bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of empathy training on the empathy skills of nurses working in intensive care units
Authors: Mirzaei Maghsud Azam , Abazari Farrokh , Miri Sakineh , Sadat Nematollahi Monir 
Published: October 2020

Background Empathy is an essential condition for effective nursing care. An empathetic relationship between the nurse and the patient leads to positive therapeutic outcomes, increases nurses' adjustment in educational and therapeutic environments and influences their ethical sensitivities. Aims The current study aimed to determine the effectiveness of empathy training on the empathy skills of nurses working in intensive care units of Shahid Bahonar Hospital in Kerman, Iran. Methods This experimental study was conducted on nurses working in intensive care units of Shahid Bahonar Hospital affiliated to Kerman University of Medical Sciences in Iran. All nurses working in intensive care units of Shahid Bahonar Hospital were selected by randomised sampling. Data were collected by the Davis Empathy Scale (possible range 0–105) and analysed using descriptive statistics and analysis of variance. Results Comparison of the mean empathy scores showed the mean scores of empathy skills in the control group were 63.45 ± 8.102 and 63.54 ± 8.05 in the pre- and post-test, respectively, which was not significantly different. But the mean scores of empathy skills in the Experimental group were 63.40 ± 8.136 and 67.7 ± 9.027 in the pre- and post-test, respectively, which showed a significant increase ( p < 0.05). Conclusions The present intervention showed the effectiveness of empathy training on the empathy skills of nurses. Empathy can be acquired and learned.
Public health counselling following an HIV diagnosis among men who have sex with men: tensions between individual needs and health protection mandates
Authors: Orser Lauren , O'Byrne Patrick 
Published: October 2020

Background In Ontario, provincial regulations stipulate that public health units must complete post-test counselling with all persons newly diagnosed with human immunodeficiency virus. Public health nurses conduct this follow-up and are responsible for ensuring appropriate surveillance and management of human immunodeficiency virus with the primary objective of reducing ongoing human immunodeficiency virus transmission in their health jurisdiction. To date, little research has explored the effectiveness of this mandatory public health counselling from the perspective of patients – the majority of whom are men who have sex with men. Aims To address gaps in public health nursing practice, a pilot study was conducted with men who have sex with men in Ottawa to explore their attitudes and experiences of receiving mandatory human immunodeficiency virus follow-up after their diagnosis. Methods Qualitative interviews were conducted and interpreted using thematic analysis. Results This analysis revealed a contrariety between the needs of individuals and of public health units, with patients' perceiving their personal wishes to be secondary to public health mandates – and led patients to simultaneously want to evade, and be assisted by, public health nurses. Conclusions Public health units and nurses should consider adopting a more patient-centered approach to HIV case management, which incorporates patients’ experiences of receiving an HIV diagnosis.
Healthcare-seeking behaviours in college students and young adults: a review
Authors: Tran Dieu-My T , Silvestri-Elmore Angela 
Published: October 2020

Background/aims To review the literature on college students’ healthcare-seeking behaviours to uncover the current evidence and promote better healthcare-seeking behaviours and essentially better health outcomes in young adults. Methods The researchers conducted an extensive literature review using CINAHL, Cochrane, PubMed, EBSCOhost and Google Scholar in the years 2018 and 2019. The search was limited to the past 18 years (2000–2018) and to studies reported in the English language focused on the general healthcare-seeking behaviour of college students. The search was also extended to young adults (aged 18–39 years). Results A total of 56 articles were identified for abstract review and only 28 articles met the inclusion criteria for the final review. The following themes emerged to organise our findings: healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviours and barriers to accessing care among college students. Conclusions This review summarises the current body of knowledge related to healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviour and barriers to accessing care among this population. Important measures further to address the health needs and interventions for addressing these needs among the college student population are discussed.
Natural history of nonbacterial thrombotic endocarditis treated with warfarin
Authors: Slivka Andrew P , Agriesti Julie E , Orsinelli David A 
Published: October 2020

