bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social support network of family members of abused children and adolescents: Perspectives and possibilities
Authors: Carlos Diene Monique , Silva Lygia Maria Pereira , Beserra Maria Aparecida , Aragão Ailton de Souza , Gregory Alison , Ferriani Maria das Graças Carvalho 
Published: September 2018

AbstractAims and objectivesTo analyse the network of care and social support from the perspectives of family members of children and adolescents who have been abused.BackgroundThe theoretical–methodological background of the ecological model for understanding violence and the Paradigm of Complexity provide a broad perspective of violence. The paradigm considers all aspects that constitute a phenomenon as well as particular features.DesignQualitative research based on the Paradigm of Complexity, developed by Edgar Morin, the primary philosopher. We have adhered to the COREQ Checklist guidelines for qualitative research.MethodsData were collected through Minimal Maps of Personal Social Networks, and semi‐structured interviews were held with 15 families who were assisted by a nongovernmental organisation in a Brazilian city. The notions of comprehension and contextualisation guided the data analysis.ResultsTwo categories emerged from the data analyses: “Social isolation” and “Affective relationships needs.” The maps revealed a weakened and limited network with low‐density, homogeneous bonds and few significant bonds. Therefore, the network provided predominantly instrumental and material social support with few important effective relationships. The participants disclosed some strategies to empower their lives.ConclusionsWe conclude that it is urgent to develop strategies in a broad manner to promote family empowerment, especially on education and employment dimension, and to construct supportive and respectful relationships between services and families as well.Relevance to clinical practiceThe present study contributes to international clinical nursing, especially in low‐ and middle‐income countries, by discussing (a) looking at and caring for family members of children and adolescents who have been abused in a contextualised manner; (b) family empowerment, which enables them to have access to healthier environments and to educational/employment opportunities; and (c) broad comprehension of health care among the family members, which provides perspectives not only for looking at violence but also for strengthening supportive social relationships.
A narrative analysis of the stories of mothers who have parented a child with Hodgkin lymphoma who is currently in early survivorship
Authors: Darcy Jennifer 
Published: September 2018

Aims and ObjectivesTo explore the lived experience of mothers of children who have survived Hodgkin lymphoma, from diagnosis, through treatment and recovery as she has lived it and in her own words and to discuss the self‐reported experiences in the context of the theoretical propositions of Attachment Theory and birth order as it applies to the mother–child dyad with this life experience.BackgroundWhile much has been written about childhood cancer survivors and their parents independently, there are unique struggles that a mother and a childhood cancer survivor face as a dyad. Examining the dyadic relationship over time offers a unique perspective to understanding the parenting experience with a child whose fate is uncertain.Design and MethodNarrative Inquiry was utilised to explore the bonds the mother has with her child before he or she is diagnosed with cancer, the relationship during treatment and the subsequent relationship when the child has entered survivorship. Most specifically, the research explored the attachment of the mother to her child as it relates to the Caregiving System. A purposive sample of 13 mothers of children diagnosed with Hodgkin lymphoma representing children from each birth order category (youngest child, middle child, oldest child and only child) was chosen. The interviews were analysed through thematic analysis with final themes identified.ResultsSeveral core themes emerged from the narratives regardless of birth order. The most significant was the “need to protect.” Additional themes were “things will never be the same,” “unique bond,” “shifting priorities” and “lost innocence.”Conclusions and relevance to practiceThe research shows activation of the Caregiving Behavioral Response System as it relates as a reciprocal to Attachment Theory.
Current status and influencing factors of barriers to enteral feeding of critically ill patients: A multicenter study
Authors: Huang Jingying , Yang Lili , Zhuang Yiyu , Qi Haiou , Chen Xiangpin , Lv Kai 
Published: September 2018

AbstractAims and objectivesTo investigate the barriers in administering enteral feeding to critically ill patients from the nursing perspective. Our objectives are to provide tailored interventions for addressing identified barriers and propose an optimal enteral nutrition (EN) practice in intensive care unit (ICU).BackgroundDespite the availability of numerous verified clinical practice guidelines focusing on enteral feeding of critically ill patients, a wide gap remains between the guideline recommendations and actual nutrition performances. Underfeeding is also a global problem. Therefore, to further understand the reasons of the systemic iatrogenic underfeeding in ICUs, several potential issues are investigated.DesignThis research is a cross‐sectional descriptive study.MethodsA total of 808 nurses were recruited from 10 comprehensive hospitals from different districts in China. The nursing staff demographic, the unit's EN management information and the Chinese version of barriers to enteral feeding critically ill patients questionnaire were the parameters used to collect data via WeChat app. Moreover, the collected data were analysed by descriptive and correlative statistical analysis methods.ResultsResults obtained by multiple linear regression showed that frequency of EN‐related training, full‐time ICU nutritionist, hospital level, specific protocols for enteral feeding and position were significantly influencing the enteral feeding of ICU patients.ConclusionsEnteral feeding barriers of ICU patients are at a moderate level and are influenced by multiple aspects. Hence, hospital departments should strengthen standardisation and systematic EN training, provide ICU full‐time nutritionists and distribute medical resources and personnel rationally. Moreover, construction of a localised feeding process and exerting subjective initiative of clinical nurses from an evidence‐based guideline are important. Multifaceted tailored interventions should be implemented to address these barriers.Relevance to clinical practiceThe findings of this study can be used to inform future intervention and guidelines aimed at addressing these barriers systematically and improving adherence to critical care nutrition guidelines for the provision of enteral nutrition.
Determining the impact of a bowel management protocol on patients and clinicians' compliance in cardiac intensive care: A mixed‐methods approach
Authors: Warren Dawn , Kent Bridie 
Published: September 2018

