bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ perceptions of and barriers to the optimal end‐of‐life care in hospitals: A cross‐sectional study
Authors: Chan Carmen W. H. , Chow Meyrick C. M. , Chan Sally , Sanson‐Fisher Robert , Waller Amy , Lai Theresa T. K. , Kwan Cecilia W. M. 
Published: December 2019

AbstractAims and objectivesTo assess nurses’ perceptions of what constitutes optimal end‐of‐life (EOL) care in hospital and evaluate nurses’ perceived barriers to EOL care delivery.BackgroundCare of dying patients is common in hospitals. However, little is known about the important elements of and barriers to optimal EOL care from key service providers’ perspective, which is crucial for quality EOL care in hospital settings.MethodThis is a cross‐sectional survey. Nurses practising in hospitals recruited by convenience sampling completed self‐report survey questionnaires. STROBE checklist was used in study reporting.ResultsOne hundred and‐seventy‐five nurses participated in the survey. The majority (70%) had experience in caring for dying patients. The five most highly perceived factors constituting optimal EOL care included the following: “families know and follow patient's EOL wishes”; “patients emotional concerns identified and managed well”; “patients participating in decision‐making”; “EOL care documents stored well and easily accessed”; and “provide private rooms and unlimited visiting hours for families of dying patients”. Top five barriers were “doctors are too busy”; “nurses are too busy”; “insufficient private room/space”; “nurses have limited training in EOL care”; and “families have unrealistic expectations of patient's prognosis.” Multivariate regression analysis identified that nurses without experience in caring for dying patients reported a significantly higher number of perceived barriers towards EOL care (p = .012). Those with postgraduate degree training reported significantly fewer perceived barriers (p = .007).ConclusionFindings identified essential elements for optimal hospital EOL care not only involving patients and families in EOL decision and care, but also documentation and environmental issues in the healthcare system level and the needs for strengthening manpower and expertise at palliative care policy level.Relevance to clinical practiceThis study revealed quantitative data to inform health service managers and policy makers in terms of training and service development/ re‐design for EOL care in hospital settings.
Nursing home residents’ perspectives on their social relationships
Authors: Kang Bada , Scales Kezia , McConnell Eleanor S. , Song Yuting , Lepore Michael , Corazzini Kirsten 
Published: December 2019

AbstractAims and objectivesTo explore nursing home residents’ perspectives on their relationships with other residents, family members and staff.BackgroundThe cultivation of social relationships is central to promoting well‐being in nursing homes, as these relationships allow residents, family members and staff to be valued as unique persons and empowered as partners in care. Few studies have examined how nursing home residents perceive the relationships in their social networks, both within and beyond the facility.DesignQualitative secondary analysis.MethodsWe analysed individual and group interviews obtained during “stakeholder engagement sessions” with cognitively intact residents (N = 11 sessions; N = 13 participants) from two nursing homes in North Carolina. The interviews were conducted as part of a larger study on person‐directed care planning. We integrated thematic and narrative analytic approaches to guide the analysis of interview data, using a three‐cycle coding approach. The COREQ checklist was followed.ResultsFour broad themes emerged from this analysis: (a) peer relationships foster a sense of belonging, purpose, achievement and significance; (b) residents’ relationships with family members support a sense of belonging, continuity and significance; (c) mutual respect and reciprocity between residents and nursing home staff promote a sense of belonging and significance; and (d) organisational factors pose barriers to forging meaningful relationships. Each type of relationship—peer, family and staff—made distinctive contributions residents’ psychosocial well‐being.ConclusionRecognising the diverse roles of different actors from residents’ social networks raises questions for future research to optimise the distinctive contributions of network members that promote residents’ psychosocial well‐being.Relevance to clinical practiceThis study highlights the need for nursing home staff to understand how residents’ social relationships influence residents’ psychosocial outcomes. Staff training programmes are needed to support residents’ rights and to dispel inaccurate interpretations of regulations that threaten sustained meaningful relationships.
Family INvolvement in inTensive care: A qualitative exploration of critically ill patients, their families and critical care nurses (INpuT study)
Authors: Kydonaki Kalliopi , Kean Susanne , Tocher Jennifer 
Published: December 2019

