bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repeat pregnancies in teenage mothers: An exploratory study
Authors: Bucknall Amy , Bick Debra 
Published: June 2019

AbstractAimTo explore young mothers' experience of rapid repeat pregnancy.BackgroundDespite a reduction in teenage pregnancies in England over the last two decades, the number of repeat pregnancies remains high, accounting for around 25% of teenage pregnancies. There is a lack of qualitative evidence of teenage perspectives making planning appropriate interventions challenging.DesignExploratory design.MethodsSix young women were purposively sampled from a Family Nurse Partnership programme in the South London. Semi‐structured interviews conducted in spring 2017 elicited experiences of repeat pregnancy.FindingsEach repeat pregnancy was unplanned and accounted for by participants' rejection of Long Acting Reversible Contraceptives and inconsistent use of non‐ Long Acting Reversible Contraceptives. Misinformation about Long Acting Reversible Contraceptives contributed to their rejection and staff delivery of contraceptive advice was influential. Motherhood was initially prioritised over other life goals to make sense of second pregnancy. Discharge from the Family Nurse Partnership may lead to fractured service contacts. Peer support and health professional contact through social media were proposed as “stepping stones” out of the service.ConclusionsPractice developments working in partnership with young mothers to reduce the risk of a repeat teenage pregnancy are highlighted. Further research is recommended.ImpactUnderstanding the experiences of teenage mothers who are at risk of rapid repeat pregnancy can assist nurses to provide preventative care and support. Structured advice through social media platforms can provide “stepping stones” that bridge gaps in provision as young mothers transition through services. Further research and development into the role of social media and contraceptive counselling are necessary.
Factors that influence the development and performance of academic oral presentations using a blended learning environment
Authors: Barrett Neil Edward , Liu Gi‐Zen 
Published: June 2019

AbstractThis study investigated how students designed English academic oral presentations via a blended language learning environment. Data were collected from focus group interviews, observations of students, and instructor perspectives to explore how students develop academic presentation skills. In addition, a total of 36 oral presentations were assessed by a rubric and frequency counts of presentation language and features. By adopting an ecological approach, we identified the interactions between different factors that influenced learning. Interview findings and observations suggested students welcomed the immediacy of the technology and demonstrated signs of autonomous learning by self‐selecting the chat application Line for group collaboration. Participants preferred both online and face‐to‐face collaboration, as students discovered the limits of online communication. Results indicated that group oral presentations improved, with stronger introductions, linking devices, and visual elements. However, students had problems constructing conclusions and trouble linking the main ideas to the content.
Longitudinal association between serum uric acid levels and multiterritorial atherosclerosis
Authors: Song Meiyue , Li Na , Yao Yan , Wang Kaile , Yang Jichun , Cui Qinghua , Geng Bin , Chen Jianxin , Wang Youxin , Cheng Wenli , Zhou Yong 
Published: June 2019

AbstractMultiterritorial atherosclerosis has dramatically increased annual risk of adverse cardiovascular events than atherosclerotic disease with single‐artery affected. Serum uric acid (SUA) is an important predictor of stroke and atherosclerosis; however, which is supported by few direct evidence based on cohort studies. A prospective cohort study including 2644 North Chinese adults aged ≥40 years was performed in 2010‐2012 to investigate the association between SUA and multiterritorial vascular stenosis. Hyperuricaemia was defined as SUA levels >6 and >7 mg/dL for males and females, respectively. All participants underwent twice transcranial Doppler (TCD) and bilateral carotid duplex ultrasound to evaluate intracranial artery stenosis (ICAS) and extracranial arterial stenosis (ECAS) and peripheral arterial disease (PAD) was determined by ankle‐brachial index (ABI) on January 2010 and January 2012 based on regular health check‐ups. The cumulative incidence of vascular stenosis was significantly higher in subjects with hyperuricaemia than in those without hyperuricaemia (54.1% vs. 34.7%, P < 0.001). The adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new on‐set vascular stenosis due to hyperuricaemia and a 1‐mg/dL change in SUA level were 1.75 (1.32‐2.31) and 1.29 (1.21‐1.38), respectively. Furthermore, in the gender‐stratified analysis, the association between SUA levels and ICAS was statistically significant in males (OR: 2.02; 95% CI: 1.18‐3.46), but not females (OR: 0.85, 95% CI: 0.41‐1.76, P for interaction: 0.026).
Effect of high hydrostatic pressure in physicochemical properties and in vitro digestibility of cornstarch by nuclear magnetic resonance relaxometry
Authors: Okur Ilhami , Ozel Baris , Oztop Mecit H. , Alpas Hami 
Published: June 2019

