bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a Chinese version critical‐care pain observation tool in nonintubated and intubated critically ill patients: Two cross‐sectional studies
Authors: Chen Jie , Hu Fen , Yang Jian , Wu Xiao‐Ying , Feng Yi , Zhan Yan‐Chun , An You‐Zhong , Lu Qian , Zhang Hai‐Yan 
Published: April 2019

AbstractAims and objectivesTo validate the Chinese version of the Critical‐Care Pain Observation Tool (CPOT) in nonintubated and intubated ICU patients.BackgroundWhile CPOT was found to have the best psychometric properties among objective pain assessment scales, there is no Chinese version CPOT for nonintubated patients.DesignCross‐sectional design was used in these two observational studies.MethodsSeventy‐six nonintubated patients and 53 intubated patients were assessed to examine internal consistency, criterion‐related and discriminative validity of CPOT in the first study. Pain assessment during low pain condition as well as increased pain condition was performed by Numeric Rating Scale (NRS) and the Chinese version COPT. Forty nonintubated patients and 43 intubated patients were assessed to examine inter‐rater reliability in the second study. A bedside nurse and a researcher independently executed paired pain assessments with CPOT in the same conditions. The STROBE Statement was followed to guide these studies.ResultsThe Cronbach's α in nonintubated patients and intubated patients was 0.903–0.930 and 0.868–0.870. The intraclass correlation coefficients (ICCs) in nonintubated patients ranged from 0.959–0.982, and the ICC in intubated patients ranged from 0.947–0.959, confirming the inter‐rater reliability. The moderately positive Pearson's correlations between CPOT and NRS scores (r = 0.757–0.838 in nonintubated patients, r = 0.574–0.705 in intubated patients) indicated the criterion‐related validity. A significant increase in CPOT scores in the increased pain condition compared with those acquired in the low pain condition verified the discriminative validity.ConclusionsThe Chinese version of CPOT was presented to be valid and reliable for both nonintubated and intubated critically ill adults, which could be applicable for pain assessment in patients in ICU.Relevance to clinical practiceThis study provides an applicable pain assessment tool for both nonintubated patients and intubated patients in ICU.
The impact of congenital heart disease on the psychological well‐being and quality of life of Hong Kong Chinese adolescents: A cross‐sectional study
Authors: So Serana Chun Yee , Li William Ho Cheung , Ho Ka Yan 
Published: April 2019

AbstractAims and objectivesTo examine the psychological well‐being and quality of life of Hong Kong Chinese adolescents with congenital heart disease.BackgroundCongenital heart disease (CHD) in adolescents is associated with having negative psychological impact and impairment to quality of life. A literature review revealed that most studies on the impact of CHD on the psychological well‐being and quality of life of adolescents to date have been conducted in Western populations.MethodA cross‐sectional design was employed. Adolescents aged 12–18 with CHD attending an outpatient clinic in an acute public hospital were invited to participate. Another similar age group of healthy Chinese adolescents was also invited to participate for comparison purposes. Subjects were asked to respond to the Chinese version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales, Center for Epidemiologic Studies Depression Scale for Children, Rosenberg Self‐Esteem Scale and a demographic sheet. A STROBE checklist was completed.ResultsAdolescents with CHD exhibited more depressive symptoms, lower self‐esteem and poorer quality of life than their healthy counterparts. Disease severity might affect the self‐esteem, depressive symptoms and quality of life of adolescents with CHD. Disease severity, depressive symptoms, self‐esteem level and types of treatment received were associated with the quality of life of adolescents with CHD.ConclusionsHong Kong Chinese adolescents suffering from CHD experience negative impacts on their psychological well‐being and quality of life. In this group, disease severity may affect psychological well‐being and quality of life. Specifically, quality of life of adolescents with CHD was associated with disease severity, depressive symptoms, self‐esteem level and the type of treatment received.Relevance to clinical practiceThe findings contribute to clinical care guidelines and serve as a reference in developing nursing intervention to adolescents with CHD so as to uphold quality of care. Clinical trial registration: NCT03255850 (Clinical trial.gov).
Implementing mandatory early warning scoring impacts nurses’ practice of documenting free text notes
Authors: Bunkenborg Gitte , Smith‐Hansen Lars , Poulsen Ingrid 
Published: April 2019

