bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apnoeic oxygenation with high‐flow nasal oxygen for laryngeal surgery: a case series
Authors: Lyons C. , Callaghan M. 
Published: October 2017

SummarySurgery under apnoeic conditions with the use of high‐flow nasal oxygen is novel. Between November 2016 and May 2017, 28 patients underwent tubeless laryngeal or tracheal surgery under apnoeic conditions with high‐flow nasal oxygen as the sole method of gas exchange. Patients received total intravenous anaesthesia and neuromuscular blocking agents for the duration of their surgery. The median (IQR [range]) apnoea time was 19 (15–24 [9–37]) min. Four patients experienced an episode of oxygen desaturation to a value between 85% and 90%, lasting less than 2 min in each case. Median (IQR [range]) end‐tidal carbon dioxide (ETCO2) level following apnoea was 8.2 (7.2–9.4 [5.8–11.8]) kPa. The mean (SD) rate of ETCO2 increase was 0.17 (0.07) kPa.min−1 from an approximated baseline value of 5.00 kPa. Venous blood sampling from 19 patients demonstrated a mean (SD) partial pressure of carbon dioxide (PVCO2) of 6.29 (0.71) kPa at baseline and 9.44 (1.12) kPa after 15 min of apnoea. This equates to a mean (SD) PVCO2 rise of 0.21 (0.08) kPa.min−1 during this period. Mean (SD) pH was 7.40 (0.03) at baseline and 7.23 (0.04) after 15 min of apnoea. Mean (SD) standard bicarbonate was 26.7 (1.8) mmol.l−1 at baseline and 25.4 (1.8) mmol.l−1 at 15 min. We conclude that high‐flow nasal oxygen under apnoeic conditions can provide satisfactory gas exchange in order to allow tubeless anaesthesia for laryngeal surgery.
Severity strata for five patient-reported outcomes in adults with atopic dermatitis
Authors: Vakharia P.P. , Chopra R. , Sacotte R. , Patel N. , Immaneni S. , White T. , Kantor R. , Hsu D.Y. , Simpson E.L. , Silverberg J.I. 
Published: October 2017

SummaryBackgroundSeveral patient-reported outcomes have been used to assess the burden of atopic dermatitis (AD). Some are disease specific, such as the Patient-Oriented Eczema Measure (POEM), while others pertain to itch, for example the numerical rating scale (NRS)-itch, ItchyQoL and 5-D itch, or dermatological disease in general, for example the Dermatology Life Quality Index (DLQI). Development of severity strata is essential for proper interpretability of these assessments.ObjectivesTo confirm previously developed strata for POEM, DLQI and raw ItchyQoL, and develop strata for the NRS-itch, mean ItchyQoL and 5-D itch scale for use in adults with AD.MethodsSelf-administered questionnaires were completed by 210 adults with AD in a dermatology practice setting. Strata were selected using an anchoring approach based on patient-reported disease severity.ResultsWe confirmed the existing strata for POEM (mild 0–7, moderate 8–16, severe 17–28; κ = 0·440), DLQI (mild 0–5, moderate 6–10, severe 11–30; κ = 0·398) and NRS-itch (mild 0–3, moderate 4–6, severe 7–10; κ = 0·499). However, the preferred band for raw ItchyQoL was mild 22–58, moderate 59–74 and severe 75–110 (κ = 0·379) and for mean ItchyQoL, mild 1–2·9, moderate 3·0–3·9, severe 4·0–5·0 (κ = 0·374). The preferred band for 5-D itch scale was mild 0–11, moderate 12–17 and severe 18–25 (κ = 0·331).ConclusionsExisting strata for POEM and DLQI performed well in adult AD. Previously reported strata for visual analogue scale-itch performed best for NRS-itch. We identified banding for the raw ItchyQoL for our AD population that varies slightly from the banding published for a more heterogeneous population. Finally, we proposed strata for mean ItchyQoL and 5-D itch scale in adult AD.
How I manage relapse of chronic myeloid leukaemia after stopping tyrosine kinase inhibitor therapy
Authors: Rea Delphine , Mahon François‐Xavier 
Published: October 2017