AbstractStarch is the major polysaccharide consumed by human being. It is not classified as a dietary fiber as it is digestible by the enzymes present in the saliva and small intestines. However, it is possible to modify starch with thermal and nonthermal techniques. High hydrostatic pressure (HHP) is a cold pasteurization technique that has increased application in food industry with minimum effect on nutritional quality of the food products. It is hypothesized that the use of HHP could be a modification strategy for starch. In this study, effects of different HHP parameters (400 and 500 MPa) at different temperatures (20, 30, and 40°C) for 5, 15, and 30 min on in vitro digestibility and physicochemical properties of cornstarch were studied by Nuclear magnetic resonance (NMR) relaxometry. Results showed that HHP treatment increased slowly digestible starch (SDS) and rapid digestible starch (RDS) significantly with pressure and temperature (p < .05). In addition, it was shown that HHP treatment decreased the solubility and swelling power of the cornstarch and it is proposed that 30 min HHP treatment at 500 MPa and 40°C is the onset for cornstarch gelatinization according to NMR relaxometry results.Practical ApplicationsHigh hydrostatic pressure (HHP) is a nonthermal processing technology that is commonly used in the food industry for extending the shelf life of food products by destroying vegetative cells, enzymes, microorganisms effectively, and it can modify the starch so the aim of this study was to investigate the effects of different HHP parameters on in vitro digestibility and physicochemical properties of cornstarch by nuclear magnetic resonance relaxometry.
Impact of Social Network on the Risk and Consequences of Injurious Falls in Older Adults
Authors: Trevisan Caterina , Rizzuto Debora , Maggi Stefania , Sergi Giuseppe , Wang Hui‐Xin , Fratiglioni Laura , Welmer Anna‐Karin 
Published: June 2019

OBJECTIVESA smaller social network is associated with worse health‐related outcomes in older people. We examined the impact of social connections and social support on the risk of injurious fall and on fall‐related functional decline and mortality.DESIGNProspective study with 6‐year follow‐up.SETTINGCommunity.PARTICIPANTSA total of 2630 participants (aged ≥60 years) from the Swedish National Study on Aging and Care in Kungsholmen.MEASUREMENTSSocial connections (social network size and contact frequency) and social support (social resource perception and satisfaction) were assessed through validated questionnaires. Data on injurious falls (falls requiring inpatient or outpatient care) and mortality came from official registers. We defined injurious falls as severe if they caused fracture and/or intracranial injury and as multiple if two or more occurred during the 6‐year follow‐up. Functional decline was defined as the loss of ability to perform one or more activities of daily living during the follow‐up.RESULTSDuring the follow‐up, 322 participants experienced injurious falls. After adjusting for potential confounders, the hazard ratio of injurious falls was 1.7 (95% confidence interval [CI] = 1.1‐2.4) for people with poor social connections and 1.5 (95% CI = 1.1‐2.1) for people with moderate social connections (reference: rich social connections). Social support was not associated with fall risk. The odds of functional decline among those with severe/multiple falls and (1) poor social connections (odds ratio [OR] = 5.2 [95% CI = 2.1‐12.9]) or (2) poor social support (OR = 4.5 [95% CI = 1.7‐12.0]) was up to twice as high as among those with severe/multiple falls and (3) rich social connections (OR = 2.5 [95% CI = .9‐6.6]) or (4) rich social support (OR = 2.7 [95% CI = 1.2‐6.3]). Similar but more attenuated results emerged for mortality.CONCLUSIONSSocial network may influence fall risk and fall‐related functional decline and mortality. J Am Geriatr Soc 67:1851–1858, 2019
Care of Pregnant Women: Experience from a Maternity‐Specific Ebola Isolation Unit in Sierra Leone
Authors: Garde Diana Leigh , Kahn Rebecca J. , Mesman Annelies W. , Koroma Alimamy Philip , Marsh Regan H. 
Published: June 2019

