bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personalised discharge care planning for postmyocardial infarction patients through the use of the Personalised Patient Education Protocol – implementing theory into practice
Authors: Lau‐Walker Margaret , Landy Anne , Murrells Trevor 
Published: March 2016

Aims and objectivesThis study aims to evaluate the service impact of the integration of an evidence‐based instrument – the Personalised Patient Education Protocol – into an existing postmyocardial infarction care pathway.BackgroundRecent research indicates that while better patient health outcomes can be achieved when care planning is personalised, delivery staff feel less satisfied and less confident in its provision. To achieve a shift to personalised care, innovations are needed to enable an effective transition for staff.DesignA service evaluation using a patient survey and nurse interviews.MethodA longitudinal patient survey measured changes in patient illness beliefs, cardiac diet and exercise self‐efficacy, anxiety, depression and quality of life study of a patient cohort of 74. Paired t‐tests analysed the effects before and after the implementation of the Personalised Patient Education Protocol. Cardiac rehabilitation nurses who implemented the Personalised Patient Education Protocol were interviewed and a patient survey identified perceptions of the usefulness of the service innovation.ResultsAnalysis of change from baseline to three months results showed statistically significant changes in Illness Belief component ‘Understanding’ and the Dartmouth Quality of Life ‘General Health’. The integration of the Personalised Patient Education Protocol into the existing discharge process identified service improvements for cardiac nurse training and care pathway delivery, while patients identified the level and frequency of their use of the protocol following discharge.ConclusionThe introduction of the Personalised Patient Education Protocol succeeded in increasing patient engagement, facilitated a more patient‐centred service by enabling practitioners to systematically provide personalised patient education, and gave patients a postdischarge structure to better follow‐up their illness concerns with health professionals in the community.Relevance to clinical practiceIntegration of the Personalised Patient Education Protocol into an existing postmyocardial infarction care pathway enabled nurses to systematically respond to individual patients’ illness beliefs and expectations.
‘Don't put the parent out’: parents' perspectives of being present during an inter‐hospital transfer
Authors: Masterson Kate , Brenner Maria 
Published: March 2016

Aims and objectivesTo understand Irish parents' experiences of the inter‐hospital transfer of their acutely ill child from a regional hospital to a tertiary children's hospital.BackgroundMuch of the literature on inter‐hospital transfer focuses on the medical outcome of children who have been transferred for specialist care. While parental presence during this journey is the focus of discussion papers, little is known about the experience of parents as service users.DesignA qualitative design using a Husserlian phenomenological approach was adopted for this study.MethodsSemi‐structured interviews were conducted with ten parents between March and October 2014 to explore their experiences of parental presence during the transfer of an acutely ill child. Data were analysed using the modified Van Kaam method.ResultsTwo key themes emerged ‘don't put the parent out’ and ‘being a parent’. Given a choice, all parents interviewed would have wished to stay with their child during transfer and the findings portray the specific contribution of parents during the journey.ConclusionsNot being permitted to travel with their acutely ill child had a negative effect on parents' perceptions of their ability to continue to parent their child during transfer to specialist paediatric services. To address this there is a need for parents to have the choice, when at all possible, to stay with their child at this time.Relevance to clinical practiceThere is a need to maximise the facilitation of parental presence in an Irish context through the introduction of guidelines to support staff involved in the transfer of an acutely ill child.
Contribution of a Comparative Western Blot Method to Early Postnatal Diagnosis of Congenital Syphilis
Authors: Marangoni Antonella , Foschi Claudio , Capretti Maria Grazia , Nardini Paola , Compri Monica , Corvaglia Luigi Tommaso , Faldella Giacomo , Cevenini Roberto 
Published: March 2016

