bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectories of change in cognitive function in people with chronic obstructive pulmonary disease
Authors: Park Soo Kyung 
Published: February 2018

Aims and objectivesTo describe changes in cognitive function, as measured by the trail making test; to identify distinct patterns of change in cognitive function; and to examine predictors of change in cognitive function in people with severe chronic obstructive pulmonary disease.BackgroundHow cognitive function changes in people with chronic obstructive pulmonary disease and what factors influence those changes over time is not well known, despite the fact that it declines rapidly in this population and significantly impacts functional decline in healthy older adults.DesignA secondary analysis and longitudinal study with a follow‐up period of 3 years.MethodsA data set from the National Emphysema Treatment Trial provided participant data. Patients with severe chronic obstructive pulmonary disease (n = 307) were recruited at a clinical site. Several demographic and clinical measures were assessed at baseline. Trail making test scores were measured at baseline, 1, 2 and 3 years.ResultsCognitive function was stable for 3 years in people with chronic obstructive pulmonary disease. However, four distinct patterns of change in cognitive function were identified. Age, education, 6‐min walk distance and cognitive impairment scores at baseline on the trail making test Part B were significant predictors of worsening cognitive function and below‐average cognitive function over 3 years.ConclusionsThese findings suggest that increasing exercise capacity improves cognitive function and delays deterioration of cognitive function in people with COPD.Relevance to clinical practiceUnderstanding the trajectories of change in cognitive function and predictors of change in cognitive function over 3 years may enable health care providers to identify patients at greatest risk of developing mental deterioration and those who might benefit from interventions to improve cognitive function. Health care providers should periodically assess and frequently screen people with COPD for cognitive function.
Trapped like a butterfly in a spider's web: Experiences of female spousal caregivers in the care of husbands with severe mental illness
Authors: Rahmani Farnaz , Ebrahimi Hossein , Seyedfatemi Naeimeh , Namdar Areshtanab Hossein , Ranjbar Fatemeh , Whitehead Bill 
Published: February 2018

Aims and objectivesTo explore the experiences of female spousal caregivers in the care of husbands with severe mental illness.BackgroundFamily involvement in the care of patients with chronic illness is essential to provide a backbone of support for them. However, little is known about how female spousal caregivers are confronted with challenges while taking care of their husbands with severe mental illness.DesignAn exploratory qualitative study.MethodsFourteen female spousal caregivers of people with severe mental illness (defined here as schizophrenia, schizoaffective disorders and bipolar affective disorders) were recruited using purposive sampling and were interviewed using a semistructured in‐depth interview method. Data were analysed by conventional content analysis until data saturation was achieved.ResultsCare of a husband with severe mental illness had a disruptive influence on the emotional relationships of the family and resulted in emotional detachment over time. Despite the caregivers’ struggle to protect their families, the lack of supportive resources caused emotional exhaustion. Caregiving tasks interfering with their many other responsibilities, along with being a reference for family matters, led to loss of self. Consequently, they experienced psychological distress because of the transition to a caregiver role without any supportive resources.ConclusionConstant caring, without supportive resources, forced them to do various roles and manage other issues within the family. Being unprepared for a caregiving role led to the psychological distress of female spousal caregivers. Therefore, adequate information, education and supportive resources must be provided for spouses to facilitate their transition to caregiving roles.Relevance to clinical practiceIt is necessary to pay close attention to the spousal caregivers’ own mental health problems while they care for their mentally ill husbands. Mental health professionals should adopt a new approach to the prioritisation and planning of policies that support both family caregivers and patients.
Inertia in nursing care of hospitalised patients with urinary incontinence
Authors: Artero‐López Consuelo , Márquez‐Hernández Verónica V. , Estevez‐Morales María Teresa , Granados‐Gámez Genoveva 
Published: February 2018

