bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient‐centred care is a way of doing things: How healthcare employees conceptualize patient‐centred care
Authors: Fix Gemmae M. , VanDeusen Lukas Carol , Bolton Rendelle E. , Hill Jennifer N. , Mueller Nora , LaVela Sherri L. , Bokhour Barbara G. 
Published: August 2017

AbstractBackgroundPatient‐centred care is now ubiquitous in health services research, and healthcare systems are moving ahead with patient‐centred care implementation. Yet, little is known about how healthcare employees, charged with implementing patient‐centred care, conceptualize what they are implementing.ObjectiveTo examine how hospital employees conceptualize patient‐centred care.Research DesignWe conducted qualitative interviews about patient‐centred care during site four visits, from January to April 2013.SubjectsWe interviewed 107 employees, including leadership, middle managers, front line providers and staff at four US Veteran Health Administration (VHA) medical centres leading VHA's patient‐centred care transformation.MeasuresData were analysed using grounded thematic analysis. Findings were then mapped to established patient‐centred care constructs identified in the literature: taking a biopsychosocial perspective; viewing the patient‐as‐person; sharing power and responsibility; establishing a therapeutic alliance; and viewing the doctor‐as‐person.ResultsWe identified three distinct conceptualizations: (i) those that were well aligned with established patient‐centred care constructs surrounding the clinical encounter; (ii) others that extended conceptualizations of patient‐centred care into the organizational culture, encompassing the entire patient‐experience; and (iii) still others that were poorly aligned with patient‐centred care constructs, reflecting more traditional patient care practices.ConclusionsPatient‐centred care ideals have permeated into healthcare systems. Additionally, patient‐centred care has been expanded to encompass a cultural shift in care delivery, beginning with patients' experiences entering a facility. However, some healthcare employees, namely leadership, see patient‐centred care so broadly, it encompasses on‐going hospital initiatives, while others consider patient‐centred care as inherent to specific positions. These latter conceptualizations risk undermining patient‐centred care implementation by limiting transformational initiatives to specific providers or simply repackaging existing programmes.
Carers' involvement in decision making about antipsychotic medication: A qualitative study
Authors: Stomski Norman J. , Morrison Paul 
Published: August 2017

AbstractBackgroundCurrent Australian mental health policy recommends that carers should be involved in the provision of mental health services. Carers often provide intensive support to mental health consumers and gain detailed insight into their lives. As such, carers could make valuable contributions to well‐informed decisions about mental health consumers' use of antipsychotic medication.ObjectivesThe aim of this study was to explore carers' participation in antipsychotic medication decision making.MethodsSnowball sampling was used to enrol 29 carers in this study. Of these carers, 19 participated in semi‐structured interviews, and ten participated in a focus group. Data were analysed thematically.ResultsFour main themes emerged from the analysis. The findings highlighted that carers typically received little or no information about antipsychotic medication. Carers commonly addressed the shortfall in information by obtaining additional information through online sources or distributing among carer networks material that they had developed themselves. Almost all carers emphasized that they should be involved in decisions about antipsychotic medication, but noted that they were typically excluded. The lack of involvement in medication decisions was a source of frustration, as carers could contribute saliently through sharing detailed knowledge about mental health consumers' lives, address communication gaps that resulted from disjointed care and improve communication between health professionals and mental health consumers.ConclusionHealth professionals could consider improving the extent to which they collaborate with carers in medication decisions.
Transcriptional repressor Blimp1 regulates follicular regulatory T‐cell homeostasis and function
Authors: Yang Guang , Yang Xiaosu , Zhang Junmei , Li Guancheng , Zheng Dandan , Peng Anjiao , Hu Jue , Xu Liqun , Yang Baifeng , Yang Huan , Zhou Wenbin , Tuzun Erdem , Li Jing 
Published: August 2017