AbstractAims and objectivesTo evaluate whether implementing the Modified Early Warning Scoring system impacts nurses’ free text notes related to Airway, Breathing, Circulation and Pain in general ward medical and surgical patients.BackgroundThe quality of nursing documentation in patient health records is important to secure patient safety, but faces multiple challenges whether being paper‐based or electronic. Nurses’ ability to draw a complete picture of the patient situation is thereby compromised. Structured use of the Modified Early Warning Score, found to reduce unexpected death, might affect nurses’ free text documentation of clinical observations.DesignA prospective, pre‐ and postinterventional, nonrandomised study adhering to the EQUATOR guideline TREND.MethodsData on nurses’ free text notes were obtained in 1,497 patient records during one preinterventional (March–June 2009) and two postinterventional study periods (September–December 2010 and March–June 2011) in a Danish university hospital. Data were organised by the Airway, Breathing and Circulation principles and by nurses’ working shifts in the 56 hr surrounding the first recording of deviating vital parameters or a Modified Early Warning Score ≥ 2. Preinterventional free text notes were compared with notes from the two postinterventional periods, respectively.ResultsIn the 8‐hr working shift where deviations in vital parameters were recorded for the first time, nurses’ free text notes related to patients’ breathing (B) increased significantly, comparing 2009 with 2010 and 2011, respectively. In the 24 hr following initial deviations in vital parameters, a significant increase in free text notes was identified concerning Airway, Breathing and Circulation‐related symptoms or problems.ConclusionMandatory use of the Modified Early Warning Score and related implementation activities significantly impacts nursing documentation of free text notes.Relevance to clinical practiceNurses’ practice of communicating observed clinical symptoms by documenting free text notes should be supported through measures to enhance situation awareness.
How to use visual methods to promote health among adolescents: A qualitative study of school nursing
Authors: Laholt Hilde , Guillemin Marilys , McLeod Kim , Beddari Ellinor , Lorem Geir 
Published: April 2019

AbstractAims and objectivesPublic health nurses attended a 3‐day course to learn the use of visual methods in health dialogue with adolescents. The aim of this study was to explore how to use visual methods to promote health among adolescents in a school nursing context.BackgroundPhotovoice is a visualising technique that enables adolescents to participate in health promotion projects in a school setting. Photovoice also enhances work of public health nurses and other health professionals.DesignThis was a qualitative action research study. We developed and conducted a course in visual methods and used data from focus group discussions in combination with participant observations involving public health nurses working in school health services.MethodsWe conducted focus group interviews (n = 40) using separate semi‐structured discussion guides before and after a course in visual methods. The interviews were audio recorded and transcribed verbatim, and we documented the workshops (n = 8) through field notes. We collected the data from January–October 2016. Data were analysed and coded into themes and subthemes using systematic text condensation. We reported the study in accordance with the COREQ checklist.FindingsPublic health nurses found photovoice useful in school nursing. The use of images offered pupils an active role in dialogues and more control in defining the topics and presenting their stories. When nurses allowed adolescents to bring images into conversations, they discovered new insights into public health promotion. The public health nurses pointed out the benefits and challenges of using new methods in practice.ConclusionPublic health nurses considered photovoice to be useful in health promotion and other public health issues. Involving pupils in bringing images to conversations offered them an active role and voice in health promotion.Relevance to clinical practiceWe recommend the use of photovoice and visual technologies (e.g., smartphones) in health promotion activities for adolescents.
'Hands‐off/poised' or 'Hands‐on' method among Chinese midwives: A cross‐sectional survey
Authors: Zhou Xuan , Ma Dong‐Mei , Wang Fang , Tian Yanping , Xu Xinfen 
Published: April 2019