Aims and objectivesTo assess the existence of therapeutic inertia in the nursing care of patients with urinary incontinence during the patient's time in hospital, together with the sociodemographic and professional variables involved.BackgroundInertia in care is a problem which appears in the nursing care process. Actions related to inertia can be attributed to not adhering to protocols, clinical guidelines and the lack of prevention measures which have undesirable effects on the efficiency of care.DesignThis was a prospective observational study.MethodsA total of 132 nursing professionals participated over two consecutive months. Data were collected randomly through the method of systematic, nonparticipative observation of medical practice units and patients’ medical records.ResultsThe results showed a pattern of severely compromised action in the assessment of the pattern of urinary elimination, in actions related to urinary continence, in therapeutic behaviour and in patient satisfaction and were found to be consistent with professional experience (p < .05). In the 600 records analysed, no statistically significant differences were found between gender and the use of records. In 50% (n = 301), the use of a rating scale was not reflected. In over 90% (n = 560) of cases, the type of incontinence was not recorded. In no continuity of care report were recommendations regarding incontinence included, nor was the type of continence products recommended indicated.ConclusionIt is clear that inertia exists in nursing care in the hospital environment while the patient is hospitalised, in prevention care, in the treatment of urinary incontinence and in the management of records.Relevance to clinical practiceContributing to the understanding of the existence of inertia in nursing care raises questions regarding its causes and interventions to predict or monitor it.
Recognition and assessment of resident’ deterioration in the nursing home setting: A critical ethnography
Authors: Laging Bridget , Kenny Amanda , Bauer Michael , Nay Rhonda 
Published: February 2018

Aims and objectivesTo explore the recognition and assessment of resident deterioration in the nursing home setting.BackgroundThere is a dearth of research exploring how nurses and personal‐care‐assistants manage a deteriorating nursing home resident.DesignCritical ethnography.MethodsObservation and semi‐structured interviews with 66 participants (general medical practitioners, nurses, personal‐care‐assistants, residents and family members) in two Australian nursing homes. The study has been reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.ResultsThe value of nursing assessment is poorly recognised in the nursing home setting. A lack of clarity regarding the importance of nursing assessments associated with resident care has contributed to a decreasing presence of registered nurses and an increasing reliance on personal‐care‐assistants who had inadequate skills and knowledge to recognise signs of deterioration. Registered nurses experienced limited organisational support for autonomous decision‐making and were often expected to undertake protocol‐driven decisions that contributed to potentially avoidable hospital transfers.ConclusionsNurses need to demonstrate the importance of assessment, in association with day‐to‐day resident care and demand standardised, regulated, educational preparation of an appropriate workforce who are competent in undertaking this role. Workforce structures that enhance familiarity between nursing home staff and residents could result in improved resident outcomes. The value of nursing assessment, in guiding decisions at the point of resident deterioration, warrants further consideration.
“Dignity”: A central construct in nursing home staff understandings of quality continence care
Authors: Ostaszkiewicz Joan , Tomlinson Emily , Hutchinson Alison M 
Published: February 2018

Aims and objectivesTo explore nursing home staff members’ beliefs and expectations about what constitutes “quality continence care” for people living in nursing homes.BackgroundMost nursing home residents require assistance to maintain continence or manage incontinence. Best practice guidelines promote active investigation of incontinence, treatment of underlying potentially reversible causes, and initial conservative interventions to prevent, minimise and/or treat incontinence. Despite research showing the positive benefits of implementing active interventions, translating the findings of research into practice in nursing homes has been modest. Understanding the perspectives of individuals who provide continence care may help bridge the gap between evidence and practice.DesignA qualitative exploratory descriptive design.MethodsQualitative interviews were conducted with 19 nursing home staff: eight registered nurses, four enrolled nurses and seven personal care workers working in a nursing home in Australia between 2014–2015. Data were analysed inductively to identify themes and subthemes that described and explained staff beliefs about quality continence care in nursing homes.FindingsParticipants’ understanding and expectations about quality continence care were linked to beliefs about incontinence being an intractable and undignified condition in nursing homes. The key theme to emerge was “protecting residents’ dignity” which was supported by the following six subthemes: (i) using pads, ii) providing privacy, (iii) knowing how to “manage” incontinence, (iv) providing timely continence care, (v) considering residents’ continence care preferences and (vi) communicating sensitively.ConclusionThe findings provide new insight into the basis for continence care practices in nursing homes. Education about continence care should challenge beliefs that limit continence care practice to cleaning, containing and concealing incontinence. There is a need for a multidimensional framework that is informed by social, psychological and biomedical research about incontinence, research about the fundamental elements of care, care‐dependent individuals’ expectations about care, and values about dignity and care.Relevance to clinical practice

