bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses attitudes towards death, dying patients and euthanasia: A descriptive study
Authors: Ay Melike Ayça , Öz Fatma 
Published: March 2018

Background: Attitudes of nurses towards death and related concepts influence end-of-life care. Determining nurses’ views and attitudes towards these concepts and the factors that affect them are necessary to ensure quality end-of-life care. Objectives: The purpose of this study was to determine nurses’ views and attitudes about death, dying patient, euthanasia and the relationships between nurses’ characteristics. Methods: Participants consist of the nurses who volunteered to take part in this descriptive study from 25 hospitals (n = 340) which has a paediatric or adult intensive care unit and located within the boundaries of Ankara, Turkey. ‘Nurse Information Form’ and ‘Attitude Scale about Euthanasia, Death and Dying Patients (DAS)’ were used as data collection tool. Ethical consideration: Written permissions were received from the ‘Noninterventional Clinical Researches Ethics Board’ of authors’ university and education councils of each hospital. Informed consent was obtained from participants. Findings: It is found that there are statistically significant difference among the factors of marital status, having a child, years of experience, bereavement experience, affected by working with dying patient, definition of euthanasia, views about patients who are appropriate for euthanasia, views about patients who desire to die and feeling need for counselling on these concepts according to the mean total score of nurses’ attitudes about euthanasia, death and dying patient (p < 0.05). Conclusion: The results indicate that nurses are negatively affected to face the concepts of death, euthanasia and work with dying patient. This is reflected in their attitude. In order to gain positive attitude towards death, dying patient and euthanasia, the implementation of training and consulting services to nurses at appropriate intervals during both education and professional life are required.
Responsibility among bachelor degree nursing students: A concept analysis
Authors: Ghasemi Saeed , Ahmadi Fazlollah , Kazemnejad Anoshirvan 
Published: March 2018

Background: Responsibility is an important component of the professional values and core competencies for bachelor degree nursing students and has relationships with nursing education and professionalization. It is important for providing safe and high-quality care to the clients for the present and future performance of student. But there is no clear and operational definition of this concept for bachelor degree nursing students; however, there are extensive contents and debates about the definitions, attributes, domains and boundaries of responsibility in nursing and non-nursing literature. Objective: To examine the concept of responsibility among bachelor degree nursing students using the evolutionary approach to concept analysis. Methods: A total of 75 articles published between 1990 and 2016 and related to the concept of responsibility were selected from seven databases and considered for concept analysis based on Rogers’ evolutionary approach. Ethical considerations: Throughout all stages of data collection, analysis and reporting, accuracy and bailment were respected. Findings: Responsibility is a procedural, spectral, dynamic and complex concept. The attributes of the concept are smart thinking, appropriate managerial behaviours, appropriate communicational behaviours, situational self-mandatory and task-orientation behaviours. Personal, educational and professional factors lead to the emergence of the responsible behaviours among bachelor degree nursing students. The emergence of such behaviours facilitates the learning and education process, ensures nursing profession life and promotes clients and community health level. Responsibility has some effects on nursing students. Discussion: This concept had been changed over time since 1990–2016. There are similarities and differences in the elements of this concept in disciplines of nursing and other educational disciplines. Conclusion: The analysis of this concept can help to develop educational or managerial theories, design instruments for better identification and evaluation of responsible behaviours among bachelor degree nursing students, develop strategies for enhancing the responsibility and improve the safety and quality of nursing care in the community and healthcare system.
Comparing an on-site nurse practitioner with telemedicine physician support hospitalist programme with a traditional physician hospitalist programme
Authors: Boltz Michelle , Cuellar Norma G , Cole Casey , Pistorese Brent 
Published: March 2018