We report on the natural history of a cohort of patients presenting with transient ischemic attack or stroke and nonbacterial thrombotic endocarditis treated with warfarin. Patients with valvular vegetations on echocardiography, stroke, or transient ischemic attack presenting to a single neurologist were included. All patients were treated with warfarin until the vegetation resolved or for two years, then were switched to aspirin and had at least one clinical and echocardiographic follow-up. Twenty-nine patients were included and followed for a median of 27 months. Average age was 42 years and 72% were female. Two patients had vegetations on two valves. Five patients (17%) had recurrent strokes, three had systemic lupus erythematosus and antiphospholipid antibodies, one had antiphospholipid antibodies alone and one had neither condition. Three of the five patients did not have resolution of the vegetation at the time of the event. The valvular vegetations resolved in 23 of the 31 affected valves (74%) after a median of 11 months (range 4.5–157.5). Eleven patients had at least one follow-up echocardiogram after resolution of the vegetation and none had recurrent vegetations after warfarin was stopped. This study should serve to provide general recommendations regarding treatment of patients with TIA/stroke with nonbacterial thrombotic endocarditis. Valvular vegetations resolve in most patients and the risk of recurrent stroke is low. Warfarin can safely be switched to aspirin in most patients when the vegetation resolves or after two years if it does not resolve. Prolonged warfarin may be warranted in patients with systemic lupus erythematosus, positive antiphospholipid antibodies, and a persistent vegetation.
Ureteroscopy in the day case setting: it’s worth it! Retrospective single surgeon outcomes analysis during service relocation (inpatient to daycase) in a DGH
Authors: Kremel Darja , Siatos Dimitrios , Al Jaafari Feras 
Published: October 2020

Objective: Due to advances in surgical techniques and anaesthesia, day surgery is now becoming the standard care pathway for many complex procedures traditionally treated through inpatient pathways. Our aim was to study outcomes for patients undergoing rigid and flexible ureteroscopy before and after moving this service from a district general hospital to a day surgery unit. Methods: This was a retrospective observational study of 136 consecutive patients undergoing elective ureteroscopy for stone treatment. Half of the patients ( n=68, inpatient group) underwent treatment according to the standard inpatient pathway, while the other half underwent treatment following relocation of this service to a day case unit ( n=68, day case group). Outcomes were length of stay, readmission rate and complications. Results: In the inpatient group, 12 patients (17.6%) were discharged home the day of surgery (day 0), 42 patients (61.8%) stayed in hospital for one night. In the day case group, 58 patients (85.3%) were discharged on day 0, nine patients (13.2%) stayed for one night. Length of stay in the day case group was significantly shorter ( P<0.001). Rates of postoperative complications and readmissions were not significantly different. Conclusion: Day case ureteroscopy for stone treatment is feasible and safe. It is associated with a significantly reduced length of stay without an increase in postoperative complications or readmission.
A comparative study of tolerability and effects on immunoglobulin levels and CD19 cell counts with ocrelizumab vs low dose of rituximab in multiple sclerosis
Authors: Evertsson Björn , Hoyt Tammy , Christensen Angel , Nimer Faiez AL , Foley John , Piehl Fredrik 
Published: October 2020

Background Rituximab (RTX) and ocrelizumab (OCR) are two anti-CD20 biologics used in MS; however, comparisons on safety and efficacy are rare. Objective To compare treatment outcomes over the first year with RTX and OCR. Methods Retrospective cohort study comprising MS patients initiating RTX at the Karolinska University Hospital (Sweden; n = 311) and OCR at Rocky Mountain MS Clinic (Utah, USA; n = 161), respectively. Results Levels of immunoglobulin G measured in blood dropped 0.16 g/L (95% confidence interval 0.01 to 0.31) with each OCR infusion, but remained stable with RTX. In contrast, levels of immunoglobulin M decreased to a similar extent with both drugs. Ten and 15% of patients discontinued treatment with RTX and OCR, respectively (n.s), however, adverse events leading to treatment discontinuation were more common with OCR (6.8% vs 2.6%; p = 0.026). Only 3.1 and 1.6% discontinued OCR and RTX, respectively, due to lack of effect (n.s). The degree of B cell depletion was superior with OCR. Conclusion Overall, differences between the two treatments were small. Although the study design precludes robust conclusions regarding the risk-benefit with the studied therapies, our findings indicate that the tolerability and safety with RTX is not inferior to OCR.
The Effectiveness of Flipped Classroom in Health Professions Education in China: A Systematic Review
Authors: Li Sisi , Liao Xunchen , Burdick William , Tong Kuang 
Published: October 2020

