bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reflection on the cause and avoidance of recurrent venous leg ulcers: An interpretive descriptive approach
Authors: Stewart Ann , Edwards Helen , Finlayson Kathleen 
Published: August 2017

Aims and objectivesTo gain insight into the experience of recurrent venous leg ulcers from the individual's perspective and provide knowledge on potential risks of recurrence not previously investigated.BackgroundVenous leg ulcers are a consequence of chronic venous disease and frequently recur. They are costly and can impact on physical and psychological health. Despite research suggesting the risk can be reduced through compression and lifestyle changes, recurrence rates are often high. This study provides an insight into individual's perceptions of the cause of their ulcers and how they try to avoid them.DesignA qualitative design guided by the Chronic Illness Trajectory Model and Social Cognitive Theory.MethodA purposive sample of three males and four females were recruited from a community nursing clinic. Participants were ulcer free, had experienced at least two previous venous leg ulcers and could speak and comprehend English. An interpretive descriptive approach was taken using semi‐structured interviews and thematic analysis.ResultsThree themes each containing three categories emerged: The Increasing Influence of the Recurring Wound on Mind and Body, Reflection on Past Experiences and Optimism in the Face of Adversity. Most participants reported traumatic injury and lower leg surgery triggered ulcer recurrence. Failure to replace compression stockings was also deemed a cause. Compression was reported essential, but some participants were unaware of the level they were wearing and how often it should be replaced. Other preventive activities included avoiding injury and securing immediate assistance if wounding occurred.ConclusionClinicians need to be aware that lower leg surgery may trigger recurrent venous ulceration and that individuals require ongoing emotional, physical and financial support throughout the trajectory of venous disease. The continued use of old compression stockings should be avoided and recurrence prevented by adoption of evidence‐based practice rather than reflection on past experiences.Relevance to clinical practiceThis research raises the awareness of factors from the individual’s perspective which can influence the recurrence of venous leg ulcers.
Are characteristics of team members important for quality management of chronic patients at primary care level?
Authors: Klemenc‐Ketis Zalika , Poplas‐Susič Antonija 
Published: August 2017

Aims and objectivesTo determine the possible associations between higher levels of selected quality indicators and the characteristics of providers.BackgroundIn 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians’ working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full‐time equivalents. This was an example of a personalised team approach to managing chronic patients.MethodsWe included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data.ResultsThere were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty‐six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator “Examination of diabetic foot once per year” was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit.ConclusionsCharacteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients.Relevance to clinical practiceThe quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements.
Lesbian, gay and bisexual parents’ experiences of nurses’ attitudes in child health care—A qualitative study
Authors: Andersen Anna‐Eva , Moberg Catherine , Bengtsson Tops Anita , Garmy Pernilla 
Published: August 2017

Aims and objectivesTo describe lesbian, gay and bisexual parents’ experiences of nurses′ attitudes in child healthcare.BackgroundLesbian, gay and bisexual people are often reluctant to disclose their gender identity for fear of discrimination. This fear may lead to avoidance of healthcare for themselves or their children and may negatively affect families’ health and well‐being.DesignA qualitative inductive design was employed.MethodsSemistructured interviews were conducted with 14 lesbian, gay or bisexual parents (11 mothers and three fathers) with child health care experiences in southern Sweden. Interviews were analysed using qualitative content analysis.ResultsTwo themes were identified. One, a “sense of marginalisation,” included lesbian, gay and bisexual parents’ experiences of heteronormative attitudes among child healthcare nurses which led them to feel alienated and questioned as parents. Another, “being respected for who you are,” included experiences of being respected and included at child healthcare appointments.ConclusionsFindings paint a complex picture of lesbian, gay and bisexual parents’ interactions with child healthcare nurses in that they experienced both positive and negative attitudes. Knowledge gaps about lesbian, gay and bisexual families within the child healthcare field must be filled.Relevance to clinical practiceChild health care nurses should work with the entire family to provide the best care for the child; however, discrimination in health care is common and often caused by a lack of knowledge. The number of children living with same‐sex parents has increased more than ten‐fold since the end of the 1990s. It is therefore important to explore lesbian, gay and bisexual parents’ experiences with child healthcare nurses’ attitudes to improve quality of care.
Transitioning into new clinical areas of practice: An integrative review of the literature
Authors: Kinghorn Grant R , Halcomb Elizabeth J , Froggatt Terry , Thomas Stuart DM 
Published: August 2017