The in‐depth exploration led to an understanding of the basis for continence care practices that centre on cleaning, containing and concealing residents’ incontinence in some nursing homes. There is a need to review the quality of education for the aged care workforce about incontinence to ensure it equips them with a broad understanding of the fundamentals of care and how to enact dignity in continence care through a resident‐centred approach.
Risk of hepatitis B virus reactivation in hepatitis B virus + hepatitis C virus‐co‐infected patients with compensated liver cirrhosis treated with ombitasvir, paritaprevir/r + dasabuvir + ribavirin
Authors: Preda C. M. , Popescu C. P. , Baicus C. , Constantinescu I. , Oproiu A. , Voiosu T. , Diculescu M. , Negreanu L. , Gheorghe L. , Sporea I. , Trifan A. , Ceausu E. , Proca D. , Manuc M. 
Published: February 2018

SummaryHepatitis B virus may reactivate in patients with chronic hepatitis C treated with direct‐acting antivirals. The aim of this study was to investigate the risk of hepatitis B virus (HBV) reactivation in HBV + hepatitis C virus (HCV)‐co‐infected patients with compensated liver cirrhosis treated with paritaprevir/ombitasvir/ritonavir, dasabuvir with ribavirin. We reviewed prospectively gathered data from a national cohort of 2070 hepatitis C virus patients with compensated liver cirrhosis who received reimbursed paritaprevir/ombitasvir/r, dasabuvir with ribavirin for 12 weeks from the Romanian National Health Agency during 2015‐2016. Twenty‐five patients in this cohort were HBs antigen positive (1.2%); 15 untreated with nucleotide analogues agreed to enter the study. These patients were followed up: ALT monthly, serology for HBV and DNA viral load at baseline, EOT and SVR at 12 weeks. Hepatitis B virus (HBV)‐co‐infected patients were all genotype 1b and 52% females, with a median age of 60 years (51 ÷ 74); 76% were pretreated with peginterferon + ribavirin; 72% were with severe necroinflammatory activity on FibroMax assessment; 40% presented comorbidities; and all were HBe antigen negative. Hepatitis C virus (HCV) SVR response rate was 100%. Hepatitis B virus (HBV)‐DNA viral load was undetectable in 7/15 (47%) before therapy, and for the other 8 patients, it varied between below 20 and 867 IU/mL. Five patients (33%) presented virological reactivation (>2 log increase in HBV‐DNA levels) during therapy. One patient presented with hepatitis associated with HBV reactivation, and two started anti‐HBV therapy with entecavir. Hepatitis B virus (HBV) virological reactivation was present in 33% in our patients. Generally, HBV‐DNA elevations were mild (<20 000 IU/mL); however, we report one case of hepatitis associated with HBV reactivation.
Does introgression of crop alleles into wild and weedy living populations create cryptic in situ germplasm banks?
Authors: Ellstrand Norman C. 
Published: February 2018

