bluuebunny/crossref_metadata_2025_split huggingface dataset:
An exploration of patient safety culture in Kuwait hospitals: a qualitative study of healthcare professionals' perspectives
Authors: Al Hamid Abdullah , Malik Aisha , Alyatama Shahad 
Published: August 2019

Abstract

Objective
Patient safety culture (PSC) represents a key component of the quality of care offered by healthcare professionals. Therefore, it is crucial to understand the factors that influence the implementation of a safe culture. This study explored the knowledge and attitudes of healthcare professionals in Kuwait towards the factors that might affect the PSC.

Methods
A qualitative study using semi-structured interviews with healthcare professionals was conducted between February and June 2018 at two major hospitals in Kuwait. Both hospitals had been accredited and have been applying the safety programmes recommended by the Kuwaiti Ministry of Health. Participants were purposively selected where 20 healthcare professionals were interviewed. The interviewees comprised of six physicians, six clinical pharmacists, six nurses and two members of the patient safety committee. Inclusion criteria involved healthcare professionals who had more than 1-year clinical experience, have interest in patient safety and had a good level of English. Interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview transcripts was conducted to identify the emergent themes.

Key findings
Thematic analysis of the interviews yielded three major themes related to ‘management', ‘regulations and policies' and ‘healthcare professionals'. Management issues included managerial support, resources, safety environment and staff training. Regulations and policies highlighted issues related to policies and procedures and incident reporting system. Healthcare professionals' theme covered factors related to knowledge, communication and teamwork among healthcare professionals.

Conclusions
This study gave insight into how healthcare professionals perceive the current PSC in Kuwait. Despite their positive attitudes and knowledge towards patient safety, various barriers were reported that hinder optimal PSC. These barriers were related to support, staffing, resources and response to error.
Impact of pharmacists' interventions on the pharmacotherapy of patients with complex needs monitored in multidisciplinary primary care teams
Authors: Samir Abdin Madjda , Grenier-Gosselin Lise , Guénette Line 
Published: August 2019

Abstract

Objectives
Recently, pharmacists have joined multidisciplinary healthcare teams within family medicine groups (FMG) in Quebec Province, Canada. This study assessed the impact of their interventions on the pharmacotherapy of patients with complex needs monitored in FMGs.

Methods
We performed a pre/post real-life intervention study among patients with complex needs referred to the FMG pharmacist in four FMGs in Quebec City. Pharmacists collected data at baseline, during follow-up and up to 6 months after the first encounter. They recorded all drug-related problems (DRPs) identified, interventions made and recommendations that were accepted by physicians. The researchers used the data collected to compare the medication regimen complexity index (MRCI) and medication adherence (using the proportion of days covered (PDC)) before and after the pharmacist’s interventions. Descriptive statistics and paired sample t-tests were computed.

Key findings
Sixty-four patients (median age: 74.5 years) were included; four patients were lost to follow-up. Pharmacists detected 300 DRPs (mean: 7.2 per patient) during the study period for which they made an intervention. The most common DRP was ‘drug use without indication’ (27%). The physicians accepted 263 (87.7%) of those interventions. The mean number of prescribed drugs per patient decreased from 13.8 (95% confidence interval (CI): 12.24 to 15.29) to 12.4 (95% CI: 10.92 to 13.90). The mean MRCI decreased from 47.18 to 41.74 (−5.44; 95% CI: 1.71 to 9.17), while the mean PDC increased from 84.4% to 90.0% (+5.6%; 95% CI: 2.7% to 8.4%).

Conclusion
Family medicine groups pharmacists can detect and resolve DRPs and can reduce medication regimen complexity and non-adherence to treatment in patients with complex needs monitored in FMGs.
A systematic review of outcome reporting in laser treatments for dermatological diseases
Authors: Fransen F. , Tio D.C.K.S. , Prinsen C.A.C. , Haedersdal M. , Hedelund L. , Laubach H.J. , Marini L. , Paasch U. , Passeron T. , Wolkerstorfer A. 
Published: August 2019