Background: Flipped classroom has received much attention during the last few years in China, but inconsistent conclusions are made about the effectiveness this approach in health professions education. This review examined the findings of controlled studies published in Chinese in order to summarize the effects of the flipped classroom methodology. These studies focused specifically on undergraduate level of health professions students. Methods: A literature search was conducted using China National Knowledge Infrastructure (CNKI) and Wanfang Data Knowledge Service Platform in June 2019. No date restrictions were used. Peer-reviewed papers were reviewed and experimental studies were included if the study compared student outcomes using flipped classroom method versus traditional lectures. The revised version of the Kirkpatrick’s model was applied to evaluate the effectiveness of the flipped classroom approach. Results: In total, 934 articles were obtained. Among them, 235 articles were full text reviewed and 59 met the inclusion criteria. Most of the student agreed that flipped classroom strategy was very helpful improving their self-learning ability, problem solving ability, teamwork, and communication skills, but reported increased workload and less-efficiency compared with traditional lectures. However, the majority of studies (n = 52) showed positive findings of the flipped classroom on changes in knowledge and skills, and 3 in negative. Among these 59 studies, there was little evidence of changes in behavior, organizational practice and patient outcome. Conclusions: Better design with reduced content should be considered for instructors to promote learning effectiveness. Long-term effects of flipped classroom should be considered in future studies.
Das Bild vom Arbeitnehmer im Wandel der Arbeitgeber-Arbeitnehmer-Beziehungen
Authors: Staehle Wolfgang H. 
Published: October 2020

Im Laufe der historischen Entwicklung der Arbeitsbeziehungen hat sich sowohl auf Arbeitgeberund Management-Seite wie auch auf Arbeitnehmer- und Betriebsrats-Seite die Sichtweise vom Arbeitnehmer gewandelt. Es lassen sich vier historische Phasen mit jeweils zwei zueinander komplementrären Sichtweisen vom Arbeitnehmer kennzeichnen. Die anfängliche Sicht als Kostenfaktor bzw. Lohnmaximierer ist mittlerweile auf beiden Seiten der Anerkenntnis des Arbeitnehmers als Individuum gewichen. Im folgenden werden die historischen Phasen und die jeweiligen Handlungsstrategien beschrieben.
Beschäftigungsdauer und Beschäftigungsstrukturen innerhalb betrieblicher Organisationskonfigurationen
Authors: Schwan Rolf , Soeters Joseph 
Published: October 2020

Zu den Kennzeichen interner Arbeitsmärkte gehört eine lange Beschäftigungsdauer von Arbeitnehmern. Zugrunde liegt dem die Strategie der Arbeitnehmerbindung. Diese wird nicht allein durch die Perspektive von betrieblicher Beschäftigungssicherheit erreicht, sondern auch durch die Perspektive der Beförderung. Eine darauf bezogene Organisationsstruktur läßt sich ebenfalls zu den Kennzeichen interner Arbeitsmärkte zählen. Gegenstand dieser Studie ist die empirische Überprüfung von Kennzeichen interner Arbeitsmärkte. An Hand von zwei gegensätzlich erscheinenden Organisationskonfigurationen, der Maschinenbürokratie und der professionellen Bürokratie, wird geprüft, bei welcher Organisationskonfiguration sie stärker akzentuiert sind. Die Ergebnisse zeigen, daß Maschinenbürokratien stärker mit den Kennzeichen interner Arbeitsmärkte übereinstimmen. Daraus ergeben sich Anhaltspunkte für eine divergierende betriebliche Beschäftigungsstrategie.
Managing the boss - “Führung von unten”
Authors: Wunderer Rolf 
Published: October 2020