AbstractAims and objectivesTo determine midwives' preference for “Hands‐on” and “Hands‐off/poised” methods and to explore the impact factors.BackgroundWith the increasing rate of obstetric anal sphincter injuries, great controversy surrounds the “Hands‐on” or “Hands‐off” method during childbirth to decrease obstetric anal sphincter injuries incidence. Without regular records and related research, determining the use of this technique in China is difficult.DesignThis study used a quantitative study design, following the EQUATOR guidelines (STROBE).MethodsA nationwide cross‐sectional online survey was conducted using respondent‐driven sampling across 31 provinces in China from 1st October 2017–31st December 2017. A total of 6,425 midwives were involved. Descriptive analyses, chi‐square test and binary logistic regression were undertaken.ResultsA total of 5,225 questionnaires were returned; 55.8% of the participants preferred the “Hands‐off/poised” method. The impact factors included hospital categories, total work experience in a birth unit in years, theoretical education and skill training. In the study, for situations with increased OASI risk, 100% of the midwives in the “Hands‐off” group expressed willingness to change to the “Hands‐on” method whether there was concern about impending obstetric anal sphincter injuries.ConclusionThe “Hands‐off/poised” method is heavily practised by Chinese midwives. However, majority of the midwives adopt “Hands‐on” method in the face of high risk for obstetric anal sphincter injuries. Further studies are needed to determine the association between obstetric anal sphincter injuries rate and perineal management for low‐risk birth.Relevance to clinical practiceThe result indirectly illustrates the application of “Hands‐off/poised” technique in China and provides evidence for the international midwifery organisation to understand the status of Chinese midwifery to some extent. It also provides the latest data for further study of these two methods and the study of the relationship between hands‐off/poised method and obstetric anal sphincter injuries.
Relationships between illness representations, physical activity and depression in chronic kidney disease
Authors: Nah Ryan , Robertson Noelle , Niyi‐Odumosu Faatihah A. , Clarke Amy L. , Bishop Nicolette C. , Smith Alice C. 
Published: April 2019

SUMMARYBackgroundChronic Kidney Disease (CKD) is exacerbated by depression and confers significant healthcare costs. Whilst adverse impacts may be mitigated by physical activity, many patients with CKD remain physically inactive, with this physical inactivity potentially influenced by how CKD is appraised.ObjectivesThe study aims to explore the relationship between physical activity, depression and illness representations in CKD.MethodsPatients with CKD but not requiring dialysis completed the Revised Illness Perception Questionnaire (IPQ‐R), Beck Depression Inventory (BDI‐II) and Short‐Form International Physical Activity Questionnaire (IPAQ‐SF). Demographic information was obtained via medical records. Correlation and regression analyses were conducted to determine the relationship of illness representations with levels of physical activity. Moderation and mediation analyses were performed to investigate the role of depression in any relationship between illness representations and physical activity levels.ResultsSeventy respondents, 60 % male, with a mean age of 60 ± 16 years, took part in the study. Of illness representation dimensions, personal control was positively associated with levels of physical activity whilst timeline cyclical (a subscale of the IPQ‐R relating to patient beliefs about the nature of their illness) was a significant predictor. Severity of depression was neither a moderator nor a mediator of illness representations and levels of physical activity.ConclusionFacets of illness representations had significant relationships with levels of physical activity. Future research concerning the development and validation of psychological interventions based on an illness representations framework for patients with CKD not requiring dialysis is proposed. The efficacy of such interventions could be then evaluated using a randomised controlled method.
Patients’ perceptions of their experience, control and knowledge of fluid management when receiving haemodialysis
Authors: Glyde Megan , Keane David , Dye Louise , Sutherland Ed 
Published: April 2019

SUMMARYBackgroundPerson‐centred care is increasingly promoted, empowering patients to become more involved in their treatment rather than being passive recipients of care (Barnes et al. 2013). Haemodialysis is typically required three times a week, with fluid management decision‐making occurring at each treatment session (Ahmed et al. 2017). However, no research has yet explored how haemodialysis patients’ perceptions of their fluid management may impact upon this decision‐making.ObjectivesThis study sought to explore patients’ perceptions of their fluid management.Method: Design, Participants & ApproachSemi‐structured interviews were conducted with 12 patients undergoing in‐hospital haemodialysis treatment. These were digitally recorded one‐to‐one interviews to allow for verbatim transcription. The data was analysed by thematic analysis, generating thematic patterns across patients’ experiences, control and knowledge of their fluid management.ResultsFive themes were produced: determining who has the expertise, impediments affecting patients’ lifestyle, additional difficulty of experiencing comorbidities, perceived quality of care, and establishing consistency.ConclusionsDespite varied levels of patient participation in their treatment, overall there appears to be a limited understanding of specific areas of fluid management. The implications for further research and the development of shared‐care are discussed.
Association of Teacher‐Level Factors With Implementation of Classroom‐Based Physical Activity Breaks
Authors: Abi Nader Patrick , Hilberg Evan , Schuna John M. , John Deborah H. , Gunter Katherine B. 
Published: April 2019