SummaryThe B‐lymphocyte‐induced maturation protein 1 (Blimp1) regulates T‐cell homeostasis and function. Loss of Blimp1 could double the proportion of follicular regulatory T (Tfr) cells. However, the effects that Blimp1 may have on the function of Tfr cells remain unknown. Here we document the function for Blimp1 in Tfr cells in vitro and in vivo. Data presented in this study demonstrate that Tfr cells indirectly inhibit the activation and differentiation of B cells by negatively regulating follicular helper T cells, so lowering the secretion of antibody. Lack of Blimp1 makes the immune suppression function of Tfr cells impaired in vitro. In the in vivo study, adoptive transfer of Tfr cells could reduce immune responses in germinal centres and relieve the muscle weakness symptoms of mice with experimental autoimmune myasthenia gravis. Blimp1 deficiency resulted in reduced suppressive ability of Tfr cells. This study identifies that Tfr cells are potent suppressors of immunity and are controlled by Blimp1.
The conceptualization of childhood in North American pediatric dentistry texts: a discursive case study analysis
Authors: Makansi Nora , Carnevale Franco A. , Macdonald Mary Ellen 
Published: August 2017

BackgroundIn recent years, conceptions of childhood have been evolving towards an increased recognition of children as active agents, capable of participating in the determination of their wellbeing. In pediatric dentistry, the extent to which these conceptions are being discursively endorsed is not well known.AimThe aim of this investigation was to examine the discursive construction of childhood in seminal North American pedagogical dentistry materials.DesignWe conducted a qualitative discourse analysis of a sample of prominent texts using a sociological discourse analysis approach.ResultsWe analyzed the latest edition of Macdonald and Avery's textbook (Chapter: Non pharmacologic management of children's behaviors) and the clinical practice guidelines published by the American Academy of Pediatric Dentistry, AAPD (Behavior guidance for the pediatric dental patient). The analysis produced five salient discursive categories: socialization through behavior modification; development and behavior; paternalism; the utility of child‐centered communication; and consequentialism. While there were instances of a child‐centered focus in the texts, the main discourses were rooted in developmentalism and behaviorism. There was scant acknowledgment of the importance of children's agency or voice, which runs contrary to child‐centered discourses and practices in related disciplines (e.g., pediatric medicine, nursing).ConclusionPredominant discourses in pediatric dentistry suggest a paternalistic, behaviorist approach to the ‘management’ of children in the dental office, focused primarily on completing interventions. Priorities for the future development of pediatric dentistry are discussed, integrating more child‐centered approaches.
Public sector restructuring and the re‐regulation of industrial relations: the three‐decade project of privatisation, liberalisation and marketisation in Royal Mail
Authors: Mustchin Stephen 
Published: August 2017

AbstractThe British postal service, Royal Mail, was privatised in 2013, following failed attempts at divestiture in 1994 and 2009. This article analyses processes of marketisation, liberalisation and privatisation, highlighting how strong workplace‐centred union presence allowed for considerable influence and bargaining gains within such highly sensitive political projects of restructuring.
Enabling a Disaster‐Resilient Workforce: Attending to Individual Stress and Collective Trauma
Authors: Raveis Victoria H. , VanDevanter Nancy , Kovner Christine T. , Gershon Robyn 
Published: August 2017

AbstractPurposeSuperstorm Sandy forced the evacuation and extended shutdown of New York University Langone Medical Center. This investigation explored how nurses were impacted by the disasters and how they can best be supported in their nursing responsibilities.DesignSequential mixed methods were used to explore the psychosocial issues nurses experienced throughout the course of this natural disaster and its lingering aftermath.MethodsIn‐depth interviews were conducted from April to June 2013 with a subsample of nurses who participated in the evacuation deployment (n = 16). An anonymous, Internet‐based cross‐sectional survey sent to all registered nurses employed at the hospital at the time of the storm explored storm impact and recovery. Between July and September 2013, 528 surveys were completed.FindingsThe qualitative data revealed challenges in balancing professional obligations and personal concerns. Accounts described dealing in the immediate recovery period with unexpected job changes and resultant work uncertainty. The storm's lingering aftermath did not signify restoration of their predisaster lifestyle for some, but necessitated coping with this massive storm's long‐lasting impact on their personal lives and communal loss.ConclusionsNurses working under the rapidly changing, uncontrolled, and potentially dangerous circumstances of a weather‐related disaster are also experiencing concerns about their families’ welfare and worries about personal loss. These multiple issues increase the psychosocial toll on nurses during a disaster response and impending recovery.Clinical RelevanceAwareness of concerns and competing demands nurses experience in a disaster and aftermath can inform education and services to enable nurses to perform their critical functions while minimizing risk to patients and themselves.
Artepillin C as a targeting survivin molecule in oral squamous cell carcinoma cells in vitro: A preliminary study
Authors: Pang Seokjoon , Yee Michael , Saba Yasmin , Chino Takahiro 
Published: August 2017

