bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multilevel National Analysis of Nursing Students’ Perceived Opportunity to Access Evidence‐Based Tools During Their Clinical Learning Experience
Authors: Palese Alvisa , Gonella Silvia , Grassetti Luca , Destrebecq Anne , Mansutti Irene , Terzoni Stefano , Zannini Lucia , Altini Pietro , Bevilacqua Anita , Brugnolli Anna , Dal Ponte Adriana , De Biasio Laura , Fascì Adriana , Grosso Silvia , Mantovan Franco , Marognolli Oliva , Nicotera Raffaela , Randon Giulia , Tollini Morena , Canzan Federica , Saiani Luisa , Dimonte Valerio 
Published: October 2018

AbstractBackgroundEasy‐to‐access tools have been demonstrated to improve evidence‐based practice (EBP) competences among nursing students. However, students’ perception of access to EBP tools (e.g., clinical practice guidelines [CPGs], protocols) is unknown.AimsTo explore: (1) nursing students’ opportunity to access EBP tools during their education, and (2) associated factors.MethodsA national cross‐sectional study including all Italian nursing programs. Nursing students were deemed eligible according to the following inclusion criteria: Those who (1) were attending or just ended their practical rotation lasting at least 2 weeks at the time of the survey, and (2) expressed through written informed consent their willingness to take part in the study. Participants were asked about their perceived opportunity to access EBP tools during their most recent clinical learning experience (from 0 – not at all to 3 – always). A set of explanatory variables was collected at the individual, nursing program, and regional levels by using a questionnaire.ResultsNine thousand six hundred and seven (91.6%) out of 10,480 nursing students took part in the study. Overall, 4,376 (45.6%) students perceived not at all or only a small opportunity to access EBP tools during their most recent clinical rotation. In the multilevel analysis, factors promoting access were mainly set at the clinical learning environment level (high safety and nursing care quality, high self‐directed learning opportunities, high quality of the learning environment, and being supervised by a clinical nurse). In contrast, male gender and lower academic class were associated with a lower perception of accessibility to EBP tools. A consistent variability in the perceived opportunity to access EBP tools emerged across regions.Linking Evidence to ActionEvidence‐based decision‐making is increasingly expected from nurses. Therefore, nursing faculties should safeguard and continuously improve students’ competence regarding EBP, by implementing strategies mainly at the nursing program and regional levels.
Diagnosis and management of otitis media with effusion in a tertiary hospital in Kano: a best practice implementation project
Authors: Ahmed Abdulazeez , Kolo Emmanuel , Aluko Abdulakeem , Abdullahi Hamisu , Ajiya Abdulrazaq , Bello-Muhammad Nafisatu , Raji Hanifat , Tsiga-Ahmed Fatimah 
Published: October 2018

ABSTRACT

Objective:
To implement the best available practice to improve the diagnosis and management of OME according to best available evidence at the Aminu Kano Teaching Hospital, Kano, Nigeria.

Introduction:
Otitis media with effusion (OME) is characterized by the presence of fluid in the middle ear, without signs and symptoms of an acute infection. It has high rates of physician visits and is a common cause of hearing impairment in affected children. In Nigeria, the prevalence is estimated to range from 8% to 25.2%.

Methods:
The current quality improvement project was conducted using the Joanna Briggs Institute approach for clinical audits, involving a baseline audit, an implementation of change phase and a follow-up audit, using Practical Application of Clinical Evidence System software. Eleven evidence-based audit criteria were used for this project. The same audit criteria were used for the baseline and follow-up audit. The sample size was 20 for both the baseline and follow-up. Implemented change involved the introduction of pneumatic otoscope use in the department and educational sessions with clinicians and caregivers. The project was conducted from July to November 2017.

Results:
Implementation of strategies to improve practice led to large increases in compliance with audit criteria, particularly Criteria 1, 6, 9 and 10 (from 0–25% to 70–100%). Paradoxically, a decrease in compliance was observed for two criteria.

Conclusion:
The current project succeeded in increasing clinician compliance with best available evidence. The most significant evidence-based change seen was in the use of pneumatic otoscope, whereas the most difficult barrier to overcome was resistance to change.
Clinical management of cancer-related fatigue in hospitalized adult patients: a best practice implementation project
Authors: Wang Ning , Yang Zhihui , Miao Jingxia , Mi Xue , Liu Suting , Stern Cindy , Porritt Kylie , Zhang Lili 
Published: October 2018

ABSTRACT

Objectives:
This project aimed to identify and promote evidence-based practice in the management of cancer related fatigue (CRF) in the oncology unit of Nanfang Hospital, affiliated with the Southern Medical University in People's Republic of China.

