bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transforming Ethnocentricity in Nursing: A Culturally Relevant Experience of Reciprocal Visits Between Malta and the Midwest
Authors: Dean Patrick J 
Published: January 2019

ABSTRACT
Despite efforts by the nursing profession to enhance culture competence among nurses, some limitations in understanding the potential lack of culture competence in the patient remain. Nurses are often not aware of their own cultural bias from the patient's perspective (ethnocentricity) and fail to understand that many patients are trying to function in unfamiliar social and medical cultures simultaneously. This article reviews the experiences of student nurses from Malta and the Midwestern United States who were given the opportunity to explore their cultural biases by visiting the healthcare institutions of their respective countries.
International Collaboration on Genomics Education for Nurses
Authors: Pestka Elizabeth L , Williams Janet K 
Published: January 2019

ABSTRACT
The International Society of Nurses in Genetics began in 1988 as a venue for nurses around the world to advance their knowledge and practice related to genomics. This article discusses how the organization has conducted an annual international nursing conference, promoted the incorporation of genomics topics into continuing education programs and professional nursing journals, assisted with the incorporation of genomics content into undergraduate and graduate nursing curricula, and defined genetics as a clinical nursing specialty. Genomics education is relevant to nursing practice in all specialty areas and significant to the future of health care.
Continuing Education for Nurses: A Necessity or a Nicety?
Authors: Levett-Jones Tracy L 
Published: January 2019

ABSTRACT
The changing health care climate has resulted in escalating financial constraints. One department that is often scrutinized for its cost-benefit relation to the hospital is the nursing education department. These departments are increasingly being reduced in size and investment in the continuing education of nurses is being rationalized. However, reducing financial support of education may be counterproductive in both the short- and long-term. This article does not propose a "recipe" for effectively facilitating continuing education. However, it does provide sound justification for investing in the continuing education of nurses and demonstrates not only that quality education results in enhanced knowledge and skills, but that there is also a positive correlation between professional development and factors such as staff satisfaction, staff retention, and quality patient care.
« What a piece of work is your machine, Harold » : Shakespeare et la réinvention de l’humanité dans les séries américaines d’anticipation
Authors: Hatchuel Sarah 
Published: January 2019

Si Harold Bloom a pensé Shakespeare, de manière relativement essentialiste, comme l’inventeur de ce qu’on entend par « humain », les séries télévisées américaines présentent Shakespeare comme ce qui définit une humanité en permanente re-définition, re-construction ou ré-affirmation. Shakespeare est convoqué non pas pour définir l’humain de manière fixe mais pour contribuer à une extension du domaine de l’humain. Dans des séries de science-fiction et d’anticipation comme Star Trek, Person of Interest ou Westworld, les mots de Shakespeare deviennent les signes par lesquels les machines et les anthropoïdes révèlent qu’ils acquièrent une humanité ou peut-être même qu’ils étaient toujours déjà humains. Le dialogue qui s’instaure entre Shakespeare et les séries « posthumaines » fait écho à celui qui s’était déjà établi dans le film Elephant Man réalisé en 1980 par David Lynch, réalisateur qui a lui-même fait des allers-retours entre le cinéma et les séries télévisées.
CEO-CLER Innovation Grants Program: Empowering Residents as Clinical Learning Environment Change Agents
Authors: Batalden Maren , Fisher Carolyn , Pels Richard , Gaufberg Elizabeth 
Published: January 2019

ABSTRACT

Background
Many efforts over the past decade have focused on developing quality improvement and safety curricula for residents. Sponsoring institutions have encountered challenges aligning resident projects with institutional quality and safety priorities, engaging faculty mentors, and securing support for resident initiatives from executive leadership.

Objective
We developed a small grants program to support resident-led change projects intended to improve the clinical learning environment. We assessed program acceptability to residents and faculty, impact of program structure in supporting successful change projects, and program feasibility and financial sustainability.

Methods
Program acceptability was assessed through a review of resident participation. Three aspects of resident change project success were considered: (1) accomplishment of stated aims; (2) institutional change beyond the end of grant funding; and (3) academic publication or presentation. The impact of program structure on project success was assessed through a review of submitted end-of-year narrative reports.