Natural gene flow often delivers alleles from cultivated species into unmanaged populations of weedy or wild relatives. Unmanaged populations with introgressed crop alleles may become the unintended repositories of crop alleles that are no longer available to breeders. Descriptive studies have confirmed the introgression of alleles from 17 crop species into free‐living populations. Multigeneration experimental studies allowing hybrid‐derived individuals to evolve under natural conditions are informative, but remain few. A study in this issue of Molecular Ecology (Molecular Ecology, 26, 2017) documents genomewide crop allele evolution in experimental populations of crop‐wild hybrid‐derived sunflowers. Approximately, three‐quarters of the wild alleles increased in frequency;—however, 5% of the crop alleles in each of the two sites increased (Molecular Ecology, 26, 2017; Figure ). The remainder behaved as if they were neutral. This study's results plus those of prior studies demonstrate that introgressed populations of crop‐wild relatives contain a mixture of wild and crop alleles and thereby can be valued as a distinct kind of in situ germplasm resource relative to nonintrogressed populations.A lone wild sunflower in the foreground. A field of thousands of cultivated sunflowers in the backgroundimage
Epidemiology, treatment, disposition and outcome of patients with acute exacerbation of COPD presenting to emergency departments in Australia and South East Asia: An AANZDEM study
Authors: Kelly Anne Maree , Holdgate Anna , Keijzers Gerben , Klim Sharon , Graham Colin A. , Craig Simon , Kuan Win Sen , Jones Peter , Lawoko Charles , Laribi Said 
Published: February 2018

ABSTRACTBackground and objectiveAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common presentation to emergency departments (ED) but data regarding its epidemiology and outcomes are scarce. We describe the epidemiology, clinical features, treatment and outcome of patients treated for AECOPD in ED.MethodsThis was a planned sub‐study of patients with an ED diagnosis of AECOPD identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study. The AANZDEM was a prospective, interrupted time series cohort study conducted in 46 ED in Australia, New Zealand, Singapore, Hong Kong and Malaysia over three 72‐h periods in May, August and October 2014. Primary outcomes were patient epidemiology, clinical features, treatment and outcomes (hospital length of stay (LOS) and mortality).ResultsForty‐six ED participated. There were 415 patients with an ED primary diagnosis of AECOPD (13.6% of the overall cohort; 95% CI: 12.5–14.9%). Median age was 73 years, 60% males and 65% arrived by ambulance. Ninety‐one percent had an existing COPD diagnosis. Eighty percent of patients received inhaled bronchodilators, 66% received systemic corticosteroids and 57% of those with pH < 7.30 were treated with non‐invasive ventilation (NIV). Seventy‐eight percent of patients were admitted to hospital, 7% to an intensive care unit. In‐hospital mortality was 4% and median LOS was 4 days (95% CI: 2–7).ConclusionPatients treated in ED for AECOPD commonly arrive by ambulance, have a high admission rate and significant in‐hospital mortality. Compliance with evidence‐based treatments in ED is suboptimal affording an opportunity to improve care and potentially outcomes.
The effects of flexibility training on exercise‐induced muscle damage in young men with limited hamstrings flexibility
Authors: Brusco C. M. , Blazevich A. J. , Radaelli R. , Botton C. E. , Cadore E. L. , Baroni B. M. , Trajano G. S. , Pinto R. S. 
Published: February 2018

Adaptations to 6 weeks of supervised hamstring stretching training and its potential impact on symptoms of eccentric exercise‐induced muscle damage (EIMD) were studied in 10 young, untrained men with limited hamstrings flexibility. Participants performed unilateral flexibility training (experimental leg; EL) on an isokinetic dynamometer, while the contralateral limb acted as control (CL). Hip range of motion (ROM), passive, isometric, and concentric torques, active optimum angle, and biceps femoris and semitendinosus muscle thickness and ultrasound echo intensity were assessed both before and after the training. Additionally, muscle soreness was assessed before and after an acute eccentric exercise bout in both legs (EL and CL) at post‐training only. Hip ROM increased (P < .001) only in EL after the training (EL = 10.6° vs CL = 1.6°), but no changes (P > .05) in other criterion measurements were observed. After a bout of eccentric exercise at the end of the program, isometric and dynamic peak torques and muscle soreness ratings were significantly altered at all time points equally in EL and CL. Also, active optimum angle was reduced immediately, 48 and 72 hours post‐exercise, and hip ROM was reduced at 48 and 72 hours equally in EL and CL. Finally, biceps femoris muscle thickness was significantly increased at all time points, and semitendinosus thickness and echo intensity significantly increased at 72 hours, with no significant differences between legs. The stretching training protocol significantly increased hip ROM; however, it did not induce a protective effect on EIMD in men with tight hamstrings.
Organization of the TC and TE cellular T‐DNA regions in Nicotiana otophora and functional analysis of three diverged TE‐6b genes
Authors: Chen Ke , Dorlhac de Borne François , Sierro Nicolas , Ivanov Nikolai V. , Alouia Malek , Koechler Sandrine , Otten Léon 
Published: February 2018