ABSTRACTSerology has a pivotal role in the diagnosis of congenital syphilis (CS), but problems arise because of the passive transfer of IgG antibodies across the placenta. The aim of this study was to assess the diagnostic value of a comparative Western blot (WB) method finalized to match the IgG immunological profiles of mothers and their own babies at birth in order to differentiate between passively transmitted maternal antibodies and antibodies synthesized by the infants againstTreponema pallidum. Thirty infants born to mothers with unknown or inadequate treatment for syphilis were entered in a retrospective study, conducted at St. Orsola-Malpighi Hospital, Bologna, Italy. All of the infants underwent clinical, instrumental, and laboratory examinations, including IgM WB testing. For the retrospective study, an IgG WB assay was performed by blottingT. pallidumantigens onto nitrocellulose sheets and incubating the strips with serum specimens from mother-child pairs. CS was diagnosed in 11 out of the 30 enrolled infants; 9/11 cases received the definitive diagnosis within the first week of life, whereas the remaining two were diagnosed later because of increasing serological test titers. The use of the comparative IgG WB testing performed with serum samples from mother-child pairs allowed a correct CS diagnosis in 10/11 cases. The CS diagnosis was improved by a strategy combining comparative IgG WB results with IgM WB results, leading to a sensitivity of 100%. The comparative IgG WB test is thus a welcome addition to the conventional laboratory methods used for CS diagnosis, allowing identification and adequate treatment of infected infants and avoiding unnecessary therapy of uninfected newborns.
Capsular Typing Method for Streptococcus agalactiae Using Whole-Genome Sequence Data
Authors: Sheppard Anna E. , Vaughan Alison , Jones Nicola , Turner Paul , Turner Claudia , Efstratiou Androulla , Patel Darshana ,   Modernising Medical Microbiology Informatics Group, Walker A. Sarah , Berkley James A. , Crook Derrick W. , Seale Anna C. 
Published: March 2016

ABSTRACT
Group B streptococcus (GBS) capsular serotypes are major determinants of virulence and affect potential vaccine coverage. Here we report a whole-genome-sequencing-based method for GBS serotype assignment. This method shows strong agreement (kappa of 0.92) with conventional methods and increased serotype assignment (100%) to all 10 capsular types.
Quantitative Phosphotyrosine Profiling of Patient-Derived Xenografts Identifies Therapeutic Targets in Pediatric Leukemia
Authors: Dolai Sibasish , Sia Keith C.S. , Robbins Alissa K. , Zhong Ling , Heatley Sue L. , Vincent Tiffaney L. , Hochgräfe Falko , Sutton Rosemary , Kurmasheva Raushan T. , Revesz Tamas , White Deborah L. , Houghton Peter J. , Smith Malcolm A. , Teachey David T. , Daly Roger J. , Raftery Mark J. , Lock Richard B. 
Published: March 2016

Abstract
Activating mutations in tyrosine kinases (TK) drive pediatric high-risk acute lymphoblastic leukemia (ALL) and confer resistance to standard chemotherapy. Therefore, there is urgent need to characterize dysregulated TK signaling axes in patients with ALL and identify actionable kinase targets for the development of therapeutic strategies. Here, we present the first study to quantitatively profile TK activity in xenografted patient biopsies of high-risk pediatric ALL. We integrated a quantitative phosphotyrosine profiling method with “spike-in” stable isotope labeling with amino acids in cell culture (SILAC) and quantified 1394 class I phosphorylation sites in 16 ALL xenografts. Moreover, hierarchical clustering of phosphotyrosine sites could accurately classify these leukemias into either B- or T-cell lineages with the high-risk early T-cell precursor (ETP) and Ph-like ALL clustering as a distinct group. Furthermore, we validated this approach by using specific kinase pathway inhibitors to perturb ABL1, FLT3, and JAK TK signaling in four xenografted patient samples. By quantitatively assessing the tyrosine phosphorylation status of activated kinases in xenograft models of ALL, we were able to identify and validate clinically relevant targets. Therefore, this study highlights the application and potential of phosphotyrosine profiling for identifying clinically relevant kinase targets in leukemia. Cancer Res; 76(9); 2766–77. ©2016 AACR.
Impact of Spironolactone on Longitudinal Changes in Health-Related Quality of Life in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial
Authors: Lewis Eldrin F. , Kim Hae-Young , Claggett Brian , Spertus John , Heitner John F. , Assmann Susan F. , Kenwood Christopher T. , Solomon Scott D. , Desai Akshay S. , Fang James C. , McKinlay Sonia A. , Pitt Bertram A. , Pfeffer Marc A. 
Published: March 2016

Background—
Heart failure (HF) with preserved ejection fraction patients have equally impaired health-related quality of life (HRQL) compared with those with HF with reduced ejection fraction, but limited studies have evaluated the impact of therapies on changes in HRQL.