Introduction:
Cancer-related fatigue is one of the most common symptoms in patients with cancer and significantly affects their functioning and quality of life. However, it is often inadequately addressed and evidence-based practices are not always followed.

Methods:
The Joanna Briggs Institute (JBI) has a validated audit and feedback tool to assist with best practice implementation audits. The JBI Practical Application of Clinical Evidence System (PACES) was used in this project. A three-phase project was undertaken: i) a pre-implementation audit of current practice against evidence-based audit criteria, ii) identification of barriers and implementation of strategies to improve practice using the JBI Getting Research into Practice (GRiP) tool and iii) a post-implementation audit.

Results:
The baseline audit results identified non-compliance to best practice in all areas of CRF. Strategies to improve practice involved relevant education for nurses, establishment of a CRF management routine and related documentation systems and displaying and distributing educational materials for the patients. Improved compliance was shown across all audit criteria in post-evaluation.

Conclusions:
The implementation of institution specific evidence-based resources demonstrated immediate improvement in CRF management and practice. Continuous effort is required to maintain changes and further improve practice. Future projects should focus on measuring the impact of changed practice on patient outcomes.
Admission and discharge criteria for adolescents requiring inpatient or residential mental healthcare: a scoping review protocol
Authors: Evans Nicola , Edwards Deborah 
Published: October 2018

Review objective/question
The question of this review is: what are the admission and discharge criteria for mental health inpatient care for adolescents?
The objective is to identify the criteria:For admission to mental health inpatient or residential care for adolescentsFor discharge from mental health inpatient or residential care for adolescentsFor not admitting adolescents to mental health inpatient or residential care.
Serial circulating omega 3 polyunsaturated fatty acids and healthy ageing among older adults in the Cardiovascular Health Study: prospective cohort study
Authors: Lai Heidi TM , de Oliveira Otto Marcia C , Lemaitre Rozenn N , McKnight Barbara , Song Xiaoling , King Irena B , Chaves Paulo HM , Odden Michelle C , Newman Anne B , Siscovick David S , Mozaffarian Dariush 
Published: October 2018

AbstractObjectiveTo determine the longitudinal association between serial biomarker measures of circulating omega 3 polyunsaturated fatty acid (n3-PUFA) levels and healthy ageing.DesignProspective cohort study.SettingFour communities in the United States (Cardiovascular Health Study) from 1992 to 2015.Participants2622 adults with a mean (SD) age of 74.4 (4.8) and with successful healthy ageing at baseline in 1992-93.ExposureCumulative levels of plasma phospholipid n3-PUFAs were measured using gas chromatography in 1992-93, 1998-99, and 2005-06, expressed as percentage of total fatty acids, including α-linolenic acid from plants and eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid from seafoood.Main outcome measureHealthy ageing defined as survival without chronic diseases (ie, cardiovascular disease, cancer, lung disease, and severe chronic kidney disease), the absence of cognitive and physical dysfunction, or death from other causes not part of the healthy ageing outcome after age 65. Events were centrally adjudicated or determined from medical records and diagnostic tests.ResultsHigher levels of long chain n3-PUFAs were associated with an 18% lower risk (95% confidence interval 7% to 28%) of unhealthy ageing per interquintile range after multivariable adjustments with time-varying exposure and covariates. Individually, higher eicosapentaenoic acid and docosapentaenoic acid (but not docosahexaenoic acid) levels were associated with a lower risk: 15% (6% to 23%) and 16% (6% to 25%), respectively. α-linolenic acid from plants was not noticeably associated with unhealthy ageing (hazard ratio 0.92, 95% confidence interval 0.83 to 1.02).ConclusionsIn older adults, a higher cumulative level of serially measured circulating n3-PUFAs from seafood (eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid), eicosapentaenoic acid, and docosapentaenoic acid (but not docosahexaenoic acid from seafood or α-linolenic acid from plants) was associated with a higher likelihood of healthy ageing. These findings support guidelines for increased dietary consumption of n3-PUFAs in older adults.
Feasibility of collecting and assessing patient-reported outcomes for emergency admissions: laparotomy for gastrointestinal conditions
Authors: Kwong Esther , Neuburger Jenny , Murray Dave , Black Nick 
Published: October 2018

