bluuebunny/crossref_metadata_2025_split huggingface dataset:
EMPOWERing Hospitalized Older Adults to Deprescribe Sedative Hypnotics: A Pilot Study
Authors: Wilson Marnie Goodwin , Lee Todd C. , Hass Aaron , Tannenbaum Cara , McDonald Emily G. 
Published: March 2018

ObjectivesTo distribute the EMPOWER patient education brochure and use hospitalization as an opportunity to reduce inappropriate sedatives.DesignParticipants were sequentially recruited until we achieved 30‐day follow‐up telephone and pharmacy records for 50 individuals. The proportion meeting the primary outcome was compared with that of a control cohort and with rates of cessation achieved in the community.SettingFifty‐two‐bed medical clinical teaching unit in Montréal, Canada.ParticipantsInpatients aged 65 and older who were chronic, regular sedative users.MeasurementsThe primary outcome was short‐term sustained cessation 30‐days after discharge. As a secondary outcome, we compared self‐reported sleep disturbance before and after the intervention.ResultsSedatives were deprescribed in 32 of 50 (64%) participants who received the EMPOWER brochure, which was significantly higher than our historical rate of 21% (p<.001). Participants did not report significant worsening in their quality of sleep after sedative cessation.ConclusionHospitalized individuals are willing to deprescribe, and contact with the healthcare system provides the opportunity to initiate the process with educational brochures. This type of intervention requires few resources and is feasible and inexpensive.
Treatment of disseminated Strongyloides spp. infection in an infant Sumatran orangutan (Pongo abelii)
Authors: Kleinschmidt Laura M. , Kinney Matthew E. , Hanley Christopher S. 
Published: March 2018

AbstractStrongyloides nematodes have been reported in all species of great apes with orangutans ≤5 years old most susceptible to severe clinical disease. This brief communication describes the first published case of antemortem diagnosis and treatment of disseminated strongyloidiasis in a clinically affected 5‐month‐old Sumatran orangutan (Pongo abelii).
Empowering members of a rural southern community in Nigeria to plan to take action to prevent maternal mortality: A participatory action research project
Authors: Esienumoh Ekpoanwan E , Allotey Janette , Waterman Heather 
Published: March 2018

Aims and objectivesTo facilitate the empowerment of members of a rural community to plan to take action to prevent maternal mortality.BackgroundGlobally, about 300,000 maternal deaths occur yearly. Sub‐Saharan Africa and Southern Asia regions account for almost all the deaths. Within those regions, India and Nigeria account for over a third of the global maternal deaths. Problem of maternal mortality in Nigeria is multifaceted. About 80% of maternal deaths are avoidable, given strategies which include skilled attendants, emergency obstetric care and community mobilisation. In this article, a strategy of community empowerment to plan to take action to prevent maternal mortality is discussed.DesignParticipatory action research was used.MethodsTwelve volunteers were recruited as coresearchers into the study through purposive and snowball sampling who, following an orientation workshop, undertook participatory qualitative data collection with an additional 29 community members. Participatory thematic analysis of the data was undertaken which formed the basis of the plan of action.ResultsCommunity members attributed maternal morbidities and deaths to superstitious causes, delayed referrals by traditional birth attendants, poor transportation and poor resourcing of health facilities. Following critical reflection, actions were planned to empower the people to prevent maternal deaths through community education and advocacy meetings with stakeholders to improve health and transportation infrastructures; training of existing traditional birth attendants in the interim and initiating their collaboration with skilled birth attendants.ConclusionThe community is a resource which if mobilised through the process of participatory action research can be empowered to plan to take action in collaboration with skilled birth attendants to prevent maternal mortality.Relevance to clinical practiceInterventions to prevent maternal deaths should include community empowerment to have better understanding of their circumstances as well as their collaboration with health professionals.
The role of empathy and emotional intelligence in nurses’ communication attitudes using regression models and fuzzy‐set qualitative comparative analysis models
Authors: Giménez‐Espert María del Carmen , Prado‐Gascó Vicente Javier 
Published: March 2018