Introduction Since 2010, more than 75 rural hospitals have closed in the USA and more than one-third are at risk of closure due to lower patient volumes, lower funding levels, decreased hospital revenue and lower physician employment pools. Telemedicine can provide new models of care delivery that maintain quality and reduce cost of healthcare in rural populations. The purpose of this project was to evaluate a cross-organizational pilot program by comparing a NP/telemedicine physician hospitalist programme with a traditional physician hospitalist model to assess effects on length of patient stay, mortality rates, readmission rate, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings of provider communication, and total hospital costs. Methods The Standard for Quality Improvement Reporting Excellence (SQUIRE) guidelines were followed. Using a one-year retrospective chart review, average length of stay, mortality rates, 30-day readmission rates and provider communication ratings were compared between hospitalists that were nurse practitioners working with physicians through telemedicine support and physicians alone. Results There was no statistically significant variance in average length of stay, mortality rates, 30-day readmission rates, or provider communication ratings on HCAHPS surveys compared to the NP or physician hospitalist. Discussion This new model of care demonstrates that telemedicine can be used to provide safe and efficient physician support from a regional hub medical centre to nurse practitioners practising as hospitalists in rural Critical Access Hospitals at up to 58% cost savings while maintaining quality of care and increasing access to community-based physicians.
The views of birth families regarding access visits in foster care
Authors: García-Martín Miguel Ángel , Fuentes María J , Bernedo Isabel M , Salas María D 
Published: March 2018

Summary This study aims to give voice to parents and gather their views about contact visits in foster care. Participants were 23 birth families who had contact visits with 35 children in non-kinship foster care. Semistructured individual interviews were conducted in order to explore two key aspects: the parents’ opinions regarding the contact visits and the main areas they felt needed improving. The interviews were transcribed and the transcripts were examined using an inductive method by Atlas.ti. Findings The main themes to emerge concerned their general view of contact visits, the input and support from social workers, the contribution of foster families, the contact venue, and the organization of visits. In general, the birth families’ comments were positive about the support and treatment received from social workers. However, they also mentioned certain aspects should be improved, such as supervision during visits. Applications The results suggest several ways to improve social work practice. Social workers should aim to involve birth families more in the process of drawing up contact arrangements and offering birth families adequate preparation prior to visits. Child protection agencies also have a role to play in relation to improving the facilities in which visits are held, as well as their overall organization, such as, the venue should provide a space that enables everyday family relationships to take place, and in the absence of this, attempts should be made to organize visits outside the official meeting place.
Family Group Conferencing for older adults: Social workers’ views
Authors: Metze Rosalie N , Abma Tineke A , Kwekkeboom MH 
Published: March 2018

Summary Family Group Conferencing as deployed in child care might be useful in elderly care to strengthen older adults’ social networks and self-mastery. When Family Group Conferencing was implemented for older adults in the Netherlands, social workers were reluctant to refer. To discover reasons for this reluctance, we examined social workers’ views and attitudes concerning Family Group Conferencing for their clients. Findings In an initial exploratory study, we distributed a survey among social workers who worked with older adults and were informed about Family Group Conferencing, followed by three focus groups of social workers with and without Family Group Conferencing experience. We also held semi-structured individual interviews with social workers and an employee of the Dutch Family Group Conferencing foundation. The respondents were positive about Family Group Conferencing, but hesitant about referring their older clients. Reasons were: they were already working with their clients’ social networks; they feared losing control over the care process; and they wondered how they could motivate their clients. They also reported that their clients themselves were reluctant, because they seemed to fear that Family Group Conferencing would lose them self-mastery, and they did not want to burden their social networks. Applications Our findings indicate that implementing Family Group Conferencing in elderly care is a complicated and slow process, partly because social workers have little experience with Family Group Conferencing. To facilitate social workers it might be necessary to offer them more guidance, in a joint process with the Family Group Conferencing foundation. One might also experiment with alterations to the Family Group Conferencing model, for example, by focusing less on family networks and more on reciprocity.
Asymmetric dimethylarginine levels and diabetes duration: Relationship with measures of subclinical atherosclerosis and cardiac function in children and adolescents with Type 1 diabetes
Authors: Ersoy Betül , Eroğlu Nilgün , Çetin Mecnun , Onur Ece , Özkol Mine , Coşkun Şenol 
Published: March 2018

