injury caused transient constriction upstream and downstream of the injury site resulting in a 50% reduction in arteriole diameter. The amount of platelet accumulation and fibrin formation did not depend on arteriole diameter or deformation but displayed an exponentially increasing dependence on injury length. The height of the platelet clot depended linearly on injury length and the arteriole diameter. Upstream arteriolar constriction correlated with delayed upstream velocity increase, which, in turn, determined downstream velocity. Before clot formation, flow velocity positively correlated with the arteriole diameter. After the onset of thrombus growth, flow velocity at the injury site negatively correlated with the arteriole diameter and with the size of the above-clot lumen.

Conclusions:
Injury severity increased platelet accumulation and fibrin formation in a persistently steep fashion and, together with arteriole diameter, defined clot height. Arterial constriction and clot formation were characterized by a dynamic change in the blood flow, associated with increased flow velocity.
Composite endpoints in COPD: clinically important deterioration in the UPLIFT trial
Authors: Rabe Klaus F. , Halpin David M. G. , Han MeiLan K. , Miravitlles Marc , Singh Dave , Grönke Lars , Voß Florian , Martinez Fernando J. 
Published: July 2020

Abstract
Background
Assessments of lung function, exacerbations and health status are common measures of chronic obstructive pulmonary disease (COPD) progression and treatment response in clinical trials. We hypothesised that a composite endpoint could more holistically assess clinically important deterioration (CID) in a COPD clinical trial setting.

Methods
A composite endpoint was tested in a post hoc analysis of 5652 patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2–4 COPD from the 4-year UPLIFT study. Patients received tiotropium 18 μg or placebo.

Results
The composite endpoint included time to first confirmed decrease in trough forced expiratory volume in 1 s (FEV1) ≥100 mL, confirmed increase in St. George’s Respiratory Questionnaire (SGRQ) total score ≥ 4 units, or moderate/severe exacerbation. Most patients (> 80%) experienced CID, with similar incidence among GOLD subgroups. Most confirmed trough FEV1 (74.6–81.6%) and SGRQ (72.3–78.1%) deteriorations were sustained across the study and in all GOLD subgroups. Patients with CID more frequently experienced subsequent exacerbation (hazard ratio [HR] 1.79; 95% confidence interval [CI] 1.67, 1.92) or death (HR 1.21; 95% CI 1.06, 1.39) by Month 6. CID was responsive to bronchodilator treatment.

Conclusions
Composite endpoints provide additional information on COPD progression and treatment effects in clinical trials.

Trial registration
ClinicalTrials.gov NCT00144339.

Graphical abstract
Chemical composition and antioxidant capacity of black pepper pericarp
Authors: Lee Joon-Goo , Chae Young , Shin Youngjae , Kim Young-Jun 
Published: July 2020

AbstractPiper nigrum L. is a widely used spice because of its flavour and health effects. It is prepared as black and white pepper, according to the harvest time and inclusion of the outer skin. Pepper pericarp is usually considered waste when making white pepper. In this study, bioactive and flavour compounds and minerals in the pericarp of black pepper were determined to identify its applications. The pericarp contained total phenol, total flavonoid and piperine contents of 1421.95 ± 22.35 mg GAE/100 g, 983.82 ± 8.19 mg CE/100 g and 2352.19 ± 68.88 mg/100 g, respectively. There were higher levels of total phenols and total flavonoids in the pericarp compared with black pepper and white pepper. Piperine content was lower in the pericarp than in black pepper. The principal monoterpene compounds in the pericarp were α-pinene (9.2%), 2-β-pinene (14.3%), δ-3-carene (21.5%) and dl-limonene (18.8%), and the primary sesquiterpenes were α-copaene (5.1%) and caryophyllene (17.2%). The higher percentages of flavour compounds found in the pericarp would impart a more potent odour, and the pericarp exhibited higher minor and tiny differences based on electronic nose analysis. It had more minerals than black pepper and peeled black pepper.
The turbulent dynamics of Jupiter’s and Saturn’s weather layers: order out of chaos?
Authors: Read Peter L. , Young Roland M. B. , Kennedy Daniel 
Published: July 2020

