bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative exploration of intentional nursing round models in the emergency department setting: investigating the barriers to their use and success
Authors: Kirk Kate , Kane Ros 
Published: March 2016

Aims and objectivesThis research aimed to investigate the use of intentional rounding within in the emergency department setting through exploration of the staff nurse experience. The focus was its implementation at a large teaching hospital in England.BackgroundResearch into the use of intentional rounding in any area of practice is minimal in the UK; however, a broader evidence base comes from America. The majority of this research supports the notion of intentional rounding for improved patient care and outcomes. Research from the UK is generally more contested. There is less literature on using intentional rounding specifically in the emergency department setting.DesignQualitative methodological approach.MethodsSemi‐structured interviews (n = 5) were completed with staff nurses working within an emergency department. A purposive sampling technique was used for recruitment. The data was then analysed using ‘Framework Method of Qualitative Analysis’ (Spencer et al. 2014).ResultsThe findings were categorised into four headings: (1) Improved patient experience, (2) Current unmanageability, (3) Adapting for the emergency department, (4) Benefits on achieving quality indicators and targets.ConclusionThe findings show that although staff felt the introduction of intentional rounding techniques could lead to improvements in patient safety and overall care experience, they also identified a range of difficulties and adaptations needed to ensure its success within this acute care environment.Relevance to clinical practiceThe research offers an insight into the staff's perceptions of using intentional rounding and also explains the practical difficulties faced by the nursing staff with potential suggestions that may help to address these problems. Benefits include more open communication between staff and patients and potentially more timely response to patient need, which positively impacts levels of safety and satisfaction. Barriers include lack of staff engagement, and the environmental factors and pressures, within the ED setting.
Accuracy of EASI 12‐lead ECGs in monitoring ST‐segment and J‐point by nurses in the Coronary Care Units
Authors: Loreto Lancia , Andrea Toccaceli , Lucia Dignani , Carla Lucertini , Cristina Petrucci , Silvio Romano 
Published: March 2016

Aims and objectivesTo confirm the accuracy of the EASI system compared to the standard 12‐lead electrocardiogram, which is the gold standard, in monitoring the two major parameters used in the Coronary Care Units to detect myocardial ischaemia: ST‐segment and J‐point.BackgroundContinuous electrocardiograph monitoring is used in the Coronary Care Units to detect cardiac conduction abnormalities and to show the morphology of electrocardiographic waves and tracts. Its accuracy is essential for efficient nursing vigilance, particularly for monitoring the ST segment and the J‐point, in which alterations may indicate the onset of myocardial ischaemia.DesignAn observational study was conducted.MethodsThe enrolled patients (n = 253) simultaneously underwent standard electrocardiogram (10 electrodes) and EASI electrocardiogram (five electrodes). Data were collected by the Coronary Care Units nurses. Tests to compare differences in means and medians between the two sets of measurements were performed, and the Bland‐Altman plots were used to illustrate their agreement.ResultsAll 6·072 electrocardiographic leads (3·036 standard and 3·036 EASI) were recorded and analysed. Between the two measurement methods, very small statistically significant differences were found in some leads which are not clinically relevant for both the ST‐segment or the J‐point.ConclusionsThis study confirms that the accuracy of the EASI 12‐leadelectrocardiogram, compared to the standard 12‐leadelectrocardiogram, which is the gold standard, is acceptable for clinical practice to monitor the two major parameters used in the Coronary Care Units for detecting myocardial ischaemia: ST‐segment and J‐point.Relevance to clinical practiceThe EASI system ensures: (1) ease of use and comfort for patients admitted to Coronary Care Units because it only requires five electrodes; (2) increased efficacy of nursing vigilance in the early detection of changes in ST‐segment and J‐ point measurements.
Mutuality in health care: review, concept analysis and ways forward
Authors: Brown Brian J 
Published: March 2016