AbstractBackgroundBowel management protocols standardise care and, potentially, improve the incidence of diarrhoea and constipation in intensive care. However, little research exists reporting compliance with such protocols in intensive care throughout patients' stay. Furthermore, there is a limited exploration of the barriers and enablers to bowel management protocols following their implementation, an important aspect of improving compliance.Aim and objectiveTo investigate the impact of a bowel management protocol on the incidence of constipation and diarrhoea, levels of compliance, and to explore the enablers and barriers associated with its use in intensive care.MethodsA mixed‐methods study was conducted in cardiac intensive care using two phases: (a) a retrospective case review of patients' hospital notes, before and after the protocol implementation, establishing the levels of diarrhoea and constipation and levels of compliance; (b) focus groups involving users of the protocol, 6 months following its implementation, exploring the barriers and enablers in practice.Results and findingsFifty‐one patients' notes were reviewed during phase one: 30 pre‐implementation and 21 post‐implementation. Following the protocol implementation, there was a tendency for a higher incidence of constipation and less severe cases of diarrhoea. Overall compliance with the protocol was low (2.3%). However, there was evidence of behavioural change following protocol implementation, including less variation in aperients given and a shorter, less varied time period between starting enteral feed and administering aperients. Several themes emerged from the focus groups: barriers and enablers to the protocol characteristics and dissemination; barriers to bowel assessment; nurse as a barrier; medical involvement and protocol outcomes.ConclusionsThe bowel management protocol implementation generated some positive outcomes to bowel care practices. However, compliance was low and until there is improvement, through overcoming the barriers identified, the impact of such protocols in practice will remain largely unknown.
Factors associated with the increased bleeding in the postoperative period of cardiac surgery: A cohort study
Authors: Pereira Kárla M. F. S. M. , de Assis Caroline S. , Cintra Haulcionne N. W. L. , Ferretti‐Rebustini Renata Eloah L. , Püschel Vilanice A. A. , Santana‐Santos Eduesley , Rodrigues Adriano Rogério B. , de Oliveira Larissa B. 
Published: September 2018

AbstractAims and objectivesTo identify factors associated with the increased bleeding in patients during the postoperative period after cardiac surgery.BackgroundBleeding is among the most frequent complications that occur in the postoperative period after cardiac surgery, representing one of the major factors in morbidity and mortality. Understanding the factors associated with the increased bleeding may allow nurses to anticipate and prioritise care, thus reducing the mortality associated with this complication.DesignProspective cohort study.MethodsAdult patients in a cardiac hospital who were in the postoperative period following cardiac surgery were included. Factors associated with the increased bleeding were investigated by means of linear regression, considering time intervals of 6 and 12 hr.ResultsThe sample comprised 391 participants. The factors associated with the increased bleeding in the first 6 hr were male sex, body mass index, cardiopulmonary bypass duration, anoxia duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative period. Predictors in the first 12 hr were body mass index, cardiopulmonary bypass duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative.ConclusionsThis study identified factors associated with the increased postoperative bleeding from cardiac surgery that have not been reported in previous studies. The nurse is important in the vigilance, evaluation and registry of chest tube drainage and modifiable factors associated with the increased bleeding, such as metabolic acidosis and postoperative heart rate, and in discussions with the multiprofessional team.Relevance to clinical practiceKnowledge of the factors associated with the increased bleeding is critical for nurses so they can provide prophylactic interventions and early postoperative treatment when needed.
Vaccine‐preventable disease following allogeneic haematopoietic stem cell transplant in Western Australia
Authors: Ryan Anne L , Kerr Fiona , Gough Hazel , Carter Tina L , Kotecha Rishi S 
Published: September 2018