Methods and Results—

Patients ≥50 years of age, with symptomatic HF and left ventricular ejection fraction ≥45%, were enrolled in Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) and randomized to spironolactone or placebo. Patients completed the Kansas City Cardiomyopathy Questionnaire (KCCQ), which was the primary HRQL instrument, and EQ5D visual analog scale at baseline, 4 months, 12 months, and annually thereafter. McMaster Overall Treatment Evaluation was assessed at 4 and 12 months to assess global change scores. Change scores (+SD) were calculated to determine between-group differences, and multivariable repeated-measures models were created to identify other factors associated with change scores. Paired KCCQ data were available for 91.7% of 3445 TOPCAT patients. By 4 months, the mean change in KCCQ was 7.7±16 and mean change in EQ5D visual analog scale was 4.7±16. Adjusted mean changes in KCCQ for the spironolactone group were significantly better than those for the placebo group at 4-month (1.54 better;
P
=0.002), 12-month (1.35 better;
P
=0.02), and 36-month (1.86 better;
P
=0.02) visits. No between-group differences in EQ5D visual analog scale change scores or McMaster Overall Treatment Evaluation were noted. Older age, obesity, current smoking, New York Heart Association class III/IV, and comorbid illnesses were associated with declines in KCCQ scores. Use of spironolactone was an independent predictor of improved KCCQ scores.

Conclusions—
In symptomatic HF with preserved ejection fraction patients, use of spironolactone was associated with an improvement in HF-specific HRQL. Several modifiable risk factors were associated with HRQL deterioration.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00094302.
Traditional Chinese Exercise for Cardiovascular Diseases: Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Wang Xue‐Qiang , Pi Yan‐Ling , Chen Pei‐Jie , Liu Yu , Wang Ru , Li Xin , Chen Bing‐Lin , Zhu Yi , Yang Yu‐Jie , Niu Zhan‐Bin 
Published: March 2016

Background

Traditional Chinese exercise (
TCE
) has widespread use for the prevention and treatment of cardiovascular disease; however, there appears to be no consensus about the benefits of
TCE
for patients with cardiovascular disease. The objective of this systematic review was to determine the effects of
TCE
for patients with cardiovascular disease.

Methods and Results

Relevant studies were searched by PubMed, Embase, Web of Science, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, and the China National Knowledge Infrastructure. We covered only published articles with randomized controlled trials. The outcome measures included physiological outcomes, biochemical outcomes, physical function, quality of life, and depression. A total of 35 articles with 2249 cardiovascular disease patients satisfied the inclusion criteria. The pooling revealed that
TCE
could decrease systolic blood pressure by 9.12 mm Hg (95%
CI
−16.38 to −1.86,
P
=0.01) and diastolic blood pressure by 5.12 mm Hg (95%
CI
−7.71 to −2.52,
P
<0.001). Patients performing
TCE
also found benefits compared with those in the control group in terms of triglyceride (standardized mean difference −0.33, 95%
CI
−0.56 to −0.09,
P
=0.006), 6‐minute walk test (mean difference 59.58 m, 95% CI −153.13 to 269.93,
P
=0.03), Minnesota Living With Heart Failure Questionnaire results (mean difference −17.08, 95% CI −23.74 to −10.41,
P
<0.001), 36‐Item Short Form physical function scale (mean difference 0.82, 95% CI 0.32–1.33,
P
=0.001), and Profile of Mood States depression scale (mean difference −3.02, 95% CI −3.50 to −2.53,
P
<0.001).

Conclusions

This study demonstrated that
TCE
can effectively improve physiological outcomes, biochemical outcomes, physical function, quality of life, and depression among patients with cardiovascular disease. More high‐quality randomized controlled trials on this topic are warranted.
Association Between Severe Hypoglycemia and Cardiovascular Disease Risk in Japanese Patients With Type 2 Diabetes
Authors: Goto Atsushi , Goto Maki , Terauchi Yasuo , Yamaguchi Naohito , Noda Mitsuhiko 
Published: March 2016

Background

It remains unclear whether severe hypoglycemia is associated with cardiovascular disease (
CVD
) in Asian populations with type 2 diabetes (T2D). Furthermore, no study in Japan, where the prescription patterns differ from those in other countries, has examined this association.