AbstractAims and objectivesTo understand the different factors that impact on the involvement of adult family members in the care of critically ill patients from the perspective of patients, families and nurses, with the aim to inform the enactment of a patient‐ and family‐centred care intervention to support the patient–family–nurse partnership in care involvement.BackgroundExisting evidence lacks theoretical underpinning and clarity to support enactment of patient‐ and family‐centred care and involvement of families in the care of the critically ill patient.DesignQualitative exploratory design using thematic analysis.MethodsThis study was conducted at two adult intensive care units in two tertiary university hospitals in the central belt of Scotland. Between 2013–2014, we conducted semi‐structured interviews with critically ill survivors (n = 19) and adult family members (n = 21), and five focus groups with nurses (n = 15) across both settings. Data were digitally recorded, transcribed verbatim, and uploaded in NVivo 10. Data were analysed thematically using a constructivist epistemology. Ethical approval was obtained prior to data collection. Data are reported according to the Consolidated Criteria for Reporting Qualitative Research checklist.ResultsFamily's situational awareness; the perceived self in care partnership; rapport and trust; and personal and family attributes were the main factors that affected family involvement in care. Two key themes were identified as principles to enact patient‐ and family‐centred care in adult intensive care units: “Need for ‘Doing family’” and “Negotiations in care involvement.”ConclusionsNegotiating involvement in care requires consideration of patients' and family members' values of doing family and the development of a constructive patient–family–nurses' partnership.Relevance to clinical practiceFuture policy and research should consider patients' and family's needs to demonstrate family bonds within a negotiated process in care participation, when developing tools and frameworks to promote patient‐ and family‐centred care in adult intensive care units.
To What Extent Are Multiword Sequences Associated With Oral Fluency?
Authors: Tavakoli Parvaneh , Uchihara Takumi 
Published: December 2019

AbstractThis study examined the relationship between oral fluency and use of multiword sequences (MWSs) across four proficiency levels (Low B1 to C1 of the Common European Framework of Reference). Data came from 56 learners taking the speaking test of the Test of English for Educational Purposes, and our analysis obtained different measures of fluency (speed, breakdown, repair) and MWSs (frequency, proportion, association). Results showed that (a) high‐frequency n‐grams correlated positively with articulation rate; (b) n‐gram proportion correlated negatively with frequency of mid‐clause pauses; and (c) n‐gram association strength correlated positively with frequency of end‐clause pauses and negatively with repair frequency. Qualitative analysis suggested that the test‐takers borrowed some task‐specific n‐grams from the task instructions and used them frequently in their performance. Whereas lower proficiency speakers used these n‐grams verbatim, C1 level speakers used them competently in a variety of forms. We discuss significant implications of the findings for phraseology and language testing research.
Negotiating the Multilingual Turn in SLA: Response to Stephen May
Authors: MENDOZA ANNA 
Published: December 2019

AbstractIn volume 103 of Modern Language Journal, Stephen May suggested that the multilingual turn has not fully delivered on its promises, pointing out second language acquisition (SLA) researchers’ continued focus on parallel monolingualisms rather than on dynamic bi/multilingualism, the lack of theorization of historicity in sociolinguistic research on the latter, the balkanization of academic knowledge preventing transdisciplinary scholarship, and West‐centered methodological nationalism. While I agree with his points, I believe the solution requires more than critical reflexivity, reading beyond our areas of interest, and relinquishing fast‐held methodological principles. Scholarly hegemony and disciplinary elitism exist because we are more than minds touting theories and epistemologies. We must acknowledge how we, as researchers, seek cultural prestige and economic well‐being by affiliating with the global North and its mechanisms for knowledge production. Given this, I discuss what scholars in both the global North and South can do to reform the discipline to address May's concerns, in terms of 1 action those in the global South must consistently attempt, and 4 responsibilities of those in the global North.
Current and emerging therapies for managing hyperphagia and obesity in Prader‐Willi syndrome: A narrative review
Authors: Tan Qiming , Orsso Camila E. , Deehan Edward C. , Triador Lucila , Field Catherine J. , Tun Hein Min , Han Joan C. , Müller Timo D. , Haqq Andrea M. 
Published: December 2019