Results
The Award Selection Committee has given 41 awards to 44 residents over 4 years, engaging 21% (44 of 213) of residents. Seventy-one percent of projects (29 of 41) produced changes that continued beyond the grant year, and 46% (19 of 41) produced an academic publication or presentation. At the end of the grant period that funded the program's initial 3 years, the chief executive officer elected to continue program funding.

Conclusions
A small grants program supporting resident-led change projects intended to improve the clinical learning environment is acceptable to residents and faculty, feasible to administer, and sustainable with support from institutional senior leaders.
ACGME Milestones Within Subspecialty Training Programs: One Institution's Experience
Authors: Heath Janae K. , Dine C. Jessica 
Published: January 2019

ABSTRACT

Background
The Accreditation Council for Graduate Medical Education Milestones were created as a criterion-based framework to promote competency-based education during graduate medical education. Despite widespread implementation across subspecialty programs, extensive validity evidence supporting the use of milestones within fellowship training is lacking.

Objective
We assessed the construct and response process validity of milestones in subspecialty fellowship programs in an academic medical center.

Methods
From 2014–2016, we performed a single center retrospective cohort analysis of milestone data from fellows across 5 programs. We analyzed summary statistics and performed multivariable linear regression to assess change in milestone ratings by training year and variability in ratings across fellowship programs. Finally, we examined a subset of Professionalism and Interpersonal and Communication Skills subcompetencies from the first 6 months of training to identify the proportion of fellows deemed “ready for independent practice” in these domains.

Results
Milestone data were available for 68 fellows, with 75 933 unique subcompetency ratings. Multivariable linear regression, adjusted for subcompetency and subspecialty, revealed an increase of 0.17 (0.16–0.19) in ratings with each postgraduate year level increase (P &lt; .005), as well as significant variation in milestone ratings across subspecialties. For the Professionalism and Interpersonal and Communication Skills domains, mean ratings within the first 6 months of training were 3.78 and 3.95, respectively.

Conclusions
We noted a minimal upward trend of milestone ratings in subspecialty training programs, and significant variability in implementing milestones across differing subspecialties. This may suggest possible difficulties with the construct validity and response process of the milestone system in certain medical subspecialties.
In vitro analysis of urinary stone composition in dual-energy
computed tomography
Authors: Stępień Monika , Chrzan Robert , Gawlas Wojciech 
Published: January 2019

PurposeDual energy computed tomography (DECT) is a new method of computed tomography (CT) imaging, allowing the assessment of not only the object’s morphology, but also its composition. The aim of the study was to evaluate the potential of <i><i>in vitro</i></i> DECT evaluation of urinary stones’ chemical composition.Material and methodsSix samples of surgically removed renal stones were scanned using DECT and analyzed by scanner vendor software. Uric acid stones were marked red and calcium stones white by the software. The real composition of the stones was finally verified using physicochemical laboratory analysis.ResultsIn 5 out of 6 samples, the composition of stones in DECT (3 samples identified as uric acid and 2 samples as calcium) was consistent with the physicochemical analysis (3 samples identified as uric acid, 1 as calcium phosphate, 1 as calcium oxalate). In DECT it was not possible to determine more precisely the type of calcium compounds (calcium phosphate vs. calcium oxalate) as established in the physicochemical analysis.
In one stone identified in physicochemical analysis as uric acid, DECT detected a composite layered structure containing both uric acid and calcium compounds.ConclusionsDECT allows uric acid to be distinguished from calcium urinary tract stones, which is crucial in the choice of appropriate therapy. Using the available hardware and software, it was not possible to more accurately distinguish types of calcified stones. Evaluation of the stone type in DECT may be limited in the case of mixed chemical composition.
Improved imaging of colorectal liver metastases using single-source fast kVp-switching dual-energy CT: preliminary results
Authors: Ratajczak Przemysław , Serafin Zbigniew , Sławińska Agata , Słupski Maciej , Leszczyński Waldemar 
Published: January 2019

