bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association of HLA B*15:02 allele and Stevens–Johnson syndrome/toxic epidermal necrolysis induced by aromatic anticonvulsant drugs in a South Indian population
Authors: Devi Keerankulangara 
Published: October 2017

AbstractBackgroundThe presence of HLA‐B*15:02 allele is considered a risk factor for development of Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in patients taking aromatic anticonvulsant drugs like carbamazepine and phenytoin. The genetic association is ethnicity specific. Testing for HLA‐B*15:02 allele is suggested as a prerequisite before starting carbamazepine in certain ethnic groups. There are only a few/no studies from south India on HLA association of SJS/TEN.AimsTo identify any association between HLA‐B*15:02 allele and SJS/TEN induced by carbamazepine/phenytoin among native population.Methods (including settings, design, and statistical analysis used)A case–control study done in a tertiary care center at Kottayam in Kerala state of south India. Cases were 12 native patients who developed SJS/TEN owing to aromatic anticonvulsant drugs (phenytoin – 8; carbamazepine – 4), and controls were 11 persons tolerant to these drugs from unrelated families of the same ethnic group. HLA‐B typing was done by PCR SSP method.ResultsThere was only one HLA‐B*15:02 carrier among cases and controls. He/she had SJS/TEN induced by carbamazepine.ConclusionsAssociation of HLA‐B*15:02 with phenytoin‐induced SJS/TEN is rare in the population studied. The one limitation of the study was the small sample size.
Teaching children about good health? Halo effects in child‐directed advertisements for unhealthy food
Authors: Harris J. L. , Haraghey K. S. , Lodolce M. , Semenza N. L. 
Published: October 2017

SummaryBackgroundFood companies often use healthy lifestyle messages in child‐directed advertising, raising public health concerns about health halo effects for nutrient‐poor food/drinks.ObjectiveExamine effects of health messages promoting nutrient‐poor foods in child‐directed advertising.MethodsRandomized controlled experiment (N = 138). Children (7–11 years) viewed three child‐friendly commercials in one of three conditions: (1) health halo (unfamiliar nutrient‐poor food/drink ads with healthy messages); (2) nutrient‐poor food/drink ads with other messages and (3) healthy food/drink ads. They rated the commercials and advertised products, provided attitudes about exercise and nutrition and consumed and rated healthy and unhealthy snack foods.ResultsChildren in the health halo condition rated the advertised nutrient‐poor products as significantly healthier compared with children in other conditions (p = .003), but the other commercials did not affect children's attitudes about other advertised products (p's > .50). Child age, gender or TV viewing habits did not significantly predict their ratings (p's > .18). There was no evidence that healthy lifestyle messages and/or healthy food commercials improved children's attitudes about nutrition, exercise or healthy snack consumption.ConclusionPromoting healthy lifestyle messages in child‐directed commercials for nutrient‐poor food/drinks likely benefits brands by increasing products' perceived healthfulness, but these ads are unlikely to positively affect children's attitudes about health and nutrition.
Size effects of electrocaloric cooling in ferroelectric nanowires
Authors: Huang Houbing , Zhang Guangzu , Ma Xingqiao , Liang Deshan , Wang Jianjun , Liu Yang , Wang Qing , Chen Long‐Qing 
Published: October 2017

AbstractConsidering finite size effect, ferroelectric nanowires may show novel phenomena compared to ferroelectric thin film and bulk. Here we investigated the effect of width and surface compressive stress on electrocaloric cooling in ferroelectric nanowire by using thermodynamic calculations and phase‐field simulations. It was found that the isothermal entropy change and adiabatic temperature change in nanowire are 50% larger than that in thin film due to different mechanical boundary conditions of nanowire and thin film. The largest electrocaloric temperature changes were shown to increase significantly either with the decrease in nanowire width or the increase with the surface compressive stress. It was also revealed that the largest intrinsic entropy changes are almost the same for different nanowires with different widths and various stresses. The present study therefore contributes to the understanding of size effects of electrocaloric cooling and provides guidance for experiments to design high‐efficiency cooling devices using ferroelectric nanosystems.
Ferroelectric‐quasiferroelectric‐ergodic relaxor transition and multifunctional electrical properties in Bi0.5Na0.5TiO3‐based ceramics
Authors: Zhou Changrong , Li Qingning , Xu Jiwen , Yang Ling , Zeng Weidong , Yuan Changlai , Chen Guohua 
Published: October 2017

