bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why we should understand the patient experience: clinical empathy and medicines optimisation
Authors: Jubraj Barry , Barnett Nina L , Grimes Lesley , Varia Sneha , Chater Angel , Auyeung Vivian 
Published: April 2016

Abstract

Objectives
To critically discuss the need for pharmacists to underpin their consultations with appropriate ‘clinical empathy’ as part of effective medicines optimisation.

Methods
Use of literature around empathy, consultation and pharmacy practice to develop a case for greater clinical empathy in pharmacy consultations.

Key findings
Clinical empathy is defined from the literature and applied to pharmacy consultations, with a comparison to empathy in other clinical professions. Historical barriers to the embedding of clinical empathy into pharmacy consultations are also explored.

Conclusions
We challenge the pharmacy profession to consider how clinical empathy should underpin consultations with a series of introspective questions and provide some sample questions to support pharmacy consultations. We also make the case for appropriate education and professional development of consultation skills at undergraduate and postgraduate level. We contend that patients’ relationships with practitioners are critical, and a lack of empathy can impact the effectiveness of care.
A comparative study of the effects of intra and extra circumoral exercise for older people on oral health at nursing homes: a non‐equivalent trial
Authors: Nam Mijung , Uhm Dongchoon 
Published: April 2016

AbstractAimsTo investigate the effects of using intra and extra circumoral exercise on subjective and objective parameters of pre‐ and postoral health of older people living in nursing homes.BackgroundOral health problems, such as dry mouth and halitosis, are very common complaints for older people and might be the cause of a physiological, psychological or social handicap. In an ageing society, a simple and convenient nursing intervention is needed to resolve these oral health problems without side effects.DesignThe present study adopted a pre‐ and posttest non‐equivalent control group in a quasi‐experimental design.MethodsA total of 41 older people (experimental group 21, control group 20) living in nursing homes participated in intra and extra circumoral exercise (25 min a day, six times per week for 4 weeks) to improve oral health in 2013. Chi‐square test/Fisher's exact test, t‐test/Mann–Whitney U‐test and analysis of covariance were used for the data analysis.Resultsancova was used to control the covariates (age and the basic values of dependent variables) to identify the effect of intra and extra circumoral exercise on the oral health between the two groups. Dry mouth symptoms decreased, oral motor function improved, salivary secretion and mouth opening size increased, salivary pH improved, halitosis decreased more in the experimental group than in the control group. However, the salivary IgA was not significantly different between the two groups.ConclusionsThe intra and extra circumoral exercises as an independent nursing intervention can effectively promote oral health of older people.
Stop. Think. Delirium! A quality improvement initiative to explore utilising a validated cognitive assessment tool in the acute inpatient medical setting to detect delirium and prompt early intervention
Authors: Malik Angela , Harlan Todd , Cobb Janice 
Published: April 2016

Aims and objectivesThe paper examines the ability of nursing staff to detect delirium and apply early intervention to decrease adverse events associated with delirium. To characterise nursing practices associated with staff knowledge, delirium screening utilising the Modified Richmond Assessment Sedation Score (mRASS), and multicomponent interventions in an acute inpatient medical unit.BackgroundDelirium incidence rates are up to 60% in frail elderly hospitalised patients. Under‐recognition and inconsistent management of delirium is an international problem. Falls, restraints, and increased hospital length of stay are linked to delirium.DesignA descriptive study.MethodsExploration of relationships between cause and effect among cognitive screening, knowledge assessment and interventions.ResultsSuccess in identifying sufficient cases of delirium was not evident; however, multicomponent interventions were applied to patients with obvious symptoms. An increase in nursing knowledge was demonstrated after additional training. Delirium screening occurred in 49–61% of the target population monthly, with challenges in compliance and documentation of screening and interventions. Technological capabilities for trending mRASS results do not exist within the current computerised patient record system.ConclusionsDelirium screening increases awareness of nursing staff, prompting more emphasis on early intervention in apparent symptoms. Technological support is needed to effectively document and visualise trends in screening results. The study imparts future research on the effects of cognitive screening on delirium prevention and reduction in adverse patient outcomes.Relevance to clinical practiceEvidence‐based literature reveals negative patient outcomes associated with delirium. However, delirium is highly under‐recognised indicating future research is needed to address nursing awareness and recognition of delirium. Additional education and knowledge transformation from research to nursing practice are paramount in the application of innovative strategies. Focus is placed on nursing staff because nurses are at the bedside and are able to identify early signs of delirium.
Caregiving activities closely associated with the development of low‐back pain among female family caregivers
Authors: Suzuki Kishiko , Tamakoshi Koji , Sakakibara Hisataka 
Published: April 2016