Aims and objectivesTo analyse link between empathy and emotional intelligence as a predictor of nurses’ attitudes towards communication while comparing the contribution of emotional aspects and attitudinal elements on potential behaviour.BackgroundNurses’ attitudes towards communication, empathy and emotional intelligence are key skills for nurses involved in patient care. There are currently no studies analysing this link, and its investigation is needed because attitudes may influence communication behaviours.DesignCorrelational study.MethodTo attain this goal, self‐reported instruments (attitudes towards communication of nurses, trait emotional intelligence (Trait Emotional Meta‐Mood Scale) and Jefferson Scale of Nursing Empathy (Jefferson Scale Nursing Empathy) were collected from 460 nurses between September 2015–February 2016.Two different analytical methodologies were used: traditional regression models and fuzzy‐set qualitative comparative analysis models.ResultsThe results of the regression model suggest that cognitive dimensions of attitude are a significant and positive predictor of the behavioural dimension. The perspective‐taking dimension of empathy and the emotional‐clarity dimension of emotional intelligence were significant positive predictors of the dimensions of attitudes towards communication, except for the affective dimension (for which the association was negative). The results of the fuzzy‐set qualitative comparative analysis models confirm that the combination of high levels of cognitive dimension of attitudes, perspective‐taking and emotional clarity explained high levels of the behavioural dimension of attitude.ConclusionsEmpathy and emotional intelligence are predictors of nurses’ attitudes towards communication, and the cognitive dimension of attitude is a good predictor of the behavioural dimension of attitudes towards communication of nurses in both regression models and fuzzy‐set qualitative comparative analysis. In general, the fuzzy‐set qualitative comparative analysis models appear to be better predictors than the regression models are.Relevance to clinical practiceTo evaluate current practices, establish intervention strategies and evaluate their effectiveness. The evaluation of these variables and their relationships are important in creating a satisfied and sustainable workforce and improving quality of care and patient health.
STOPDVTs: Development and testing of a clinical assessment tool to guide nursing assessment of postoperative patients for Deep Vein Thrombosis
Authors: O'Brien Alanna , Redley Bernice , Wood Beverley , Botti Mari , Hutchinson Anastasia F 
Published: March 2018

Aims and objectivesTo develop and test a clinical tool to guide nurses’ assessment of postoperative patients for Deep Vein Thrombosis.BackgroundPreventing venous thromboembolism in hospitalised patients is an international patient safety priority. Despite high‐level evidence for optimal venous thromboembolism prophylaxis, implementation is inconsistent and the incidence of Deep Vein Thrombosis remains high.MethodsA two‐stage sequential multi‐method design was used. In stage 1, the STOPDVTs tool was developed using a review of the literature and focus groups with local clinical experts. Stage 2 involved pilot testing the tool with 38 surgical nurses who conducted repeated assessments on a prospective sample of 50 postoperative orthopaedic patients.ResultsStage 1: The focus group members who were members of the nursing leadership team agreed on eight local and systemic signs and symptoms that should be included in a nursing patient assessment tool for early Deep Vein Thrombosis. Local symptoms were pain in the limbs, calf swelling and tightness, changes in the affected limb's skin temperature. Systemic signs included in the tool were as follows: increased shortness of breath, increased respiratory and heart rates, and decreased oxygen saturation. Stage 2: The STOPDVTs tool had acceptable face and content validity, the agreement between the expert nurse and surgical nurses on assessments of individual signs and symptoms varied between 44%–94%. Surgical nurses were less likely than the expert nurse to identify signs indicative of Deep Vein Thrombosis.ConclusionDespite finding the STOPDVTs clinical assessment tool was a useful guide for nursing assessment, surgical nurses often underestimated the potential importance of clinical signs. The findings reveal a gap in nursing knowledge and skill in assessing for Deep Vein Thrombosis in postoperative orthopaedic patients.Relevance to clinical practiceThis study identified a possible risk to patient safety related to under‐recognition of the signs and symptoms of possible Deep Vein Thrombosis (DVT) in postoperative orthopaedic patients. The findings demonstrate the feasibility of developing and implementing a protocol for consistent screening by nurses for possible DVT in the postoperative period.
Recognition of preclinical signs of dementia: A qualitative study exploring the experiences of family carers and professional care assistants
Authors: Jenkins Catharine , Feldman Gerald 
Published: March 2018

Aims and objectivesTo identify preclinical signs of dementia by exploring the experiences of family caregivers and professional care assistants.BackgroundDementia results in disability, emotional strain and financial loss for people with dementia, family members and nations. Informal identification of social and behavioural risk signifiers could facilitate timely interventions with potential to delay onset of serious disability.DesignA retrospective qualitative approach using a naturalistic interpretive design was used. Focus groups enabled in‐depth understanding of the participants’ experiences of life or work with people who subsequently developed dementia.MethodsPurposive sampling was used to recruit family carers and professional carers who had cared for people who later developed dementia. The data from focus groups were fully transcribed and anonymised, and transcripts were analysed by two researchers. These researchers coded and analysed the transcripts independently; subsequently, overlapping and similar themes were identified and consensus reached on final themes. A third researcher was invited to review the analysis and ensure trustworthiness of the study findings.ResultsFindings revealed that preclinical signs of dementia were identifiable in retrospect Participants’ accounts resulted in four themes, “Lowered Threshold of Frustration”, “Insight and Coping Strategies,” “Early signs of poor memory” and “Alarming Events.”ConclusionsEarlier recognition of preclinical signs of dementia would allow affected individuals to follow health promotion advice and plan for the future. Identification of social exclusion prior to diagnosis has implications for antistigma campaigns and development of “dementia‐friendly communities.”Relevance to clinical practiceHealthcare professionals could work with those at risk, facilitating lifestyle changes to postpone symptoms and advance planning for improved autonomy. Predementia should be viewed as a disability for which reasonable adjustments can be made at a community level, to enhance and extend emotional well‐being and social inclusion.
Barriers to medication error reporting among hospital nurses
Authors: Rutledge Dana N , Retrosi Tina , Ostrowski Gary 
Published: March 2018