IntroductionThe Ebola virus disease epidemic was devastating to the West African region, particularly for pregnant women. Prior to the epidemic, maternal mortality in this region was among the highest in the world. Throughout the region, screening of patients with Ebola was difficult, as the symptoms of malaria or typhoid mimicked Ebola, but even more difficult for pregnant women, because of the large overlap between Ebola symptoms and pregnancy‐related complications. In November 2014, the world's first maternity‐specific isolation and screening system, to our knowledge, was created at the Princess Christian Maternity Hospital in Freetown to meet the emergent needs of the population of pregnant women during the epidemic.ProcessStarting in December 2014 through June 2016, in collaboration with hospital leadership and the Ministry of Health and Sanitation, Partners In Health supported Princess Christian Maternity Hospital in creating a safer health care environment with the shared goal of improving safety and health outcomes and of addressing the unique needs of pregnant women, by focusing on improving 4 key areas: 1) screening, 2) isolation, 3) laboratory diagnostics, and 4) clinical service delivery in isolation, including human resource management and training.OutcomesThe screening guidelines were adapted to include maternal health care considerations, a new screening area was constructed, the laboratory result turnaround time was reduced, and the isolation unit was improved to enhance safety and care delivery. Human resources were supported with additional staff hired and trainings on infection prevention and control, overall resulting in better preparing Princess Christian Maternity Hospital to provide care for pregnant women during outbreaks.DiscussionThe authors’ experience at Princess Christian Maternity Hospital provides a model of screening, isolation, and care specifically for maternity patients, and directly addresses infection risk and mortality. The recommendations we provide can be used in future outbreaks.
Treatment of atrophic acne scars using autologous platelet‐rich plasma vs combined subcision and autologous platelet‐rich plasma: A split‐face comparative study
Authors: Hassan Akmal Saad , El‐Hawary Marwa Safwat , Abdel Raheem Heba Mohammed , Abdallah Samar Hassan , El‐Komy Mohamed Medhat 
Published: June 2019

AbstractBackgroundMultiple therapeutic approaches are usually required when treating atrophic acne scars. Subcision was reported to be of value in improving rolling scars. Autologous platelet‐rich plasma (PRP) has recently been proposed as an adjuvant treatment option for atrophic acne scars with few reports evaluating its efficacy.ObjectiveOur objective was to compare the effect of intradermal injection of PRP vs combined PRP and subcision in the treatment of atrophic acne scars.MethodsThirty patients with bilateral atrophic acne scars were enrolled. Each patient received three monthly sessions. Each side of the face was randomly treated either with intradermal PRP alone or with combined treatment with subcision followed by PRP injection. Patients were assessed at 3 and 6 months following the last treatment session. Evaluation of serial photographs was performed by two blinded investigators.ResultsPlatelet‐rich plasma alone showed a better response, fewer side effects, and shorter downtime compared to combined subcision and PRP.ConclusionAutologous PRP injection can be a therapeutic option in the treatment of atrophic acne scars, with fewer complications and better tolerability than combined subcision and autologous PRP.
12‐hr shifts in nursing: Do they remove unproductive time and information loss or do they reduce education and discussion opportunities for nurses? A cross‐sectional study in 12 European countries
Authors: Dall’Ora Chiara , Griffiths Peter , Emmanuel Talia , Rafferty Anne Marie , Ewings Sean ,   the RN4CAST Consortium
Published: June 2019

AbstractAims and objectivesTo examine the association between registered nurses' (referred to as “nurses” for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers.BackgroundThe introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps.DesignCross‐sectional survey of 31,627 nurses within 487 hospitals in 12 European countries.MethodsThe associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist.ResultsWhen nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant.ConclusionWorking shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care.Relevance to clinical practiceImplementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients.
Nurses' decision‐making about intravenous administration set replacement: A qualitative study
Authors: Ray‐Barruel Gillian , Woods Christine , Larsen Emily N. , Marsh Nicole , Ullman Amanda J. , Rickard Claire M. 
Published: June 2019

AbstractAims and objectivesTo explore nurses' decision‐making regarding intravenous administration set replacement for vascular access device infusions in paediatric and adult clinical settings.BackgroundIntravenous administration sets are routinely replaced at regular intervals in clinical practice with the goal of preventing catheter‐related bloodstream infection; however, emerging evidence is challenging traditional hang‐time durations. Nurses' perceptions and contextual factors affecting decision‐making for administration set replacement have not been assessed previously.DesignQualitative study using focus groups with contextualism methodology and inductive analysis.MethodDuring November–December 2016, eight semi‐structured focus groups were conducted with 38 nurses at two metropolitan hospitals in Queensland, Australia. Interviews were audio‐recorded and transcribed. Two authors independently reviewed transcripts and extracted significant statements using Braun and Clarke's 7‐step method of thematic analysis. The COREQ checklist provided a framework to report the study methods, context, findings, analysis and interpretation.ResultsFive key themes emerged from the analysis: (a) infection prevention, (b) physical safety, (c) patient preference, (d) clinical knowledge and beliefs, and (e) workload. Administration set replacement can be a complex task, particularly when patients have multiple infusions and incompatible medications. Nurses drew on perceptions of patient preference, as well as previous experience, knowledge of peer experts and local policies, to aid their decisions.ConclusionsNurses use clinical reasoning to balance patient safety and preferences with competing workplace demands when undertaking administration set replacement. Nurses rely on previous experience, hospital and medication manufacturer policies, and peer experts to guide their practice.Relevance to clinical practiceNurses at times deviate from clinical guidelines in the interests of patient acuity, nurses' experience and workload. The findings of this study indicate nurses also balance considerations of patient preference and safety with these competing demands.
Chromosomal aberrations in women with primary and secondary amenorrhea: A cross‐sectional study
Authors: Al‐Jaroudi Dania , Hijazi Ayah , Bashir Mohammed , Heena Humariya , Tashkandi Soha A. 
Published: June 2019