Aims: We aimed to evaluate asymmetric dimethylarginine levels in young patients with Type 1 diabetes mellitus according to diabetes duration and to examine the relationship between these levels and measures of atherosclerosis and myocardial function. Materials and methods: In total, 83 patients (8.5–22 years) with Type 1 diabetes mellitus were stratified by diabetes duration: 12–60 months (Group 1, n = 27), >60–120 months (Group 2, n = 29) and >120 months (Group 3, n = 27). Asymmetric dimethylarginine levels were assessed. Carotid intima–media thickness was measured. Myocardial function was assessed by M-mode, conventional Doppler and tissue Doppler echocardiography. Results: Asymmetric dimethylarginine level was significantly higher in Group 1, while carotid intima–media thickness was significantly greater in Group 3 ( p < 0.05). Tissue Doppler echocardiography showed the ratio of peak early to peak late diastolic myocardial annular velocity decreased significantly in Groups 2 and 3 with a negative correlation with duration (r: −0.310, p = 0.004) and HBA1c levels (r = −0.391, p < 0.001). Myocardial performance index in all groups and isovolumic relaxation time in Group 3 increased significantly. Asymmetric dimethylarginine levels were negatively correlated with carotid intima–media thickness and isovolumic relaxation time ( p < 0.05). Conclusion: In contrast to adult diabetics, asymmetric dimethylarginine concentration decreases as diabetes duration increases in young Type 1 diabetic patients and is associated with worsening measures of cardiovascular risk and poorer diastolic function.
Endovascular management of inferior vena cava filter thrombotic occlusion
Authors: Branco Bernardino C , Montero-Baker Miguel F , Espinoza Eduardo , Gamero Maria , Zea-Vera Rodrigo , Labropoulos Nicos , Leon Luis R 
Published: March 2018

Objective Inferior vena cava occlusion is a potentially life-threatening complication related to caval filters. We present our experience with filter-induced inferior vena cava occlusion in order to assess the feasibility, safety, and effectiveness of endovascular management. Methods A retrospective review of all patients undergoing inferior vena cava filter placement over a 60-month study period was performed. From this cohort, a total of 10 cases of inferior vena cava occlusion after filter placement were identified. Demographics, clinical data, procedures, and outcomes were extracted. Patients were followed to the last clinic visit or until they died. Results One-hundred eighty filters were placed by our group practice during the study period. Of those, a total of 10 patients were identified. Overall, there were 7 males; the mean age was 57.1 years (25–78 years). The median time between inferior vena cava filter placement and filter occlusion was 105 days (range 5–4745 days). All patients were clinically symptomatic at the time of their presentation. Nine out of 10 patients were successfully managed endovascularly. Trellis™-8 thrombectomy was the most common endovascular strategy performed ( n = 9). Four patients had balloon angioplasty, two of those with stent placement for chronically occluded inferior vena cava/iliac veins. No thromboembolic complications developed during a median follow-up period of 233 days (range 4–1083 days). Conclusions Endovascular management of inferior vena cava occlusion is feasible, safe, and effective in decreasing thrombus burden in the presence of an inferior vena cava filter. Further studies evaluating long-term inferior vena cava patency and optimal surveillance regimen after endovascular management of filter-related inferior vena cava occlusion are warranted.
The reporting of harms in publications on randomized controlled trials funded by the “Programme Hospitalier de Recherche Clinique,” a French academic funding scheme
Authors: Favier Romain , Crépin Sabrina 
Published: March 2018