PurposeComputed tomography remains the first-choice modality for assessment of colorectal cancer liver metastases (CRLM). Dual-energy computed tomography (DECT) is a relatively new technique that is becoming increasingly available. One of the advantages of DECT is the ability to maximise iodine detection. Our aim was to test whether single-source, fast kVp-switching DECT can improve imaging quality of CRLM compared to conventional (polychromatic) CT.Material and methodsTwenty consecutive patients were enrolled into a preliminary prospective study. The scanning protocol consisted of four phases: non-contrast with standard 120 kV tube voltage and three post-contrast phases with rapid voltage switching. As a result, three sets of images were reconstructed: pre- and postcontrast polychromatic (PR), monochromatic (MR), and iodine concentration map (IM). To compare the sensitivity of the tested reconstructions, the number of CRLMs and the maximum diameter of the largest lesion were calculated. Objective image quality was measured as signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The radiation dose was expressed as CTDIvol.ResultsImaging was successfully performed in all patients. The number of detected lesions was significantly lower on PR images than on IM and MR 50-70 keV (mean number: 4.20 and 4.45, respectively). IM and MR at 70 keV presented the highest quality. SNR was significantly higher for IM and 70 keV images than for other reconstructions.
The mean radiation dose was 14.61 mGy for non-contrast 120 kV scan and 17.89 mGy for single DECT scan (p < 0.05).ConclusionsDECT is a promising tool for CRLM imaging. IM and low-photon energy MR present the highest differences in contrast between metastases and the normal liver parenchyma.
Civilização, violência e educação: uma leitura a partir de Freud e Adorno
Authors: Pereira dos Santos Dayanna 
Published: January 2019

Este artigo propõe a reflexão sobre alguns pontos do pensamento de Adorno e Horkheimer e da teoria freudiana, destacando-se a temática da existência e da violência na tensão entre a coletividade e a individualidade. Para tanto, busca-se identificar as raízes do conflito entre as pulsões e a cultura e a forma que a repressão comparece na civilização. Sob esse marco teórico, a reflexão sobre indivíduo-sociedade terá como objetivo realçar tramas e enlaces aparentes e abstrusos operantes no processo civilizatório em resistência e oposição à consubstancialização do sujeito com a realidade exterior e os votos de violência prenunciados pela sociedade capitalista.
Palavras-Chave: Civilização, repressão, violência, educação, humanização
CORPO EM MOVIMENTO: DOR E SUBJETIVAÇÃO EM MODALIDADES ESTÉTICAS DE ALTO RENDIMENTO
Authors: Herrera Lima Thayara Paule , Padovani Ricardo Da Costa 
Published: January 2019

A dor se manifesta com continuidade na vida de atletas, produz formas através das quais estes se relacionam com o esporte, consigo. Buscaremos compreender as modulações subjetivas da dor, os ecos e significações advindos dessa experiência continuada nas perspectivas cognitivas e comportamentais em atletas de modalidades individuais cujo componente estético constitui indicador de desempenho e excelência. Este ensaio discute o papel das interpretações que modulam a figura do atleta e da dor, não reduzida a uma realidade estritamente biológica.
Sophia Chambers, Founder of the Holiness Church: A Case Study of Victorian Entrepreneurial Religious Leadership
Authors: Bundy David 
Published: January 2019

ABSTRACT
The Holiness Church, founded by Sophia Chambers (1838–87), is one of the rare religious denominations in any country founded and led by a woman. The central primary source is the periodical created and edited by Chambers, the Holiness Advocate. The article argues that Sophia Chambers's leadership approach provides an additional exception to common scholarly conceptions of women's ministry, leadership, and gender roles of the late Victorian period. To make this argument, the extant sources for Sophia Chambers and the Holiness Church are provided, narratives of her life and of the history of the Holiness Church during her lifetime are reconstructed, and her theological framework is examined. At her death, she left the leadership in the hands of four of her male subordinates. The developments in the transition of power and their effect on the church are examined before reflecting on her approach to leadership. It demonstrates that the ‘two spheres’ paradigm is not adequate for understanding Chambers.
A retrospective analysis of retirement of football players in Portugal
Authors: Carapinheira António , Torregrossa Miquel , Mendes Pedro , Guedes carvalho Pedro , Travassos Bruno Filipe Rama 
Published: January 2019