AbstractA‐site substituted 0.88(Bi0.5Na0.5)1−x(Li0.5Nd0.5)xTiO3–0.12BaTiO3 (BNTLNx–BT12) ceramics were synthesized using a conventional solid‐state reaction route. The structural transformation and miscellaneous electrical properties were systematically investigated. The A‐site modification induced two sequence transitions from ferroelectric tetragonal (T) to quasi‐ferroelectric pseudocubic (PC) phase, followed closely by the second transition from non‐ergodic to ergodic relaxor (NR‐ER), and finally to dynamic polar nanoregions (PNRs). The significant enhancement in piezoelectric activity, strain response, broad plateau‐like maximum dielectric permittivity over a large temperature range and energy‐storage level at different compositions may be attributed to the compositionally‐induced T‐PC to NR‐ER transition and the alignment of dynamically‐fluctuating PNRs, respectively. The evolution of multifunctional electrical properties, associated with the variations in structure/microstructure, might provide a new insight to investigate the underlying mechanism of structure‐electrical properties relationship in ferroelectric solid solutions.
Determination of crystal size distributions in alumina ceramics by a novel X‐ray diffraction procedure
Authors: Neher Sigmund H. , Klein Helmut , Kuhs Werner F. 
Published: October 2017

AbstractA novel X‐ray diffraction based method is presented, capable of determining volume‐based crystal size distribution (CSD) of polycrystalline materials and crystalline powders with unprecedented sampling statistics; the method is named fast X‐ray diffraction crystal size distribution analysis (FXD‐CSD).FXD‐CSDcan be performed with standard laboratory X‐ray diffractometers equipped with a position sensitive detector and uses a software package written in Python for the data analysis.FXD‐CSDis a destruction‐free and generally applicable method to establishCSDs of polycrystalline materials as well as powders for sizes well below 1 μm up to about 100 μm; it even allows for studies of samples enclosed in complex environments, e.g., for in situ measurements in a furnace or in a pressure cell. To show the capability of the method the microstructural evolution of four alumina substrates with different time‐spans of sintering (4, 8, 16, and 24 hour at 1600°C) is investigated viaFXD‐CSDandSEMimaging. The correspondingCSDs and average grain sizes are determined, results obtained byFXD‐CSDand the line‐intersection methods are compared and clear evidence for the presence of abnormal grain growth (AGG) during sintering is shown. From three tested probability density functions (PDF) describing theCSDs a log‐normalPDFfits best to the volume basedCSDs; the method provides size distributions with unprecedented precision opening the way to a systematic and meaningful comparison between theoretically predicted and observedCSDs.
Patient and public involvement in the design of clinical trials: An overview of systematic reviews
Authors: Price Amy , Albarqouni Loai , Kirkpatrick Jo , Clarke Mike , Liew Su May , Roberts Nia , Burls Amanda 
Published: October 2017