Aims and objectivesTo describe what effects low back pain has on the daily lives of female family caregivers and to elucidate the caregiving factors associated with its development.BackgroundLow back pain is a common musculoskeletal symptom in caregivers. However, few detailed studies have examined the association of low back pain with the daily lives of female family caregivers or which caregiving activities lead to their low back pain. The elucidation of these issues will contribute to the prevention and treatment of their low back pain.DesignA cross‐sectional study.MethodsJapanese female family caregivers (n = 156) completed a self‐administered questionnaire assessing lifestyle, health status, daily activity and caregiving situation. Correlation analysis measured the association between low back pain and daily activity. Logistic regression analysis identified care activities related to low back pain.ResultsThirty‐five (22·4%) participants almost always experienced low back pain. The severity of low back pain was significantly and positively associated with difficulty in daily activities, especially bending and extending the lower back. As for care situation factors and caregiving activities, night care, assisting the family member to stand up and to lie down, dealing with problem behaviours, and taking medication were associated with the development of low back pain. After reclassifying the respective caregiving activities, those involving body repositioning and those mainly performed in a static position showed significant associations.ConclusionsLow back pain in female family caregivers negatively affects their daily activities and certain caregiving activities are involved in the development of low back pain.Relevance to clinical practiceClinical nurses understand the situation of female caregivers and could prevent the development of low back pain with early intervention by providing adequate strategies to alleviate the burden of identified care activities related to low back pain.
RETRACTED: Melatonin inhibits the sphingosine kinase 1/sphingosine‐1‐phosphate signaling pathway in rabbits with fulminant hepatitis of viral origin
Authors: Crespo Irene , San‐Miguel Beatriz , Sánchez Diana I. , González‐Fernández Bárbara , Álvarez Marcelino , González‐Gallego Javier , Tuñón María J. 
Published: April 2016

AbstractThe sphingosine kinase (SphK)1/sphingosine‐1‐phosphate (S1P) pathway is involved in multiple biological processes, including liver diseases. This study investigate whether modulation of the SphK1/S1P system associates to the beneficial effects of melatonin in an animal model of acute liver failure (ALF) induced by the rabbit hemorrhagic disease virus (RHDV). Rabbits were experimentally infected with 2 × 104 hemagglutination units of a RHDV isolate and received 20 mg/kg of melatonin at 0, 12, and 24 hr postinfection. Liver mRNA levels, protein concentration, and immunohistochemical labeling for SphK1 increased in RHDV‐infected rabbits. S1P production and protein expression of the S1PR1 receptor were significantly elevated following RHDV infection. These effects were significantly reduced by melatonin. Rabbits also exhibited increased expression of toll‐like receptor (TLR)4, tumor necrosis factor alpha (TNF‐α), interleukin (IL)‐6, nuclear factor‐kappa B (NF‐κB) p50 and p65 subunits, and phosphorylated inhibitor of kappa B (IκB)α. Melatonin administration significantly inhibited those changes and induced a decreased immunoreactivity for RHDV viral VP60 antigen in the liver. Results obtained indicate that the SphK1/S1P system activates in parallel to viral replication and the inflammatory process induced by the virus. Inhibition of the lipid signaling pathway by the indole reveals novel molecular pathways that may account for the protective effect of melatonin in this animal model of ALF, and supports the potential of melatonin as an antiviral agent.
The scale of local adaptation in Mimulus guttatus: comparing life history races, ecotypes, and populations
Authors: DeMarche Megan L. , Kay Kathleen M. , Angert Amy L. 
Published: April 2016

Summary

Fitness trade‐offs between environments are central to the evolution of biodiversity. Although transplant studies often document fitness trade‐offs consistent with local adaptation (LA), many have also found an advantage of foreign genotypes (foreign advantage (FA)). Understanding the mechanisms driving the magnitude and distribution of fitness variation requires comparative approaches that test the ecological scales at which these different patterns emerge.