The purpose of this study was to analyse the retirement of elite football players in Portugal. Specifically, the quality of retirement and the resources available were evaluated. To develop an understanding of the process of the sporting retirement of elite football players we used data from in-depth, semi-structured interviews with ninety professional players from the portuguese football national team. Most of the elite Portuguese footballers we investigated retired from sport between 36 and 40 years of age, their retirement had been involuntary and it had taken them less than a year to accept retirement. Most had only been educated to secondary level and had a strong athletic identity, no plans for their post-football career exist and relied on family as their main psychological support. None of the players had received support from a formal programme. Despite of the findings being consistent with previous research from other Southern European cultures, it seems that the athletic retirement of portuguese footballers has some particularities. Most portuguese footballers retired later and had longer playing careers than athletes in other countries. In addition, retirement was involuntary in most of cases, yet players reported that it took them a relatively short time to accept retirement.
Changes in interleukin-27 levels in patients with acute coronary syndrome and their clinical significance
Authors: Zhang Lin , Zhang Junfeng , Su Shaohong , Luo Suyan 
Published: January 2019

Background
This study evaluated changes in interleukin (IL)-27 levels in patients with acute coronary syndrome (ACS) and their influence on Th1, Th2, and Th17 cells.

Methods
Serum levels of IL-27, IL-4, IL-17, and interferon (IFN)-γ in healthy subjects as well as patients with ACS, including stable angina pectoris (SA), unstable angina pectoris (UA), and acute myocardial infarction (AMI), were determined using an enzyme-linked immunosorbent assay. The proportions of Th1, Th2, and Th17 cells among peripheral blood mononuclear cells (PBMCs), were measured using flow cytometry, after incubation with phorbol myristate acetate (PMA) for 4 h. The proportions of Th1 and Th17 cells among PBMCs in AMI and UA were detected after stimulation with IL-27 or PMA + IL-27 for 4, 8, and 12 h.

Results
Serum levels of IL-27 in patients with AMI and UA were significantly lower than those in SA and control groups, while serum levels of IL-17 and IFN-γ in AMI and UA groups were dramatically increased compared to those in SA and healthy control groups. However, there were no statistically significant differences in serum IL-4. The proportions of Th1 and Th17 cells among PBMCs were statistically significantly higher in the AMI and UA groups than those in the SA and control groups, while there was no statistically significant difference in the proportion of Th2 cells among different groups. For patients with AMI and UA, the effect of co-stimulation of PBMCs with PMA and IL-27 was not significantly different from that of PMA single stimulation, while PMA + IL-27 co-stimulation lowered the Th17 cell proportion significantly compared to PMA single stimulation.

Discussion
Compared to SA patients and healthy controls, patients with ACS (AMI + UA) had lower serum levels of IL-27 and higher proportions of PBMC Th1 and Th17 cells, which could be attributed to the inhibitory effects of IL-27 on the proliferation of Th17 cells. These results indicated that IL-27 could be a novel therapeutic target in ACS patients.
Primulina anisocymosa(Gesneriaceae), a new species with a unique inflorescence structure from Guangdong, China
Authors: Hong Xin , Keene Jeremy , Qiu Zhi-Jing , Wen Fang 
Published: January 2019

A newPrimulinaspecies from Guangdong, China with an unusual inflorescence is described here.Primulina anisocymosais vegetatively most similar toP. bobaiensis. It can be distinguished from all species withinPrimulinamorphologically by its unique zigzag monochasial cyme and infructescence. To confirm the phylogenetic relationships and generic placement of this species, not only morphological anatomical features but also chromosome and DNA sequence data were examined and analysed here. Two samples from different populations identified asPrimulina anisocymosaare monophyletic and were nested in a monophyletic clade withinPrimulinawith high branch support. The somatic chromosome number of the new species is also reported (2n = 36), supporting its placement in the genus.
Evaluation of posttraumatic stress disorder diagnosis and therapy on diurnal blood pressure patterns from 24-hour ambulatory blood pressure monitoring
Authors: Cave Brandon , Hough Augustus R. 
Published: January 2019