AbstractThe standardization of outcome reporting is crucial for interpretation and comparison of studies related to laser treatment of skin disorders. In collaboration with the Cochrane Skin‐Core Outcome Set Initiative (CS‐COUSIN), a procedure has been proposed to find consensus on the most important generic outcome domains (what to measure) for implementation in the international Laser TrEAtment in Dermatology (LEAD) registry. As the first step in the development of a generic outcome set for the LEAD registry, we undertook a systematic review to identify outcomes, outcome measurement instruments, methods and definitions reported in recently published literature of laser treatments for skin disorders. A systematic search was conducted and generated a total of 707 papers. We assessed 150 studies including all types of studies involving laser treatments for the skin. Two researchers independently extracted the type, definition and frequency of all outcomes and used outcome measurement instruments. We identified 105 verbatim outcomes that were categorized into eight domains recommended by the COMET framework: appearance, long‐term effects, physician and patient‐reported physical signs, satisfaction, health‐related quality of life, psychological functioning and adverse events. Heterogeneity in outcome reporting (e.g. categories and outcome measurement instruments) was high, and definitions were insufficiently reported. There was a clear under representation of life impact domains, including satisfaction (23%) quality of life (3%) and psychological functioning (1%). Outcome reporting concerning laser treatments for the skin is heterogeneous. Standardized outcomes are needed for improving evidence synthesis. Results of this review will be used in the next step to reach consensus between stakeholders on the outcome domains to be implemented in the LEAD registry.
Ecological and phylogenetic determinants of life‐history patterns among ten loricariid species
Authors: Borzone Mas Dalmiro , Alvarenga Patricio F. , Scarabotti Pablo A. 
Published: August 2019

AbstractWe analysed the influence of ecological factors, phylogenetic history and trade‐offs between traits on the life‐history variation among 10 loricariid species of the middle Paraná River. We measured eight life‐history variables and classified the life‐history strategies following the equilibrium–periodic–opportunistic (EPO) model. Principal‐component analysis of life‐history traits segregated species along a gradient from small opportunistic (low fecundity, low parental investment) to large equilibrium (low‐medium fecundity, high parental investment) species. A clear periodic strategist was absent in the analysed assemblage. Variation partitioning by canonical phylogenetic ordination analysis showed both a component of variation uniquely explained by phylogenetic history (PH; 32.2%) and a component shared between PH and ecological factors (EF; 37%). The EPO model is a useful tool for predicting correlations among life‐history traits and understanding potential demographic responses of species to environmental variation. Life‐history patterns observed throughout Loricariidae suggests that this family has diversified across all three endpoint strategies of the EPO model. Our study indicates that evolutionary lineage affiliation at the level of subfamily can be a strong predictor of the life‐history strategy used by each species.
Multiplex PCR for genotypingFlavobacterium columnare
Authors: LaFrentz Benjamin R. , García Julio C. , Shelley John P. 
Published: August 2019

AbstractRecent research has identified four distinct genetic groups among isolates ofFlavobacterium columnarethrough multilocus phylogenetic analyses; however, there are no quick methods to determine the genotype of an isolate. The objective of this research was to develop a multiplex PCR to rapidly genotypeF. columnareto genetic group. Comparative bacterial genomics was used to identify regions in the genomes unique to each genetic group, and primers were designed to specifically amplify different sized amplicons for each genetic group. The optimized assay was demonstrated to be specific for each genetic group andF. columnare, and no specific amplicons were generated using gDNA from a panel of otherFlavobacteriumspp. and bacterial fish pathogens. The analytical sensitivity of the assay ranged from 209 to 883 genome equivalents depending on the genetic group. The multiplex PCR was evaluated by genotyping a panel of 22 unknownF. columnareisolates and performing DNA sequencing of thednaKgene in parallel. The results demonstrated 100% accordance between multiplex PCR results and assignment to genetic group via phylogenetic analysis. The multiplex PCR provides a useful tool for assigning an unknown isolate to genetic group and may be used to determine which genetic groups ofF. columnareare circulating and most predominant in different aquaculture industries.
Growth hormone secretagogue receptor signalling affects high‐fat intake independently of plasma levels of ghrelin andLEAP2, in a 4‐day binge eating model
Authors: Cornejo María Paula , Castrogiovanni Daniel , Schiöth Helgi B. , Reynaldo Mirta , Marie Jacky , Fehrentz Jean‐Alain , Perello Mario 
Published: August 2019

