bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting the severity of central centrifugal cicatricial alopecia
Authors: Suchonwanit Poonkiat , Hector Clare E. , Bin Saif Ghada A. , McMichael Amy J. 
Published: January 2016

AbstractBackgroundCentral centrifugal cicatricial alopecia (CCCA) is a type of scarring hair loss primarily seen in African‐American women. The risk factors that affect the severity of disease remain unclear.ObjectivesThis study was designed to elucidate risk factors that may be associated with severity of CCCA.MethodsA cross‐sectional survey study was conducted. Women with biopsy‐confirmed CCCA responded to a questionnaire and were grouped according to a photographic scale of central scalp alopecia. The severity of disease was considered: grade 1 and 2 disease was interpreted as early‐stage CCCA, and grade 3–5 disease was interpreted as advanced‐stage CCCA. Data from the questionnaire were compared with levels of severity to determine the strength of associations with severity of disease.ResultsA total of 38 women with biopsy‐confirmed CCCA were recruited to participate in this study. Early‐stage CCCA was seen in 22 subjects (57.9%), and advanced‐stage CCCA was noted in 16 subjects (42.1%). The average duration of hair loss was 5.7 years in early‐stage disease and 10.1 years in advanced‐stage disease. There was a positive correlation between duration of hair loss and degree of hair loss (Spearman's correlation 0.471, P = 0.003).ConclusionsThis study reports on data sourced from patients with biopsy‐confirmed CCCA and examines the relationships between various factors and severity of CCCA. The findings demonstrate that duration of hair loss is positively associated with severity of disease and that androgen‐related conditions are prevalent in those affected with CCCA.
Pilot testing and validation of an atopic dermatitis screening and evaluation questionnaire
Authors: Chen Chen A. , Lin Longde , Tsibris Hillary C. , Li Wen‐Qing , Li Tricia Yunhui , Qureshi Abrar A. 
Published: January 2016

AbstractBackgroundAtopic dermatitis (AD) is a major public health concern worldwide. Given its rising prevalence, there is a pressing need to study its epidemiology. To date, no validated, cost‐effective, and patient self‐administered screening instrument exists that can reliably distinguish AD from other skin conditions. Our aim is to develop an instrument that can validate a self‐reported AD diagnosis quickly and with reasonable accuracy in a population at a distance.MethodsA one‐page, 13‐question atopic dermatitis screening and evaluation questionnaire (ADSEQ) was generated after literature review and consultation with dermatologists. The questionnaire was administered to 121 patients with and without AD in a dermatology clinic. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for all questions. The questions with the highest sensitivities were selected for logistic regression analysis, and a receiver operating characteristics curve was plotted.ResultsFour scoring algorithms using different combinations of responses were then developed. A combination of Q7 (itching) and Qpic (the image questions combined) had the highest sensitivity (96.3%) and specificity (84%) for a diagnosis of AD. Cronbach's alpha coefficient was 0.71, indicating acceptable internal consistency. Other algorithms combining Qpic and questions about past diagnosis (Q1) or family history of atopy (Q5) also had sensitivities and specificities in the 80s or 90s.ConclusionsIn this pilot study, we found that our questionnaire was a valid and reliable self‐administered tool for distinguishing individuals with AD from individuals without AD.
Medium‐dose ultraviolet A1 phototherapy improves SCORAD index and increases mRNA expression of interleukin‐4 without direct effect on human β defensin‐1, interleukin‐10, and interleukin‐31
Authors: Bogaczewicz Jaroslaw , Malinowska Karolina , Sysa‐Jedrzejowska Anna , Wozniacka Anna 
Published: January 2016