Aims and objectivesThis paper aims to critically investigate the notion of mutuality in nursing, and explore how to resolve the tension between individualised accounts of mutuality and institutional and political factors.BackgroundThe concept of mutuality underlies many theories and models of nursing yet this does not capture the power relations in health care or institutional constraints on mutuality.DesignThis is a position paper informed by a narrative literature review.MethodsA search of the Scopus, PubMed, Web of Knowledge and CINAHL databases for the terms mutual, mutuality and nursing was conducted, to capture English language literature published from 1990 to mid‐2015.ResultsThere is a large literature discussing the nature and value of mutual exchange and mutuality. There is acknowledgement of institutional and professional constraints which limit the potential of mutuality. Yet there is often a reluctance to engage with critical thinking which emphasises the inequalities of power in health care situations. Accordingly, the notion of social capital is introduced, which emphasises the role of social relationships which individuals and groups can deploy to their advantage. Finally the paper explores how new thinking about mutuality and social capital can make health care more effective.ConclusionsMutuality and social capital can be enhanced in a variety of ways and may improve client and practitioner outcomes via training, educational and organisational design, and initiatives involving patients and service users, as well as practitioners and service leaders.Relevance to clinical practiceThe sociologically nuanced account of mutuality advanced here sensitises us to questions of power and domination, as well as enabling us to see mutuality in terms of networks of relationships instead of merely an interpersonal phenomenon. This enables practitioners to enhance clients' and their own capacity for mutuality and develop effective resources to increase resilience and recovery.
The Huddling Programme: effects on empowerment, organisational commitment and ego‐resilience in clinical nurses – a randomised trial
Authors: Im Sook Bin , Cho Mi‐Kyoung , Kim Se Young , Heo Myoung Lyun 
Published: March 2016

Aim and objectiveTo identify effects of the huddling programme as a strategy for retention of clinical nurses.BackgroundIn Korea, new nurses leave hospitals more than experienced nurses for many reasons. Hospitals with a high nurse turnover require larger budgets and longer periods of time to train large numbers of newly recruited nurses until they can perform as well as those who have left. Furthermore, the remaining nurses have an additional workload associated with both the shortage of manpower and the need to train the incoming nurses. This means that reducing nurse turnover intention requires preventive measures that promote empowerment and organisational commitment among nurses in Korea.DesignRandomised controlled trial.MethodsThis research used a pretest–post‐test experimental‐group–control‐group design to investigate the effect of the huddling programme. The participants were 49 clinical nurses working at two general hospitals with more than 500 beds that are located in D city and S city of Korea. The experimental group participated in the huddling programme that comprised a full‐day retreat and after‐work social networking services during January and February 2013. Self‐reported questionnaires were used to assess empowerment, organisational commitment and ego‐resilience. The data were analysed by descriptive analysis using the t‐test.ResultsThe mean scores for normative commitment and impact of empowerment were higher in the experimental group, but ego‐resilience did not differ significantly between the two groups.ConclusionThe huddling program positively increased nurses' perception of organisational commitment and empowerment who participated in huddling programme. The huddling programme could be a useful strategy for improving the retention of clinical nurses.Relevance to clinical practiceThis study is both significant and relevant to nursing science and practice given that it demonstrated the effectiveness of an empowerment programme in increasing organisational commitment and decreasing actual turnover rates of clinical nurses.
Undergraduate nursing students’ attitudes and use of research and evidence‐based practice – an integrative literature review
Authors: Ryan Elizabeth Jo 
Published: March 2016

Aims and objectivesThis integrative review of the literature addresses undergraduate nursing students’ attitudes towards and use of research and evidence‐based practice, and factors influencing this. Current use of research and evidence within practice, and the influences and perceptions of students in using these tools in the clinical setting are explored.BackgroundEvidence‐based practice is an increasingly critical aspect of quality health care delivery, with nurses requiring skills in sourcing relevant information to guide the care they provide. Yet, barriers to engaging in evidence‐based practice remain. To increase nurses’ use of evidence‐based practice within healthcare settings, the concepts and skills required must be introduced early in their career. To date, however, there is little evidence to show if and how this inclusion makes a difference.DesignIntegrative literature review.MethodsProQuest, Summon, Science Direct, Ovid, CIAP, Google scholar and SAGE databases were searched, and Snowball search strategies used. One hundred and eighty‐one articles were reviewed. Articles were then discarded for irrelevance. Nine articles discussed student attitudes and utilisation of research and evidence‐based practice.ResultsFactors surrounding the attitudes and use of research and evidence‐based practice were identified, and included the students’ capability beliefs, the students’ attitudes, and the attitudes and support capabilities of wards/preceptors.ConclusionsUndergraduate nursing students are generally positive toward using research for evidence‐based practice, but experience a lack of support and opportunity. These students face cultural and attitudinal disadvantage, and lack confidence to practice independently. Further research and collaboration between educational facilities and clinical settings may improve utilisation.Relevance to clinical practiceThis paper adds further discussion to the topic from the perspective of and including influences surrounding undergraduate students and new graduate nurses.
Alzheimer's disease with cerebrovascular disease: current status in the Asia–Pacific region
Authors: Chen C. , Homma A. , Mok V. C. T. , Krishnamoorthy E. , Alladi S. , Meguro K. , Abe K. , Dominguez J. , Marasigan S. , Kandiah N. , Kim S.Y. , Lee D. Y. , De Silva H. A. , Yang Y.‐H. , Pai M.‐C. , Senanarong V. , Dash A. 
Published: March 2016