SummaryIn early childhood, individuals with Prader‐Willi syndrome (PWS) experience excess weight gain and severe hyperphagia with food compulsivity, which often leads to early onset morbid obesity. Effective treatments for appetite suppression and weight control are currently unavailable for PWS. Our aim to further understand the pathogenesis of PWS led us to carry out a comprehensive search of the current and emerging therapies for managing hyperphagia and extreme weight gain in PWS. A literature search was performed using PubMed and the following keywords: “PWS” AND “therapy” OR “[drug name]”; reference lists, pharmaceutical websites, and the ClinicalTrials.gov registry were also reviewed. Articles presenting data from current standard treatments in PWS and also clinical trials of pharmacological agents in the pipeline were selected. Current standard treatments include dietary restriction/modifications, exercise, and growth hormone replacement, which appear to have limited efficacy for appetite and weight control in patients with PWS. The long‐term safety and effectiveness of bariatric surgery in PWS remains unknown. However, many promising pharmacotherapies are in development and, if approved, will bring much needed choices into the PWS pharmacological armamentarium. With the progress that is currently being made in our understanding of PWS, an effective treatment may not be far off.
Reducing postoperative pain in children undergoing strabismus surgery: From bundle implementation to clinical decision support tools
Authors: Ali Usman , Tsang Maisie , Campbell Fiona , Matava Clyde , Igbeyi Brenda , Balakrishnan Sindu , Shackell Kelly , Kotzer Gloria , Mc Donnell Conor 
Published: December 2019

AbstractBackgroundPostoperative pain is a significant cause of morbidity in pediatric anesthesia, which can result in delayed discharge and unplanned hospital admission. Children undergoing strabismus surgery are known to be a particularly high‐risk group for postoperative pain.AimThe aim of this project was to reduce the incidence of moderate to severe postoperative pain by 25% over a period of 12 months in children undergoing strabismus surgery.MethodsThis was a multidisciplinary quality improvement project using the Institute for Healthcare Improvement model for improvement and iterative Plan‐Do‐Study‐Act cycles. Baseline data from one hundred patients were collected retrospectively from patient records. Subsequently, iterative interventions introduced comprised: a perioperative bundle (comprising preoperative acetaminophen, intraoperative dexamethasone and ketorolac, a long‐acting opioid, and two anti‐emetics), email reminders, dissemination of results at departmental rounds, and an intraoperative clinical decision aide. Postoperative pain data were collected as an outcome measure, and length of stay in PACU was monitored as a balancing measure. Statistical process control charts were constructed to monitor bundle compliance and incidence of postoperative pain in the postanesthesia care unit.ResultsPostoperative pain and bundle compliance data were collected for 1127 children in total. Baseline mean monthly incidence of moderate to severe postoperative pain was 47.3%. By the conclusion of this project, the incidence of postoperative pain decreased to 21%. Concurrently, mean bundle compliance increased to 78.7%. Mean length of PACU stay for baseline audit patients was 72.5 min compared with 70 min for patients after the introduction of the strabismus macro (November 2018‐April 2019, n 91) (mean difference, 2.5; 95% CI, −3.86 to 8.86; P = .439).ConclusionThrough the implementation and adoption of an evidence‐based bundle of care, we successfully decreased the incidence of moderate to severe postoperative pain for children undergoing strabismus repair. We demonstrated that combining nudge theory with QI methodology can be an effective means of delivering positive results in quality improvement projects.
Pediatric waitlist and heart transplant outcomes in patients with syndromic anomalies
Authors: Wilkens Sarah J. , Priest James , Kaufman Beth D. , Barkoff Lynsey , Rosenthal David N. , Hollander Seth A. 
Published: December 2019