BackgroundSurvivin, a member of the inhibitor of apoptosis family, is overexpressed in most human tumors, but undetectable in normal adult tissues. It is a promising target molecule in cancer treatment, as interference in its function promotes apoptosis. Artepillin C, a major, biologically active ingredient of Brazilian propolis, possesses anticancer activity against several cancer cells with different tissue origins. However, little is known about its bioactivity on oral squamous cell carcinoma cells or its effect on survivin expression. The aim of this study was to investigate the cytotoxic and antisurvivin activities of artepillin C in oral squamous cell carcinoma cells.MethodsHSC‐3 human oral squamous cell carcinoma cells were treated with varying doses of artepillin C for up to 72 hours. Cell viability was measured by WST‐1, and the cytotoxic effects of artepillin C on HSC‐3 cells were quantified with flow cytometry. The survivin levels were determined by ELISA.ResultsArtepillin C exhibited dose‐ and time‐dependent cytotoxic effects on HSC‐3 cells. Flow cytometric analysis showed that 22% of untreated HSC‐3 cells underwent spontaneous cell death, whereas 77.32% of the cells were killed in response to the highest dose of artepillin C at 72 hours. Survivin expression was reduced in treated cells.ConclusionsHSC‐3 cells are vulnerable to artepillin C in a dose‐ and time‐dependent manner. HSC‐3 cell death induced by artepillin C, at least in part, was a result of a decrease in survivin levels.
Nonstructural protein 5A resistance profile in patients with chronic hepatitis C treated with ledipasvir‐containing regimens without sofosbuvir
Authors: Kitrinos K. M. , Corsa A. C. , Worth A. , Hedskog C. , Brainard D. M. , Miller M. D. , Mo H. 
Published: August 2017

SummaryThe study aimed to evaluate the effects of baseline hepatitis C virus (HCV) nonstructural protein 5A (NS5A) resistance‐associated substitutions (RASs) on sustained virologic response to ledipasvir (LDV)‐containing regimens in the absence of sofosbuvir (SOF) in patients with HCV genotype (GT) 1 infection across 6 phase 2 clinical studies. We analysed data from 1103 patients who received either LDV + vedroprevir (NS3 protease inhibitor) + tegobuvir (NS5B inhibitor) ± ribavirin or LDV + ribavirin + pegylated interferon. Population sequencing of HCV NS5A was performed at baseline and at virologic failure from patient plasma samples. Of 1045 patients with available baseline sequences, 747 (67.7%) had GT1a, and 298 (26.9%) had GT1b infection. The overall prevalence of NS5A RASs at baseline was 9.4%; 7.6% (57/747) and 13.8% (41/298) of patients with GT1a and GT1b infection, respectively. The majority of GT1a‐infected patients with NS5A RASs at baseline had a single NS5A RAS (78.9%) at NS5A positions K24R, M28T, Q30H/L, L31M and Y93H/N/C/S. The spectrum of NS5A RASs detected in GT1b patients was much less diverse compared to GT1a patients, with all patients harbouring a single NS5A RAS either L31M or Y93H/C. For patients treated with LDV‐containing regimens in the absence of SOF, the presence of baseline NS5A RASs was associated with low SVR rates. In patients with virologic failure, nearly all had either pre‐existing and/or emergent NS5A RASs: 287/287 (100%) and 40/42 (95.2%) patients with GT1a and GT1b infection, respectively. Three novel NS5A substitutions were identified as emergent NS5A RASs: K26E and S38F in GT1a; and L31I in GT1b. In conclusion, the presence of NS5A RASs at baseline reduced the SVR rate in patients treated with LDV in combination vedroprevir + tegobuvir ± ribavirin or ribavirin + pegylated interferon. Virologic failure was associated with the detection of NS5A RASs in nearly all patients. These results suggest that the resistance barrier may differ depending on HCV drug combination and may be more important than that of the individual DAAs.
Poor adherence to hepatocellular carcinoma surveillance: A systematic review and meta‐analysis of a complex issue
Authors: Zhao Changqing , Jin Mingjuan , Le Richard Hieu , Le Michael Huan , Chen Vincent Lingzhi , Jin Michelle , Wong Grace Lai‐Hung , Wong Vincent Wai‐Sun , Lim Young‐Suk , Chuang Wan‐Long , Yu Ming‐Lung , Nguyen Mindie H. 
Published: August 2017