Methods and Results

We retrospectively included 58 223 patients (18–74 years old) with T2D. First, we examined the potential predictors of severe hypoglycemia. Then, we investigated the association between severe hypoglycemia and
CVD
risk. Finally, we performed an updated systematic review and meta‐analysis to incorporate our findings and recently published studies into the previous systematic review and meta‐analysis. During 134 597 person‐years from cumulative observation periods, 128 persons experienced severe hypoglycemia and 550 developed
CVD
events. In a multivariate Cox proportional hazard model, severe hypoglycemia was strongly and positively associated with the risk of
CVD
(multivariate‐adjusted adjusted hazard ratio, 3.39; 95%
CI
, 1.25–9.18). In a propensity score–matched cohort that had similar baseline characteristics for patients with severe hypoglycemia and those without, severe hypoglycemia was more strongly associated with the risk of
CVD
. An updated systematic review and meta‐analysis that included 10 studies found that severe hypoglycemia was associated with an ≈2‐fold increased risk of
CVD
(pooled relative risk, 1.91; 95%
CI
, 1.69–2.15).

Conclusions

Our results suggest that severe hypoglycemia is strongly associated with an increased risk of
CVD
in Japanese patients with T2D, further supporting the notion that avoiding severe hypoglycemia may be important in preventing
CVD
in this patient population.
A New Light on the Shadows of Heavenly Bodies
Authors: Oliveira Lopes Rui 
Published: March 2016

The distinct tradition of Indian shadow puppetry has been the subject of much interest among scholars, focusing mainly on its origin, the mutual exchange between different regions across Asia, and the relationship between theater performance and popular culture. This study discusses the similarities of shadow puppets with temple mural painting and loose-leaf paintings, and shows how puppets may have shifted technically from narrative paintings on loose-leaf folios toward motion pictures, in order to create a more interactive link between the audience and the storyteller.
The first part of this paper explores the archetypal and psychological meanings of shadow in Indian culture and religion, as well as its relationship with the origins of painting. The main issues include archetypal references to the shadow of Hindu gods described in Vedic, epic, and Purāņic sources, the use of prototypes to transmit knowledge to humankind, and the analysis of shadow puppets as moving pictures. Secondly, the paper analyzes the materiality of puppets and their consistency with Indian aesthetics and art criticism in the form of theoretical principles found in classical texts and art treatises such as the Nāțyaśāstra, the Viṣṇudhārmottāra, and the Śilpaśāstra.
Southern Ocean Overturning Compensation in an Eddy-Resolving Climate Simulation
Authors: Bishop Stuart P. , Gent Peter R. , Bryan Frank O. , Thompson Andrew F. , Long Matthew C. , Abernathey Ryan 
Published: March 2016

AbstractThe Southern Ocean’s Antarctic Circumpolar Current (ACC) and meridional overturning circulation (MOC) response to increasing zonal wind stress is, for the first time, analyzed in a high-resolution (0.1° ocean and 0.25° atmosphere), fully coupled global climate simulation using the Community Earth System Model. Results from a 20-yr wind perturbation experiment, where the Southern Hemisphere zonal wind stress is increased by 50% south of 30°S, show only marginal changes in the mean ACC transport through Drake Passage—an increase of 6% [136–144 Sverdrups (Sv; 1 Sv ≡ 106 m3 s−1)] in the perturbation experiment compared with the control. However, the upper and lower circulation cells of the MOC do change. The lower cell is more affected than the upper cell with a maximum increase of 64% versus 39%, respectively. Changes in the MOC are directly linked to changes in water mass transformation from shifting surface isopycnals and sea ice melt, giving rise to changes in surface buoyancy forcing. The increase in transport of the lower cell leads to upwelling of warm and salty Circumpolar Deep Water and subsequent melting of sea ice surrounding Antarctica. The MOC is commonly supposed to be the sum of two opposing components: a wind- and transient-eddy overturning cell. Here, the transient-eddy overturning is virtually unchanged and consistent with a large-scale cancellation of localized regions of both enhancement and suppression of eddy kinetic energy along the mean path of the ACC. However, decomposing the time-mean overturning into a time- and zonal-mean component and a standing-eddy component reveals partial compensation between wind-driven and standing-eddy components of the circulation.
Educational Gradients and Pathways of Disability Onset Among Older Mexicans
Authors: Saenz Joseph L. , Wong Rebeca 
Published: March 2016