AbstractThe growth hormone secretagogue receptor (GHSR) is a G protein‐coupled receptor that is highly expressed in the central nervous system.GHSRacts as a receptor for ghrelin and for liver‐expressed antimicrobial peptide 2 (LEAP2), which blocks ghrelin‐evoked activity.GHSRalso displays ligand‐independent activity, including a high constitutive activity that signals in the absence of ghrelin and is reduced byLEAP2.GHSRactivity modulates a variety of food intake‐related behaviours, including binge eating. Previously, we reported thatGHSR‐deficient mice daily and time‐limited exposed to a high‐fat (HF) diet display an attenuated binge‐likeHFintake compared to wild‐type mice. In the present study, we aimed to determine whether ligand‐independentGHSRactivity affects binge‐likeHFintake in a 4‐day binge‐like eating protocol. We found that plasma levels of ghrelin andLEAP2 were not modified in mice exposed to this binge‐like eating protocol. Moreover, systemic administration of ghrelin orLEAP2 did not alterHFintake in our experimental conditions. Interestingly, we found that central administration ofLEAP2 or K‐(D‐1‐Nal)‐FwLL‐NH2, which are both blockers of constitutiveGHSRactivity, reduced binge‐likeHFintake, whereas central administration of ghrelin or the ghrelin‐evokedGHSRactivity blockers [D‐Lys3]‐GHRP‐6 andJMV2959 did not modify binge‐likeHFintake. Taken together, current data indicate thatGHSRactivity in the brain affects binge‐likeHFintake in mice independently of plasma levels of ghrelin andLEAP2.
Resisting “Politics as Usual”: Examining the Rise of Anti‐Establishment Politics by Comparing the Narratives of Opportunity Used Within the Single Payer Movement During Two Presidential Eras
Authors: Hern Lindy S. 
Published: August 2019

AbstractThe recent rise of “Medicare for All” in American political discourse was many years in the making. Behind this rise is a movement composed of grassroots activists and organizations focused on the goal of establishing a single‐payer health care system in the United States. I examine the ways in which activists used narrative to interpret opportunity within their historically specific environments to work towards this goal. I find that while the Single Payer Movement's narrative practice during the Clinton era was focused on opportunity within the political sphere, the focus in the Obama era shifted to mobilizing the public sphere, or grassroots opportunity. This was related to the critique that the Obama Administration was engaging in “politics as usual”, which was defined as the “enemy” of “real” health care reform. This narratively produced critique is tied to the anti‐establishment turn that factors into the current era of American politics.
Religious Social Support Protects against Social Risks for Adolescent Substance Use
Authors: Peviani Kristin M. , Brieant Alexis , Holmes Christopher J. , King‐Casas Brooks , Kim‐Spoon Jungmeen 
Published: August 2019

We used a social developmental perspective to identify how prominent social contexts influence substance use during adolescence. Longitudinal data were collected annually from 167 parent–adolescent dyads over four years. We investigated whether parent substance use was related to adolescent substance use directly and indirectly via peer substance use and whether these associations were moderated by religious social support. Structural equation modeling (SEM) analysis indicated significant moderated mediation: Greater parent substance use predicted increases in adolescent substance use indirectly via increased peer substance use when adolescent religious social support was low or average, but not high. These results suggest religious social support may protect adolescents against prominent social risks for intergenerational substance use.
Effects of dietary crude protein and tannic acid on nitrogen excretion, urinary nitrogenous composition and urine nitrous oxide emissions in beef cattle
Authors: Zhou Ke , Bao Yu , Zhao Guangyong 
Published: August 2019