AbstractThe weather layers of the gas giant planets, Jupiter and Saturn, comprise the shallow atmospheric layers that are influenced energetically by a combination of incoming solar radiation and localised latent heating of condensates, as well as by upwelling heat from their planetary interiors. They are also the most accessible regions of those planets to direct observations. Recent analyses in Oxford of cloud-tracked winds on Jupiter have demonstrated that kinetic energy is injected into the weather layer at scales comparable to the Rossby radius of deformation and cascades both upscale, mostly into the extra-tropical zonal jets, and downscale to the smallest resolvable scales in Cassini images. The large-scale flow on both Jupiter and Saturn appears to equilibrate towards a state which is close to marginal instability according to Arnol’d’s 2nd stability theorem. This scenario is largely reproduced in a hierarchy of numerical models of giant planet weather layers, including relatively realistic models which seek to predict thermal and dynamical structures using a full set of parameterisations of radiative transfer, interior heat sources and even moist convection. Such models include (amongst others) the Jason GCM, developed in Oxford, which also represents the formation of (energetically passive) clouds of NH3, NH4SH and H2O condensates and the transport of condensable tracers. Recent results show some promise in comparison with observations from the Cassini and Juno missions, but some observed features (such as Jupiter’s Great Red Spot and other compact ovals) are not yet captured spontaneously by most weather layer models. We review recent work in this vein and discuss a number of open questions for future study.
Giving patients a voice: a participatory evaluation of patient engagement in Newfoundland and Labrador Health Research
Authors: Vat Lidewij Eva , Warren Mike , Goold Susan , Davidge Everard , Porter Nicole , Schuitmaker-Warnaar Tjerk Jan , Broerse Jacqueline E. W. , Etchegary Holly 
Published: July 2020

Abstract
Background
Efforts to engage patients as partners in health research have grown and thereby the need for feedback and evaluation. In this pilot evaluation study, we aimed to 1) evaluate patient engagement in health research projects in Newfoundland and Labrador, Canada, and 2) learn more about how to best monitor and evaluate patient engagement. This paper presents the results of our participatory evaluation study and the lessons learned. The evaluation of the projects was driven by questions patients wanted answered.

Methods
We conducted a formative evaluation of patient engagement in health research projects. Projects spanned a variety of topics, target groups, research designs and methods of patient engagement. Participants included principal investigators (n = 6) and their patient partners (n = 14). Furthermore, graduate students (n = 13) working on their own research projects participated. Participants completed an online survey with closed and open-ended questions about their patient engagement efforts, experiences and preliminary outcomes. Patients were involved as co-investigators in the entire evaluation study. We used qualitative methods to evaluate our participatory process.

Results
The evaluation study results show that most patients and researchers felt prepared and worked together in various phases of the research process. Both groups felt that the insights and comments of patients influenced research decisions. They believed that patient engagement improved the quality and uptake of research. Students felt less prepared and were less satisfied with their patient engagement experience compared to researchers and their patient partners. Involvement of patient co-investigators in this evaluation resulted in learnings, transparency, validation of findings and increased applicability. Challenges were to select evaluation questions relevant to all stakeholders and to adapt evaluation tools to local needs.

Conclusions
Our findings show that researchers, patient partners and students value patient engagement in health research. Capacity building at the supervisor level in academic institutions is needed to better support students. Sufficient time is also needed to permit observable outcomes. Participatory evaluation may increase the relevance and usefulness of information, but it also raises issues such as who defines and designs the content of evaluation tools. A co-creation process is required to develop appropriate monitoring and evaluation strategies.
Transfusion characteristics and hemostatic conditions in octogenarians undergoing emergency surgery for acute aortic dissection: a retrospective study
Authors: Masubuchi Tetsuhito , Yoshitani Kenji , Minami Kimito , Yokoyama Chisaki , Tsukinaga Akito , Goto Takahisa , Ohnishi Yoshihiko 
Published: July 2020

Abstract
Background
The number of elderly patients undergoing elective as well as emergent cardiac surgery is increasing. Octogenarian and older patients undergoing surgery for acute type A aortic dissection (AAD) have a significantly higher risk of postoperative mortality than younger patients. Hemostasis is difficult in octogenarians with AAD. However, few studies have investigated perioperative blood transfusion volumes and hemostatic conditions in patients undergoing AAD surgery. We retrospectively investigated whether these factors differed between octogenarians and younger patients with AAD.

Methods
The records of 207 patients who underwent emergency surgery for AAD were reviewed between 2008 and 2014. We compared the total volumes of transfused blood components (red blood cell concentrate, fresh frozen plasma, platelets concentrate, and cryoprecipitate), perioperative blood coagulation test results (prothrombin time-international normalized ratio, activated partial thrombin time, and activated coagulation time), and intensive care unit and hospital stay durations between octogenarians (n = 33) and patients < 80 years old (n = 170).

Results
A significantly greater volume of red blood cell concentrates was transfused in octogenarians than in patients < 80 years old. Isolated prolonged activated partial thromboplastin time was observed in octogenarian patients. Duration of hospital stays was significantly longer in octogenarians than in patients < 80 years old.