Aims and objectivesTo critically synthesise research related to the transition of registered nurses into new areas of clinical practice.BackgroundGlobal workforce shortages and rising healthcare demands have encouraged registered nurses to move into new clinical settings. While a body of literature reports on the transition of newly qualified nurses, evidence surrounding the transition of more experienced registered nurses to new clinical areas remains poorly explored.DesignAn integrative review was conducted, guided by Whittemore and Knafl (Journal of Advanced Nursing,52, 2005, 546) framework.MethodsAn electronic database search was conducted for papers published between 1996–2016. Papers were then subjected to a methodological quality appraisal, with findings synthesised using thematic analysis into core themes.ResultsTen articles met the inclusion criteria. Three themes emerged, namely Support, Professional Development and Emotional Impact. These themes suggest that transitioning nurses experience challenges in adapting to new clinical areas and developing necessary skills. Such challenges prompted various emotional and physical responses. While formal and informal support systems were regarded as valuable by transitioning nurses, they were inconsistent across the new clinical areas.ConclusionsThere is some evidence to highlight the initial shock and emotional stress experienced by registered nurses during transition to a new clinical area. However, the influence of formal and informal support systems for such registered nurses is far from conclusive. Further research is needed, to examine registered nurse transition into a variety of clinical areas to inform workforce support, policy and practices.Relevance to clinical practiceThe demand of health care is growing while global shortages of nursing workforce remain. To ensure retention and enhance the transition experience of registered nurses, it is important for nurse leaders, managers and policymakers to understand the transition experience and factors that impact this experience.
Factors that influence care priority for chest pain patients using the manchester triage system
Authors: Nonnenmacher Carine Lais , Pires Ananda Ughini Bertoldo , Moraes Vítor Monteiro , Lucena Amália de Fátima 
Published: August 2017

Aims and objectivesTo analyse crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System.BackgroundTriage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis.DesignRetrospective cohort study with 217 patients in the emergency department of a Brazilian hospital.MethodsData were collected from patients' records with a primary diagnosis of myocardial infarction, from March 2014–February 2015. Patients were divided into two groups for statistical analysis: high priority (immediate and very urgent) and low priority (urgent, standard and nonurgent).ResultsMost of the patients were male, with a mean age of 62.1 years, with a prevalence of high blood pressure and smoking as risk factors. Lower care priority level was assigned to 116 (53.4%) patients. Sixty‐four (29.5%) patients had ST‐segment elevation acute myocardial infarction, and 29 (45.3%) of these patients were assigned lower care priority level. Coughing, abdominal pain, onset of symptoms over 24 hr ago and pain of mild to moderate intensity were clinical predictors associated with lower care priority level. Sweating and high blood pressure were associated with high care priority level. Lower care priority level was associated with increased door‐to‐electrocardiogram and door‐to‐troponin times. There was no significant difference between the two groups for door‐to‐needle and door‐to‐balloon times.ConclusionsMost of the patients with myocardial infarction were classified as low care priority, showing triage failure either due to symptom variability or need for professional qualification in clinical data collection and interpretation.Relevance to clinical practiceThe results may support clinical evaluation, bringing chest pain assessment into focus.
Innovation across cities
Authors: Soo Kwok Tong 
Published: August 2017

AbstractThis paper examines the distribution of patenting activity across cities in the OECD, using a sample of 218 cities from 2000 to 2008. We obtain three main results. First, patenting activity is more concentrated than population and GDP. Second, patenting activity is less persistent than population and GDP, especially in the middle of the distribution. Third, in a parametric model, patenting does not exhibit mean‐reversion, and is positively associated with GDP and population density. Our results suggest that policymakers can influence the amount of innovative activity through the use of appropriate policies.
Melatonin reduces inflammatory response in peripheral T helper lymphocytes from relapsing‐remitting multiple sclerosis patients
Authors: Álvarez‐Sánchez Nuria , Cruz‐Chamorro Ivan , Díaz‐Sánchez María , Sarmiento‐Soto Helia , Medrano‐Campillo Pablo , Martínez‐López Alicia , Lardone Patricia J. , Guerrero Juan M. , Carrillo‐Vico Antonio 
Published: August 2017