IntroductionAudit of emergency surgery is usually limited to immediate clinical outcomes relating to outcomes during the acute hospital episode with little attempt to capture patients’ views of their longer-term outcomes. Our aim was to determine the response rate to patient-reported outcome measures (PROMs) for patients who underwent an emergency laparotomy for gastrointestinal conditions, identify response bias and explore the feasibility of comparing outcomes with their prior health based on their recalled view collected during their admission.MethodsPatients undergoing emergency laparotomy in 11 hospitals were recruited to complete a retrospective questionnaire containing the EQ-5D-3L and Gastrointestinal Quality of Life Index (GIQLI). Response rate for 3-month mailed follow-up questionnaire and potential response biases were assessed. Patients’ outcomes were compared with their baseline using χ2and paired t-test to assess for differences.ResultsOf 255 patients contacted at 3 months, 190 (74.1%) responded. Responders were more likely to be older, female and more affluent. Patients’ health improved significantly as regards the GIQLI (93.3 vs 97.9; p=0.048) and the subscale on symptoms (51.9 vs 59.6; p<0.001). No significant change in subscales on emotion or physical aspects or for overall health status (EQ-5D: 0.58 vs 0.64; p=0.06). According to the social subscale, patients had deteriorated (11.0 vs 9.8; p<0.0006). Differences in change scores by patient characteristics were slight, suggesting minimal response bias.ConclusionThis approach offers the opportunity for assessing the impact of treatment, from the patient’s perspective and the potential to evaluate emergency laparotomy care using PROMs.
Idiopathic intracranial hypertension: consensus guidelines on management
Authors: Mollan Susan P , Davies Brendan , Silver Nick C , Shaw Simon , Mallucci Conor L , Wakerley Benjamin R , Krishnan Anita , Chavda Swarupsinh V , Ramalingam Satheesh , Edwards Julie , Hemmings Krystal , Williamson Michelle , Burdon Michael A , Hassan-Smith Ghaniah , Digre Kathleen , Liu Grant T , Jensen Rigmor Højland , Sinclair Alexandra J 
Published: October 2018

The aim was to capture interdisciplinary expertise from a large group of clinicians, reflecting practice from across the UK and further, to inform subsequent development of a national consensus guidance for optimal management of idiopathic intracranial hypertension (IIH).MethodsBetween September 2015 and October 2017, a specialist interest group including neurology, neurosurgery, neuroradiology, ophthalmology, nursing, primary care doctors and patient representatives met. An initial UK survey of attitudes and practice in IIH was sent to a wide group of physicians and surgeons who investigate and manage IIH regularly. A comprehensive systematic literature review was performed to assemble the foundations of the statements. An international panel along with four national professional bodies, namely the Association of British Neurologists, British Association for the Study of Headache, the Society of British Neurological Surgeons and the Royal College of Ophthalmologists critically reviewed the statements.ResultsOver 20 questions were constructed: one based on the diagnostic principles for optimal investigation of papilloedema and 21 for the management of IIH. Three main principles were identified: (1) to treat the underlying disease; (2) to protect the vision; and (3) to minimise the headache morbidity. Statements presented provide insight to uncertainties in IIH where research opportunities exist.ConclusionsIn collaboration with many different specialists, professions and patient representatives, we have developed guidance statements for the investigation and management of adult IIH.
e–e recollision dynamics of nonsequential double ionization with mid-infrared laser field
Authors: Li Yingbin , Mei Lingli , Chen Hongmei , Xu Jingkun , Tang Qingbin , Zhao Yiguang , Han Qianqian , Wang Chunlei , Tong Aihong , Ge Guixian , Yu Benhai 
Published: October 2018