SummaryDuring the last 10 years, clinical trials formally demonstrated that about 50% of patients with chronic phase (CP) chronic myeloid leukaemia (CML) who achieve and maintain deep molecular responses for a prolonged period of time during treatment with imatinib or new generation tyrosine kinase inhibitors (TKIs) may successfully stop their anti‐leukaemic therapy. Based on the accumulated knowledge from abundant clinical trial experience, TKI discontinuation is becoming an important goal to achieve and is about to enter clinical practice. This review focuses on relapse definition, laboratory tests to identify relapse and relapse management after TKI discontinuation.
Brief workshops to teach drug and alcohol first aid: A pilot evaluation study
Authors: Kostadinov Victoria R. , Roche Ann M. , McEntee Alice , Allan Julaine M. , Meumann Nicholas R. , McLaughlin Lara L. 
Published: October 2017

AbstractIntroduction and AimsHealth and community service workers frequently encounter people with alcohol and other drug (AOD) problems in the course of their work, yet few have had training on how to respond effectively. A Drug and Alcohol First Aid workshop was developed by Lyndon, a non‐government organisation treatment provider, and delivered to community and health sector workers and the general public. It presented evidence‐based information regarding AOD use and harm reduction and treatment options. A pilot evaluation of the workshop was conducted to assess changes in participants’ knowledge about AOD, methods of responding to use and attitudes towards individuals who use AOD, over a 3 month period.Design and MethodsA self‐report evaluation survey was developed and administered to workshop participants at three time points: before (T1), immediately after (T2) and 3 months after the workshop (T3). Paired samples t‐tests examined changes in knowledge, role adequacy, motivation and personal views.ResultsA total of 142 participants completed the T1 survey, 184 completed the T2 survey and 98 completed the T3 survey. Between T1 and T2, there were significant increases in scores for knowledge and role adequacy, indicating significant improvements in these areas. No significant differences were found for motivation and personal views. At T3, knowledge and role adequacy scores remained significantly higher than at baseline.Discussion and ConclusionsDrug and Alcohol First Aid appears to be a viable initiative to improve AOD‐related knowledge and role adequacy. However, alternative strategies may be required to shift negative attitudes towards individuals who use AOD. [Kostadinov VR, Roche AM, McEntee A, Allan JM, Meumann NR, McLaughlin LL. Brief workshops to teach drug and alcohol first aid: A pilot evaluation study. Drug Alcohol Rev 2018;37:23–27]
The evolution of the political criteria for accession to the European Community, 1957–1973
Authors: Janse Ronald 
Published: October 2017

AbstractThis article describes the evolution of political conditions for accession to the European Community from 1957 to 1973 on the basis of the responses of the Community and national parliaments to applications for association (Article 238 EC Treaty) and membership (Article 237 EC Treaty) and to a US foreign policy initiative. It challenges the thesis that the European Community was originally uninterested in the political nature of its members as long as they were non‐communist and that the Community made a volte face in 1962 in reaction to a request for an association agreement by Franco's Spain. It argues that the Copenhagen political criteria, except minority protection, were firmly established by 1973 after a series of pronouncements and decisions by the European Parliament, national parliaments (both 1962), the Commission (1967) and the Council (1973). The article aims to contribute to the early history of the constitutionalization of the Union and discusses how demands from outsiders prompted the Six to define the constitutional requirements for (candidate) members. It is partly based on new archival research.
Efficacy and safety of Nuwiq® (human‐cl rhFVIII) in patients with severe haemophilia A undergoing surgical procedures
Authors: Zozulya N. , Kessler C. M. , Klukowska A. , von Depka M. , Hampton K. , Hay C. R. M. , Jansen M. , Bichler J. , Knaub S. , Rangarajan S. 
Published: October 2017

