bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ representations of caring for intellectually disabled patients and perceived needs to ensure quality care
Authors: Ndengeyingoma Assumpta , Ruel Julie 
Published: July 2016

Aims and objectivesTo explore nurses’ representations of caring for people with an intellectual disability, intervention strategies they currently use, and to identify needs to ensure quality care.BackgroundNurses work in many environments and with diverse clienteles. Certain clienteles have needs that require specific approaches, such as persons who have an intellectual disability. The care offered to these patients can be influenced by the representations held by the nurses caring for them.DesignQualitative descriptive study.MethodsSemi‐structured interviews using thematic analysis were conducted with 18 nurses working in hospital and community settings.ResultsNurses are concerned with their ability to recognise the specific nature and complex needs associated with patients’ intellectual disabilities, promoting quality care by managing the behavioural and communication challenges, as well as coping with the perceived lack of time and organisation within the work environment. Current strategies involve trying to promote the continuity of care. Participants also identified their learning needs, which are relational and informational in nature.ConclusionsNurses appear typically mindful of wanting to provide quality care to patients who have an intellectual disability, while recognising that there are many contextual and practical elements that require improvement to ensure the security of these patients.Relevance to clinical practiceNurses must be educated to adapt to findings emerging from current research showing that people with an intellectual disability want to be part of their local communities and encourage these persons to do so. This can be facilitated through the adoption of specific guidelines, protocols and care programmes. Further research is needed to develop a better understanding of the expectations of these patients and their caregivers, focusing on self‐advocacy as well as health promotion techniques, with the goal of enhancing personalised practice standards and reducing health education inequalities for these patients.
Working with complexity: experiences of caring for mothers seeking residential parenting services in New South Wales, Australia
Authors: Fowler Cathrine , Schmied Virginia , Dickinson Marie , Dahlen Hannah Grace 
Published: July 2016

Aim and objectivesTo investigate staff perception of the changing complexity of mothers and infants admitted to two residential parenting services in New South Wales in the decade from 2005–2015.BackgroundFor many mothers with a young child, parenting is difficult and stressful. If parenting occurs within the context of anxiety, mental illness or abuse it often becomes a high‐risk situation for the primary caregiver. Residential parenting services provide early nursing intervention before parenting problems escalate and require physical or mental health focused care.DesignA qualitative descriptive design using semi‐structured interview questions was used as phase three of a larger study. Data were gathered from 35 child and family health nurses and ten physicians during eight focus groups.ResultsThree main themes emerged: (1) dealing with complexity; (2) changing practice; and (3) appropriate knowledge and skills to handle greater complexity.ConclusionsThere was a mix of participant opinions about the increasing complexity of the mothers presenting at residential parenting services during the past decade. Some of the nurses and physicians confirmed an increase in complexity of the mothers while several participants proposed that it was linked to their increased psychosocial assessment knowledge and skill. All participants recognised their work had grown in complexity regardless of their perception about the increased complexity of the mothers.Relevance to clinical practiceAustralian residential parenting services have a significant role in supporting mothers and their families who are experiencing parenting difficulties. It frequently provides early intervention that helps minimise later emotional and physical problems. Nurses are well placed to work with and support mothers with complex histories. Acknowledgement is required that this work is stressful and nurses need to be adequately supported and educated to manage the complex presentations of many families.
Working in partnership: the application of shared decision‐making to health visitor practice
Authors: Astbury Ruth , Shepherd Ashley , Cheyne Helen 
Published: July 2016