We have investigated the recollision dynamics of correlated electron from nonsequential double ionization (NSDI) with 3200 nm laser fields at a wide range of intensities using a full-dimensional classical ensemble method. The numerical results show that for the mid-infrared laser fields, the double ionization probability versus laser peak intensity still displays a much clear “traditional” knee structure representing NSDI. At low intensity, the electron momentum correlated spectrum along the laser polarization direction shows a V-shaped structure; whereas at high intensity, the spectrum exhibits a clearly cross-shaped structure. We demonstrate that both the V-shaped structure and the cross-shaped structure are the results of extremely asymmetric energy sharing of the two electrons at recollision. Moreover, the most prominent contribution to NSDI is from the second-returning trajectory and the first-returning trajectory is significantly suppressed. What’s more, the mechanism of NSDI is from recollision impact ionization (RII) channel as well as recollision-excitation-with-subsequent-ionization (RESI) channel. We find that at low intensity, only the RII channel contributes to V-shaped structure; whereas at high intensity, both the RII and RESI channels have comparable contribution to the cross-shaped structure. Further, we diagnose the recolliding electron and the bound electron separately by tracing the classical trajectories.
Maximal strength training: the impact of eccentric overload
Authors: Tøien Tiril , Pedersen Haglo Håvard , Unhjem Runar , Hoff Jan , Wang Eivind 
Published: October 2018

The search for the most potent strength training intervention is continuous. Maximal strength training (MST) yields large improvements in force-generating capacity (FGC), largely attributed to efferent neural drive enhancement. However, it remains elusive whether eccentric overload, before the concentric phase, may augment training-induced neuromuscular adaptations. A total of 53 23 ± 3 (SD)-yr-old untrained males were randomized to either a nontraining control group (CG) or one of two training groups performing leg press strength training with linear progression, three times per week for 8 wk. The first training group carried out MST with four sets of four repetitions at ~90% one-repetition maximum (1RM) in both action phases. The second group performed MST with an augmented eccentric load of 150% 1RM (eMST). Measurements were taken of 1RM and rate of force development (RFD), countermovement jump (CMJ) performance, and evoked potentials recordings [V-wave (V) and H-reflex (H) normalized to M-wave (M) in musculus soleus]. 1RM increased from 133 ± 16 to 157 ± 23 kg and 123 ± 18 to 149 ± 22 kg and CMJ by 2.3 ± 3.6 and 2.2 ± 3.7cm for MST and eMST, respectively (all P < 0.05). Early, late, and maximal RFD increased in both groups [634–1,501 N/s (MST); 644–2,111 N/s (eMST); P < 0.05]. These functional improvements were accompanied by increased V/M-ratio (MST: 0.34 ± 0.11 to 0.42 ± 14; eMST: .36 ± 0.14 to 0.43 ± 13; P < 0.05). Resting H/M-ratio remained unchanged. Training-induced improvements did not differ. All increases, except for CMJ, were different from the CG. MST is an enterprise for large gains in FGC and functional performance. Eccentric overload did not induce additional improvements, suggesting firing frequency and motor unit recruitment during MST may be maximal. NEW & NOTEWORTHY This is the first study to apply evoked potential recordings to investigate effects on efferent neural drive following high-intensity strength training with and without eccentric overload in a functionally relevant lower extremity exercise. We document that eccentric overload does not augment improvements in efferent neural drive or muscle force-generating capacity, suggesting that high-intensity concentric loads may maximally tax firing frequency and motor unit recruitment.
Direct assessment of presynaptic modulation of cortico-striatal glutamate release in a Huntington’s disease mouse model
Authors: Koch Ellen T. , Woodard Cameron L. , Raymond Lynn A. 
Published: October 2018

Glutamate is the main excitatory neurotransmitter in the brain, and impairments in its signaling are associated with many neurological disorders, including Huntington’s disease (HD). Previous studies in HD mouse models demonstrate altered glutamate receptor distribution and signaling at cortico-striatal synapses, and some studies suggest that glutamate release is altered; however, traditional methods to study synaptic glutamate release are indirect or have poor temporal resolution. Here we utilize iGluSnFR, a modified green fluorescent protein reporter for real-time imaging of glutamate transmission, to study presynaptic modulation of cortical glutamate release in the striatum of the YAC128 HD mouse model. We determined that iGluSnFR can be used to accurately measure short- and long-term changes in glutamate release caused by modulation of extracellular Ca2+ levels, activation of presynaptic receptors, and high-frequency stimulation (HFS) protocols. We also confirmed a difference in the expression of HFS-induced long-term depression in YAC128. Together, this research demonstrates the utility of iGluSnFR in studying presynaptic modulation of glutamate release in healthy mice and disease models that display impairments in glutamate signaling. NEW & NOTEWORTHY We use iGluSnFR to directly assess presynaptic modulation of cortico-striatal glutamate release in brain slice and compare changes in glutamate release between wild type and a Huntington’s disease mouse model, YAC128. We observed reductions in glutamate release after low extracellular Ca2+ and activation of various presynaptic receptors. We also demonstrate a presynaptic mechanism of reduced glutamate release in high-frequency stimulation-induced long-term depression and show this to be altered in YAC128.
The EGFR T790M Mutation Is Acquired through AICDA-Mediated Deamination of 5-Methylcytosine following TKI Treatment in Lung Cancer
Authors: El Kadi Najwa , Wang Luo , Davis April , Korkaya Hasan , Cooke Alexander , Vadnala Varun , Brown Noah A. , Betz Bryan L. , Cascalho Marilia , Kalemkerian Gregory P. , Hassan Khaled A. 
Published: October 2018