AbstractTwo consecutive trials were carried out to study the effects of dietary crude protein (CP) and tannic acid (TA) on nitrogen (N) metabolism of beef cattle and consequently, the N2O emissions from the urine of cattle. In Trial I, eight growing castrated cattle were used as the experimental animals. Two levels of dietary CP (110.6 and 135.7 g/kg dry matter [DM]) and two levels of TA (0 and 16.9 g/kg DM) were allocated in a replicated 2 × 2 crossover design. In Trial II, the N2O emissions from the urine of cattle collected from Trial I were determined using the static incubation technique. An interaction between dietary CP and TA on the urinary N excretion (p < .05) was found but not on the N2O‐N emission of cattle urine. Increasing dietary CP level from 110.6 g/kg DM to 135.7 g/kg DM increased the total N excretion (p < .001), the N retention (p < .05) and the ratio of urinary urea‐N/urinary N (p < .01), did not affect the N use efficiency (NUE; p > .05) and shifted the N excretion from faeces to urine. Increasing the dietary CP level increased the N2O‐N emission of cattle urine. Dietary addition of TA decreased the urinary excretions of urea (p < .001) and shifted the N excretion from urine to faeces, did not affect the NUE of beef cattle (p > .10), and decreased the N2O‐N emission of cattle urine. Pyrogallol and resorcinol of the TA metabolites were detected in urine with dietary addition of TA. Feeding beef cattle with relatively low CP level and adding TA in rations are effective approaches to mitigate the N2O‐N emissions from cattle urine.
Effects of a posttonsillectomy management program using a mobile instant messenger on parents’ knowledge and anxiety, and their children's compliance, bleeding, and pain
Authors: Yu Kyoung Eun , Kim Jin Sun 
Published: August 2019

AbstractPurposePediatric tonsillectomy is a highly common surgery for children. The inclusion of tonsillectomy in the diagnosis‐related group payment system in Korea has resulted in a shorter hospital stay for patients who undergo tonsillectomy. This, in turn, provides parents with additional caregiver roles in the home.ObjectivesThis study aimed to investigate the effects of a postdischarge management program (PDMP) using Mobile Instant Messenger (MIM) on parents’ knowledge and state anxiety about postoperative care, and their children's compliance with care instructions at home, frequency of bleeding, and pain intensity after tonsillectomy.Design and MethodsA nonequivalent control group nonsynchronized design.Settings and ParticipantsParticipants were 52 tonsillectomy children aged 3–7 years and their 52 parents (27 for the experimental group and 25 for the control group) from a hospital, in Korea. The control group received a routine written and oral predischarge education, while the experimental group received a predischarge education and a daily MIM for 7 days. For the experimental group, bidirectional communication between the nurse and parent when necessary using MIM are available during the intervention period.ResultsParents in the experimental group reported a significantly higher knowledge about postdischarge management and lower state anxiety than the control group. Children in the experimental group showed a significantly greater improvement in compliance with the care instructions at home than the control group. However, bleeding frequency and pain intensity were not significantly lower in the experimental group than that in the control group.Practical ImplicationsNurses play a critical role in preventing and managing the complications of tonsillectomy. Providing proper parental education about pediatric posttonsillectomy care at home is critical for a successful recovery. With the explosion of smartphone technology, the MIM‐based PDMP is a useful and effective strategy in helping parents and children in posttonsillectomy care at home.
Local Government Fiscal Policy, Social Capital and Electoral Payoff: Evidence across Italian Municipalities
Authors: Batinti Alberto , Andriani Luca , Filippetti Andrea 
Published: August 2019

SummaryCitizens' attitudes and reactions to policymakers' decisions depend on several factors, including informal institutions. The novelty of this paper is to use social capital as a moderator factor to shed light on the relationship between fiscal policies and electoral outcomes. We investigate this relationship using a sample of 6,000 Italian municipalities over the period 2003‐2012 and use a Conditional Logit Matching model comparing incumbents to challengers' characteristics within each election. We find that social capital increases the odds of the re‐election of incumbent mayors who adopted a local fiscal policy more oriented towards capital investment (versus current expenditure) and towards property tax (versus income surcharge). This suggests that social capital encourages governmental functions and public policies improving long‐term economic commitments, institutional transparency, and accountability. It also shows that decentralization works relatively better with social capital.
Productivity growth, Smith effects and Ricardo effects in Euro Area's manufacturing industries
Authors: Carnevali Emilio , Godin Antoine , Lucarelli Stefano , Veronese Passarella Marco 
Published: August 2019