Abstract

Introduction
The veteran population has a high incidence of posttraumatic stress disorder (PTSD), which is associated with increased risk of hypertension and cardiovascular death. Ambulatory blood pressure monitoring (ABPM) can identify abnormal diurnal blood pressure (BP) patterns, which are associated with increased risk of cardiovascular events. The intent of this evaluation was to examine prior ABPM studies to determine whether veterans with PTSD are more likely to have abnormal nocturnal dipping patterns compared with the general veteran population.

Methods
Retrospective chart review was performed on all archived ABPM studies and classified by nocturnal dipping status and BP control rates. Pertinent patient demographics of age, sex, concomitant PTSD, and use of selected PTSD therapies were identified at the time of ABPM study. Association between dipping status, BP control rates, and patient demographics were analyzed using appropriate statistical tests.

Results
A total of 470 ABPM studies were determined to be valid and included. There were no differences in the distribution of nocturnal dipping patterns in veterans with or without PTSD. Likewise, rates of nocturnal, awake, and 24-hour hypertension were similar between groups. In patients with PTSD who were treated with evening PTSD therapy, there was a higher rate of normal dipping status compared with those without treatment (66.7% vs 29.7%, P = .03).

Discussion
Veterans with PTSD had similar distributions of dipping patterns and rates of overall, awake, and nocturnal hypertension compared with the general veteran population. The association of nocturnal PTSD therapy prescription in patients with PTSD and higher rates of normal dipping status may warrant further investigation.
(Re)discussing the drug administration technique by the intramuscular route: a systematic review / (Re)discutindo a técnica de administração de medicamentos pela via intramuscular: revisão sistemática
Authors: Gomes Barbara Ragasse Pereira , Paes Graciele Oroski , Traverso Fabíola Alves 
Published: January 2019

Objetivos:Identificar a produção do conhecimento da enfermagem atrelado a técnica de administração de medicamentos pela via intramuscular; descrever as divergências, congruências, e ocorrência de complicações acerca da técnica; e analisar as recomendações descritas na literatura com as melhores práticas e atualizações clínicas na enfermagem. Método: Revisão sistemática sem meta-análise.Realizada busca nas bases de dados LILACS, Pubmed, Medline, DEDALUS, Portal de Evidência em Saúde e Bibliotecas SciELO e Cochrane, no período de 1993 a 2012,totalizando 16 estudos. Resultados:Os estudos evidenciaram divergências na variações de demarcação da região ventroglútea; realização de antissepsia; e aplicação de pressão antes da administração intramuscular.Consonâncias na aspiração do conteúdo da seringa após inserção da agulha na massa muscular, rodízio do local de aplicação durante sequências de injeções IM, dentre outros.Conclusão:A incorporação das melhores evidências permite a execução segura da técnica intramuscular, gerando conforto ao paciente e excelência na assistência.
Hypoxia exposure alleviates impaired muscular metabolism, glucose tolerance, and aerobic capacity in apelin‐knockout mice
Authors: He Shiyi , Li Junping , Wang Jianxiong , Zhang Ying 
Published: January 2019

High altitude hypoxia adaptation can improve glucose tolerance in people with metabolic syndrome and type 2 diabetes (T2D). Apelin is an endogenous ligand of the G protein‐coupled receptor APJ and has possible roles in energy metabolism. Apelin‐null mice have been reported to exhibit impaired insulin sensitivity, which can be reversed by supplementation of exogenous apelin. Here, we examined the effects of 4 weeks’ intermittent hypoxia exposure on physiological and biochemical variables in apelin knockout (KO) mice. Apelin KO mice exhibited decreased expression of substrate metabolism‐associated genes/proteins, impaired glucose tolerance, and reduced exercise capacity compared to wild‐type mice, and all of these effects were rescued by hypoxia. These findings suggest that hypoxia intervention may possibly be able to alleviate metabolic conditions caused by genetic defects.