AbstractPurposeWe sought to determine whether the presence of a systemic SA with potential complicating factors affects waitlist and post–HT outcomes in pediatric patients.MethodsThis is a single‐center retrospective review of pediatric patients listed for HT between January 1, 2009, and July 1, 2018. Patients were selected based on the presence of any underlying syndromes, which included chromosomal anomalies, skeletal myopathies, connective tissue disorders, mitochondrial disease,and other systemic disorders. Waitlist and post–HT outcomes were compared to those without SA.ResultsA total of 243 patients were listed for HT, of which 21 (9%) patients had associated SA. Of those, 16 (76%) survived to transplant, 3 (14%) died while on the waitlist, 1 (5%) improved and was removed from the waitlist, and 1 (5%) patient is currently listed. Waitlist survival was not different between those with/without an associated syndrome (P = 1.0). Among those who survived to HT, there was no difference in listing days (70 vs 90, P = .8), survival to hospital discharge [14 (93%) vs 150 (95%), P = .6], post‐HT intubation days (2 vs 2 days, P = .6), or post‐HT hospital length of stay (18 vs 18 days, P = .8). Overall survival during the study period post‐HT was not different between groups (P = .8).ConclusionA SA was present in 9% of pediatric patients wait‐listed for HT, but was not associated with an increased waitlist mortality or post‐HT hospital morbidity or long‐term survival. For several anomalies, HT is safe and feasible.
Understanding Motivations of Mega‐Gift Donors to Higher Education: A Qualitative Study
Authors: Worth Michael J. , Pandey Sheela , Pandey Sanjay K. , Qadummi Suhail 
Published: December 2019

AbstractPatterns of giving to higher education by individual donors have changed in recent years, with large gifts accounting for an increasing percentage of the total. In light of this shift, understanding the motivations of donors who make very large gifts, commonly known as “mega‐gifts,” has become important. Efforts to explore these motivations run into access barriers. This article uses an innovative methodological approach to overcome this challenge. Drawing on the media coverage of mega‐gifts, the authors create donor biographies and carry out qualitative analysis of these donor biographies to examine donor motivations and evolution in motivations. The article draws on the existing literature to synthesize a typology of donor motivations and uses this typology to categorize the motivations of mega‐gift donors. The identification of additional subcategories under the broad category of impact is a significant contribution of this study and adds nuance to our understanding of mega‐gift donors to higher education institutions.
Rerandomization and Regression Adjustment
Authors: Li Xinran , Ding Peng 
Published: December 2019

SummaryRandomization is a basis for the statistical inference of treatment effects without strong assumptions on the outcome-generating process. Appropriately using covariates further yields more precise estimators in randomized experiments. R. A. Fisher suggested blocking on discrete covariates in the design stage or conducting analysis of covariance in the analysis stage. We can embed blocking in a wider class of experimental design called rerandomization, and extend the classical analysis of covariance to more general regression adjustment. Rerandomization trumps complete randomization in the design stage, and regression adjustment trumps the simple difference-in-means estimator in the analysis stage. It is then intuitive to use both rerandomization and regression adjustment. Under the randomization inference framework, we establish a unified theory allowing the designer and analyser to have access to different sets of covariates. We find that asymptotically, for any given estimator with or without regression adjustment, rerandomization never hurts either the sampling precision or the estimated precision, and, for any given design with or without rerandomization, our regression-adjusted estimator never hurts the estimated precision. Therefore, combining rerandomization and regression adjustment yields better coverage properties and thus improves statistical inference. To quantify these statements theoretically, we discuss optimal regression-adjusted estimators in terms of the sampling precision and the estimated precision, and then measure the additional gains of the designer and the analyser. We finally suggest the use of rerandomization in the design and regression adjustment in the analysis followed by the Huber–White robust standard error.
Technical Development of the Sutureless ELANA Clip Anastomosis Device
Authors: de Boer B. , van Doormaal T. P. C. , van Thoor S. , Gortzak K. , van der Zwan A. 
Published: December 2019