AbstractBackgroundFunders encourage lay‐volunteer inclusion in research. There are controversy and resistance, given concerns of role confusion, exploratory methods, and limited evidence about what value lay‐volunteers bring to research. This overview explores these areas.MethodsEleven databases were searched without date or language restrictions for systematic reviews of public and patient involvement (PPI) in clinical trials design. This systematic overview of PPI included 27 reviews from which areas of good and bad practice were identified. Strengths, weaknesses, opportunities, and threats of PPI were explored through use of meta‐narrative analysis.ResultsInclusion criteria were met by 27 reviews ranging in quality from high (n = 7), medium (n = 14) to low (n = 6) reviews. Reviews were assessed using CERQUAL NICE, CASP for qualitative research and CASP for systematic reviews. Four reviews report risk of bias. Public involvement roles were primarily in agenda setting, steering committees, ethical review, protocol development, and piloting. Research summaries, follow‐up, and dissemination contained PPI, with lesser involvement in data collection, analysis, or manuscript authoring. Trialists report difficulty in finding, retaining, and reimbursing volunteers. Respectful inclusion, role recognition, mutual flexibility, advance planning, and sound methods were reported as facilitating public involvement in research. Public involvement was reported to have increased the quantity and quality of patient relevant priorities and outcomes, enrollment, funding, design, implementation, and dissemination. Challenges identified include lack of clarity within common language, roles, and research boundaries, while logistical needs include extra time, training, and funding. Researchers report struggling to report involvement and avoid tokenism.ConclusionsInvolving patients and the public in clinical trials design can be beneficial but requires resources, preparation, training, flexibility, and time. Issues to address include reporting deficits for risk of bias, study quality, and conflicts of interests. We need to address these tensions and improve dissemination strategies to increase PPI and health literacy.
Palliative care for advanced dementia: Knowledge and attitudes of long‐term care staff
Authors: Chen I‐Hui , Lin Kuan‐Yu , Hu Sophia H , Chuang Yeu‐Hui , Long Carol O , Chang Chia‐Chi , Liu Megan F 
Published: October 2017

Aims and objectivesTo investigate the knowledge of and attitudes towards palliative care for advanced dementia and their associations with demographics among nursing staff, including nurses and nursing assistants, in long‐term care settings.BackgroundNursing facilities are places where persons with dementia die; therefore, providing quality end‐of‐life care to residents with advanced dementia is crucial. To date, little attention has been paid to palliative care practice for patients with advanced dementia.DesignA descriptive, cross‐sectional, survey design was used.MethodsIn total, a sample of 300 nurses (n = 125) and nursing assistants (n = 175) working in long‐term care settings in Taiwan participated in this study. Two instruments were administered: demographic characteristics and responses to the Questionnaire of Palliative Care for Advanced Dementia. Descriptive statistics and multiple regression were used for data analysis.ResultsOverall, the nurses and nursing assistants had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Additionally, nursing staff who were nurses with greater work experience and those who had received palliative care and hospice training had greater knowledge of palliative care. In addition, nursing staff who had received dementia care training and who had worked in nursing homes had higher levels of positive attitudes towards palliative care.ConclusionsThis study indicates the need to provide nurses and nursing assistants with more information about palliative care practice for people with advanced dementia. Particularly, providing education to those who are nursing assistants, who have less working experience, who have not received palliative and dementia care training, and who have not worked in nursing homes can improve overall nursing staff knowledge of and attitudes towards palliative care.Relevance to clinical practiceContinuing education in principles of palliative care for advanced dementia is necessary for currently practicing nursing staff and should be developed according to their educational background and needs.
The impact of primary nursing care pattern: Results from a before–after study
Authors: Dal Molin Alberto , Gatta Claudia , Boggio Gilot Chiara , Ferrua Rachele , Cena Tiziana , Manthey Marie , Croso Antonella 
Published: October 2017