We used a common garden transplant experiment to compare the relative fitnesses of native vs foreign genotypes at three nested ecological scales within Mimulus guttatus: annual vs perennial life history races, perennial ecotypes across an elevational range, and populations within perennial elevational ecotypes. We integrated fitness across the life‐cycle and decomposed LA vs FA into contributions from different fitness components.

We found LA, measured as home‐site advantage, between annual and perennial races and a trend towards LA among populations within montane habitats. Conversely, we found strong FA of low‐elevation perennials in a montane environment.

LA between life history races reflects the fitness advantages of adult survival and vegetative growth in a mesic environment. Within the perennial race, recent climate conditions or nonselective processes, such as dispersal limitation or mutational load, could explain FA of low‐elevation perennials in a montane environment.
An improved approach for measuring the impact of multiple CO2 conductances on the apparent photorespiratory CO2 compensation point through slope–intercept regression
Authors: Walker Berkley J. , Skabelund Dane C. , Busch Florian A. , Ort Donald R. 
Published: April 2016

AbstractBiochemical models of leaf photosynthesis, which are essential for understanding the impact of photosynthesis to changing environments, depend on accurate parameterizations. One such parameter, the photorespiratory CO2 compensation point can be measured from the intersection of several CO2 response curves measured under sub‐saturating illumination. However, determining the actual intersection while accounting for experimental noise can be challenging. Additionally, leaf photosynthesis model outcomes are sensitive to the diffusion paths of CO2 released from the mitochondria. This diffusion path of CO2 includes both chloroplastic as well as cell wall resistances to CO2, which are not readily measurable. Both the difficulties of determining the photorespiratory CO2 compensation point and the impact of multiple intercellular resistances to CO2 can be addressed through application of slope–intercept regression. This technical report summarizes an improved framework for implementing slope–intercept regression to evaluate measurements of the photorespiratory CO2 compensation point. This approach extends past work to include the cases of both Rubisco and Ribulose‐1,5‐bisphosphate (RuBP)‐limited photosynthesis. This report further presents two interactive graphical applications and a spreadsheet‐based tool to allow users to apply slope–intercept theory to their data.
Napkin psoriasis
Authors: Afsar Fatma Sule , Uysal Sila Seremet , Salis Fatma Muderrisoglu , Calli Aylin Orgen 
Published: April 2016

AbstractNapkin psoriasis is a variant of psoriasis and is characterized by macerated, sharply demarcated, and bright erythematous plaques that can also spread to other areas of the body, especially in infancy. Given that differential diagnosis and treatment can be a challenge, we present and discuss the case of a 5½‐month‐old boy diagnosed with napkin psoriasis clinically and on histopathology.
Evaluation of engraftment syndrome in children following full‐matched related donor hematopoietic stem cell transplantations
Authors: İleri Talia , Ünal İnce Elif , Çakmaklı Hasan , Uysal Zümrüt , Gençtürk Zeynep , Ertem Mehmet 
Published: April 2016