ABSTRACTBACKGROUNDClassroom‐based physical activity (CBPA) breaks are a common strategy to increase elementary school children's physical activity (PA) levels. There is limited research examining how teacher‐level factors impact teacher implementation of CBPA breaks. In this study, we assessed the relationship of teacher‐level factors with teacher use of a CBPA resource.METHODSWe randomized 6 elementary schools in rural Oregon into control (N = 3) or intervention (N = 3) conditions. Each teacher at intervention schools received the CBPA resource. Teachers at control schools received 1 CBPA‐Toolkit per grade level to share, and received no training. We surveyed teachers on their use of the toolkit, implementation support and self‐efficacy, and value for PA. Logistic regression was used to examine the odds of toolkit use by teacher‐level factors.RESULTSAmong survey respondents (N = 83), 57% were self‐identified toolkit users and 48% attended a training. Training participation and teacher implementation self‐efficacy were associated with greater odds of using the toolkit (odds ratio, OR = 7.76 [95% confidence interval, CI = 1.39‐43.19] and OR = 5.54 [95% CI = 1.24‐23.87], respectively).CONCLUSIONCBPA tools supported with training aimed at developing teachers' implementation self‐efficacy increased the likelihood of teachers employing CBPA tools.
MT1 and MT2 melatonin receptors are expressed in nonoverlapping neuronal populations
Authors: Klosen Paul , Lapmanee Sarawut , Schuster Carole , Guardiola Beatrice , Hicks David , Pevet Paul , Felder‐Schmittbuhl Marie Paule 
Published: April 2019

AbstractMelatonin (MLT) exerts its physiological effects principally through two high‐affinity membrane receptors MT1 and MT2. Understanding the exact mechanism of MLT action necessitates the use of highly selective agonists/antagonists to stimulate/inhibit a given MLT receptor. The respective distribution of MT1 and MT2 within the CNS and elsewhere is controversial, and here we used a “knock‐in” strategy replacing MT1 or MT2 coding sequences with a LacZ reporter. The data show striking differences in the distribution of MT1 and MT2 receptors in the mouse brain: whereas the MT1 subtype was expressed in very few structures (notably including the suprachiasmatic nucleus and pars tuberalis), MT2 subtype receptors were identified within numerous brain regions including the olfactory bulb, forebrain, hippocampus, amygdala and superior colliculus. Co‐expression of the two subtypes was observed in very few structures, and even within these areas they were rarely present in the same individual cell. In conclusion, the expression and distribution of MT2 receptors are much more widespread than previously thought, and there is virtually no correspondence between MT1 and MT2 cellular expression. The precise phenotyping of cells/neurons containing MT1 or MT2 receptor subtypes opens new perspectives for the characterization of links between MLT brain targets, MLT actions and specific MLT receptor subtypes.
Identification of oxidative stress–related Xdh gene as a di(2‐ethylhexyl)phthalate (DEHP) target and the use of melatonin to alleviate the DEHP‐induced impairments in newborn mouse ovaries
Authors: Liu Jing‐Cai , Li Lan , Yan Hong‐Chen , Zhang Teng , Zhang Pan , Sun Zhong‐Yi , De Felici Massimo , Reiter Russel J. , Shen Wei 
Published: April 2019