AbstractBackgroundEffectiveness of ultraviolet (UV)A1 in flares of atopic dermatitis (AD) is thought to influence the expression of cytokines involved in its pathogenesis. The aim of the study was to investigate whether mRNA expression of human β defensin‐1 (hβD‐1) correlates with that of interleukin (IL)‐4, IL‐10, and IL‐31 in skin lesions in AD before and after UVA1 phototherapy, to determine whether UVA1 decreases the expression of the aforementioned mediators, and to confirm whether changes in mRNA expression correspond with the clinical efficacy of UVA1.MethodsTwenty‐five patients with AD underwent medium‐dose UVA1 phototherapy. Before and after UVA1, biopsies from acute skin lesions were studied using reverse transcription and real‐time polymerase chain reaction.ResultsLevels of mRNA hβD‐1 correlated with those of IL‐10 and IL‐31, levels of IL‐4 mRNA correlated with those of IL‐10 and IL‐31, and IL‐10 expression correlated with that of IL‐31, both before and after UVA1. Phototherapy with UVA1 improved SCORing of Atopic Dermatitis (SCORAD) values, decreased pruritus, and increased expression of IL‐4. After UVA1, no difference was found in the mRNA expression of other molecules. The SCORAD index did not correlate with the expression of any examined mRNA either before or after UVA1.ConclusionshβD‐1, IL‐4, IL‐10, and IL‐31 are expressed in acute skin lesions in AD, and their levels correlate with each other. UVA1 improves SCORAD and pruritus and increases the expression of IL‐4 without direct effect on other molecules.
Estimation of clinical and economic effects of prophylaxis against venous thromboembolism in medical patients, including the effect of targeting patients at high‐risk
Authors: Millar J. A. , Gee A. L. K. 
Published: January 2016

BackgroundThe clinical and economic effects of medical thromboprophylaxis (MT) using low molecular weight heparin in Australia are unknown.AimTo estimate the effects of MT in Australia.MethodsA decision tree model of MT was populated with national data for medical admissions. The Prevention of Recurrent Venous Thromboembolism (PREVENT) trial was chosen as the primary data source because its design uniquely avoided bias caused by treatment of sub‐clinical events. Clinical efficacy and costs were estimated compared with no prophylaxis, assuming full compliance and according to three definitions of eligibility. Effectiveness was estimated as thrombotic events saved, mortality from bleeding or pulmonary embolus (PE), cost and $/year of life saved. Model outputs were subjected to sensitivity analysis.Results
MT decreased thrombotic events, and the numbers avoided increased as eligibility broadened (deep vein thrombosis (DVT): 2597, 2771 and 3232 at restricted, intermediate and broad eligibility; PE: 454, 484 and 565 respectively). The annual cost of no prophylaxis was $88.7 m. Costs were reduced at most restricted eligibility (−$7.9 m), but increased by $3.0 and $32.1 m at broader eligibility. PE deaths declined, but this was offset by deaths from haemorrhage, causing a net increase (158, 299 and 672 respectively). Estimates were sensitive to the incidence of venous thromboembolic event (VTE), case‐fatality rates for PE and bleeds and the relative risk reduction for PE with prophylaxis.ConclusionsUnder PREVENT trial conditions, MT avoids up to 3200 DVT and 565 PE events annually, but may increase mortality.
The atypical IκB protein IκBNS is important for Toll‐like receptor‐induced interleukin‐10 production in B cells
Authors: Miura Minami , Hasegawa Naoki , Noguchi Mitsuo , Sugimoto Kenkichi , Touma Maki 
Published: January 2016

SummaryAlthough a major function of B cells is to mediate humoral immunity by producing antigen‐specific antibodies, a specific subset of B cells is important for immune suppression, which is mainly mediated by the secretion of the anti‐inflammatory cytokine interleukin‐10 (IL‐10). However, the mechanism by which IL‐10 is induced in B cells has not been fully elucidated. Here, we report that IκBNS, an inducible nuclear IκB protein, is important for Toll‐like receptor (TLR)‐mediated IL‐10 production in B cells. Studies using IκBNS knockout mice revealed that the number of IL‐10‐producing B cells is reduced in IκBNS−/− spleens and that the TLR‐mediated induction of cytoplasmic IL‐10‐positive cells and IL‐10 secretion in B cells are impaired in the absence of IκBNS. The impairment of IL‐10 production by a lack of IκBNS was not observed in TLR‐triggered macrophages or T‐cell‐receptor‐stimulated CD4+ CD25+ T cells. In addition, IκBNS‐deficient B cells showed reduced expression of Prdm1 and Irf4 and failed to generate IL‐10+ CD138+ plasmablasts. These results suggest that IκBNS is selectively required for IL‐10 production in B cells responding to TLR signals, so defining an additional role for IκBNS in the control of the B‐cell‐mediated immune responses.
Evidence‐based practice among nurses in Slovenian Hospitals: a national survey
Authors: Skela‐Savič B. , Pesjak K. , Lobe B. 
Published: January 2016