Aims and objectivesTo explore the effect of “Primary Nursing” on nursing‐sensitive patient outcomes, staff‐related outcomes and organisation‐related outcomes.BackgroundPrimary nursing is one example of a care pattern that has recently been implemented in many countries.DesignBefore–after study.MethodsThis study was conducted in an Italian hospital. We observed patient‐related outcomes (pressure ulcers, falls, urinary tract infection and venous catheter infection) in 2,857 inpatients before the implementation of primary nursing and in 3,169 inpatients after its implementation. Staff‐related outcomes (nursing competence and diagnostic thinking) and organisation‐related outcomes (empowerment and team climate) were collected from 369 nurses. From a subgroup of inpatients, we collected data regarding their satisfaction with the care provided.ResultsAfter the implementation of primary nursing, some nursing competencies and diagnostic thinking were improved, so were organisation‐related outcomes. Our data showed that the number of inpatients with urinary catheter infections (5.5% vs. 4.3%) and venous catheter infections (peripheral: 2.2% vs. 1%; central: 5.6% vs. 1%) was significantly decreased; also, the numbers of falls (2.4% vs. 1.9%) and pressure ulcers (4.8% vs. 4%) decreased, although these decreases were not statistically significant. Overall, the implementation of primary nursing increased patient satisfaction with nursing care (193.57 vs. 210.21).ConclusionsPrimary nursing improved staff‐related outcomes, nursing‐sensitive patient outcomes and organisation outcomes.Relevance to clinical practiceOur results show that primary nursing has the potential to positively impact on inpatients, nurses and organisations. Moreover, the implementation of this care pattern is feasible.
Health literacy among caregivers of patients with heart failure: A multicentre cross‐sectional survey
Authors: Della Pelle Carlo , Orsatti Vincenzo , Cipollone Francesco , Cicolini Giancarlo 
Published: October 2017

Aims and objectivesTo assess the levels of health literacy of Italian caregivers of patients with heart failure.BackgroundHealth literacy is related to patients’ health outcomes. Low health literacy has been found in older people with heart failure, and less is known on the health literacy of caregivers whose patients are suffering from heart failure.DesignObservational, multicentre, cross‐sectional study.MethodsFrom July 2015–May 2016, caregivers were recruited in five hospitals from Central and Southern Italy. To assess health literacy, the Italian version of the Short Test of Functional Health Literacy tool was used.ResultsA total of 173 caregivers participated in the research, the majority being females (60.1%), aged between 46–60 years (52.6%) and 96 (55.5%) were from Central Italy. 33.5% of caregivers were patients’ children, and 16.2% were paid caregivers of foreign origins. The average level of health literacy was adequate; however, lower levels were found among patients’ spouses and those of older age.ConclusionOur results, in contrast with previous studies, showed adequate health literacy levels of caregivers. However, caregivers older in age and with a low education level showed the lowest health literacy, emphasising the need for healthcare workers, to check caregivers’ health literacy, before entrusting them with the care of patients.Relevance to clinical practiceAs this research gives, for the first time, an overview on Italian caregivers’ levels of health literacy, its results may be used to improve Italian healthcare professionals’ knowledge of caregivers’ health literacy, before entrusting them with the care of patients.
Benefits of the humidified low‐flow oxygen therapy in infants with mild–moderate bronchiolitis
Authors: Lorente Sánchez Sonia , Gimeno Rebeca , Losilla Josep‐Maria , Garzón Sandra , Vives Jaume 
Published: October 2017

Aims and objectivesTo investigate the clinical benefits of using humidification in low‐flow oxygen therapy. Specific objectives were to investigate via an assessment of the number of nasal lavages whether humidification can help to decrease the nasal mucus viscosity, to determine whether it can relieve feeding difficulties by comparing the weight gain in infants, to ascertain whether it can relieve respiratory distress by assessing the heart and respiratory rates and contribute to improved clinical outcomes, measured by the length of stay and oxygen requirements.BackgroundThere is no evidence to support the use of humidification in low‐flow oxygen therapy as a usual clinical practice in the management of bronchiolitis.DesignA controlled quasi‐experimental study.MethodsA total of 97 infants were included, aged ≤6 months, with bronchiolitis, low‐flow oxygen therapy and bronchodilators nebulised with hypertonic saline 3%. Data from the control group (nonhumidified) were gathered from 2010–2012 (49 infants), and data from the group with humidification from 2012–2014 (48 infants). Linear and Poisson regressions were performed adjusting for relevant characteristics of patients.ResultsHumidification was shown to be associated with significant reductions in the number of nasal lavages in infants with Sant Joan de Déu Bronchiolitis Scores of BROSJOD≤7, in the heart rate of infants with mixed bronchodilators treatment, and in the length of stay and oxygen requirements of infants with Score BROSJOD≤5. No differences in weight and respiratory rate were found.ConclusionsHumidification in low‐flow oxygen therapy is an effective nursing intervention to improve the clinical outcomes of infants with mild–moderate bronchiolitis.Relevance to clinical practiceHumidifying the nasal mucosa can help to reduce the need for professional procedures, oxygen requirements and hospitalisation length. Further research into the economic savings involved is recommended.
Registered nurses’ perceptions of safe care in overcrowded emergency departments
Authors: Eriksson Julia , Gellerstedt Linda , Hillerås Pernilla , Craftman Åsa G 
Published: October 2017