AimInfection is an important and frequent cause of mortality and morbidity following allogeneic haematopoietic stem cell transplantation (HSCT). This study was conducted to determine the epidemiology and clinical phenotype of vaccine‐preventable disease in children who have undergone HSCT following the implementation of a standard revaccination programme.MethodsChildren receiving first allogeneic HSCT in Western Australia between January 2005 and December 2014 were eligible for recruitment. Patients received standard antimicrobial prophylaxis and were vaccinated according to the West Australian post‐HSCT immunisation schedule, commencing 6 months following HSCT. Children who developed any illness post‐HSCT were reviewed, and investigations for infectious disease were undertaken as clinically indicated. Positive identification of vaccine‐preventable disease was documented with the clinical course of the illness.ResultsA total of 71 patients were enrolled in the study. The overall incidence of vaccine‐preventable disease following HSCT was 19.7%; influenza accounted for 50% of all cases, herpes zoster for 42.9%. All episodes occurred late, beyond day 100 post‐HSCT. Overall survival for matched‐sibling donor transplants was 83.3 and 75.0% at 1 and 5 years, respectively, and was 72.3 and 63.3% for alternative donor transplants. Mortality due to vaccine‐preventable disease was low, with one death from disseminated herpes zoster.ConclusionsThere is a high incidence of vaccine‐preventable morbidity post‐allogeneic HSCT in West Australian children. Viral aetiology constitutes the main burden, namely, influenza infection and varicella zoster virus reactivation. Further efforts are required to identify the most appropriate preventative strategies.
Brood‐tending males in a biparental fish suffer high paternity losses but rarely cuckold
Authors: Bose Aneesh P. H. , Zimmermann Holger , Henshaw Jonathan M. , Fritzsche Karoline , Sefc Kristina M. 
Published: September 2018

AbstractExtra‐pair paternity within socially monogamous mating systems is well studied in birds and mammals but rather neglected in other animal taxa. In fishes, social monogamy has evolved several times but few studies have investigated the extent to which pair‐bonded male fish lose fertilizations to cuckolders and gain extra‐pair fertilizations themselves. We address this gap and present genetic paternity data collected from a wild population of Variabilichromis moorii, a socially monogamous African cichlid with biparental care of offspring. We show that brood‐tending, pair‐bonded males suffer exceptionally high paternity losses, siring only 63% of the offspring produced by their female partners on average. The number of cuckolders per brood ranged up to nine and yet, surprisingly, brood‐tending males in the population were rarely the culprits. Brood‐tending males sired very few extra‐pair offspring, despite breeding in close proximity to one another. While unpaired males were largely responsible for the cuckoldry, pair‐bonded males still enjoyed higher fertilization success than individual unpaired males. We discuss these results in the context of ecological and phenotypic constraints on cuckoldry and the fitness payoffs of alternative male tactics. Our study provides new insights into how pair‐bonded males handle the trade‐off between securing within‐pair and extra‐pair reproduction.
Fluconazole resistance is not a predictor of poor outcome in patients with cryptococcosis
Authors: Vena Antonio , Muñoz Patricia , Guinea Jesús , Escribano Pilar , Peláez Teresa , Valerio Maricela , Bonache Francisco , Gago Sara , Álvarez‐Uría Ana , Bouza Emilio 
Published: September 2018

SummaryBackgroundCryptococcus isolates with high MICs to fluconazole are increasingly reported, and a potential clinical impact has been advocated. However, there are different methods to evaluate fluconazole MICs and comparative analysis among such techniques and their comprehensive correlation with clinical outcome are not available.MethodsOver a 13‐year period (2000‐2013), fluconazole MICs were determined for 62 cryptococcal isolates recovered from 22 patients with cryptococcosis using CLSI M27‐A3, EUCAST, E test and Sensititre YeastOne, simultaneously. The relationship between the fluconazole MICs and the clinical outcome at week 10 was assessed in patients who received fluconazole as induction or maintenance therapy (n = 16).ResultsThe percentage of cryptococcal strains with MIC values ≥16 μg/mL according to different methods was CLSI 1.6%, EUCAST 16.1%, E test 31.6% and Sensititre YeastOne 53.2%. Among the 16 patients treated with fluconazole, no correlation between clinical outcome and any MIC value obtained with either method was observed. The only variable independently associated with a poor outcome was having a disseminated disease.ConclusionsThere is a weak correlation between fluconazole MICs against Cryptococcus spp. as determined by CLSI, EUCAST, E test and Sensititre YeastOne. Neither procedure could predict the clinical outcome of patients with cryptococcosis receiving fluconazole‐based therapy. With present methods, fluconazole resistance in Cryptococcus may be clinically misleading.
A high‐resolution einkorn (Triticum monococcum L.) linkage map involving wild, domesticated and feral einkorn genotypes
Authors: Marino Rosanna , Volante Andrea , Brandolini Andrea , Heun Manfred 
Published: September 2018