Background/aims: Accurate information on harms arising from medical interventions is essential for assessing benefit–risk ratios. Since 2004, there has been an extension of the Consolidated Standards of Reporting Trials statement for reporting harms data in publications on randomized clinical trials. The objective of our study was to assess the quality of this reporting from academic randomized clinical trials on drugs. Methods: We searched for articles on randomized clinical trials funded between 2004 and 2008 by the “Programme Hospitalier de Recherche Clinique.” We included all published randomized clinical trials that assessed drugs. Harm-related data were extracted and compared with the Consolidated Standards of Reporting Trials Harms extension, and the space in the articles devoted to harms data was measured. Results: In total, 37 randomized clinical trials met the inclusion criteria. The median harm score was 9/18. In 73.0% of the randomized clinical trials, the reporting of adverse events was selective. Less than 50% of articles provided information on reasons for drug discontinuation that were related to adverse events. The score and the space allocated to harms were higher in antineoplastic and immunomodulating drugs randomized clinical trials, while the median proportion of the space in the results section allocated to harms was 16.8%. In 67.6% of the articles, the space allocated to the authors’ list and affiliations was greater than the space in the results section allocated to descriptions of harms. No significant improvement in the score or the space allocation was observed during the study period. Conclusion: Reporting of harms in French academic drug randomized clinical trials is suboptimal; moreover, this shortcoming is a critical barrier to evaluating the benefit–risk ratio of drug randomized clinical trials. Thus, the authors should be encouraged to adhere to the Consolidated Standards of Reporting Trials Harms extension.
Challenges faced in daily life by persons with type 2 diabetes: A meta-synthesis
Authors: Inga-Britt Lindh , Kerstin Blomqvist 
Published: March 2018

Objectives To derive improved understanding of the implicit meanings of challenges in daily life from the perspective of persons with type 2 diabetes. Methods A meta-synthesis was conducted with an interpretive and constructivist approach. Four databases were searched for articles published between 2007 and 2011, producing 37 articles for analysis. Van Deurzen’s life world theory was applied as an analytic grid. Results Challenges in daily life with type 2 diabetes could be understood as living in a tension between opposing forces, implying a struggle with inevitable paradoxes: living in the present and for the future, trusting oneself while relying on others, and being normal while feeling changed and different. Discussion This synthesis adds knowledge to previous understanding of living with type 2 diabetes, revealing the complexity of daily life when struggling with a lifelong illness. Person-centred care could be used to understand what challenges diabetes may cause in family and working life and the ambivalent feelings the illness can lead to. Future research is needed to implement and evaluate a person-centred care in practice. Since new qualitative research is continuously added to this topic, metasyntheses should be undertaken regularly.
Fragmented hyaluronan has no alarmin function assessed in arthritis synovial fibroblast and chondrocyte cultures
Authors: Olsson Mia , Bremer Lisa , Aulin Cecilia , Harris Helena Erlandsson 
Published: March 2018

Hyaluronan (HA) is a large polymer and an important component of the extracellular matrix. During homeostasis, high molecular mass HA is the predominant form, but upon inflammation, degradation products of HA accumulate. These HA fragments (HA-fs) have been reported to possess pro-inflammatory activities and thus act as alarmins, notifying immune cells of danger via TLR4 and CD44. HA is found in large quantities in synovial joint fluid. In order to reveal a potential role of HA-fs in arthritis pathogenesis, the in vitro effects of HA of various molecular masses (from 1680 kDa to oligosaccharide HA) on synovial fibroblasts and chondrocytes from rheumatoid arthritis patients, and on peripheral blood mononuclear cells from healthy donors, were investigated. TLR4 and CD44 surface expression was confirmed by immunocytochemistry, and cell activation was determined based on cytokine and chemokine production. While the cell types investigated expressed TLR4 and CD44, no increased release of IL-1ß, IL-6, IL-8, IL-10, IL-12 or TNF-α was detected after HA stimulation. Similarly, HA did not enhance activation after priming cells with low doses of LPS or by forming complexes with LPS. Hence, this study does not support the common view of HA-fs being pro-inflammatory mediators and it is not likely that HA-fs generated during arthritis contribute to disease pathogenesis.
Risk factors and outcomes of infected pancreatic necrosis: Retrospective cohort of 148 patients admitted to the ICU for acute pancreatitis
Authors: Garret Charlotte , Péron Matthieu , Reignier Jean , Le Thuaut Aurélie , Lascarrou Jean-Baptiste , Douane Frédéric , Lerhun Marc , Archambeaud Isabelle , Brulé Noëlle , Bretonnière Cédric , Zambon Olivier , Nicolet Laurent , Regenet Nicolas , Guitton Christophe , Coron Emmanuel 
Published: March 2018