Aims and objectivesThe study purpose was to report medication error reporting barriers among hospital nurses, and to determine validity and reliability of an existing medication error reporting barriers questionnaire.BackgroundHospital medication errors typically occur between ordering of a medication to its receipt by the patient with subsequent staff monitoring. To decrease medication errors, factors surrounding medication errors must be understood; this requires reporting by employees. Under‐reporting can compromise patient safety by disabling improvement efforts.DesignThis 2017 descriptive study was part of a larger workforce engagement study at a faith‐based Magnet®‐accredited community hospital in California (United States).MethodsRegistered nurses (~1,000) were invited to participate in the online survey via email. Reported here are sample demographics (n = 357) and responses to the 20‐item medication error reporting barriers questionnaire. Using factor analysis, four factors that accounted for 67.5% of the variance were extracted. These factors (subscales) were labelled Fear, Cultural Barriers, Lack of Knowledge/Feedback and Practical/Utility Barriers; each demonstrated excellent internal consistency.ResultsThe medication error reporting barriers questionnaire, originally developed in long‐term care, demonstrated good validity and excellent reliability among hospital nurses. Substantial proportions of American hospital nurses (11%–48%) considered specific factors as likely reporting barriers. Average scores on most barrier items were categorised “somewhat unlikely.” The highest six included two barriers concerning the time‐consuming nature of medication error reporting and four related to nurses’ fear of repercussions.ConclusionsHospitals need to determine the presence of perceived barriers among nurses using questionnaires such as the medication error reporting barriers and work to encourage better reporting.Relevance to clinical practiceBarriers to medication error reporting make it less likely that nurses will report medication errors, especially errors where patient harm is not apparent or where an error might be hidden. Such under‐reporting impedes collection of accurate medication error data and prevents hospitals from changing harmful practices.
Identification of additional sources of resistance to Puccinia striiformis f. sp. hordei (PSH) in a collection of barley genotypes adapted to the high input condition
Authors: Verma Ramesh P. S. , Selvakumar Rajan , Gangwar Om P. , Shekhawat Pradeep S. , Bhardwaj Subhash C. , Rehman Sajid , Sharma‐Poudyal Dipak , Gyawali Sanjaya 
Published: March 2018

AbstractA total of 336 barley genotypes consisting of released cultivars, advanced lines, differentials and local landraces from the ICARDA barley breeding programme were screened for seedling and adult‐plant resistances to barley stripe rust pathogen (Puccinia striiformis f. sp. hordei [PSH]). Seedling resistance tests were undertaken at Shimla, India by inoculating 336 barley genotypes with five prevalent PSH races [Q (5S0), 24 (0S0‐1), 57 (0S0), M (1S0) and G (4S0)] in India. Barley genotypes were also evaluated at the adult‐plant stage for stripe rust resistance at Durgapura (Rajasthan, India) in 2013 and 2014, and at Karnal (Haryana, India) in 2014 under artificial PSH infection in fields, using a mixture of the five races. Twelve barley genotypes (ARAMIR/COSSACK, Astrix, C8806, C9430, CLE 202, Gold, Gull, Isaria, Lechtaler, Piroline, Stirling, and Trumpf) were resistant to all five PSH races at the seedling and adult‐plant stages. Two of these genotypes, Astrix and Trumpf, were part of international differentials and reveal that five races were avirulent to genes Rps4 (yr4), rpsAst, rpsTr1 and rpsTr2. These genes were highly effective against PSH races prevalent in India. The virulence/avirulence formula reported in this study helped to determine the effectiveness of PSH resistance genes against Indian races. Forty‐five genotypes showed adult‐stage plant resistance (APR) in the field. The identified PSH resistant genotypes may possess novel resistance genes and might serve as potential donors of PSH resistance at seedling and APR in the future. Further research is needed to determine the nature of resistance genes through allelic studies and mapping of these genes.
Sleep deprivation compromises resting‐state emotional regulatory processes: An EEG study
Authors: Zhang Jinxiao , Lau Esther Yuet Ying , Hsiao Janet H. 
Published: March 2018