AbstractA high‐resolution consensus linkage map of Triticum monococcum was assembled from two separate maps involving domesticated, feral and wild einkorn wheat accessions. The genotyping‐by‐sequencing (GBS) approach based on DArTseq markers yielded overstretched maps. Deleting all markers with missing data and then converting dubious singletons to missing data produced two maps of about 1,380 cM, close to the published genome size. The consensus map spanned 1,562 cM, had one bin mapped every 0.92 cM and showed only one gap > 10 cM. Chromosome length varied between 151 cM (chromosome 4) and 270 cM (chromosome 7). The consensus map was compared to other A‐genome maps, and the sequences of genetically mapped DArTseq were used to anchor contigs of the T. monococcum, T. urartu and T. aestivum draft genomes based on sequence homology to assess colinearity and to assign mapped markers to the seven chromosomes of the bread wheat A‐genome. Finally, an in silico functional characterization of the sequences was performed. This high‐resolution map will facilitate QTL and association analysis and assist the genome assembly of the einkorn genome.
Solar Ultraviolet Radiation Exposure and Sun Protection Behaviors and Knowledge Among a High‐Risk and Overlooked Group of Outdoor Workers in South Africa
Authors: Nkogatse Mahlako Malesele , Ramotsehoa Motsehoa Cynthia , Eloff Frederick Christofel , Wright Caradee Yael 
Published: September 2018

AbstractThe exposure of outdoor car guards to solar ultraviolet radiation (UVR), the majority with deeply pigmented skin, to solar UVR was measured for five consecutive days during early spring (September 2017) in South Africa using electronic UVR dosimeters attached to the upper arm of each participant. The exposure of the nape of the neck, forehead, nose, cheek and hand was extrapolated from the measurements. The onsite ambient solar UVR on a flat, horizontal, unshaded surface was measured concurrently. The sun‐related knowledge, behavior and attitudes of the car guards were evaluated using questionnaires. Total personal daily solar UVR exposure as a percentage of the ambient solar UVR exposure was 24%. The exposure of car guards on several body sites was in excess of the occupational threshold limit value. Sleeved shirts and hats were the most commonly used sun protection measures (worn by 70% and 80%, respectively). Considering the high levels of solar UVR reported on most days throughout the year in South Africa, more studies quantifying the personal exposure of outdoor workers in both the informal and formal sectors are necessary.
The hidden patient: chronic physical morbidity, psychological distress, and quality of life in caregivers of older adults
Authors: Sambasivam Rajeswari , Liu Jianlin , Vaingankar Janhavi A. , Ong Hui L. , Tan Min‐En , Fauziana Restria , Picco Louisa , Chong Siow Ann , Subramaniam Mythily 
Published: September 2018

AimIncreasing demands for care provision to older adults require good physical and mental health among caregivers. Few studies have examined the health status and correlates of quality of life among caregivers of older adults. The present study therefore sought to examine the prevalence of chronic physical conditions, psychological distress, and correlates of physical and mental quality of life among caregivers of older adults (≥60 years) in Singapore.MethodsParticipants were 285 informal caregivers who were providing care to an older relative. Participants were recruited at the Institute of Mental Health, Singapore, and they completed self‐report measures on chronic physical morbidity, psychological distress, and physical and mental quality of life. Multiple regression models were constructed to examine correlates of physical and mental quality of life.ResultsMore than half of the caregivers had at least one chronic physical condition (58.6%) and psychological distress (52.6%). Chronic physical morbidity, psychological distress, and secondary education status were associated with lower physical quality of life. Psychological distress, younger age, primary education status, and more time spent caregiving were associated with lower mental quality of life.ConclusionPoor physical and mental health among caregivers may impair their ability to provide adequate care to older adults with progressive medical needs. It is important for medical practitioners not to neglect the physical and mental health of caregivers through continued assessment of chronic physical morbidity, psychological distress, and quality of life.
A Dynamic Inhomogeneous Latent State Model for Measuring Material Deprivation
Authors: Dotto Francesco , Farcomeni Alessio , Pittau Maria Grazia , Zelli Roberto 
Published: September 2018

SummaryMaterial deprivation can be used to assess poverty in a society. The status of poverty is not directly observable, but it can be measured with error for instance through a list of deprivation items. Given two unobservable classes, corresponding to poor and not poor, we develop a time inhomogeneous latent Markov model which enables us to classify households according to their current and intertemporal poverty status, and to identify transitions between classes that may occur year by year. Households are grouped by estimating their posterior probability of belonging to the latent status of poverty. We then estimate an optimal weighting scheme, associated with the list of items, to obtain an optimal deprivation score. Our score is arguably better at predicting the poverty status than simple item counting (equal weighting). We use the longitudinal component of the European Union statistics Survey on Income and Living Conditions for evaluating poverty patterns over the period 2010–2013 in Greece, Italy and the UK.