IntroductionHaemophilia A patients are at a high risk of excess bleeding during surgeries. The aim of haemostatic therapy during the perioperative period is to normalize FVIII level perioperatively and postoperatively to maintain normal haemostasis until wound healing is complete.Aims/MethodsTo examine the efficacy of Nuwiq® (simoctocog alfa, human‐cl rhFVIII), a 4th generation recombinant FVIII produced in a human cell line, for surgical prophylaxis in patients with severe haemophilia A. This analysis assessed the efficacy of Nuwiq® during surgical procedures and in the postoperative period in seven clinical studies of previously treated patients (PTPs) with severe haemophilia A.ResultsThirty‐six patients, aged 3‐55 years, received surgical prophylaxis with Nuwiq® for 60 surgeries (28 major and 32 minor). Efficacy was evaluated for 52 surgeries (25 major and 27 minor). The success rate of Nuwiq® treatment was 98.1% (51 of 52 evaluated surgeries); haemostatic efficacy was assessed as “excellent” or “good” in all but one major surgery (assessed as “moderate”). The number of infusions ranged from 1 to 19 for minor surgeries and from 3 to 76 for major surgeries. The median (range) daily doses were 42.0 (28.2‐100.9) IU kg−1 for minor surgeries and 69.3 (43.3‐135.6) IU kg−1 for major surgeries. There were no serious treatment‐related adverse events, and none of the patients developed FVIII inhibitors.ConclusionsThe results of this pooled analysis show that Nuwiq® was efficacious in maintaining haemostasis during and after major and minor surgical procedures in PTPs with severe haemophilia A.
Associations Between Depression/Anxiety and Headache Frequency in Migraineurs: A Cross‐Sectional Study
Authors: Chu Hsuan‐Te , Liang Chih‐Sung , Lee Jiunn‐Tay , Yeh Ta‐Chuan , Lee Meei‐Shyuan , Sung Yueh‐Feng , Yang Fu‐Chi 
Published: October 2017

BackgroundWhile migraines have been associated with emotional disturbances, it remains unknown whether the intensity of emotional expression is directly related to migraine frequency.ObjectiveThe present study investigated depression/anxiety among migraineurs.MethodsThis cross‐sectional study included 588 clinical outpatients in Taiwan. Migraines were stratified by attack frequency, with and without auras, and with well‐controlled confounding variables. Demographic and clinical data, including sleep characteristics, were collected. Multivariable linear regressions were employed to examine whether migraine frequency (1‐4 headache days per month, 5‐8 headache days per month, 9‐14 headache days per month, or >14 headache days per month) was associated with depression/anxiety symptoms, as indicated by the Beck's Depression Inventory (BDI) and Hospital Anxiety and Depression Subscales (HADS).ResultsBDI total scores were highest in patients with chronic migraines (mean ± SD: 13.2 ± 8.5), followed by those with high frequency (12.1 ± 8.5), medium frequency (10.6 ± 8.0), low frequency (9.1 ± 7.1), and lowest in nonmigraine controls (6.6 ± 5.9), with a significant trend in frequency (P trend < .001); similar results were obtained for HADS scores. BDI and HADS scores were independently related to high‐frequency episodic and chronic migraine frequency and to poor sleep quality. The relationship between BDI score and migraine frequency was present in both aura‐present (P trend = .001) and aura‐absent subgroups (P trend = .029).ConclusionHigher migraine frequency, either with or without auras, correlated with higher symptom scores of anxiety and depression.
Melting behavior and superheating capacity of REBa2Cu3Oy films with nano‐layer buffered structures
Authors: Wang Wei , Xiang Hui , Hussain Ghulam , Yu Dejing , Zhu Yisha , Zhang Letian , Samoilenkov Sergey V. , Kaul Andrey R. , Yao Xin 
Published: October 2017

AbstractUsing high temperature‐optical microscopy, in situ investigations were conducted on melting and superheating behaviors of REBa2Cu3O7−δ (RE123, RE = Nd, Gd) films, which were grown on nano‐layer buffered substrates. The results demonstrate that all buffered RE123 films have improved crystallinity and in‐plane alignments, leading to the higher superheating capability. In the first case, due to its good lattice match with the buffer material of Y123, the Nd123 film with the minimal extrinsic property grew from the superior interface. In the second circumstance, because of its stronger chemical bonding with the buffer layer of Gd2O3, the pure c‐axis oriented Gd123 film was fabricated. Moreover, the optimized thickness of buffer layer plays an important role in reducing interface energy of RE123 films and enhancing its superheating capacity.
From job stress to intention to leave among hospital nurses: A structural equation modelling approach
Authors: Lo Wen‐Yen , Chien Li‐Yin , Hwang Fang‐Ming , Huang Nicole , Chiou Shu‐Ti 
Published: October 2017