AbstractAimAmong women of childbearing age, about 2–5% are affected by amenorrhea that is either primary or secondary. However, there are no data regarding the frequency and type of chromosomal abnormalities associated with amenorrhea in Saudi women. The present study aims to establish the frequency and pattern of chromosomal abnormalities in primary amenorrhea (PA) and secondary amenorrhea (SA) cases in a tertiary care center, Riyadh, Saudi Arabia.MethodsThis cross‐sectional study was conducted between 2013 and 2016 on women referred to the Reproductive Endocrine and Infertility Medicine Department at a tertiary care center in Riyadh. Women were divided into two groups: PA and SA. After the initial diagnosis of amenorrhea based on medical history, physical examination, hormonal profile and ultrasonography, chromosome karyotype analysis was conducted on metaphase preparations following routine cytogenetics culture and harvest methods.ResultsChromosomal tests were performed for 53 patients (42 with PA and 11 with SA) out of 79 referred patients with amenorrhea. About 19% of the 42 patients with PA and 1 patient (9.1%) diagnosed as SA showed an abnormal karyotype. The most common abnormal karyotypes observed were 46, XY and 45, X.ConclusionThe present study indicates that the chromosomal analysis after the exclusion of nongenetic causes should be essentially considered for the precise diagnosis and the development of more successful management for females with amenorrhea. This study also revealed that the prevalence of chromosomal abnormalities in women with PA and SA is similar to that reported in the literature.
Ectophoma iranica sp. nov. and new hosts and records of Allophoma spp. in Iran
Authors: Larki Reihaneh , Mehrabi‐Koushki Mehdi , Farokhinejad Reza 
Published: June 2019

AbstractA survey was conducted to identify fungi associated with leaf diseases of ornamental herbs, including Christ plant, dracaena, rose geranium, rose periwinkle and treasure flower, in Ahvaz, southwestern Iran. Twenty‐five symptomatic herbs were collected and studied, which led to the isolation of seven Phoma‐like strains belonging to four taxa. These fungi were characterised based on DNA sequence data for the partial large subunit 28S nrDNA (LSU‐D1/D2), the internal transcribed spacer 1 and 2 and 5.8S nrDNA (ITS) and part of the β‐tubulin (tub2) gene regions. A multi‐locus‐based phylogeny, in combination with morphology, allowed for the identification of Allophoma hayatii, A. labilis, A. tropica and a novel species of the genus Ectophoma. Ectophoma iranica sp. nov. is morphologically and genetically distinctive from previously described species. In pathogenicity tests, the two strains of E. iranica (CBS 144681 and IRAN 3354C) caused leaf spot symptoms on leaves of Catharanthus roseus. New host plant species and records for A. hayatii, A. labilis and A. tropica are reported, plus further emended characterization of A. hayatii.
Dietary guidelines for children under 2 years of age in the context of nurturing care
Authors: Pérez‐Escamilla Rafael , Segura‐Pérez Sofia , Hall Moran Victoria 
Published: June 2019

AbstractDietary guidelines provide advice on what to eat to different subsets of the population but often do not take into account the “how” to eat. Responsive feeding is a key dimension of responsive parenting involving reciprocity between the child and caregiver during the feeding process and is characterized by caregiver guidance and recognition of the child's cues of hunger and satiety. Evidence indicates that providing responsive feeding guidance to mothers on how to recognize and respond appropriately to children's hunger and satiety cues can lead to improved feeding practices and weight status and developmental outcomes among infants and young children. In addition, early and nurturing exposures to foods with different tastes and textures and positive role modelling help children to learn to eat healthy foods. The importance of improving caregiver's responsive feeding behaviours to ensure the adequate introduction of complementary foods is becoming increasing recognized, but responsive feeding principles have not been taken into account in a comprehensive way in the development of dietary guidelines. The incorporation of all responsive feeding principles into dietary guidelines has a strong potential to enhance their impact on early childhood development outcomes for infants and young children but will require adaptation to the different contexts across countries to ensure that they are culturally sensitive and grounded in a deep understanding of the types of foods and other resources available to diverse communities.