AbstractBackground & AimsHepatocellular carcinoma (HCC) surveillance is associated with improved outcomes and long‐term survival. Our goal is to evaluate adherence rates to HCC surveillance.MethodsWe performed a systematic search of the PubMed and Scopus databases and abstract search of relevant studies from recent major liver meetings. All searches and data extraction were performed independently by two authors. Analysis was via random‐effects models and multivariate meta‐regression.ResultsA total of 22 studies (n = 19 511) met inclusion criteria (original non‐interventional studies with defined cirrhosis or chronic hepatitis B or chronic hepatitis C with advanced fibrosis populations, and surveillance tests and intervals). Overall adherence rate was 52% (95% CI 38%‐66%). Adherence was significantly higher in cirrhotic patients compared to chronic hepatitis B and other high‐risk patients, in European compared to North American studies, in less than 12‐month compared to yearly surveillance intervals, and in prospective compared to retrospective studies (71%, 95% CI 64%‐78% vs 39%, 95% CI 26%‐51%, P < .001). The between‐study heterogeneity of all above analyses was significant (P < .001). Only the study design (retrospective vs prospective cohort) had statistical significance in a multivariate meta‐regression model (P < .05) and could account for some of the differences above.ConclusionsOverall adherence rate to HCC surveillance was suboptimal at 52% with no significant differences by liver disease aetiology or study location in multivariate meta‐regression analysis. Further research and educational efforts are needed to improve the current rate of HCC surveillance.
Error analysis of finite difference and Markov chain approximations for option pricing
Authors: Li Lingfei , Zhang Gongqiu 
Published: August 2017

AbstractMijatović and Pistorius proposed an efficient Markov chain approximation method for pricing European and barrier options in general one‐dimensional Markovian models. However, sharp convergence rates of this method for realistic financial payoffs, which are nonsmooth, are rarely available. In this paper, we solve this problem for general one‐dimensional diffusion models, which play a fundamental role in financial applications. For such models, the Markov chain approximation method is equivalent to the method of lines using the central difference. Our analysis is based on the spectral representation of the exact solution and the approximate solution. By establishing the convergence rate for the eigenvalues and the eigenfunctions, we obtain sharp convergence rates for the transition density and the price of options with nonsmooth payoffs. In particular, we show that for call‐/put‐type payoffs, convergence is second order, while for digital‐type payoffs, convergence is generally only first order. Furthermore, we provide theoretical justification for two well‐known smoothing techniques that can restore second‐order convergence for digital‐type payoffs and explain oscillations observed in the convergence for options with nonsmooth payoffs. As an extension, we also establish sharp convergence rates for European options for a rich class of Markovian jump models constructed from diffusions via subordination. The theoretical estimates are confirmed using numerical examples.
Acute fall and long‐term rise in oxygen saturation in response to meditation
Authors: Bernardi Nicolò F. , Bordino Marco , Bianchi Lucio , Bernardi Luciano 
Published: August 2017