In diesem Beitrag wird eine empirisch zentrale, wissenschaftlich aber vernachlässigte Dimension von Führung behandelt. Zunächst werden Aspekte der “Gewährung” von Geführteneinfluß diskutiert - vor allem über kooperativ-delegative Führungsstile. Es folgen empirisch häufig ermittelte Einflußstrategien von Geführten - auch vergleichend mit Formen der Vorgesetzten- und Kollegenbeeinflussung. Abschließend wird ein Strategieansatz zur Förderung einer “Führung von unten” entwickelt.
Tibial Plafond Attachment of the Posterior-Inferior Tibiofibular Ligament: A Cadaveric Study
Authors: Fujimoto Shutaro , Teramoto Atsushi , Anzai Ken , Murahashi Yasutaka , Okada Yohei , Kamiya Tomoaki , Watanabe Kota , Fujimiya Mineko , Yamashita Toshihiko 
Published: October 2020

Background: Some recent studies have reported the role of the posterior malleolus as an attachment of the posterior-inferior tibiofibular ligament (PITFL) and suggested that even a small fragment should be fixed. However, there are few anatomic studies of the tibial plafond attachment of the PITFL. Methods: Seven Thiel-embalmed ankles were obtained. The margin of the distal tibial joint surface and the attachments of the superficial fiber of the PITFL (sPITFL) and the deep fiber (dPITFL) were identified. In the frontal view, the percentages of the attachments of the sPITFL and dPITFL of the mediolateral dimension of the posterior tibial plafond were measured. In the lateral view, the line that started from the proximal margin of the attachment of the sPITFL and parallel to the tibial axis was drawn, and the distance between that line and the posterior edge of the joint surface was measured (AP distance of the sPITFL). Then, the percentage of the AP distance of the sPITFL of the joint surface in the anteroposterior dimension of the tibial plafond was measured. Results: In the frontal view, the mediolateral distance of the attachment of the sPITFL was 5.0 mm, and that of the dPITFL was 19.5 mm. The percentage of the attachment of the sPITFL on the tibial plafond was 20.6%, and that of the dPITFL was 78.2%. In the lateral view, the average AP distance of the sPITFL was 0.5 mm, and the percentage in the anteroposterior dimension of the tibial plafond was 1.7%. Conclusion: The PITFL was attached to less than 10% of the anteroposterior dimension of the tibial plafond in most ankles. Conversely, the PITFL attached widely in the mediolateral dimension. Clinical Relevance: This study suggests that the size of the posterior malleolar fragment in the mediolateral dimension could help estimate how much of the PITFL attaches to the fragment which may have implications for ankle stability.
Interaction between the genetic risk score and dietary protein intake on cardiometabolic traits in Southeast Asian
Authors: Alsulami Sooad , Aji A. S. , Ariyasra U. , Sari S. R. , Tasrif N. , Yani F. F. , Lovegrove J. A. , Sudji I. R. , Lipoeto N. I. , Vimaleswaran K. S. 
Published: October 2020

Abstract
Background
Cardiometabolic diseases are complex traits which are influenced by several single nucleotide polymorphisms (SNPs). Thus, analysing the combined effects of multiple gene variants might provide a better understanding of disease risk than using a single gene variant approach. Furthermore, studies have found that the effect of SNPs on cardiometabolic traits can be influenced by lifestyle factors, highlighting the importance of analysing gene-lifestyle interactions.

Aims
In the present study, we investigated the association of 15 gene variants with cardiometabolic traits and examined whether these associations were modified by lifestyle factors such as dietary intake and physical activity.

Methods
The study included 110 Minangkabau women [aged 25–60 years and body mass index (BMI) 25.13 ± 4.2 kg/m2] from Padang, Indonesia. All participants underwent a physical examination followed by anthropometric, biochemical and dietary assessments and genetic tests. A genetic risk score (GRS) was developed based on 15 cardiometabolic disease-related SNPs. The effect of GRS on cardiometabolic traits was analysed using general linear models. GRS-lifestyle interactions on continuous outcomes were tested by including the interaction term (e.g. lifestyle factor*GRS) in the regression model. Models were adjusted for age, BMI and location (rural or urban), wherever appropriate.