Aims and objectivesTo explore the processes that support shared decision‐making when health visitors and parents are creating plans to improve the well‐being of babies and children.BackgroundWorldwide, there is a focus on promoting children's well‐being to enhance the population health. Within the United Kingdom, health visitors have a key responsibility for working in partnership with parents to support this agenda. Despite evidence that the application of ‘shared decision‐making’ frameworks can increase patient participation, improve patient satisfaction and improve health outcomes, there is limited research linking shared decision‐making with health visitor practice.DesignA qualitative, descriptive study.MethodsThe study was undertaken in two phases: in Phase 1, data were collected by audio recording two health visitor–parent decision‐making conversations, in the absence of the researcher, where decisions around planning for a baby or child were being made as part of usual care, and then the participants’ experiences were sought through individual questionnaires. In Phase 2, semistructured interviews were conducted with nine health visitors and nine parents in relation to their recent experiences of planning care.ResultsEvidence of supportive processes included having a shared understanding around the issue needing to be addressed; being able to identify interventions that were accessible for the family; engaging in decision‐making through deep, meaningful conversations using sensitive and responsive approaches; and establishing positive relationships between health visitors and parents, significant others within the family and other professionals.ConclusionDespite evidence of strong, trusting relationships between parents and health visitors, there were times when shared decision‐making was unable to take place due to the absence of supportive processes.Relevance to clinical practiceHealth visitors are aware that planning interventions with parents can be complex. These findings indicate the value of using a shared decision‐making framework to structure planning, as application of a framework identified the processes that support a collaborative approach in practice.
Efficacy and Safety of Local Intracoronary Drug Delivery in Treatment of No‐Reflow Phenomenon: A Pilot Study
Authors: Abu Arab Tamer , Rafik Ramy , El Etriby Adel 
Published: July 2016

BackgroundSuccessful reopening of epicardial coronary artery does not always mean optimal myocardial reperfusion in a sizable portion of patients, mostly because of no‐reflow phenomenon.ObjectivesWe investigated whether local injection of adrenaline ± verapamil in the distal coronary bed is more effective than their intracoronary (IC) injection through the guiding catheter in the treatment of no‐reflow phenomenon following percutaneous coronary intervention (PCI).MethodsA total of 40 patients with no‐reflow following PCI were randomized into two groups. Group 1 received IC adrenaline ± verapamil through a well‐cannulated guiding catheter while Group 2 received the above‐mentioned drugs in the distal coronary bed through a perfusion balloon or selective microcatheter. The primary end points were the achievement of TIMI III flow with MBG II or III. Secondary end points were the occurrence of hypotension, arrhythmias, and major adverse cardiac events (MACEs) during hospital stay.ResultsAfter drug injection, the percentage of patients achieving Thrombolysis in Myocardial Infarction (TIMI) III flow in Group 1 was 40% versus 80% in Group 2, P = 0.032. MBG II and III was significantly lower in Group 1; 10% and 25% versus 15% and 65% in Group 2, respectively, P = 0.033. Primary end points were achieved in only 35% of patients in Group 1 and in 80% of patients in Group 2 (odds ratio, 7.43, 95% confidence interval 1.78–31.04, P < 0.01). Secondary end points were not different between both groups.ConclusionLocal intra‐coronary delivery of adrenaline ± verapamil is a safe and effective method for the treatment of no‐reflow phenomenon complicating PCI.
Evaluation of Cystatin C for the Detection of Chronic Kidney Disease in Cats
Authors: Ghys L.F.E. , Paepe D. , Lefebvre H.P. , Reynolds B.S. , Croubels S. , Meyer E. , Delanghe J.R. , Daminet S. 
Published: July 2016

BackgroundSerum cystatin C (sCysC) and urinary cystatin C (uCysC) are potential biomarkers for early detection of chronic kidney disease (CKD) in cats. An in‐depth clinical validation is required.ObjectivesTo evaluate CysC as a marker forCKDin cats and to compare assay performance of the turbidimetric assay (PETIA) with the previously validated nephelometric assay (PENIA).AnimalsNinety cats were included: 49CKDand 41 healthy cats.MethodsSerum CysC anduCysC concentrations were prospectively evaluated in cats withCKDand healthy cats. Based on plasma exo‐iohexol clearance test (PexICT),sCysC was evaluated to distinguish normal, borderline, and lowGFR. Sensitivity and specificity to detect PexICT < 1.7 mL/min/kg were calculated. Serum CysC results ofPENIAandPETIAwere correlated withGFR. Statistical analysis was performed using general linear modeling.ResultsCats withCKDhad significantly higher mean ± SD sCysC (1.4 ± 0.5 mg/L) (P < .001) anduCysC/urinary creatinine (uCr) (291 ± 411 mg/mol) (P < .001) compared to healthy cats (sCysC 1.0 ± 0.3 anduCysC/uCr 0.32 ± 0.97).UCysC was detected in 35/49CKDcats.R2values betweenGFRandsCysC orsCr were 0.39 and 0.71, respectively (sCysC orsCr = μ + GFR + ε). Sensitivity and specificity were 22 and 100% forsCysC and 83 and 93% forsCr. Serum CysC could not distinguish healthy fromCKDcats, nor normal from borderline or low GFR, in contrast withsCr.ConclusionSerum CysC is not a reliable marker of reducedGFRin cats anduCysC could not be detected in allCKDcats.
QuantitativePCRand Cytology of Bronchoalveolar Lavage Fluid in Dogs withBordetella bronchisepticaInfection
Authors: Canonne A.M. , Billen F. , Tual C. , Ramery E. , Roels E. , Peters I. , Clercx C. 
Published: July 2016

