bluuebunny/crossref_metadata_2025_split huggingface dataset:
NRF2 activation with Protandim attenuates salt‐induced vascular dysfunction and microvascular rarefaction
Authors: Priestley Jessica R. C. , Fink Katie E. , McCord Joe M. , Lombard Julian H. 
Published: May 2019

AbstractHypothesisThis study tested the hypothesis that dietary activation of the master antioxidant and cell protective transcription factor nuclear factor, erythroid ‐2‐like 2 (NRF2), protects against salt‐induced vascular dysfunction by restoring redox homeostasis in the vasculature.MethodsMale Sprague‐Dawley rats and Syrian hamsters were fed a HS (4.0% NaCl) diet containing ~60 mg/kg/day Protandim supplement for 2 weeks and compared to controls fed HS diet alone.ResultsProtandim supplementation restoredendothelium‐dependent vasodilation in response to acetylcholine (ACh) in middle cerebral arteries (MCA)of HS‐fed rats and hamster cheek pouch arterioles, and increased microvessel density in the cremastermuscle of HS‐fed rats. The restored dilation to ACh in MCA of Protandim‐treated rats was prevented by inhibiting nitric oxide synthase (NOS) with L‐NAME [100 μM] and was absent in MCA from Nrf2(−/−) knockout rats fed HS diet. Basilar arteries from HS‐fed rats treated with Protandim exhibited significantly lower staining for mitochondrial oxidizing species than untreated animals fed HS diet alone; and Protandim treatment increased MnSOD (SOD2) protein expression in mesenteric arteries of HS‐fed rats.ConclusionsThese results suggest that dietary activation of NRF2 protects against salt‐induced vascular dysfunction, vascular oxidative stress, and microvascular rarefaction by upregulating antioxidant defenses and reducing mitochondrial ROS levels.
Hormonal Status and Cognitivo‐Emotional Profile in Real‐Life Patients With Neuropathic Pain: A Case Control Study
Authors: Corriger Alexandrine , Duclos Martine , Corcuff Jean‐Benoit , Lambert Céline , Marceau Geoffroy , Sapin Vincent , Macian Nicolas , Roux Delphine , Pereira Bruno , Pickering Gisèle 
Published: May 2019

AbstractBackgroundThe specific impact of neuropathic pain and recommended neuropathic pain treatments on the hormonal and immune status of patients has been so far poorly explored. This study aimed at studying, in real life, the hypothalamic‐pituitary‐adrenal axis and the cytokine profile of patients with neuropathic pain. It also explored their links with cognition, emotion, quality of life, and drug treatment.MethodsThis prospective study (clinicaltrials.gov NCT01543425) included 60 patients with neuropathic pain and 60 age‐ and gender‐matched healthy volunteers after obtaining signatures of informed consent. A number of parameters were measured: adrenocorticotropic hormone, cortisol, cortisol awakening response, dehydroepiandrosterone sulphate, sex hormone binding globulin, testosterone, 17‐β‐estradiol, progesterone, luteinizing hormone, follicle‐stimulating hormone, cytokines, brain‐derived neurotrophic factor, and vitamin D. Psychological parameters were assessed by questionnaires.ResultsPatients with neuropathic pain had lower levels of adrenocorticotropic hormone (P = 0.009) and dehydroepiandrosterone sulphate (P < 0.001) than controls, and the cortisol awakening response was impaired. Patients were more depressed and anxious (P < 0.001) and had a diminished quality of life (P < 0.001), which was influenced by cytokines (P = 0.0067) and testosterone (P = 0.028). Antidepressants and antiepileptics appeared to interfere with testosterone and cognitivo‐emotional domains.ConclusionAn impairment of the hormonal status and of the immune system was observed in patients. It identified testosterone as a potential pivotal mediator between antidepressants/antiepileptics and quality of life. Further studies must address the exact impact of different types of drugs on central effects, of gender differences, and of the immune system of neuropathic pain.
‘So, the circle has grown’ – Child Health Services nurses’ experiences of giving parental interviews with nonbirthing parents
Authors: Ståhl Malin , Kristensson Hallström Inger , Skoog Malin , Vilhelmsson Andreas 
Published: May 2019