AbstractMultiple sclerosis (MS) is a neuroinflammatory disease of the central nervous system in which the immune system plays a central role. In particular, effector populations such as T helper (Th) 1, Th9, Th17, and Th22 cells are involved in disease development, whereas T regulatory cells (Tregs) are associated with the resolution of the disease. Melatonin levels are impaired in patients with MS, and exogenous melatonin ameliorates the disease in MS animal models by modulating the Th1/Th17/Treg responses and also improves quality of life and several symptoms in patients with MS. However, no study has examined melatonin's effect on T cells from relapsing‐remitting MS (RR‐MS) patients. Therefore, the objectives of the present study were to evaluate the effects of the in vitro administration of melatonin to peripheral blood mononuclear cells (PBMCs) from 64 RR‐MS patients and 64 sex‐ and age‐matched healthy subjects on Th1, Th9, Th17, Th22, and Treg responses and to analyze the expression of the melatonin effector/receptor system in these cells. Melatonin decreased Th1 and Th22 responses in patients, whereas it did not affect the Th17 and Treg subsets. Melatonin also promoted skewing toward a more protective cytokine microenvironment, as shown by an increased anti‐inflammatory/Th1 ratio. Furthermore, for the first time, we describe the overexpression of the melatonin effector/receptor system in PBMCs from patients with MS; this alteration might be relevant to the disease because acetylserotonin O‐methyltransferase expression significantly correlates with disease progression and T effector/regulatory responses in patients. Therefore, our data suggest that melatonin may be an effective treatment for MS.
The messenger matters: Pollinator functional group influences mating system dynamics
Authors: Weber Jennifer J. 
Published: August 2017

The incredible diversity of plant mating systems has fuelled research in evolutionary biology for over a century. Currently, there is broad concern about the impact of rapidly changing pollinator communities on plant populations. Very few studies, however, examine patterns and mechanisms associated with multiple paternity from cross‐pollen loads. Often, foraging pollinators collect a mixed pollen load that may result in the deposition of pollen from different sires to receptive stigmas. Coincident deposition of self‐ and cross‐pollen leads to interesting mating system dynamics and has been investigated in numerous species. But, mixed pollen loads often consist of a diversity of cross‐pollen and result in multiple sires of seeds within a fruit. In this issue of Molecular Ecology, Rhodes, Fant, and Skogen () examine how pollinator identity and spatial isolation influence multiple paternity within fruits of a self‐incompatible evening primrose. The authors demonstrate that pollen pool diversity varies between two pollinator types, hawkmoths and diurnal solitary bees. Further, progeny from more isolated plants were less likely to have multiple sires regardless of the pollinator type. Moving forward, studies of mating system dynamics should consider the implications of multiple paternity and move beyond the self‐ and cross‐pollination paradigm. Rhodes et al. () demonstrate the importance of understanding the roles that functionally diverse pollinators play in mating system dynamics.
Transcriptomic basis of genome by genome variation in a legume‐rhizobia mutualism
Authors: Burghardt Liana T. , Guhlin Joseph , Chun Chan Lan , Liu Junqi , Sadowsky Michael J. , Stupar Robert M. , Young Nevin D. , Tiffin Peter 
Published: August 2017

AbstractIn the legume‐rhizobia mutualism, the benefit each partner derives from the other depends on the genetic identity of both host and rhizobial symbiont. To gain insight into the extent of genome × genome interactions on hosts at the molecular level and to identify potential mechanisms responsible for the variation, we examined host gene expression within nodules (the plant organ where the symbiosis occurs) of four genotypes of Medicago truncatula grown with either Ensifer meliloti or E. medicae symbionts. These host × symbiont combinations show significant variation in nodule and biomass phenotypes. Likewise, combinations differ in their transcriptomes: host, symbiont and host × symbiont affected the expression of 70%, 27% and 21%, respectively, of the approximately 27,000 host genes expressed in nodules. Genes with the highest levels of expression often varied between hosts and/or symbiont strain and include leghemoglobins that modulate oxygen availability and hundreds of Nodule Cysteine‐Rich (NCR) peptides involved in symbiont differentiation and viability in nodules. Genes with host × symbiont‐dependent expression were enriched for functions related to resource exchange between partners (sulphate/iron/amino acid transport and dicarboxylate/amino acid synthesis). These enrichments suggest mechanisms for host control of the currencies of the mutualism. The transcriptome of M. truncatula accession HM101 (A17), the reference genome used for most molecular research, was less affected by symbiont identity than the other hosts. These findings underscore the importance of assessing the molecular basis of variation in ecologically important traits, particularly those involved in biotic interactions, in multiple genetic contexts.
Deciphering the origin of mito‐nuclear discordance in two sibling caddisfly species
Authors: Weigand Hannah , Weiss Martina , Cai Huimin , Li Yongping , Yu Lili , Zhang Christine , Leese Florian 
Published: August 2017