ObjectiveThe primary objective of this article is to identify risk factors for infected pancreatic necrosis (IPN) in patients admitted to the intensive care unit (ICU) for severe acute pancreatitis. We also described outcomes of IPN.BackgroundAcute pancreatitis is common and associated with multiple, potentially life‐threatening complications. Over the last decade, minimally invasive procedures have been developed to treat IPN.MethodsWe retrospectively studied consecutive patients admitted for severe acute pancreatitis to the ICUs of the Nantes University Hospital in France, between 2012 and 2015. Logistic regression was used to evaluate potential associations linking IPN to baseline patient characteristics and outcomes.ResultsOf the 148 included patients, 26 (17.6%) died. IPN developed in 62 (43%) patients and consistently required radiological, endoscopic, and/or surgical intervention. By multivariate analysis, factors associated with IPN were number of organ failure (OF) (for ≥ 3: OR, 28.67 (6.23–131.96), p < 0.001) and portosplenomesenteric venous thrombosis (OR, 8.16 (3.06–21.76)).ConclusionIPN occurred in nearly half our ICU patients with acute pancreatitis and consistently required interventional therapy. Number of OFs and portosplenomesenteric venous thrombosis were significantly associated with IPN. Early management of OF may reduce IPN incidence, and management of portosplenomesenteric venous thrombosis should be investigated.
Early Versus Delayed Vitrectomy for Nondiabetic Vitreous Hemorrhage
Authors: Connors Daniel , Shah Gaurav , Blinder Kevin , Dang Sabin 
Published: March 2018

Purpose: To analyze the surgical and visual outcomes in patients who underwent early versus delayed vitrectomy for dense nondiabetic, nonvascular vitreous hemorrhage from undetermined cause. Methods: A retrospective, consecutive series evaluating all patients with a preoperative diagnosis of nondiabetic vitreous hemorrhage treated surgically at The Retina Institute over the past 5 years. Vitreous hemorrhage had to be described as dense, with first-order vessels not visualized on funduscopic examination. Exclusion criteria included a diagnosis of diabetes mellitus, retinal vascular disease, any prior intraocular surgery other than cataract extraction, or any previously diagnosed ocular conditions. A total of 275 patients and 286 eyes were evaluated, with 52 patients and 52 eyes meeting inclusion criteria. Surgical treatment was with standard pars plana vitrectomy. Results: Of the 52 eyes that met inclusion criteria, 32 (61.5%) were found to have at least 1 retinal break. Sixteen eyes (30.1%) had a rhegmatogenous retinal detachment. Mean time from diagnosis of the vitreous hemorrhage to surgical intervention was 15 days (range, 0-78 days). Early vitrectomy was defined as surgical intervention within 10 days of diagnosis, while late vitrectomy was defined as surgical intervention following 10 days. Of eyes that were found to have a retinal detachment, 75% were phakic and 25% were pseudophakic. Final postoperative visual acuity in the early surgery cohort was 20/66, while in the late surgery cohort was 20/89, which did not achieve statistical significance ( P = .67). Conclusion: A significant percentage of patients with retinal detachment were phakic at the time of vitreous hemorrhage (75%) as compared to pseudophakic. Data from the largest series to date indicate that in phakic patients with dense hemorrhage, the risk of retinal detachment is high and should prompt consideration for more urgent surgical intervention.