Conclusions
Octogenarians required more red blood cells during surgery for AAD and exhibited isolated APTT prolongation.
Wzory granic Europy Środkowej z perspektywy wielokulturowego Wiednia
Authors: Dębicki Marcin , Zenderowski Radosław 
Published: July 2020

Patterns of Central Europe’s Borders from the Perspective of Multicultural Vienna. Reminiscences, Rehearsals, Extravagances, and Their Wider Context
The article analyzes the concept of the territorial distribution of Central Europe and the inhabitants of Vienna as a par excellence Central European city. It lays out the findings from material gathered through 173 questionnaires in the form of a map of Europe, upon which the respondents indicated the territorial scope of Central Europe. Surveys were carried out both among Austrians and migrants living in Vienna. The authors point at two distinct trends: (a) the inclusion of individual states and regions into Central Europe, (b) exclusion of individual countries and regions from Central Europe. As a result, there is a picture of Central Europe conceived in positive terms (as a cultural and civilizational entity) as well as a negative one (in opposition to the East and the Balkans). However, the study is a pilot and requires further scientific research using alternative methods and techniques.
ANÁLISE DAS REDAÇÕES DO ENEM À LUZ DA TEORIA DA ICONICIDADE VERBAL
Authors: Settecerze Helena Lima , Malfacini Ana Cristina Dos Santos , Moraes Geórgia Barbosa Bernardino de 
Published: July 2020

Resumo: O presente artigo tem como objetivo analisar 5 redações que obtiveram nota máxima no Exame Nacional do Ensino Médio (Enem) de 2018, sob um estudo da Semiótica do filósofo Charles Sanders Peirce, foco de estudo do livro utilizado como suporte para esta pesquisa, Iconicidade Verbal: Teoria e Prática, de Darcilia Simões. As redações fazem parte de uma cartilha chamada Redação a mil, compilada por um dos estudantes com o intuito de auxiliar outros candidatos em edições futuras do Enem. A cartilha contém 30 textos dissertativos-argumentativos com o tema “Manipulação do comportamento do usuário pelo controle de dados na internet”.Palavras-chave: Semiótica. Teoria da Iconicidade Verbal. Enem. Abstract:The current article aims to analyze 5 essays that obtained a maximum score in the National High School Exam (Enem) of 2018, under a study of the Semiotics of the philosopher Charles Sanders Peirce, who was the focus of the book used as support for this research, Verbal Iconicity: Theory and Practice, by Darcilia Simões. The essays are part of a guideline called Redação a mil, compiled by one of the students to assist other candidates in future editions of Enem. The guideline contains 30 dissertations as examples of argumentative texts with the theme “Manipulation of user's behaviour through data control on the internet”.Keywords: Semiotics. Verbal Iconicity Theory. Enem.
A interseccionalidade
Authors: Moraes Eunice Léa 
Published: July 2020

O objetivo deste ensaio é destacar, nas bases epistemológicas do pensamento feminista negro, a resistência das mulheres negras às opressões vivenciadas, com base na seguinte problematização: como a formação da consciência crítica de classe, a identidade de gênero e o pertencimento étnico-racial têm constituído a resistência das mulheres negras contra a opressão interseccional de gênero, raça e classe no contexto da luta de classes? A metodologia utilizada foi a revisão bibliográfica. O ensaio apresenta a interseccionalidade, a resistência e a libertação, que compõem o feminismo negro e contribuem para que se compreenda a condição de opressão vivenciada pelas mulheres negras, sua luta contra essa opressão e sua consequente libertação desta. O ensaio contém: introdução; ideias básicas do materialismo histórico-crítico no contexto da resistência à opressão; feminismos, opressões e resistências; interseccionalidade da opressão de gêneros, raças e classe, e considerações finais.
PALAVRAS-CHAVE: Resistência. Opressão. Interseccionalidade. Libertação. Feminismo Negro.
Learning Physics of Motion and Force Using the Outdoor Activities: An Effort to Increase Students’ Interest and Achievement at Secondary School
Authors: Djajadi M. , Rauf A. 
Published: July 2020

This study aimed to determine the increase in students’ interest and achievement of science in the 8th graders of SMP Negeri 1 Watampone, Bone Regency Indonesia, when using outdoor activities. This study applied Classroom Action Research (CAR), which consists of two learning cycles following the procedural phase such as planning, implementation, observation phase, and reflection. The sample was taken using a purposive sampling technique class. The data collected included data about the students’ science achievement before the implementation of the action, data about the students’ interest in learning science, data about the students’ science achievement in the cycle I and cycle II, and data on the observations/notes of the teacher in each research cycle. Data were obtained through a questionnaire asking about students’ interest in learning science, students’ achievement result test before the implementation of the action, students’ achievement test in cycle I and cycle II, and student learning observation sheet. Data then analyzed using quantitative and qualitative descriptive analysis techniques. The results showed that there was an increase in students’ achievement, both in cycle I and in cycle II. Students’ mastery level in science materials was in the high category and their readiness, sincerity, and activeness in participating in the learning process were increased. Recommendation and direction for further research are included in the study.