AbstractWe analyse the determinants of labour productivity across (a sample of) EA member states. We focus on the divergent dynamics before and after the financial crisis, and of core countries relative to peripheral countries. We ground our empirical analysis in Paolo Sylos‐Labini's productivity equations. We test different models, including a Panel 2S‐LS model and a Panel vector autoregression model. Our preliminary findings confirm and strengthen Sylos‐Labini's main insights. Labour productivity in manufacturing industries is strongly and positively correlated with the market size (Smith effect), the relative cost of labour (Ricardo effect), the absolute cost of labour (organization effect) and past investment, whereas it is negatively correlated with current investment. Furthermore, we find evidence that the crisis has affected the size of these effects. Focusing on the core periphery dichotomy, the signs of the effects are the same for both groups of countries, although the Smith, Ricardo and long‐run investment effects are usually stronger for core countries compared to peripheral countries. The opposite holds for the organization effect, while investment effects are less clear.
Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy ‐ A Safe and Effective Low‐Dose Protocol
Authors: Poh Cheng Boon , Tan Poh Choo , Kam Jia Wen , Siau Chuin , Lim Noelle L , Yeon Wenxiang , Cui Hai Hua , Ding Hai Ting , Song Xiao Ying , Yan Peng , Chea Kai Li , Liu Jin Shu , Chionh Chang Yin 
Published: August 2019

ABSTRACTAimsRegional citrate anticoagulation (RCA) is the preferred mode of anticoagulation for continuous renal replacement therapy (CRRT). Conventional RCA‐CRRT citrate dose ranges from 3 to 5 mmol/L of blood. This study explored the effectiveness of an RCA protocol with lower citrate dose and its impact on citrate‐related complications.MethodsThis prospective observational study compared two RCA‐CRRT protocols in the intensive care unit. RCA Protocol 1 used an initial citrate dose of 3.0 mmol/L while Protocol 2 started with 2.5 mmol/L. The citrate dose was titrated by sliding scale to target circuit‐iCa 0.26–0.40 mmol/L. Calcium was re‐infused post‐dialyzer and titrated by protocol to target systemic‐iCa 1.01–1.20 mmol/L.ResultsTwo hundred RCA‐CRRT sessions were performed (81 Protocol 1; 119 Protocol 2). The median age was 65.4 years and median APACHE‐II score was 23. Citrate dose for Protocol 1 was significantly higher than Protocol 2 in the first 12 h. The circuit clotting rate was similar in both arms (Protocol 1: 9.9%; Protocol 2: 9.2%; P = 0.881). With Protocol 2, circuit‐iCa levels were 2.42 times more likely to be on target (P = 0.003) while the odds of hypocalcaemia was 4.67 times higher with Protocol 1 (P < 0.001). There was a wider anion gap was noted with Protocol 1, which suggests a propensity for citrate accumulation with higher citrate exposure.ConclusionThe RCA protocol with a lower initial citrate dose of 2.5 mmol/L blood had less citrate‐related complications with no loss of efficacy. A more precise RCA prescription at the start of treatment avoids unnecessary citrate exposure and improves safety.
Divergence of duplicated genes by repeated partitioning of splice forms and subcellular localization
Authors: Qiu Yichun , Tay Yii Van , Ruan Yuan , Adams Keith L. 
Published: August 2019

Summary

Gene duplication is a prominent and recurrent process in plant genomes. Among the possible fates of duplicated genes, subfunctionalization refers to duplicates taking on different parts of the function or expression pattern of the ancestral gene. This partitioning could be accompanied by changes in subcellular localization of the protein products. When alternative splicing of gene products leads to protein products with different subcellular localizations, we propose that after gene duplication there will be partitioning of the alternatively spliced forms such that the products of each duplicate are localized to only one of the original locations, which we refer to as sublocalization.

We identified the plastid ascorbate peroxidase (cpAPX) genes across angiosperms and analyzed their duplication history, alternative splicing, and subcellular targeting patterns to identify cases of sublocalization.

We found angiosperms typically have one cpAPX gene that generates both thylakoidal APX (tAPX) and stromal APX (sAPX) through alternative splicing. We identified several independent lineage‐specific sublocalization cases with specialized paralogues of tAPX and sAPX. We determined that the sublocalization happened through two types of sequence evolution patterns.

Our findings suggest that the divergence through sublocalization is key to the retention of paralogous cpAPX genes in angiosperms.