AbstractBackgroundThere is growing awareness of the coexistence of Alzheimer's disease and cerebrovascular disease (AD+CVD), however, due to lack of well‐defined criteria and treatment guidelines AD+CVD may be underdiagnosed in Asia.MethodsSixteen dementia specialists from nine Asia Pacific countries completed a survey in September 2014 and met in November 2014 to review the epidemiology, diagnosis and treatment of AD+CVD in Asia. A consensus was reached by discussion, with evidence provided by published studies when available.ResultsAD accounts for up to 60% and AD+CVD accounts for 10‐20% of all dementia cases in Asia. The reasons for underdiagnosis of AD+CVD include lack of awareness as a result of a lack of diagnostic criteria, misdiagnosis as vascular dementia or AD, lack of diagnostic facilities, resource constraints and cost of investigations. There is variability in the tools used to diagnose AD+CVD in clinical practice. Diagnosis of AD+CVD should be performed in a stepwise manner of clinical evaluation followed by neuroimaging. Dementia patients should be assessed for cognition, behavioural and psychological symptoms, functional staging and instrumental activities of daily living. Neuroimaging should be performed using computed tomography or magnetic resonance imaging. The treatment goals are to stabilize or slow progression as well as to reduce behavioural and psychological symptoms, improve quality of life and reduce disease burden. First‐line therapy is usually an acetylcholinesterase inhibitor such as donepezil.ConclusionAD+CVD is likely to be under‐recognised in Asia. Further research is needed to establish the true prevalence of this treatable and potentially preventable disease.
Optimization of Fracture Resistance and Stiffness of Heat‐Polymerized High Impact Acrylic Resin with Localized E‐Glass FiBER FORCE® Reinforcement at Different Stress Points
Authors: Agha Haitham , Flinton Robert , Vaidyanathan Tritala 
Published: March 2016

AbstractPurposeDentures are subject to fracture through flexural stresses during masticatory function. Distribution of stresses under flexural loading varies from compressive to tensile stress along the thickness of the denture cross section. The goal of this investigation was to evaluate the effect of reinforcing compressive, tensile, and no stress regions of flexurally loaded rectangular bars of heat‐cured denture base acrylic resin reinforced with tough E‐Glass FiBER FORCE (GFF) on their fracture resistance under flexural loading.Materials and MethodsForty rectangular specimens (65 mm long × 10 mm wide × 2.5 mm thick) were prepared and divided into four groups (n = 10). Group FN had no fiber reinforcement, group FM had fiber in the middle at the no‐stress neutral axis, group FC had fiber close to the surface on the compressive stress side, and group FT had the fiber close to the surface on the tensile stress side. The effect of GFF reinforcement on flexural strength (FS), flexural toughness (TG), and flexural modulus of elasticity (MOE) was evaluated.ResultsThe mean and (SD) of the FS, TG, and MOE varied as follows. FS (MPa): group FN: 91.49 (7.88); group FM: 102.83 (13.5); group FC: 107.68 (11.21); group FT: 141.46 (14.77). TG (mJ/mm3): group FN: 0.171 (0.026); group FM: 0.236 (0.033); group FC: 0.156 (0.032); group FT: 0.347 (0.010). MOE (MPa): group FN: 2682 (761); group FM: 2601 (417); group FC: 4188 (1012); group FT: 4215 (674). Statistical analysis showed that reinforcement on the tensile side of the neutral axis yielded improvement in all properties evaluated.ConclusionsPlacement of the GFF close to the tensile stress side surface of the bar increased the resistance to elastic deformation (i.e., higher MOE or stiffness) and the stress level needed for flexural fracture (i.e., higher FS). In addition, more energy was absorbed by reinforced specimens before fracture occurred (i.e., higher toughness). Localized reinforcement targeting tensile stress centers is thus a practical way to improve clinical durability of dentures against intra‐ and extraoral fracture.
Private, Social, and Self‐Insurance for Long‐Term Care in the Presence of Family Help
Authors: DONDER PH. DE , PESTIEAU P. 
Published: March 2016