BackgroundThe use of quantitativePCR(qPCR) for detection ofBordetella bronchisepticain bronchoalveolar lavage fluid (BALF) and demonstration of bacteria adhering to ciliated epithelial cells inBALFor bronchial brushing fluid (BBF) has not been assessed in a series of affected dogs. Coinfections can worsen the clinical severity in bordetellosis, but the specific association withMycoplasma cynoshas not been evaluated.ObjectivesTo assess the utility of culture,qPCRand cytologic examination of cytospin preparations in the diagnosis of bordetellosis in dogs and the influence of coinfection byM. cynoson disease severity.AnimalsTwenty‐four referred dogs withB. bronchisepticainfection and 10 healthy dogs.MethodsRetrospective case series.qPCR(B. bronchisepticaandM. cynos) and culture results fromBALFwere recorded. Cytospin preparations fromBALFandBBFwere reviewed.qPCRonBALFfrom 10 healthy dogs were used as negative control.ResultsTheBALFculture andqPCRdetectedB. bronchisepticain 14/24 and 18/18 dogs, respectively. Coccobacilli were found adhering to ciliated epithelial cells in 20 of the 21BALFcytologic preparations where epithelial cells were found, and 2/3BBFcytologic preparations. Quantitative PCR detected a low level ofB. bronchisepticain one healthy dog. The frequency of detection ofM. cynoswas not significantly different inB. bronchiseptica(9/17 dogs) compared with healthy dogs (2/10 dogs) (P = .09).Conclusion and Clinical ImportanceQuantitative PCR detection ofB. bronchisepticainBALFappears to be a useful diagnostic tool. Cytologic examination ofBALForBBF, when positive, allows a rapid and reliable diagnosis.
Clinical and histological features of lupus nephritis in Japan: A cross‐sectional analysis of the Japan Renal Biopsy Registry (J‐RBR)
Authors: Hiromura Keiju , Ikeuchi Hidekazu , Kayakabe Ken , Sugiyama Hitoshi , Nagata Michio , Sato Hiroshi , Yokoyama Hitoshi , Nojima Yoshihisa 
Published: July 2016

AbstractAimThe clinical and histological features of lupus nephritis (LN) are highly variable, depending on race and ethnicity. The Japan Renal Biopsy Registry (J‐RBR) is a nationwide registry of renal biopsies. Here, we report a cross‐sectional analysis of Japanese LN using the J‐RBR database.MethodsOut of 18 463 patients registered in the J‐RBR, 331 LN patients, who received renal biopsy for the first time, were extracted and their clinical features were analyzed according to the ISN/RPS 2003 classification.ResultsThe median age of the 331 LN patients was 37 years (women, 81.3%). The frequencies of each of the ISN/RPS Classes were as follows: I, 1.2%; II, 7.9%; III (±V), 25.1%; IV‐S (±V), 13.0%; IV‐G (±V), 31.1%; V, 20.8%; and VI, 0.9%. The level of proteinuria and the prevalence of nephrotic syndrome were highest for Class IV‐G (±V). When Classes I, II, and VI were excluded from the analysis, Class IV‐G (±V) was significantly associated with a lower eGFR and severer haematuria than the other classes.ConclusionThis nationwide study revealed that Class IV‐G (±V) was the most prevalent form of LN in Japan and was associated with a severe clinical renal presentation.
Bispectral index under propofol anesthesia in children: a comparative randomized study between TIVA and TCI
Authors: Louvet Nicolas , Rigouzzo Agnès , Sabourdin Nada , Constant Isabelle 
Published: July 2016