Abstract

Almost all patients with EGFR-driven lung cancer who are treated with EGFR tyrosine kinase inhibitors (TKI) develop resistance to treatment. A single base (c.2369C&gt;T) transition mutation, EGFR T790M, is the most frequent resistance event after first-generation exposure to EGFR TKIs. Whether T790M mutation is acquired or is selected from a preexisting clone has been a matter of significant debate. In this study, we show that treatment with EGFR TKIs leads to activation of the NFκB pathway, which in turn induces expression of activation-induced cytidine deaminase (AICDA). In turn, AICDA causes deamination of 5-methylcytosine to thymine at position c.2369 to generate the T790M mutation. Pharmacologic inhibition of the NFκB pathway or knockout of AICDA decreased the frequency or prevented the development of T790M mutation, respectively. In addition, patients treated with first-line EGFR TKI displayed increased expression of AICDA and detection of the T790M mutation upon progression. These results identify the mechanism of T790M acquisition and present an opportunity to target the process to delay or prevent it.

Significance:
These findings identify the mechanism behind acquisition of a common resistance mutation to TKI treatment in lung cancer.
Glioma Cell Secretion: A Driver of Tumor Progression and a Potential Therapeutic Target
Authors: Almiron Bonnin Damian A. , Havrda Matthew C. , Israel Mark A. 
Published: October 2018

AbstractCellular secretion is an important mediator of cancer progression. Secreted molecules in glioma are key components of complex autocrine and paracrine pathways that mediate multiple oncogenic pathologies. In this review, we describe tumor cell secretion in high-grade glioma and highlight potential novel therapeutic opportunities. Cancer Res; 78(21); 6031–9. ©2018 AACR.
Decision Support and Navigation to Increase Colorectal Cancer Screening Among Hispanic Patients
Authors: Myers Ronald E. , Stello Brian , Daskalakis Constantine , Sifri Randa , González Evelyn T. , DiCarlo Melissa , Johnson Melanie B. , Hegarty Sarah E. , Shaak Kyle , Rivera Alicia , Gordils-Molina Lucas , Petrich Anett , Careyva Beth , de-Ortiz Rosa , Diaz Liselly 
Published: October 2018

Abstract

Background:
Effective strategies are needed to raise colorectal cancer screening rates among Hispanics.

Methods:
We surveyed and randomized 400 Hispanic primary care patients either to a Decision Support and Navigation Intervention (DSNI) Group (n = 197) or a Standard Intervention (SI) Group (n = 203). Both groups received a colorectal cancer screening kit [bilingual informational booklet, fecal immunochemical stool blood test (SBT), and colonoscopy screening instructions]. The DSNI Group received a telephone contact from a patient navigator. The navigator clarified screening test preference and likelihood of test performance, helped to develop a screening plan, and provided guidance through test performance. An endpoint telephone survey and medical chart review were completed. Multivariable analyses were conducted to assess 12-month screening adherence, change in decision stage, and knowledge and perceptions.

Results:
Screening adherence was significantly higher in the DSNI Group than the SI Group [OR, 4.8; 95% confidence interval (CI), 3.1–7.6]. The DSNI Group, compared with the SI Group, also displayed higher SBT screening [OR, 4.2; 95% CI, 2.6–6.7), higher colonoscopy screening (OR, 8.8; 95% CI, 4.1–18.7), and greater forward change in screening decision stage (OR, 4.9; 95% CI, 2.6–9.5). At endpoint, study groups did not differ in screening knowledge or perceptions.

Conclusions:
The DSNI had a greater positive impact on colorectal cancer screening outcomes than the SI.

Impact:
Health system implementation of DSNI strategies may help to reduce Hispanic colorectal cancer screening disparities in primary care.