Introduction: Educational disparities research is less common in developing countries. We evaluate whether educational gradients of disability onset exist in Mexico across groups (birth cohort and sex) and whether the association is unexplained or indirect via health (health behaviors, chronic conditions, and self-rated health) or economic (income, wealth, and health insurance) pathways. Method: Data come from the Mexican Health & Aging study. Activities of daily living are reported in 2001, 2003, and 2012 by respondents and spouses aged 50+ ( N = 9,560). Groups are analyzed using logistic regression to test education–disability onset associations. Results: Significant education–ADL onset associations were observed across groups, and much of these associations were direct (unexplained by pathways). Indirect effects operated primarily through the health pathway. Discussion: Those with less education were disadvantaged in terms of disability across birth cohorts and sex. Unexplained effects of education may suggest unobserved mediators or differential returns to resources by educational level.
A Study of Impact of Ownership Structure and Disclosure Quality on Information Asymmetry in Iran
Authors: Shiri Mahmoud Mousavi , Salehi Mahdi , Radbon Ali 
Published: March 2016

Executive Summary Capital market uses financial information with high disclosure quality, and this information can influence capital market decision-making. Corporate governance research shows that ownership structure can influence financial reporting quality, and thus play an effective role in capital market decision-making. The main purpose of the current study is to examine the impact of ownership structure and disclosure quality on the information asymmetry phenomenon among the listed companies on the Tehran Stock Exchange (TSE). Ownership structure (including ownership concentration and institutional ownership) and disclosure quality (including reliability and timeliness) are considered as independent variables, and their impact is examined on the dependent variable (information asymmetry). Consistent with extant literature, bid-ask spread is used as a proxy variable for information asymmetry. The statistical results, based on data collected from 102 listed companies on the TSE during 2007–2014, revealed positive impact of ownership structure and negative impact of disclosure quality on information asymmetry. These results show that information asymmetry is less in firms that published more reliable and timely information, and is more in firms with more concentrated ownership structure, higher institutional ownership, and lower disclosure quality. In other words, reliability and timeliness of information have a positive role in stock price identification and close-up views of the buyer and seller in TSE. Findings of this article can assist accounting researchers and theoreticians in comparing real world facts with hypotheses developed with respect to ownership structure, disclosure quality, and information asymmetry. By increasing transparency in the capital markets, market participants, decision-makers, financial analysts, and potential investors are aided in their analysis of plans for investments in financial assets.
A portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital in Sydney by Dr Rex Money
Authors: White Richard T , McGee-Collett Martin 
Published: March 2016

Objective: The objective of this article is to provide a portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital, Sydney by the Head of Neurosurgery Dr Rex Money and to describe Dr Money’s role in the promotion of psychosurgery in Sydney. Methods: We draw attention to an oral presentation by Dr Rex Money in 1951, a journal article written by Money, archival information held at the Royal Prince Alfred Hospital, including Dr Money’s accounts of his travels and his reports regarding neurosurgery – both internationally and in Australia. Results: Dr Rex Money performed a series of 13 prefrontal lobotomies between 1945 and 1951, and presented the theoretical basis for his series, his operative procedures and the outcomes at the annual meeting of its medical officers’ association. Conclusion: Notwithstanding various deficiencies in his clinical research, Money’s descriptions give a relatively comprehensive account of one of the first series of prefrontal lobotomies performed in Australia. The current article also describes Dr Money’s contributions to the promotion of psychosurgery in Sydney, and illustrates the participation of a senior neurosurgeon and of a major Sydney teaching hospital during the psychosurgery saga.