BackgroundLately, greater focus has been given to the mental health of nonbirthing parents postpartum. However, mothers, but not nonbirthing parents, are routinely screened for postpartum depression, and until recently, nonbirthing parents have not been given the same opportunity as mothers to discuss their parental role without the other parent present. To strengthen the parental role, a separate parental interview with the nonbirthing parent began to be offered as part of the Swedish Child Health Service's (CHS) general programme.AimThis study aimed to explore CHS nurses’ experiences of performing parental interviews with nonbirthing parents.MethodsContent analysis was used when analysing data from six research interviews, of which half were focus group interviews. In total, 11 CHS nurses were interviewed.ResultsChild Health Service nurses reported that although the interview with the nonbirthing parent was a positive experience and that a more family‐oriented perspective was something many of them had been longing for, they could also feel that it demanded a lot from them, including things they had perhaps not previously considered. CHS nurses reported difficulties with having such close contact with both parents, and they also described feeling worried about the information that could come up in a standardised conversation and the knowledge provided.ConclusionThere are both possibilities and challenges in widening the responsibilities of the CHS nurse to include the nonbirthing parent by offering a postpartum interview.ImplicationsThis study provides information to healthcare professionals about the importance of providing proper guidance and education when broadening the duties and responsibilities for CHS nurses to include nonbirthing parents in mental health screening. CHS nurses must be given the resources needed to deal with the challenges they encounter and sufficient time for the interviews to be possible and meaningful.
The case for allele‐specific recognition by the TCR
Authors: Cohn Melvin , Anderson Colin C. , Dembic Zlatko 
Published: May 2019

AbstractThere is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.
Effect of subsoiling on soil properties and winter wheat grain yield
Authors: Wang Hanbo , Bai Wenbo , Han Wei , Song Jiqing , Lv Guohua 
Published: May 2019

AbstractA 2‐year field experiment was carried out in loessal soil in a semi‐humid climate to explore the integrative influences of subsoiling on soil properties and winter wheat grain yield. Results showed that it was essential to deepen the plough pan in loessal soil. The sharply increased soil penetration resistance (>7MPa) in plough pan under dry soil condition was especially harmful for plant growth. In rotary tillage treatment, the waterlogging conditions caused by shallow plough pan slightly produced macropores and preferential water flow. Significantly, higher grain yield was obtained in the subsoiling tillage treatment, increased by 21.9% in 2016 and 11.3% in 2017, respectively. Subsoiling tillage improved the resilience of winter wheat under adverse climate conditions. Subsoiling tillage should be popularized in loessal soil with shallow plough pan in semi‐humid climate. This study may provide valuable information on soil sustainable use and management in loessal soil.
Effect of Evidence‐Based Practice (EBP) Courses on MSN and DNP Students’ Use of EBP
Authors: Moore Elizabeth R. , Watters Richard , Wallston Kenneth A. 
Published: May 2019

AbstractPurposeThe purpose of this study was to evaluate the effect of evidence‐based practice (EBP) courses on nursing students’ attitudes, perceived support from their professional network, self‐efficacy, knowledge, and implementation of EBP.DesignThis study utilized a two‐group, pre‐ and posttest design with 190 Masters of Science in Nursing (MSN) and 37 Doctorate of Nursing Practice (DNP) students.MethodsAn EBP instrument based on the theory of planned behavior was administered both before and after the EBP course (the intervention).FindingsBoth the pre‐ and posttest were completed by 126 students for a 56% response rate. No significant differences between the MSN (n = 102) and DNP (n = 24) students were found in precourse scores on any of the subscales except behavior, with the DNP students reporting they performed more EBP behaviors in the clinical setting. Overall, student scores on three of the four subscales of the EBP instrument (attitudes, self‐efficacy, and behavior) significantly increased pre‐ to postcourse. The self‐efficacy subscale demonstrated the greatest pre‐ to postcourse change scores. When the DNP and MSN students were compared, change scores on attitudes and self‐efficacy remained significant in both groups. There was a significant positive change in EBP behavior only for the MSN students. Knowledge scores increased significantly only for the DNP students.Linking Evidence to ActionEBP courses can increase self‐reported EBP behaviors in the clinical setting, especially in MSN students. A precourse student evaluation will help faculty determine their learning needs in order to develop appropriate learning activities to support their acquisition of the essential knowledge, skills, and abilities to use EBP in the clinical setting. Administering the same evaluation postcourse can help faculty evaluate the effectiveness of their teaching. As a result, advanced practice nurses will be better equipped to facilitate and promote the implementation of EBP to support high‐quality care and improved health outcomes.
Understanding the healthcare workplace learning culture through safety and dignity narratives: a UK qualitative study of multiple stakeholders’ perspectives
Authors: Sholl Sarah , Scheffler Grit , Monrouxe Lynn V , Rees Charlotte 
Published: May 2019