AbstractWe study the political determination of the level of social long‐term care insurance when voters can top up with private insurance, saving and family help. Agents differ in income, probability of becoming dependent and of receiving family help, and amount of family help received. Social insurance redistributes across income and risk levels, while private insurance is actuarially fair. The income‐to‐dependency probability ratio of agents determines whether they prefer social or private insurance. Family support crowds out the demand for both social and, especially, private insurance, as strong prospects of family help drive the demand for private insurance to zero. The availability of private insurance decreases the demand for social insurance but need not decrease its majority‐chosen level. A majority of voters would oppose banning private insurance.
Melatonin pretreatment enhances the therapeutic effects of exogenous mitochondria against hepatic ischemia–reperfusion injury in rats through suppression of mitochondrial permeability transition
Authors: Chen Hong‐Hwa , Chen Yen‐Ta , Yang Chih‐Chao , Chen Kuan‐Hung , Sung Pei‐Hsun , Chiang Hsin‐Ju , Chen Chih‐Hung , Chua Sarah , Chung Sheng‐Ying , Chen Yi‐Ling , Huang Tien‐Hung , Kao Gour‐Shenq , Chen Sheng‐Yi , Lee Mel S. , Yip Hon‐Kan 
Published: March 2016

AbstractWe tested the hypothesis that melatonin (Mel) enhances exogenous mitochondria (Mito) treatment against rodent hepatic ischemia–reperfusion (IR) injury. In vitro study utilized three groups of hepatocytes (i.e. nontreatment, menadione, and menadione–melatonin treatment, 4.0 × 105 each), while in vivo study used adult male Sprague Dawley rats (n = 40) equally divided into sham‐control (SC), IR (60‐min left‐lobe ischemia + 72‐hr reperfusion), IR‐Mel (melatonin at 30 min/6/8 hr after reperfusion), IR‐Mito (mitochondria 15,000 μg/rat 30 min after reperfusion), and IR‐Mel‐Mito. Following menadione treatment in vitro, oxidative stress (NOX‐1/NOX‐2/oxidized protein), apoptotic (cleaved caspase‐3/PARP), DNA damage (γ‐H2AX/CD90/XRCC1), mitochondria damage (cytosolic cytochrome c) biomarkers, and mitochondrial permeability transition were found to be lower, whereas mitochondrial cytochrome c were found to be higher in hepatocytes with melatonin treatment compared to those without (all P < 0.001). In vivo study demonstrated highest liver injury score and serum AST in IR group, but lowest in SC group and higher in IR‐Mito group than that in groups IR‐Mel and IR‐Mel‐Mito, and higher in IR‐Mel group than that in IR‐Mel‐Mito group after 72‐hr reperfusion (all P < 0.003). Protein expressions of inflammatory (TNF‐α/NF‐κB/IL‐1β/MMP‐9), oxidative stress (NOX‐1/NOX‐2/oxidized protein), apoptotic (caspase‐3/PARP/Bax), and mitochondria damage (cytosolic cytochrome c) biomarkers displayed an identical pattern, whereas mitochondria integrity marker (mitochondrial cytochrome c) showed an opposite pattern compared to that of liver injury score (all P < 0.001) among five groups. Microscopically, expressions of apoptotic nuclei, inflammatory (MPO+/CD68+/CD14+ cells), and DNA damage (γ‐H2AX+ cells) biomarkers exhibited an identical pattern compared to that of liver injury score (all P < 0.001) among five groups. Melatonin‐supported mitochondria treatment offered an additional benefit of alleviating hepatic IR injury.
Differential responses of tetrasporophytes and gametophytes of Mazzaella laminarioides (Gigartinales, Rhodophyta) under solar UV radiation
Authors: Navarro Nelso P. , Figueroa Félix L. , Korbee Nathalie , Mansilla Andrés , Plastino Estela M. 
Published: March 2016