AbstractThe effects of meditation on arterial and tissue oxygenation are unknown and difficult to assess because respiration is often altered, directly or indirectly, during meditation practice. Thus, changes in respiration may affect cardiovascular responses independently from meditation. In this study, we aim to isolate the specific effect of meditation on arterial and tissue oxygenation and other cardiorespiratory indexes while systematically controlling for the role of respiration. Furthermore, we aim to clarify to what extent prior expertise in meditation practice is needed to observe reliable changes. Eighty participants, half with and half without prior meditation experience, were tested while pacing breathing at predetermined rates, in the presence or absence of mantra meditation instructions, and in a body scan meditation that did not involve controlled breathing. Continuous recordings were acquired for arterial and brain oxygenation, respiratory excursion, electrocardiogram, skin vasomotion, and blood pressure. In both groups, meditation acutely decreased arterial and cerebral oxygen saturation, reduced chemoreflex sensitivity, and prolonged the RR interval, independently of respiration. Conversely, slow breathing improved heart rate variability, independently of concurrent meditation. In addition to the immediate effects of meditation, the individuals with long‐term practice of meditation had overall higher arterial and cerebral oxygen saturation, overall lower blood pressure, and slower baseline respiration. Meditation acutely lowers arterial and tissue oxygenation. A repeated exposure to this condition may lead to long‐term adaptation and, through increased ventilatory efficiency and improved gas exchanges, to an increase in baseline oxygenation. Meditation induces favorable changes in cardiovascular and respiratory end points of clinical interest.
Of oysters, witches, birds, and anchors: Conceptions of space and travel in Pierre de Lancre
Authors: Maus de Rolley Thibaut 
Published: August 2017

AbstractIn 1609, the Bordeaux judge Pierre de Lancre led a brutal witch‐hunt in the Pays de Labourd, a territory in the southwestern tip of France. In his Tableau de l'inconstance des mauvais anges et demons (1612), Lancre described this fragment of the French Basque country as a New World of sorts inhabited by barely civilized people, and an inverted image of his own land: a prosperous and peaceful estate in Sainte‐Croix‐des‐Monts, in the wine‐making region of Bordeaux. The Pays de Labourd was a place of frenzy and mobility, which made it the devil's natural abode, and horrified Lancre, whose very name – a combination of the stone (pierre) and the anchor (ancre) – designated him as an incarnation of constancy and stability. This article explores the conceptions of space and travel at work in Lancre's writings, and examines the personal, literary and cultural roots of his demonization of movement. Replacing the 1612 Tableau within the wider context of Lancre's other works, it argues that Lancre's view of the Pays de Labourd and his discourse on witchcraft was shaped to a great extent by a neo‐Stoic condemnation of travel and mobility.
Mechanical properties of rock specimens containing pre‐existing flaws with 3D printed materials
Authors: Tian Wei , Han NV 
Published: August 2017

AbstractThree‐dimensional printing (3DP) technology has undergone a rapid development in the last few years and become a useful tool in many research fields. This study applied 3DP technology to prepare solid specimens simulating rock‐type materials combined with computed tomography scanning and 3D image processing. 3DP specimens with pre‐existing flaws in different inclination angles were fabricated and then conducted a series of mechanical experiments to study the influence of number and inclination angle of pre‐existing flaw on strength and failure patterns under uniaxial compression. The experimental results indicated that 3DP specimens had similar mechanical properties with rock‐type materials. The 3DP specimens with 2 pre‐existing flaws had lower compressive strength with an average of 4.26 MPa, whereas compressive strength of specimens with one flaw was no less than 5.08 MPa. Different inclination angles led to various failure patterns and compressive strengths, which took on a V‐shaped curve with the increase of inclination angles. This study demonstrated that 3DP technology provided a new perspective for conducting laboratory experimental research of rock mechanics.