ObjectivesWhile studies at the undergraduate level have begun to explore healthcare students’ safety and dignity dilemmas, none have explored such dilemmas with multiple stakeholders at the postgraduate level. The current study therefore explores the patient and staff safety and dignity narratives of multiple stakeholders to better understand the healthcare workplace learning culture.DesignA qualitative interview study using narrative interviewing.SettingTwo sites in the UK ranked near the top and bottom for raising concerns according to the 2013 General Medical Council National Training Survey.ParticipantsUsing maximum variation sampling, 39 participants were recruited representing four different groups (10 public representatives, 10 medical trainees, 8 medical trainers and 11 nurses and allied health professionals) across the two sites.MethodsWe conducted 1 group and 35 individual semistructured interviews. Data collection was completed in 2015. Framework analysis was conducted to identify themes. Theme similarities and differences across the two sites and four groups were established.ResultsWe identified five themes in relation to our three research questions (RQs): (1) understandings of safety and dignity (RQ1); (2) experiences of safety and dignity dilemmas (RQ2); (3) resistance and/or complicity regarding dilemmas encountered (RQ2); (4) factors facilitating safety and/or dignity (RQ3); and (5) factors inhibiting safety and/or dignity (RQ3). The themes were remarkably similar across the two sites and four stakeholder groups.ConclusionsWhile some of our findings are similar to previous research with undergraduate healthcare students, our findings also differ, for example, illustrating higher levels of reported resistance in the postgraduate context. We provide educational implications to uphold safety and dignity at the level of the individual (eg, stakeholder education), interaction (eg, stakeholder communication and teamwork) and organisation (eg, institutional policy).
Recommendations for integrating physiotherapy into an interprofessional outpatient care setting for people living with HIV: a qualitative study
Authors: deBoer Heather , Cudd Stephanie , Andrews Matthew , Leung Ellie , Petrie Alana , Chan Carusone Soo , O’Brien Kelly K 
Published: May 2019

ObjectivesTo identify factors to consider when integrating physiotherapy (PT) into an interprofessional outpatient HIV care setting from the perspective of healthcare professionals and adults living with HIV.DesignWe conducted a qualitative descriptive study using semi-structured interviews (healthcare professionals) and focus groups (adults living with HIV). We asked participants their perspectives on barriers, facilitators and strategies to accessing and participating in outpatient PT, important characteristics physiotherapists should possess working in outpatient HIV care, content and structure of PT delivery, and programme evaluation.Recruitment and settingWe purposively sampled healthcare professionals based on their experiences working in interprofessional HIV care and recruited adults with HIV via word of mouth and in collaboration with an HIV-specialty hospital in Toronto, Canada. Interviews were conducted via Skype or in-person and focus groups were conducted in-person at the HIV-specialty hospital.Participants12 healthcare professionals with a median of 12 years experience in HIV care, and 13 adults living with HIV (11 men and 2 women) with a median age of 50 years and living with a median of 6 concurrent health conditions in addition to HIV.ResultsOverall impressions of PT in outpatient HIV care and factors to consider when implementing PT into an interprofessional care setting include: promoting the role of, and evidence for, PT in outpatient HIV care, structuring PT delivery to accommodate the unique needs and priorities of adults living with HIV, working collaboratively with a physiotherapist on the healthcare team and evaluating rehabilitation as a component of interprofessional care.ConclusionsMultiple factors exist for consideration when implementing PT into an interprofessional outpatient HIV care setting. Results provide insight for integrating timely and appropriate access to evidence-informed rehabilitation for people living with chronic and episodic illness, such as HIV.
How do doctors experience the interactions among professional fulfilment, organisational factors and quality of patient care? A qualitative study in a Norwegian hospital
Authors: Baathe Fredrik , Rosta Judith , Bringedal Berit , Rø Karin Isaksson 
Published: May 2019

ObjectivesDoctors increasingly experience high levels of burnout and loss of engagement. To address this, there is a need to better understand doctors’ work situation. This study explores how doctors experience the interactions among professional fulfilment, organisational factors and quality of patient care.DesignAn exploratory qualitative study design with semistructured individual interviews was chosen. Interviews were transcribed verbatim and analysed by a transdisciplinary research group.SettingThe study focused on a surgical department of a mid-sized hospital in Norway.ParticipantsSeven doctors were interviewed. A purposeful sampling was used with gender and seniority as selection criteria. Three senior doctors (two female, one male) and four in training (three male, one female) were interviewed.ResultsWe found that in order to provide quality care to the patients, individual doctors described ‘stretching themselves’, that is, handling the tensions between quantity and quality, to overcome organisational shortcomings. Experiencing a workplace emphasis on production numbers and budget concerns led to feelings of estrangement among the doctors. Participants reported a shift from serving as trustworthy, autonomous professionals to becoming production workers, where professional identity was threatened. They felt less aligned with workplace values, in addition to experiencing limited management recognition for quality of patient care. Management initiatives to include doctors in development of organisational policies, processes and systems were sparse.ConclusionThe interviewed doctors described their struggle to balance the inherent tension among professional fulfilment, organisational factors and quality of patient care in their everyday work. They communicated how ‘stretching themselves’, to overcome organisational shortcomings, is no longer a feasible strategy without compromising both professional fulfilment and quality of patient care. Managers need to ensure that doctors are involved when developing organisational policies, processes and systems. This is likely to be beneficial for both professional fulfilment and quality of patient care.
Cohort profile: Development and profile of a population-based, retrospective cohort of diagnosed people living with HIV in Ontario, Canada (Ontario HIV Laboratory Cohort)
Authors: Liu Juan , Wilton James , Sullivan Ashleigh , Marchand-Austin Alex , Rachlis Beth , Giles Madison , Light Lucia , Sider Doug , Kroch Abigail E , Gilbert Mark 
Published: May 2019