Results
There was a significant association between GRS and BMI, where individuals carrying 6 or more risk alleles had higher BMI compared to those carrying 5 or less risk alleles (P = 0.018). Furthermore, there were significant interactions of GRS with protein intake on waist circumference (WC) and triglyceride concentrations (Pinteraction = 0.002 and 0.003, respectively). Among women who had a lower protein intake (13.51 ± 1.18% of the total daily energy intake), carriers of six or more risk alleles had significantly lower WC and triglyceride concentrations compared with carriers of five or less risk alleles (P = 0.0118 and 0.002, respectively).

Conclusions
Our study confirmed the association of GRS with higher BMI and further showed a significant effect of the GRS on WC and triglyceride levels through the influence of a low-protein diet. These findings suggest that following a lower protein diet, particularly in genetically predisposed individuals, might be an effective approach for addressing cardiometabolic diseases among Southeast Asian women.
Negative correlation between concentration of iron oxides and particulate matter in atmospheric dust: case study at industrial site during smoggy period
Authors: Petrovský Eduard , Kapička Aleš , Grison Hana , Kotlík Bohumil , Miturová Hana 
Published: October 2020

Abstract
Background
Environmental magnetism, focusing on ferrimagnetic iron oxides, provides useful additional information on pollution of different environments. Magnetic methods have been applied to studies of atmospheric dust, namely PM10 (particulate matter smaller than 10 µm) in, e.g., industrial or urban areas. Until now, positive correlation was reported between concentration of iron oxides (expressed in terms of either magnetic susceptibility, saturation remanent or saturation induced magnetization) and concentration of PM10 or smaller. Purpose of this study was to verify the relationship between iron oxides and PM at monitoring site close to source of emissions rich in iron oxides during period of smoggy conditions.

Results
We examined 24-h PM10 and PM1 samples, collected during 10 days of smoggy winter period at a site close to steel plant, which represents a significant source of atmospheric emissions in industrial region of Northern Moravia (Czech Republic), known for generally high degree of air pollution. Magnetic hysteresis loops were measured to obtain parameters reflecting the concentration and grain-size distribution of iron oxides. Our data show unexpected negative correlation between saturation magnetization (concentration of ferrimagnetic iron oxides) and both PM1 and PM10 concentrations, to the best of our knowledge the trend not being reported yet.

Conclusions
Our finding may seemingly disqualify magnetic methods as useful proxy in air pollution studies. However, we suggest that this is an exceptional case, specific to this region and monitoring site, as well as to synoptic conditions during the smoggy period. Although the significant dust emissions are presumably rich in iron oxides, the overall air quality at the monitoring site is determined by the general environment, controlled by many other sources of different character in the region, and by the specific climatic conditions. Thus, the steel plant, presumably emitting dust rich in ferrimagnetic iron oxides, dominates the deposited dust at the nearby monitoring site only during few days of suitable weather (namely wind speed and direction).
Assessing transport policies for tourist mobility based on accessibility indicators
Authors: Coppola Pierluigi , Carbone Armando , Aveta Carmine , Stangherlin Piera 
Published: October 2020

AbstractTourism is a key sector in the national economies, representing a real asset for increasing the competitiveness and the world-wide visibility of a Country. In Italy, the widespread diffusion of the tourist heritage represents a great potential for the economic development but requires efforts to identify sustainable and seamless travel solutions, given the limited resources available for tourist mobility. The Italian National Plan of Tourist Mobility identifies in accessibility one of the key drivers for investment, and to this aim has developed a Planning Support System (PSS) to identify the investments to bridge up the accessibility gap of national tourist sites from the main airports, ports and railway stations (i.e. the “access gates” to the Country), either on the road network or using collective transport services. The PSS is based on the methodology presented in this paper, combining two concepts extensively studied in the literature, i.e. the generalized travel cost and the accessibility, in order to identify where and how to invest either to improve existing mobility services or to build new infrastructure. Given the number of tourist sites scattered over the national territory, the application of the proposed methodology to the Italian case study represents a relevant example of how accessibility measures can be applied in practice to link with policy goals and to identify planning priorities. The application is easily replicable and transferable at regional and local level.