AbstractThis study, using an in vitro ovary culture model, investigates the mechanisms through which di(2‐ethylhexyl)phthalate (DEHP) impairs germ cell cyst breakdown and primordial follicle assembly. The results indicate the latter effects exerted by 10 or 100 µmol/L DEHP in cultured newborn ovaries were associated with increased levels of reactive oxygen species (ROS) and apoptosis. Based on a transcriptome analysis, we found the expression of the oxidative stress–related gene Xdh (xanthine dehydrogenase) was significantly upregulated in DEHP‐cultured ovaries. Two treatments, namely Xdh RNAi or the addition of melatonin to the ovary culture, inhibited the increase in Xdh expression and ROS levels caused by DEHP and, at the same time, reduced apoptosis and the impairment of primordial follicle assembly in the treated ovaries. Together, the results identify Xdh gene as one of the major targets of DEHP in newborn ovaries and that the consequent increased level of ROS is possibly responsible for the increment of apoptosis and primordial follicle assembly impairment. At the same time, they highlight that melatonin alleviates the effects of DEHP as with other endocrine‐disrupting compounds on the ovary.
The Gender Gap in Early Career Wage Growth: The Role of Children, Job Mobility, and Occupational Mobility
Authors: Reshid Abdulaziz Abrar 
Published: April 2019

AbstractDuring the first 10 years in the Swedish labor market, male university graduates experience a faster wage growth than females. We investigate the role job and upward occupational mobility have for the creation of gender difference in early career wage growth; and the role of motherhood as an underlying mechanism. We find that although men and women change jobs and occupations at the same rate, women receive a significantly lower wage returns to mobility than men. We find evidence that women's lower return to occupational mobility is largely explained by motherhood, while the evidence for job mobility is rather weak.
Association between watching TV whilst eating and children's consumption of ultraprocessed foods in United Kingdom
Authors: Martines Renata Mariana , Machado Priscila Pereira , Neri Daniela Almeida , Levy Renata Bertazzi , Rauber Fernanda 
Published: April 2019

AbstractThis study aimed to assess the association between watching TV whilst eating and consumption of ultraprocessed foods amongst children aged 4–10 years old in the United Kingdom. Cross‐sectional data from the UK National Diet and Nutrition Survey (NDNS 2008–2012) were analysed. Dietary data were derived from 4‐day food diaries of 1,277 children, and the dietary contribution of ultraprocessed foods was assessed. Meals were classified based on time of day in which foods were consumed (lunch: 11 pm–3 pm and dinner: 6 pm–9 pm). Crude and adjusted linear regression models were employed to verify the effect of watching TV during meals on dietary contribution of ultraprocessed foods (% of total energy intake). More than 70% of the children watched TV during meals, and 31.4% presented the behaviour on both “lunch and dinner.” Children's mean total energy intake was 1,532.3 kcal/day, of which 65.8% came from ultraprocessed foods. Findings indicated that children who watched TV whilst having both meals (lunch and dinner) consumed on average 85.5 kcal/day and 6.1% more energy from ultraprocessed foods than those who did not. Children who watched TV only during dinner consumed on average 37.1 kcal/day and 3.4% more energy from ultraprocessed foods than those who did not. The behaviour of watching TV whilst eating meals was associated with higher total daily consumption of ultraprocessed foods by children in the United Kingdom. Therefore, interventions designed to promote healthy eating habits should include aspects related to the context of meals.
Multi‐tasking as an ancient skill: When one gene does many things well
Authors: Donohue Kathleen 
Published: April 2019

AbstractMulti‐tasking is in our DNA. Many genes perform more than one function, and the question is how well it can do them all. Pleiotropy is frequently considered to be an adaptive constraint that prevents optimal phenotypes from evolving because of antagonistic indirect selection acting on genetically correlated traits. However, as geneticists increasingly study the effects of genes under more realistic natural environments, even the most well studied genes are expressing fascinating pleiotropic effects. Pleiotropy appears to be utterly common. The genes involved in the regulation of flowering time in Arabidopsis thaliana, such as FLOWERING LOCUS C (FLC), offer case examples of such pleiotropy. Studying an ortholog of FLC in Arabis alpina, PERPETUAL FLOWERING 1 (PEP1), Hughes, Soppe and Albani (2019) present evidence that such pleiotropy in flowering‐time genes persists through taxonomic diversification, albeit the precise function of the genes has evolved in response to taxon‐specific natural selection. Their observation that trait‐specific function can evolve even in highly pleiotropic genes suggests that pleiotropy may not constrain adaptation as much as is commonly assumed.