The effects of solar UV radiation on mycosporine‐like amino acids (MAAs), growth, photosynthetic pigments (Chl a, phycobiliproteins), soluble proteins (SP), and C and N content of Mazzaella laminarioides tetrasporophytes and gametophytes were investigated. Apical segments of tetrasporophytes and gametophytes were exposed to solar radiation under three treatments (PAR [P], PAR+UVA [PA], and PAR+UVA+UVB [PAB]) during 18 d in spring 2009, Punta Arenas, Chile. Samples were taken after 2, 6, 12, and 18 d of solar radiation exposure. Most of the parameters assessed on M. laminarioides were significantly influenced by the radiation treatment, and both gametophytes and tetrasporophytes seemed to respond differently when exposed to high UV radiation. The two main effects promoted by UV radiation were: (i) higher synthesis of MAAs in gametophytes than tetrasporophytes at 2 d, and (ii) a decrease in phycoerythrin, phycocyanin, and SPs, but an increase in MAA content in tetrasporophytes at 6 and 12 d of culture. Despite some changes that were observed in biochemical parameters in both tetrasporophytes and gametophytes of M. laminarioides when exposed to UVB radiation, these changes did not promote deleterious effects that might interfere with the growth in the long term (18 d). The tolerance and resistance of M. laminarioides to higher UV irradiance were expected, as this intertidal species is exposed to variation in solar radiation, especially during low tide.
A new species ofScytonemaisolated from Bilaspur, Chhattisgarh, India
Authors: Singh Prashant , Minj Robin Anigo , Kunui Kikku , Shaikh Zaid Muneef , Suradkar Archana , Shouche Yogesh S , Mishra Arun Kumar , Singh Satya Shila 
Published: March 2016

AbstractFilamentous cyanobacterium (strain 10C‐PS) isolated from a fresh water body of Bilaspur, Chhattisgarh, India is being described as new species of the polyphyletic genusScytonema. Phenotypic, molecular and phylogenetic characterization was performed and the combined results validated the strain as a new species. Careful observations of the filaments, presence of a distinctly textured sheath throughout the length of the trichome, differences in the shape and dimensions of the vegetative cells, and heterocytes provided reliable morphological signals that the strain differed from rest of the closely related species. Sequencing of the 16S rRNA gene showed 96.89% sequence similarity withScytonema hofmanniPCC 7110 whilerbclandpsbAsequencing showed 95% and 92% similarities withScytonema hofmanniPCC 7110 andNostocsp. PCC 7524 respectively while thenifDgene sequence similarity was found to be 96% withScytonema hofmanniPCC 7110. The PC‐IGS region was sequenced and concatenatedcpcB, IGS andcpcAregions indicated 97% closest similarity withScytonemasp. PCC 7110 andScytonema bohneriiInd24. Subsequent phylogenetic analyses gave a strong pattern of distinct clustering in case of all the molecular markers. The phenotypic, genetic and phylogenetic observations prove conclusively that the strain 10C‐PS is a new species in the genusScytonemawith the name proposed beingScytonema bilaspurensis.
Diurnal and tidal patterns of carbon uptake and calcification in geniculate inter‐tidal coralline algae
Authors: McCoy Sophie J. , Pfister Catherine A. , Olack Gerard , Colman Albert S. 
Published: March 2016

AbstractResearch on coralline algal responses to ocean acidification and other environmental stressors has increased in recent years as coralline algae is thought to stand a higher chance of being affected by acidification stress than other macroalgae. To provide context and enhance the existing eco‐physiological framework for climate change studies, it is important to understand the effects of non‐extreme stressors experienced regularly by inter‐tidal coralline algae. In this study, we tested the potentially interacting effects of diurnal and tidal treatments on calcification in the geniculate coralline algaeCorallina frondescensandCorallina vancouveriensisusing13C‐labeled bicarbonate. Both species deposited more calcium carbonate during the day than at night, and also when submerged (high tide) compared with when emerged (low tide) in their apical and mature segments (intergenicula). These results indicate that inter‐tidal coralline algae do in fact pay a cost for living inter‐tidally at the edge of an adaptive zone.