AbstractAn increasing number of phylogenetic studies have reported discordances among nuclear and mitochondrial markers. These discrepancies are highly relevant to widely used biodiversity assessment approaches, such as DNA barcoding, that rely almost exclusively on mitochondrial markers. Although the theoretical causes of mito‐nuclear discordances are well understood, it is often extremely challenging to determine the principal underlying factor in a given study system. In this study, we uncovered significant mito‐nuclear discordances in a pair of sibling caddisfly species. Application of genome sequencing, ddRAD and DNA barcoding revealed ongoing hybridization, as well as historical hybridization in Pleistocene refugia, leading us to identify introgression as the ultimate cause of the observed discordance pattern. Our novel genomic data, the discovery of a European‐wide hybrid zone and the availability of established techniques for laboratory breeding make this species pair an ideal model system for studying species boundaries with ongoing gene flow.
Long‐term outcome of dogs treated with ulnar rollover transposition for limb‐sparing of distal radial osteosarcoma: 27 limbs in 26 dogs
Authors: Séguin Bernard , O'Donnell Matthew D. , Walsh Peter J. , Selmic Laura E. 
Published: August 2017

AbstractObjectiveTo determine outcomes in dogs with distal radial osteosarcoma treated with ulnar rollover transposition (URT) limb‐sparing surgery including: viability of the ulnar graft, complications, subjective limb function, disease‐free interval (DFI), and survival time (ST).Study designRetrospective case series.AnimalsTwenty‐six client‐owned dogs with distal radial osteosarcoma and no involvement of the ulna.MethodsData of dogs treated with URT were collected at the time of surgery and retrospectively from medical records and by contacting owners and referring veterinarians.ResultsURT technique was performed on 27 limbs in 26 dogs. The ulnar graft was determined to be viable in 17 limbs, nonviable in 3, and unknown in 7. Complications occurred in 20 limbs. Infection was diagnosed in 12 limbs. Biomechanical complications occurred in 15 and local recurrence in 2 limbs. Limb function graded by veterinarians or owners was poor in 2 limbs, fair in 4, good in 14, excellent in 3, and unknown in 4. Median DFI was 245 days and median ST was 277 days.ConclusionThe URT technique maintained the viability of the ulnar graft. The complication rate was high but limb function appeared acceptable. Although sufficient length of the distal aspect of the ulna must be preserved to perform this technique, local recurrence was not increased compared to other limb‐sparing techniques when cases were appropriately selected.
The attitudes of recently‐arrived Polish migrants to Irish English
Authors: DISKIN CHLOÉ , REGAN VERA 
Published: August 2017

ABSTRACTThis article presents a case study of six Polish migrants residing in Dublin, Ireland and examines their language ideologies through an analysis of the metalinguistic discourse surrounding Irish English, world Englishes, and notions of ‘standardness’ that arose in the course of six extended interviews in 2012. Adapting Bucholtz and Hall's concept of markedness or ‘hierarchical structuring of difference’, this study structures the migrants’ views towards world Englishes as operating along two axes of markedness and desirability. Overall, the migrants exhibit three broadly differing views of Irish English: positive, negative and ambivalent, and at times explicitly articulate their views in comparison with those of traditional Inner Circle varieties, such as British and American English.
Encapsulating Irish English in literature
Authors: AMADOR‐MORENO CAROLINA P. , TERRAZAS‐CALERO ANA MARÍA 
Published: August 2017

ABSTRACTThis article examines the representation of Irish English in contemporary Irish writing, with particular reference to the narrative of the Ross O'Carroll‐Kelly saga, a series of comic novels created by Irish writer Paul Howard which has enjoyed phenomenal success in Ireland, due in part to the author's ability to convey contemporary spoken English in Dublin. Our study consists of a corpus analysis of three of his novels, where we are able to describe a number of key stylistic features which are distinctive of Howard's representation of Irish English, including the variable use of such discourse markers as like, roysh and yeah + no, as well as the use of the intensifying so.