AimsTo identify the extent of evidence‐based practice implementation among nurses in Slovenian hospital settings, to establish nurses’ beliefs on evidence‐based practice and to identify possible explanatory factors.BackgroundConducting and applying research are fundamental nurses’ tasks and an essential expectation in nursing practice.IntroductionDespite verified benefits of evidence‐based practice, research evidence across different countries has shown extremely limited implementation of this practice among nurses.MethodsA cross‐sectional research design was employed. Standardized instruments Evidence‐Based Practice Beliefs and Implementation Scale were used. The sample included 534 nurses from 19 Slovenian hospitals. The obtained data were analysed using descriptive statistics, correlation and factor analysis, and linear regression.ResultsNurses in Slovenian hospitals have positive beliefs about evidence‐based practice, but exhibit a low level of implementation. The beliefs were explained by perceived knowledge on research, job satisfaction and length of employment, whereas a low level of implementation was explained by poor perceived knowledge on research, evidence‐based practice and job satisfaction level.DiscussionNurses in Slovenian hospitals have positive beliefs about evidence‐based practice, but exhibit a low level of implementation. According to the results, some resources required for improved implementation are not made sufficiently available.LimitationsA low response rate; the sample not being balanced for educational achievement; and the accuracy of self‐report survey methods.ConclusionIn addition to the perceived knowledge and education provided, an important factor is also job satisfaction, which points to the instrumental role of management workers in determining nurses’ professional development.Implications for nursing and health policyNursing managers in Slovenian hospitals should promote the development of head nurses in research and evidence‐based care, thereby fostering a culture of evidence‐based practice.
Investigating the use of Barrows Cards to improve self‐management and reduce healthcare costs in adolescents with blood cancer: a pilot study
Authors: Bagnasco Annamaria , Calza Simona , Petralia Paolo , Aleo Giuseppe , Fornoni Laura , Sasso Loredana 
Published: January 2016

AbstractAimTo test if the Barrows Cards method improves adherence to immunosuppressive therapy self‐management following hematopoietic stem‐cell transplantation in adolescents affected by blood cancer and reduce costs.BackgroundChronically ill adolescents need to be helped to improve self‐management, make sure they can confidently and safely manage therapy at home and reduce readmissions and costs. We identified the Barrows Cards method, originally used to test decision‐making skills and critical thinking in medical students. In this pilot study, we tested the efficacy of the Barrows Cards Method in improving adhesion to immunosuppressive therapy in a group of adolescents following hematopoietic stem‐cell transplantation and analysed its cost‐effectiveness.DesignA mixed‐method study.MethodsThe Barrows Cards method is an educational intervention based on the theory of problem‐based learning that uses at least 15 cards specially designed to teach participants how to manage a specific problem.We piloted the Barrows cards method in terms of adherence to immunosuppressive therapy and self‐management in a group of 17 adolescents affected by blood cancer before being discharged. Participants were enrolled between 2013‐2015. Activity Based Costing was used to analyse the cost‐effectiveness.ResultsThe Barrows Cards method significantly improved adherence to immunosuppressive therapy in blood cancer adolescents and reduced readmissions. We also showed how this method could significantly reduce healthcare costs.ConclusionsFurther research is required, but the Barrows Cards method could be effectively used by nurses to improve self‐management in chronic patients and reduce health costs.
The enablers and barriers to continue breast milk feeding in women returning to work
Authors: Sulaiman Zaharah , Liamputtong Pranee , Amir Lisa H. 
Published: January 2016