AbstractAimsThe aim of this study was to examine the structural relationships linking job stress to leaving intentions through job satisfaction, depressed mood and stress adaptation among hospital nurses.BackgroundHigh turnover among nurses is a global concern. Structural relationships linking job stress to leaving intentions have not been thoroughly examined.DesignTwo nationwide cross‐sectional surveys of full‐time hospital staff in 2011 and 2014.MethodsThe study participants were 26,945 and 19,386 full‐time clinical nurses in 2011 and 2014 respectively. Structural equation modelling was used to examine the interrelationships among the study variables based on the hypothesized model. We used cross‐validation procedures to ensure the stability and validity of the model in the two samples.ResultsThere were five main paths from job stress to intention to leave the hospital. In addition to the direct path, job stress directly affected job satisfaction and depressed mood, which in turn affected intention to leave the hospital. Stress adaptation mitigated the effects of job stress on job satisfaction and depressed mood, which led to intention to leave the hospital. Intention to leave the hospital preceded intention to leave the profession. Those variables explained about 55% of the variance in intention to leave the profession in both years.ConclusionThe model fit was good for both samples, suggesting validity of the model. Strategies to decrease turnover intentions among nurses could focus on creating a less stressful work environment, increasing job satisfaction and stress adaptation and decreasing depressed mood. Hospitals should cooperate in this issue to decrease nurse turnover.
Clinical factors associated with the symptoms of constipation in patients with diabetes mellitus: A multicenter study
Authors: Yamada Eiji , Namiki Yulia , Takano Yuya , Takamine Hikaru , Inazumi Koji , Sasaki Hiroto , Yamada Masayo , Ito Satoshi , Iwasaki Tomoyuki , Mantani Naoki , Minami Taichi , Osada Uru Nezu , Terauchi Yasuo , Nakajima Atsushi 
Published: October 2017

AbstractBackground and AimChanges in treatment protocols for patients with diabetes mellitus (DM) may influence the functions of the digestive tract. This study examined possible clinical factors associated with the symptoms of constipation in patients with DM.MethodsThis was a multicenter study. Participants were consecutive Japanese patients undergoing treatment for type 1 or type 2 DM. Constipation was evaluated using the gastrointestinal symptom rating scale. Diabetic neuropathy was evaluated by the presence or absence of peripheral neuropathy of the lower limbs.ResultsOf 419 participants, 258 were men and 161 women (ratio: 1.6:1), with a mean age of 63.6 ± 12.5 years. In multivariate analysis, symptoms of constipation were significantly associated with age (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.01–1.04, P = 0.032), lower mental component summary (OR = 3.31, 95% CI: 1.69–6.48, P < 0.001), diabetic retinopathy (OR = 1.99, 95% CI: 1.14–3.45, P = 0.015), and diabetic neuropathy (OR = 1.86, 95% CI: 1.10–3.16, P = 0.021). In patients with peripheral neuropathy of the lower limbs, regardless of the presence of other complications (diabetic nephropathy and diabetic retinopathy), the prevalence of symptoms of constipation was twice that of patients without peripheral neuropathy (40.0–49.1% vs 22.0%). Diabetic drugs were not associated with symptoms of constipation.ConclusionsDiabetic neuropathy, defined as peripheral neuropathy of the lower limbs, was significantly associated with symptoms of constipation. Peripheral neuropathy of the lower limbs is not a direct risk factor for constipation but may be a useful criterion when assessing whether constipation is associated with DM.
Meeting the support needs of persons with mild intellectual disability or borderline intellectual functioning: still a long way to go
Authors: Nouwens P. J. G. , Smulders N. B. M. , Embregts P. J. C. M. , van Nieuwenhuizen C. 
Published: October 2017