SummaryNicotiana otophora contains Agrobacterium‐derived T‐DNA sequences introduced by horizontal gene transfer (Chen et al., 2014). Sixty‐nine contigs were assembled into four different cellular T‐DNAs (cT‐DNAs) totalling 83 kb. TC and TE result from two successive transformation events, each followed by duplication, yielding two TC and two TE inserts. TC is also found in other Nicotiana species, whereas TE is unique to N. otophora. Both cT‐DNA regions are partially duplicated inverted repeats. Analysis of the cT‐DNA divergence patterns allowed reconstruction of the evolution of the TC and TE regions. TC and TE carry 10 intact open reading frames. Three of these are TE‐6b genes, derived from a single 6b gene carried by the Agrobacterium strain which inserted TE in the N. otophora ancestor. 6b genes have so far only been found in Agrobacterium tumefaciens or Agrobacterium vitis T‐DNAs and strongly modify plant growth (Chen and Otten, 2016). The TE‐6b genes were expressed in Nicotiana tabacum under the constitutive 2 × 35S promoter. TE‐1‐6b‐R and TE‐2‐6b led to shorter plants, dark‐green leaves, a strong increase in leaf vein development and modified petiole wings. TE‐1‐6b‐L expression led to a similar phenotype, but in addition leaves show outgrowths at the margins, flowers were modified and plants became viviparous, i.e. embryos germinated in the capsules at an early stage of their development. Embryos could be rescued by culture in vitro. The TE‐6b phenotypes are very different from the earlier described 6b phenotypes and could provide new insight into the mode of action of the 6b genes.
Development and piloting of a survey to estimate the frequency and nature of potentially harmful preventable problems in primary care from a UK patient’s perspective
Authors: Stocks Susan J , Donnelly Ailsa , Esmail Aneez , Beresford Joanne , Gamble Carolyn , Luty Sarah , Deacon Richard , Danczak Avril , Mann Nicola , Townsend David , Ashley James , Bowie Paul , Campbell Stephen M 
Published: February 2018

ObjectivesTo design and pilot a survey to be used at the population level to estimate the frequency of patient-perceived potentially harmful preventable problems occurring in UK primary care. To explore the nature of the problems, patient-suggested strategies for prevention and opinions of clinicians and the public regarding the potential for harm.DesignA survey was codesigned by three members of the public and one researcher and piloted through public and patient involvement and engagement networks.SettingSelf-selected sample of the UK population.Participants977 members of the public accessed the online survey during October and November 2015.Primary outcome measuresRespondent feedback about the ease of completion of the survey, quality of responses in terms of review by clinicians and members of the public, preliminary estimates of the frequency and nature of patient-perceived potentially harmful problems occurring in the last 12 months.Results638 (65%) members of the public completed the survey and few respondents reported any difficulty in understanding or completing the survey. 132 (21%) respondents reported experiencing a potentially harmful preventable problem during the past 12 months and 108 (82%) of these respondents provided a description that was adequate for at least one clinician to form an opinion about the potentially harmful problem. Respondents were older than the UK generally, more likely to work or volunteer in the healthcare sector and tended to use primary care more frequently but their confidence and trust in their own general practitioner (GP) was similar to that of the UK population as measured by the annual English GP patient survey.ConclusionsThe survey was acceptable to patients and mostly provided data of sufficient quality for review by clinicians and members of the public. It is now ready to use at a population level to estimate the frequency and nature of potentially harmful preventable problems in primary care from a patient’s perspective.