Aims and objectivesTo explore registered nurses’ perceptions of safe practice in care for patients with an extended length of stay in the emergency department.BackgroundExtended length of stay and overcrowding in emergency departments are described internationally as one of the most comprehensive challenges of modern emergency care. An emergency department is not designed, equipped or staffed to provide care for prolonged periods of time. This context, combined with a high workload, poses a risk to patient safety, with additional medical errors and an increased number of adverse events. From this perspective, it is important to extend our knowledge and to describe registered nurses’ experiences of safe practice.DesignA qualitative, inductive and descriptive study.MethodsQualitative interview study carried out in five emergency departments. Data were analysed using a qualitative content analysis with a latent approach.ResultsPatient safety meets obstacles in the clinical environment involving experiencing deficiencies regarding patient safety in the clinical setting and the impact of working procedures and routines. Moreover, nurses are challenged in their professional responsibilities involving balancing essential nursing care and actual workload; it is common to experience emotional reactions based on feelings of loss of control.ConclusionsFrom the nurses’ perspective, a prolonged stay in the emergency department may lead to negative consequences for both patient safety and care as well as registered nurses’ psychosocial experiences. An extended length of stay significantly reduces the level of nursing and caring that registered nurses can perform in the emergency department.Relevance to clinical practiceThis study indicates that emergency departments should review their procedures to avoid both deviations from normal practice and moral stress among registered nurses. This can contribute to an increased understanding and insight about the challenge of patient safety in an emergency department setting.
Clinical leadership and nursing explored: A literature search
Authors: Stanley David , Stanley Karen 
Published: October 2017

Aims and objectivesTo explore what we know of the concept of clinical leadership and what the term means. Clues to the definition of clinical leadership, the attributes of effective and less effective clinical leaders, models of clinical leadership and the barriers that hinder clinical leadership development were explored.BackgroundWhile nursing leadership and healthcare leadership are terms that have been evident in nursing and health industry literature for many decades, clinical leadership is a relatively new term and is may still be misunderstood.DesignA search was undertaken of formal and informal literature using a library database and a range of search engines for the words “clinical leadership” and “clinical leadership in nursing.” In each case, the full search parameters were employed with searches between 1974–2016. Full‐text articles were requested, and English was the preferred language.ResultsIn total, 3,259 publications were located through seven database search tools, although these included a large number of duplications. Following further informal searches and removing irrelevant material, 27 research or literature review focused papers were retained that included 17 qualitative studies, one quantitative study, one mixed method study, one Delphi study and two that compared other research studies. As well, five literature reviews were retained in the synthesis. The data synthesis resulted five categories: definitions of clinical leadership, characteristics most likely or least associated with clinical leadership, models applied to clinical leadership and limits to clinical leadership development.ConclusionClinical leaders are recognised for having their values and beliefs parallel their actions and interventions. They are found across the spectrum of health organisations, often at the highest level for clinical interaction, but not commonly at the highest management level in a ward or unit team and they are seen in all clinical environments.Relevance to clinical practiceClinical Leadership and an understanding on how clinical leaders contribute to the health service is central to the application of values‐based practice and how clinical leaders impact on innovation, change and making care better.