PurposePopulation-based cohorts of diagnosed people living with HIV (PLWH) are limited worldwide. In Ontario, linked HIV diagnostic and viral load (VL) test databases are centralised and contain laboratory data commonly used to measure engagement in HIV care. We used these linked databases to create a population-based, retrospective cohort of diagnosed PLWH in Ontario, Canada.ParticipantsA datamart was created by integrating diagnostic and VL databases and linking records at the individual level. These databases contain information on laboratory test results and sociodemographic/clinical information collected on requisition/surveillance forms. Datamart individuals enter our cohort with the first record of a nominal HIV-positive diagnostic test (1985–2015) or VL test (1996–2015), and remain unless administratively lost to follow-up (LTFU; no VL test for >2 years and no VL test in later years). Non-nominal diagnostic tests are excluded as they lack identifying information to permit linkage to other tests. However, individuals diagnosed non-nominally are included in the cohort with record of a VL test. The LTFU rule is applied to indirectly censor for death/out-migration.Findings to dateAs of the end of 2015, the datamart contained 40 372 HIV-positive diagnostic tests and 23 851 individuals with ≥1 VL test. Almost half (46.3%) of the diagnostic tests were non-nominal and excluded, although this was lower (~15%) in recent years. Overall, 29 587 individuals have entered the cohort—contributing 229 302 person-years of follow-up since 1996. Between 2000 and 2015, the number of diagnosed PLWH (cohort individuals not LTFU) increased from 8859 to 16 110, and the percent who were aged ≥45 years increased from 29.1% to 62.6%. The percent of diagnosed PLWH who were virally suppressed (<200 copies/mL) increased from 40.7% in 2000 to 79.5% in 2015.Future plansWe plan to conduct further analyses of HIV care engagement and link to administrative databases with information on death, migration, physician billing claims and prescriptions. Linkage to other data sources will address cohort limitations and expand research opportunities.
‘At the grass roots level it’s about sitting down and talking’: exploring quality improvement through case studies with high-improving Aboriginal and Torres Strait Islander primary healthcare services
Authors: Larkins Sarah , Carlisle Karen , Turner Nalita , Taylor Judy , Copley Kerry , Cooney Sinon , Wright Roderick , Matthews Veronica , Thompson Sandra , Bailie Ross 
Published: May 2019

ObjectivesImproving the quality of primary care is an important strategy to improve health outcomes. However, responses to continuous quality improvement (CQI) initiatives are variable, likely due in part to a mismatch between interventions and context. This project aimed to understand the successful implementation of CQI initiatives in Aboriginal and Torres Strait Islander health services in Australia through exploring the strategies used by ‘high-improving’ Indigenous primary healthcare (PHC) services.Design, settings and participantsThis strengths-based participatory observational study used a multiple case study method with six Indigenous PHC services in northern Australia that had improved their performance in CQI audits. Interviews with healthcare providers, service users and managers (n=134), documentary review and non-participant observation were used to explore implementation of CQI and the enablers of quality improvement in these contexts.ResultsServices approached the implementation of CQI differently according to their contexts. Common themes previously reported included CQI systems, teamwork, collaboration, a stable workforce and community engagement. Novel themes included embeddedness in the local historical and cultural contexts, two-way learning about CQI and the community ‘driving’ health improvement. These novel themes were implicit in the descriptions of stakeholders about why the services were improving. Embeddedness in the local historical and cultural context resulted in ‘two-way’ learning between communities and health system personnel.ConclusionsPractical interventions to strengthen responses to CQI in Indigenous PHC services require recruitment and support of an appropriate and well prepared workforce, training in leadership and joint decision-making, regional CQI collaboratives and workable mechanisms for genuine community engagement. A ‘toolkit’ of strategies for service support might address each of these components, although strategies need to be implemented through a two-way learning process and adapted to the historical and cultural community context. Such approaches have the potential to assist health service personnel strengthen the PHC provided to Indigenous communities.