AbstractThe term “ES” has been widely used for describing a clinical condition consisting of skin rash, fever, and weight gain that occur during neutrophil recovery period following HSCT. In this study, the incidence, clinical features, risk factors, and outcomes of ES were evaluated in 169 children following allogeneic HSCT from full‐matched related donor according to the Spitzer criteria. Seventeen patients (10.1%) presented with clinical conditions suggesting ES. In both univariate and multivariate analysis underlying malignant disease and early release of monocytes to the PB, and in univariate analysis using only CsA for GVHD prophylaxis were found to be the significant risk factors for the development of ES. Patients with ES experienced significantly higher incidence of acute and chronic GVHD and propensity toward a higher rate of TRM. OS did not differ between the patient groups. Thirteen of 17 patients received steroid therapy, and all but one patient responded to therapy. Monitoring for early detection of ES and early intervention with steroid therapy is the key for recovery. The most crucial approach for this purpose mainly is to find out and use the most useful and feasible diagnostic criteria for routine medical practice.
Mixed‐Status Families and WIC Uptake: The Effects of Risk of Deportation on Program Use*
Authors: Vargas Edward D. , Pirog Maureen A. 
Published: April 2016

ObjectiveDevelop and test measures of risk of deportation and mixed‐status families on women, infants, and children (WIC) uptake. Mixed‐status is a situation in which some family members are U.S. citizens and other family members are in the United States without proper authorization.MethodsEstimate a series of logistic regressions to estimate WIC uptake by merging data from the Fragile Families and Child Wellbeing Survey with deportation data from U.S. Immigration Customs and Enforcement.ResultsThe findings of this study suggest that risk of deportation is negatively associated with WIC uptake and among mixed‐status families; Mexican‐origin families are the most sensitive when it comes to deportations and program use.ConclusionOur analysis provides a typology and framework to study mixed‐status families and evaluate their usage of social services by including an innovative measure of risk of deportation.
On the Nature and Structure of Self‐Interest, Morality and Practical Reasoning
Authors: Temkin Larry S. 
Published: April 2016

AbstractThis article is divided into two main sections. In section 1, I highlight some of the most significant results of Parfit's discussion of self‐defeating theories in Part I of Reasons and Persons. I then argue, against Parfit, that, depending on the nature of the good, the structure of consequentialist, or agent‐neutral, theories does not preclude the possibility that such theories may be (seriously) self‐defeating. In section 2, I discuss Parfit's ingenious argument against the self‐interest theory, to the effect that as a “hybrid” theory, which is “partial” with respect to people but “neutral” with respect to time, the self‐interest theory occupies a dangerous middle ground that is open to attack from two sides: on one side, by a “pure” theory that is partial with respect to both people and times, and on the other side, by a “pure” theory that is neutral with respect to both people and times. I then raise doubts, prompted by the form of Parfit's argument, as to whether there is a general requirement that we treat people, places and times the same, except, perhaps, in cases involving special relations. Specifically, I suggest that there may be reason to treat space differently than time, and that there are compelling reasons to treat persons differently than time.
Transfusion in adults: 10‐year survival of red cell, plasma and platelet recipients following transfusion
Authors: Morley S. L. , Hudson C. L. , Llewelyn C. A. , Wells A. W. , Johnson A. L. , Williamson L. M. ,   for the EASTR study group
Published: April 2016

SUMMARYObjectiveTo determine the long‐term survival of adult recipients (>16 years) transfused with red blood cells (RBC), platelets (PLT) and fresh frozen plasma (FFP) in England and Wales.Study design and methodsThe EASTR study (Epidemiology and Survival of Transfusion Recipients) was a national multi‐centre epidemiological study with cross‐sectional sampling from 29 representative hospitals in England supplied by NHS Blood and Transplant (NHSBT). Three separate groups of RBC (n = 9142), FFP (n = 4232) and PLT (3584) recipients were sampled over 1 year (1 October 2001–30 September 2002), with prospective survival monitoring for 10 years. This study presents the data for adult recipients (>16 years of age).ResultsThe median age interquartile range (IQR) of adult transfusion recipients was RBC 70 (54–79), FFP 66 (51–76), PLT 62 (48–72). The 10‐year survival for adult RBC, FFP and PLT recipients was highest for RBC recipients at 36% confidence interval (CI 35–37%, n = 8675), compared with 30% for both FFP (CI 29–32%, n = 3849) and PLT (CI 28–30%, n = 3110) recipients. In all groups, post‐transfusion survival decreased with age, and a risk‐adjusted analysis showed that reason for transfusion, transfusion type (surgical or medical) and cancer diagnosis (presence or absence) were all significantly associated with survival. Older patients with cancer receiving a medical rather than surgical transfusion had the highest hazard of death.ConclusionThis study shows that survival following transfusion in England is broadly similar to that reported in other wealthy nations. More than 70% of recipients die within 10 years of transfusion, but long‐term survival is common in younger patients (>80% 10‐year survival in RBC recipients aged 16–39 years).
Effect of calcium and vitamin D on growth, rickets and Kashin–Beck disease in 0‐ to 5‐year‐old children in a rural area of central Tibet
Authors: Rooze Shancy , Mathieu Françoise , Claus William , Yangzom Tashi , Yangzom Dikki , Goyens Philippe , de Maertelaer Viviane 
Published: April 2016