AbstractAimTo describe the enablers and barriers working women experience in continuing breast milk feeding after they return to work postpartum in urban Malaysia.BackgroundIn Malaysia, urban working women have low rates of breastfeeding and struggle to achieve the recommended 6 months exclusive breastfeeding.DesignA qualitative enquiry based on a phenomenological framework and multiple methods were used to explore women's experiences in depth.MethodsMultiple qualitative methods using face‐to‐face interview and participant diary were used. Data collection took place in urban suburbs around Penang and Klang Valley, Malaysia from March–September 2011. Participants were 40 employed women with infants less than 24 months.FindingsOnly 11 of the participants worked from home. Based on the women's experiences, we categorized them into three groups: ‘Passionate’ women with a strong determination and exclusively breastfed for 6 months, ‘Ambivalent’ women who initiated breastfeeding, but were unable to sustain exclusive breastfeeding after returning to work and ‘Equivalent’ women who introduced infant formula prior to returning to work.ConclusionPassion and to a lesser extent intention, influenced women's choice. Women's characteristics played a greater role in their infant feeding outcomes than their work environment.
What is resilience? An Integrative Review of the empirical literature
Authors: Aburn Gemma , Gott Merryn , Hoare Karen 
Published: January 2016

AbstractAimTo use systematic methods to examine how resilience is defined in empirical research.BackgroundResilience is a term that is increasingly being used to describe and explain the complexities of individual and group responses to traumatic and challenging situations. It is now frequently mentioned in relation to many areas of nursing practice, including research. Given the increasing use of the term, it is timely to examine how resilience has been defined in empirical research.DesignAn integrative review of the empirical literature (2000–2015).Data sourcesThree health‐related databases were searched: Medline, PsycINFO and the Cumulative Index for Nursing and Allied Health (CINAHL). Reference and citation tracking was performed on all articles included in the review.Review methodsThe methods described by Whittemore and Knafl were used to guide this review. Two reviewers were involved in screening articles for inclusion and in the data extraction process. Data were synthesized using the constant comparative method of analysis.ResultsOne hundred articles were included in the final data analysis. The most significant finding of the review was that there is no universal definition of resilience. There were, however, some common themes identified: rising above, adaptation and adjustment, dynamic process, ‘ordinary magic’ and mental illness as a marker of resilience.ConclusionDespite the increasing use of the term ‘resilience’, this review has identified that there is no universal definition of resilience adopted in the research literature. Further research is required to explore this construct in the context of nursing.
Body image disturbance in adults treated for cancer – a concept analysis
Authors: Rhoten Bethany A. 
Published: January 2016

AbstractAimTo report an analysis of the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses.BackgroundAlthough the concept of body image disturbance has been clearly defined in adolescents and adults with eating disorders, adults who have been treated for cancer may also experience body image disturbance. In this context, the concept of body image disturbance has not been clearly defined.DesignConcept analysis.Data sourcesPubMed, Psychological Information Database and Cumulative Index of Nursing and Allied Health Literature were searched for publications from 1937 – 2015. Search terms included body image, cancer, body image disturbance, adult and concept analysis.MethodsWalker and Avant's 8‐step method of concept analysis was used.ResultsThe defining attributes of body image disturbance in adults who have been treated for cancer are: (1) self‐perception of a change in appearance and displeasure with the change or perceived change in appearance; (2) decline in an area of function; and (3) psychological distress regarding changes in appearance and/or function.ConclusionsThis concept analysis provides a foundation for the development of multidimensional assessment tools and interventions to alleviate body image disturbance in this population. A better understanding of body image disturbance in adults treated for cancer will assist nurses and other clinicians in identifying this phenomenon and nurse scientists in developing instruments that accurately measure this condition, along with interventions that will promote a better quality of life for survivors.
The Role of the European Parliament and the US Congress in Shaping Transatlantic Relations: TTIP, NSA Surveillance, and CIA Renditions
Authors: Jančić Davor 
Published: January 2016