SummaryResting‐state spontaneous neural activities consume far more biological energy than stimulus‐induced activities, suggesting their significance. However, existing studies of sleep loss and emotional functioning have focused on how sleep deprivation modulates stimulus‐induced emotional neural activities. The current study aimed to investigate the impacts of sleep deprivation on the brain network of emotional functioning using electroencephalogram during a resting state. Two established resting‐state electroencephalogram indexes (i.e. frontal alpha asymmetry and frontal theta/beta ratio) were used to reflect the functioning of the emotion regulatory neural network. Participants completed an 8‐min resting‐state electroencephalogram recording after a well‐rested night or 24 hr sleep deprivation. The Sleep Deprivation group had a heightened ratio of the power density in theta band to beta band (theta/beta ratio) in the frontal area than the Sleep Control group, suggesting an affective approach with reduced frontal cortical regulation of subcortical drive after sleep deprivation. There was also marginally more left‐lateralized frontal alpha power (left frontal alpha asymmetry) in the Sleep Deprivation group compared with the Sleep Control group. Besides, higher theta/beta ratio and more left alpha lateralization were correlated with higher sleepiness and lower vigilance. The results converged in suggesting compromised emotional regulatory processes during resting state after sleep deprivation. Our work provided the first resting‐state neural evidence for compromised emotional functioning after sleep loss, highlighting the significance of examining resting‐state neural activities within the affective brain network as a default functional mode in investigating the sleep–emotion relationship.
Promoting CPAP adherence in clinical practice: A survey of Swedish and Norwegian CPAP practitioners’ beliefs and practices
Authors: Broström Anders , Pakpour Amir H. , Nilsen Per , Gardner Benjamin , Ulander Martin 
Published: March 2018

SummaryThe benefits of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea are well established, but adherence tends to be low. Research exploring CPAP practitioners’ beliefs around determinants of CPAP adherence, and the actions they use in clinical practice to promote CPAP adherence is lacking. This study aimed to: (i) develop and validate a questionnaire to assess beliefs and current practices among CPAP practitioners; (ii) explore practitioners’ beliefs regarding the main determinants of patient adherence, and the actions practitioners most commonly use to promote CPAP adherence; and (iii) explore the associations between perceived determinants and adherence‐promotion actions. One‐hundred and forty‐two CPAP practitioners in Sweden and Norway, representing 93% of all Swedish and 62% of all Norwegian CPAP centres, were surveyed via a questionnaire exploring potential determinants (18 items) and adherence‐promotion actions (20 items). Confirmatory factor analysis and second‐order structural equational modelling were used to identify patterns of beliefs, and potential associations with adherence‐promotion actions. Patients’ knowledge, motivation and attitudes were perceived by practitioners to be the main determinants of CPAP adherence, and educating patients about effects, management and treatment adjustments were the most common practices. Knowledge was shown to predict educational and informational actions (e.g. education about obstructive sleep apnea and CPAP). Educational and informational actions were associated with medical actions (e.g. treatment adjustment), but knowledge, attitude and support had no association with medical actions. These findings indicate that a wide variety of determinants and actions are considered important, though the only relationship observed between beliefs and actions was found for knowledge and educational and informational actions.
Feasibility of integrating calcium and iron–folate supplementation to prevent preeclampsia and anemia in pregnancy in primary healthcare facilities in Kenya
Authors: Omotayo Moshood O. , Dickin Katherine L. , Pelletier David L. , Martin Stephanie L. , Kung'u Jacqueline K. , Stoltzfus Rebecca J. 
Published: March 2018

AbstractCalcium (Ca) supplementation to prevent preeclampsia can save maternal and newborn lives, but there are no program models for integration into existing antenatal care platforms. We used a program impact pathway model to guide the design of integrated Ca and iron–folate (IFA) supplementation in Kenya. We provided healthcare providers with job aids (posters and counseling cards), trained them on counseling techniques and supplementation guidelines, and developed behavior change materials for pregnant women (pill‐taking calendars). We allocated health facilities to prescribe either 1.0 or 1.5 g/day Ca, with standard IFA. We collected implementation data from 16 facilities and 990 women. We also explored effects of supplementation on percentage of the population meeting recommended daily allowance. Supplements and job aids were available during 90% of facility spot‐check episodes; calendar availability was lower (78%). Over 98% of clients received Ca and IFA supplements, but only 76% received enough Ca supplements to last between antenatal care visits. Among clients that still had pills by return date, adherence was 77% and 83% for the IFA and Ca regimen, respectively. When 1.5 g/day of Ca supplements were prescribed, over 75% of participants met recommended daily allowance. Only 54% met the recommended daily allowance when 1.0 g was prescribed. This study illustrates a systematic approach for integrating Ca supplementation into primary healthcare and demonstrates that such integration is feasible when contextual bottlenecks are addressed. Policy makers and program planners should pay attention to supply chain, healthcare worker dispensing behavior, and appropriateness of regimen for their settings.