AbstractObjectiveTo evaluate the effect of calcium (15 mmol/day) and vitamin D (625 μg/month), as single supplement or in combination, vs. no supplement on growth, clinical signs of rickets and Kashin–Beck disease (KBD) and dental health.MethodsProspective controlled trial involving children aged 0–5 years living in four groups of villages in a KBD‐endemic rural area of central Tibet who received either calcium and/or vitamin D or no supplement. The cohort was followed over 3 years. Primary outcome was the impact of the different supplementation regimes on KBD, rickets and growth; secondary outcomes were impact on urinary levels of calcium and phosphorus, biomarkers of bone and cartilage turnover, and dental health.ResultsNo difference was observed between the four groups with regard to anthropometric data, rickets, KBD, urinary levels of CrossLaps® and CartiLaps®. Weight for height or age, mid‐upper arm circumference and skinfold thickness decreased in the four groups. Height for age increased and the prevalence of KBD fell in the four groups. Dental health was better in the group receiving calcium and vitamin D. Urinary calcium levels increased after 3 years of follow‐up in all groups; the group receiving vitamin D had a higher increase (P‐value: 0.044). The same global increase was observed for urinary phosphorus levels; the group receiving calcium had a higher increase (P‐value: 0.01).ConclusionsCalcium and vitamin D failed to improve growth and bone metabolism of children living in a KBD‐endemic rural area. Calcium and vitamin D supplementation improved dental health.
Whole blood for hemostatic resuscitation of major bleeding
Authors: Spinella Philip C. , Pidcoke Heather F. , Strandenes Geir , Hervig Tor , Fisher Andrew , Jenkins Donald , Yazer Mark , Stubbs James , Murdock Alan , Sailliol Anne , Ness Paul M. , Cap Andrew P. 
Published: April 2016

Recent combat experience reignited interest in transfusing whole blood (WB) for patients with life‐threatening bleeding. US Army data indicate that WB transfusion is associated with improved or comparable survival compared to resuscitation with blood components. These data complement randomized controlled trials that indicate that platelet (PLT)‐containing blood products stored at 4°C have superior hemostatic function, based on reduced bleeding and improved functional measures of hemostasis, compared to PLT‐containing blood products at 22°C.WB is rarely available in civilian hospitals and as a result is rarely transfused for patients with hemorrhagic shock. Recent developments suggest that impediments to WB availability can be overcome, specifically the misconceptions that WB must be ABO specific, that WB cannot be leukoreduced and maintain PLTs, and finally that cold storage causes loss of PLT function. Data indicate that the use of low anti‐A and anti‐B titer group O WB is safe as a universal donor, WB can be leukoreduced with PLT‐sparing filters, and WB stored at 4°C retains PLT function during 15 days of storage. The understanding that these perceived barriers are not insurmountable will improve the availability of WB and facilitate its use. In addition, there are logistic and economic advantages of WB‐based resuscitation compared to component therapy for hemorrhagic shock. The use of low‐titer group O WB stored for up to 15 days at 4°C merits further study to compare its efficacy and safety with current resuscitation approaches for all patients with life‐threatening bleeding.