SummaryBackgroundIn children, only a few studies have compared different modes of propofol infusion during a total intravenous anesthesia (TIVA) with propofol and remifentanil. The aim of this study was to compare Bispectral Index (BIS) profiles (percentage of time spent at adequate BIS values) between four modes of propofol infusion: titration of the infusion rate on clinical signs (TIVA0), titration of the infusion rate on the BIS (TIVABIS), target controlled infusion (TCI) guided by the BIS either with the Kataria model (TCI KBIS) or the Schnider model (TCI SBIS).MethodsSixty‐six children (aged from 4 to 14 years) were prospectively randomized into one of the four groups. In the TIVA0 group, the anesthesiologist was blinded to the BIS. In each group, the percentage of time with adequate BIS values (45–55), the bias, and imprecision were calculated.ResultsThe propofol consumption was similar in the four groups. During the maintenance phase, the percentage of time spent in the targeted BIS range was significantly lower in the TIVA0 group compared to the three other groups (TIVA0: 31% ± 22, TIVABIS: 59% ± 17, TCI KBIS: 53% ± 12, TCI SBIS: 56% ± 17). The bias was not statistically different between the four groups, but the imprecision was larger for the TIVA0 group. Compared to the Kataria model, the Schnider model was associated with shorter time delay to reach the desired BIS, to eyes opening, and to tracheal extubation.ConclusionsPropofol administration using manual infusion guided by clinical signs was associated with higher risks of over‐ or underdosage when compared to BIS‐guided administrations. When propofol infusion was guided by the BIS, no major difference was found between TIVA and TCI (either with the Kataria or the Schnider model). This study highlights the need of a pharmacodynamic feedback during propofol anesthesia in children.
Response to propranolol in infantile hemangioma
Authors: Sirachainan Nongnuch , Lekanan Wasuthida , Thammagasorn Yuwaluk , Wanitkun Suthep , Kadegasem Praguywan , Chunharas Amornsri 
Published: July 2016

AbstractPropranolol, 2 mg/kg/day, is effective in the treatment of infantile hemangioma. We report the response to propranolol in infants with hemangioma at a dose of 1 mg/kg/day. Sixteen infants with newly diagnosed infantile hemangioma were given propranolol at a dose titrated from 0.5 mg/kg/day then increased to 1 or 2 mg/kg/day based on response to treatment until the lesions showed clinical stability for 3 consecutive months. Five out of 16 patients (31.2%) responded to propranolol at 1 mg/kg/day, while the remainder required 2 mg/kg/day for response. Vascular endothelial growth factor significantly decreased after treatment (median, 117.8 pg/mL; range, 35.3–468.7 pg/mL vs 59.2 pg/mL; range, 26.3–133.0 pg/mL; P = 0.016). Therefore, we recommend initiating treatment at 0.5 mg/kg/day for 2 days, then 1 mg/kg/day for 1 month. If the hemangioma has not decreased in size by 1 month follow up, the dose is subsequently increased to 2 mg/kg/day.
Extrapontine myelinolysis associated with severe hypernatremia in infancy
Authors: Aoki Ryoji , Morimoto Tetsuji , Takahashi Yuno , Saito Hiroshi , Fuchigami Tatsuo , Takahashi Shori 
Published: July 2016

AbstractExtrapontine myelinolysis (EPM) is an uncommon disorder in children, with few pediatric cases reported to date. We report the first case of an infant with EPM without central pontine myelinolysis (CPM) presenting with severe hypernatremia. On admission, the infant had impaired consciousness, mild dehydration, and severe hypernatremia (190 mmol/L). The following day, the patient developed abnormal involuntary movements. Brain magnetic resonance imaging (MRI) confirmed EPM without CPM. He recovered without sequelae, and clinical examinations were within normal limits approximately 6 months after discharge. Brain MRI at 1 year after onset showed complete disappearance of the previous EPM regions. To the best of our knowledge, this represents the youngest patient with EPM without CPM presenting with severe hypernatremia. Given that treatment for osmotic demyelination syndrome (ODS) is yet to be established, preventing the development of ODS is crucial.
Clinical guides for atypical hemolytic uremic syndrome in Japan
Authors: Kato Hideki , Nangaku Masaomi , Hataya Hiroshi , Sawai Toshihiro , Ashida Akira , Fujimaru Rika , Hidaka Yoshihiko , Kaname Shinya , Maruyama Shoichi , Yasuda Takashi , Yoshida Yoko , Ito Shuichi , Hattori Motoshi , Miyakawa Yoshitaka , Fujimura Yoshihiro , Okada Hirokazu , Kagami Shoji ,   The Joint Committee for the Revision of Clinical Guides of Atypical Hemolytic Uremic Syndrome in Japan
Published: July 2016

AbstractAtypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. In 2013, we developed diagnostic criteria to enable early diagnosis and timely initiation of appropriate treatment for aHUS. Recent clinical and molecular findings have resulted in several proposed classifications and definitions of thrombotic microangiopathy and aHUS. Based on recent advances in this field and the emerging international consensus to exclude secondary TMAs from the definition of aHUS, we have redefined aHUS and proposed diagnostic algorithms, differential diagnosis, and therapeutic strategies for aHUS.
Attitudes, Beliefs, and Measures Taken by Parents to Protect Their Children from the Sun in Guangzhou City, China
Authors: Wan Miaojian , Hu Rong , Li Ying , Wang Yaning , Xie Xiaoyuan , Yue Pan , Guan Lei , Lai Wei 
Published: July 2016

AbstractExcessive sun exposure can cause sunburn, suntan, skin photoaging, and even skin cancer. Skin photoaging conflicts with the human pursuit of a young and beautiful appearance. Some research data indicate that the incidence of skin cancer in the Chinese has been increasing, although it remains lower than in whites. To estimate the prevalence of sun protection used on Chinese children aged 3–13 years and identify its predictors, a population‐based cross‐sectional questionnaire was given to 3684 parents/guardians of children in Guangzhou, China, of which 3083 questionnaires were returned. Of those returned, 35.5% of parents/guardians reported regularly using sun protection on their children and the primary reason cited was to prevent sunburn. Hats and handheld umbrellas were the most frequently used measures; sunscreen was less common, and when used, 48.8% of parents/guardians still reapplied sunscreen on their children every 2.0–3.0 h. Parental age, parents using sun protection measures themselves when outdoors, and the child's sex were factors associated with regular use of sun protection on children. These results suggest that sun protection campaigns targeted toward parents and children need to be conducted in Guangzhou, or throughout China, to strengthen awareness about sun protection and address any inadequate protocols of sun protection.
FN400 and LPC memory effects for concrete and abstract words
Authors: Stróżak Paweł , Bird Christopher W. , Corby Krystin , Frishkoff Gwen , Curran Tim 
Published: July 2016

AbstractAccording to dual‐process models, recognition memory depends on two neurocognitive mechanisms: familiarity, which has been linked to the frontal N400 (FN400) effect in studies using ERPs, and recollection, which is reflected by changes in the late positive complex (LPC). Recently, there has been some debate over the relationship between FN400 familiarity effects and N400 semantic effects. According to one view, these effects are one and the same. Proponents of this view have suggested that the frontal distribution of the FN400 could be due to stimulus concreteness: recognition memory experiments commonly use highly imageable or concrete words (or pictures), which elicit semantic ERPs with a frontal distribution. In the present study, we tested this claim using a recognition memory paradigm in which subjects memorized concrete and abstract nouns; half of the words changed font color between study and test. FN400 and LPC old/new effects were observed for abstract as well as concrete words, and were stronger over right hemisphere electrodes for concrete words. However, there was no difference in anteriority of the FN400 effect for the two word types. These findings challenge the notion that the frontal distribution of the FN400 old/new effect is fully explained by stimulus concreteness.
Business Cycle Accounting for Peripheral European Economies
Authors: Caraiani Petre 
Published: July 2016

AbstractUsing the Business Cycle Accounting methodology, this paper analyzes the dynamics of the EMU‐periphery economies before and during what was called the sovereign debt crisis. TFP dynamics and the labor wedge explain most of the dynamics before and during the crisis. The bond wedge, corresponding to the risk premium, made a low contribution, moving counter‐cyclically. The capital wedge made a modest contribution to the fall in output during the crisis. Additional evidence links the dynamics of the TFP and the labor wedge with changes in the interest rates and a spike in import prices at the onset of the crisis, corresponding to the general mechanisms of the large capital inflows, in the wake of the introduction of the Euro, followed by sudden stops.