Abstract
A cranial bypass can be a last resort procedure for patients suffering from complex neurovascular pathology. Since the clinically proven excimer laser-assisted nonocclusive anastomosis (ELANA) technique has become available, it is no longer necessary to temporarily close the recipient artery to facilitate an anastomosis. Aiming to simplify and shorten the operation time of the ELANA technique, a sutureless ELANA, the so-called SELANA slide (SEsl) was developed, but it failed during clinical study. We developed an improved device, the SELANA clip (SEcl).We describe the SEcl design and the first in vitro test results. The SEsl design was optimized with a clip at the backside, creating the SEcl which facilitates smooth and friction-free insertion in the recipient artery. Subsequently, the laser catheter was optimized by adding a grid and conus to provide an improved vacuum and flat reaction surface during lasing. We aimed to compare the SEcl to the current ELANA regarding application time difference, anastomosis success (“flap retrieval”) and technical difficulties. Hereto 32 ELANA and 32 SEcl anastomoses were performed on pressurized rabbit arteries in the ELANA practice system. Mean application time difference was 14.0 min (95%CI 13.0–15.0). The flap retrieval rate of the ELANA anastomoses was 94% (30/32) and 100% (32/32) for the SEcl technique. During the experiments no technical difficulties were encountered. The SEcl is technical feasible with promising simplicity and application times. However, extensive in vivo short-term and long-term experiments are indispensable before clinical application.
A Method to Analyze Plantar Stiffness Variation in Diabetes Using Myotonometric Measurements
Authors: Banerjee Shib Sundar , Sreeramgiri Lakshmi Lasya , Hariram Seetharam , Ananthan Srivatsa , Swaminathan Ramakrishnan 
Published: December 2019

Abstract
Diabetes mellitus is a group of metabolic disease, which has become globally prevalent, and affects a large population in socio-economically backward countries in Asian continent. Chronic diabetes can lead to ulceration in the plantar region and may result in amputation. Assessment of mechanical properties of plantar tissues can aid in early diagnosis of ulceration. Myotonometry, a technique to measure dynamic stiffness, is preferred due to its noninvasiveness, easy employability, and rapid investigation. In this study, an attempt has been made to analyze the changes in biomechanical properties of plantar soft tissue in diabetes. MyotonPro, a handheld device, is used for this purpose. 43 diabetic subjects with varied duration of diabetes are recruited. Site-specific mechanical properties of the plantar region for both the feet are acquired and statistical analysis is performed. Results show that the MyotonPro is able to differentiate the stages of diabetes. It is seen that there is a spatial variability in the mechanical properties of the plantar. Additionally, it is observed that there is a significant increment in the plantar stiffness value in the group with higher diabetic age (p &lt; 0.05). Further, significant changes in dynamic mechanical properties are also observed in submetatarsal region. Additionally, a right–left asymmetry has been observed in frequency and stiffness values for later stages of diabetes. This study demonstrated the feasibility of MyotonPro in discriminating the stages of diabetic period. Thus, the proposed approach could be useful in early diagnosis of foot ulceration for various clinical conditions.
Iterative Learning Control for a Type of Modified Smith Predictor
Authors: Tian Dongzuo , Song Xingyong 
Published: December 2019

Abstract
This article proposes a novel iterative learning control (ILC) design for a type of modified Smith predictor, in particular, to control a single-input single-output unstable plant or integral process with a time delay. Frequency domain techniques are applied to synthesize the learning control law, and a sufficient condition is given to ensure robust convergence of the tracking error. Robustness of the system is studied, considering a multiplicative uncertainty. Moreover, the impact of the load disturbance over successive iterations is investigated as well. To this end, a numerical example is given to demonstrate the efficacy of the proposed approach.