AbstractThis article analyses the manner in which the parliaments of the EU and the US – two key global strategic partners – participate in the shaping of transatlantic relations. The article argues that the European Parliament (EP) and Congress aim not only to influence their executive branches but also to act autonomously in the transnational arena through parliamentary diplomacy. They seek to secure concessions both formally by scrutinizing transatlantic international agreements, such as TTIP, as well as informally by exposing injustices and diplomatic misconduct through human rights advocacy and institutional pressure, such as in the cases of the NSA surveillance and CIA renditions. The article demonstrates that the EP and Congress have created capacities for internal scrutiny and transnational interparliamentary dialogue and that they utilize their consent powers to make claims, condition transatlantic negotiations and gain greater presence, visibility and influence in international affairs.
Latent class profiles of depressive symptoms from early to middle childhood: predictors, outcomes, and gender effects
Authors: Whalen Diana J. , Luby Joan L. , Tilman Rebecca , Mike Anissa , Barch Deanna , Belden Andy C. 
Published: January 2016

BackgroundThere has been little available data to inform the predictors and outcomes of latent class trajectories of depressive symptoms beginning during preschool and continuing throughout school age. Further, the extant literature in this domain has been limited by the use of parent report checklists of nonspecific ‘internalizing’ psychopathology rather than diagnostic interviews for depression.MethodsTo address these gaps in the literature, this study applied growth mixture modeling to depressive symptom severity endorsed by children and/or their caregivers (N = 348) during a structured clinical interview in a 10‐year longitudinal dataset spanning from preschool into late school age.ResultsThree distinct trajectories of depressive symptom severity were found in boys and girls. For boys, but not girls, the high depression severity latent class increased in depressive symptoms from preschool through school age, followed by a decline in depressive symptom severity during later school age. For girls, the high depression severity latent class remained stable across time. Early childhood social adversity, familial history of affective disorder, preschool‐onset ODD/CD, and school age functional impairment differentiated high‐risk trajectory classes among both boys and girls.ConclusionsExtending the literature on trajectories of depressive symptoms to the preschool period, these findings incorporate structured clinical interviews of depressive symptom severity and indicate gender differences as well as psychosocial predictors and functional outcomes among children in high severity latent classes. The findings from this study suggest that increased attention to screening for depressive symptoms in early childhood is of significant public health importance.
Adherence to dipeptidyl peptidase‐4 inhibitor therapy among type 2 diabetes patients with employer‐sponsored health insurance in Japan
Authors: Kurtyka Karen , Nishikino Rie , Ito Chie , Brodovicz Kim , Chen Yong , Tunceli Kaan 
Published: January 2016

AbstractAims/IntroductionDipeptidyl peptidase‐4 inhibitors (DPP‐4i) are a common first‐line treatment for type 2 diabetes in Japan. However, little is known about patients’ medication adherence, persistence and discontinuation in this setting.Materials and MethodsThis was a retrospective cohort study of new DPP‐4i users in a Japanese claims database. Adult patients (age 18–65 years) with type 2 diabetes diagnosis and no diagnosis of other diabetes or pregnancy during the study period were included if they were prescribed a DPP‐4i as monotherapy or combination oral therapy. Adherence to therapy was measured using the proportion of days covered method over a fixed period of 1 year. The proportion of days covered of ≥80% was considered adherent. Persistence was defined as continuing index DPP‐4i treatment with <90‐day gap between refills. Patient baseline characteristics were explored as potential predictors of DPP‐4i discontinuation and adherence in multivariable models.ResultsThe final sample contained 2,874 monotherapy and 3,016 dual therapy patients. The mean age was approximately 51 years, and 75% were men. The mean proportion of days covered was 76.6% among monotherapy patients and 82.5% among dual therapy patients, with 67.2% of monotherapy and 74.4% of dual therapy patients classified as adherent. At 12 months, 72.2% of monotherapy and 79.2% of dual therapy patients were persistent. In adjusted models, younger age and having fewer concomitant medications were significantly associated with lower adherence and higher discontinuation, in both treatment groups.ConclusionsThose under the age of 45 years, and those with fewer concomitant medications were less likely to be adherent and persistent, and more likely to discontinue DPP‐4i therapy.