AbstractBackgroundAmong persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the type of healthcare providers involved matched the specific support needs of persons with a mild intellectual disability or borderline intellectual functioning.MethodFive (previously identified) profiles of persons with a mild intellectual disability or borderline intellectual functioning were used to investigate to what extent the support needs of this group had been met. For the 250 persons with mild intellectual disability or borderline intellectual functioning who matched these five profiles, data were collected retrospectively from their case files.ResultsPersons with mild intellectual disability or borderline intellectual functioning received a very similar amount and type of support/treatment programs. Differences between the profiles were found for non‐verbal therapy, residential treatment and contacts with social work. Regarding the type of healthcare providers involved, differences between the profiles emerged for specialised intellectual disability services, youth services and specialised addiction services.ConclusionsThe support programs for a heterogeneous population of persons with mild intellectual disability or borderline intellectual functioning seem to be suboptimal, indicating that more differentiation is required in the services offered to these individuals.
Do men and women with intellectual disabilities understand death?
Authors: Chow A. Y. M. , McEvoy J. , Chan I. K. N. , Borschel M. , Yuen J. H. L. , Lo J. Y. M. 
Published: October 2017

AbstractBackgroundIndividuals with ID are often withheld information about the death of their loved ones as it has often been thought that they do not understand death or cannot grieve. This grief exacerbates the stress of individuals with ID as they often encounter secondary losses such as transitioning to a care facility. The aim of this study is to investigate men and women with ID understanding death concepts and to what extent.MethodAdopting a stratified random sampling method, 156 Chinese people with ID were invited to join the study. One hundred and ten participants were interviewed using simple death related vignettes expanding upon and replicating a published study carried out in Ireland. The understanding of the five death concepts: causality, irreversibility, nonfunctionality, universality and inevitability was examined. The correlates of demographics, bereavement experiences and comprehension were explored.ResultsThe majority of the participants did understand concepts such as death is irreversible and that the deceased no longer function. One third of the participants understood causality and the universality of death. One fifth understood the inevitability of death. Previous bereavement experiences were correlated with higher understanding. Communication and community skills were correlated with all concepts of death except universality.ConclusionThe results indicate that individuals with ID do have a partial to full understanding of the concepts of death. The culture of Hong Kong is one that considers death to be a taboo or unlucky subject. Therefore, the results mirror the the lack of understanding of universality and inevitability concepts as it is forbidden to speak of these concepts. An open and honest environment is encouraged to educate individuals with ID about death and bereavement.
Nursing documentation in inpatient psychiatry: The relevance of nurse–patient interactions in progress notes—A focus group study with mental health staff
Authors: Myklebust Kjellaug K. , Bjørkly Stål , Råheim Målfrid 
Published: October 2017

Aims and objectivesTo gain insight into mental health staff's perception of writing progress notes in an acute and subacute psychiatric ward context.BackgroundThe nursing process structures nursing documentation. Progress notes are intended to be an evaluation of a patient's nursing diagnoses, interventions and outcomes. Within this template, a patient's status and the care provided are to be recorded. The therapeutic nurse–patient relationship is recognised as a key component of psychiatric care today. At the same time, the biomedical model remains strong. Research literature exploring nursing staff's experiences with writing progress notes in psychiatric contexts, and especially the space given to staff–patient relations, is sparse.DesignQualitative design.MethodsFocus group interviews with mental health staff working in one acute and one subacute psychiatric ward were conducted. Systematic text condensation, a method for transverse thematic analysis, was used.ResultsTwo main categories emerged from the analysis: the position of the professional as an expert and distant observer in the progress notes, and the weak position of professional–patient interactions in progress notes.ConclusionsThe participants did not perceive that the current recording model, which is based on the nursing process, supported a focus on patients’ resources or reporting professional–patient interactions. This model appeared to put ward staff in an expert position in relation to patients, which made it challenging to involve patients in the recording process. Essential aspects of nursing care related to recovery and person‐centred care were not prioritised for documentation.Relevance to clinical practiceThis study contributes to the critical examination of the documentation praxis, as well as to the critical examination of the documentation tool as to what is considered important to document.