bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assertive community treatment (ACT) case managers’ professional identities: A focus group study
Authors: Lerbæk Birgitte , Aagaard Jørgen , Andersen Mette Brændstrup , Buus Niels 
Published: February 2016

AbstractAssertive community treatment (ACT) case managers provide healthcare services to people with severe and persistent mental illness. These case managers take on generic roles in multidisciplinary teams and provide all‐around services in the clients’ private homes. This focus group study aimed to gain insight into Danish ACT case managers’ professional identity work by examining their discussions of ethical dilemmas and collaboration in their everyday practice. Data were collected during five focus groups at three ACT teams in the North Denmark Region and subjected to discourse analysis emphasizing how identity work was accomplished through talk. The findings indicated that the case managers constructed professional identities by actively positioning themselves and the particular ACT approach in relation to other mental healthcare professionals and clients. They represented themselves as achieving better client‐related outcomes by being more assertive and persistent, and as responsible caregivers who provided the help that their clients needed when other services had failed to do so. They depicted their services as being focused on the clients’ well‐being, and their persistent efforts to establish and sustain interpersonal relationships with clients were an important part of their service. Basic nursing tasks were described as an important part of their everyday work, and even though such tasks were not distinctive for ACT case managers, the representations of their work seemed to give them a sense of worth as professionals and legitimized a unique role in the community mental healthcare services.
Extended‐release guanfacine hydrochloride in 6–17‐year olds with ADHD: a randomised‐withdrawal maintenance of efficacy study
Authors: Newcorn Jeffrey H. , Harpin Valerie , Huss Michael , Lyne Andrew , Sikirica Vanja , Johnson Mats , Ramos‐Quiroga Josep Antoni , van Stralen Judy , Dutray Benoit , Sreckovic Sasha , Bloomfield Ralph , Robertson Brigitte 
Published: February 2016

BackgroundExtended‐release guanfacine hydrochloride (GXR), a selective α2A‐adrenergic agonist, is a nonstimulant medication for attention‐deficit/hyperactivity disorder (ADHD). This phase 3, double‐blind, placebo‐controlled, randomised‐withdrawal study evaluated the long‐term maintenance of GXR efficacy in children/adolescents with ADHD.MethodsChildren/adolescents (6–17 years) with ADHD received open‐label GXR (1–7 mg/day). After 13 weeks, responders were randomised to GXR or placebo in the 26‐week, double‐blind, randomised‐withdrawal phase (RWP). The primary endpoint was the percentage of treatment failure (≥50% increase in ADHD Rating Scale version IV total score and ≥2‐point increase in Clinical Global Impression‐Severity compared with RWP baseline, at two consecutive visits). The key secondary endpoint was time to treatment failure (TTF).Trial registrationClinicalTrials.gov identifier NCT01081145; EudraCT 2009‐018161‐12.ResultsA total of 528 participants enrolled; 316 (59.8%) entered the RWP. Treatment failure occurred in 49.3% of the GXR and 64.9% of the placebo group (p = 0.006). TTF was significantly longer in GXR versus placebo (p = 0.003). GXR was well tolerated.ConclusionsGuanfacine hydrochloride demonstrated long‐term maintenance of efficacy compared with placebo in children/adolescents with ADHD. Implications of the placebo substitution design and findings with different ADHD medications are discussed.
Hyperkeratosis in human lower limb lymphedema: the effect of stagnant tissue fluid/lymph
Authors: Domaszewska‐Szostek A. , Zaleska M. , Olszewski W.L. 
Published: February 2016

AbstractBackgroundHyperkeratosis of skin in lower limb lymphedema is one of the sequelae of tissue fluid/lymph (TF/L) stasis, but its mechanisms remain unknown. It is noteworthy, nonetheless, that human TF/L contains high levels of growth factors and cytokines, and may serve as the physiological environment for keratinocyte (KC) proliferation.ObjectiveThe aim of the study was to investigate the effect of human TF/L on human KC proliferation, differentiation and on the expression of epidermal stem cell markers on them.MethodsKC were isolated from lymphedema and normal skin, and cultured for 1–14 days in TF/L with neutralized Interleukin 1β, Interleukin 6, tumour necrosis factor α (TNF‐α), keratinocyte growth factor (KGF) or tumour growth factor β (TGF‐β). Alternatively, KC receptors for these factors were blocked.ResultsThe number of KC cultured in TF/L was increased, as was the percentage of mitotic figures. There was a higher percentage of p63, CD29, Ki67, PCNA, CK6, CK17, CK16 and a lower of CK10, CK14, filaggrin and involucrin‐positive KC. Neutralization of TF/L IL‐1β, IL‐6, TNF‐α and KGF as well as blockage of their receptors resulted in decreased percentage of mitotic KC. TGF‐β had a limited effect on KC proliferation.ConclusionHyperkeratosis in lymphedema may be the effect of a high concentration of cytokines in the stagnant TF/L tissue, but not because of presumed changes in the KC.
Performance of signal‐to‐noise ratio estimation for scanning electron microscope using autocorrelation Levinson–Durbin recursion model
Authors: SIM K.S. , LIM M.S. , YEAP Z.X. 
Published: February 2016

SummaryA new technique to quantify signal‐to‐noise ratio (SNR) value of the scanning electron microscope (SEM) images is proposed. This technique is known as autocorrelation Levinson–Durbin recursion (ACLDR) model. To test the performance of this technique, the SEM image is corrupted with noise. The autocorrelation function of the original image and the noisy image are formed. The signal spectrum based on the autocorrelation function of image is formed. ACLDR is then used as an SNR estimator to quantify the signal spectrum of noisy image. The SNR values of the original image and the quantified image are calculated. The ACLDR is then compared with the three existing techniques, which are nearest neighbourhood, first‐order linear interpolation and nearest neighbourhood combined with first‐order linear interpolation. It is shown that ACLDR model is able to achieve higher accuracy in SNR estimation.
Acylated but not des‐acyl ghrelin is neuroprotective in an MPTP mouse model of Parkinson's disease
Authors: Bayliss Jacqueline A. , Lemus Moyra , Santos Vanessa V. , Deo Minh , Elsworth John D. , Andrews Zane B. 
Published: February 2016

AbstractThe gut hormone ghrelin is widely beneficial in many disease states. However, ghrelin exists in two distinctive isoforms, each with its own metabolic profile. In Parkinson's Disease (PD) acylated ghrelin administration is neuroprotective, however, the role of des‐acylated ghrelin remains unknown. In this study, we wanted to identify the relative contribution each isoform plays using the MPTP model of PD. Chronic administration of acylated ghrelin in mice lacking both isoforms of ghrelin (Ghrelin KO) attenuated the MPTP‐induced loss on tyrosine hydroxylase (TH) neuronal number and volume and TH protein expression in the nigrostriatal pathway. Moreover, acylated ghrelin reduced the increase in glial fibrillary acidic protein and Ionized calcium binding adaptor molecule 1 microglia in the substantia nigra. However, injection of acylated ghrelin also elevated plasma des‐acylated ghrelin, indicating in vivo deacetylation. Next, we chronically administered des‐acylated ghrelin to Ghrelin KO mice and observed no neuroprotective effects in terms of TH cell number, TH protein expression, glial fibrillary acidic protein and ionized calcium binding adaptor molecule 1 cell number. The lack of a protective effect was mirrored in ghrelin‐O‐acyltransferase KO mice, which lack the ability to acylate ghrelin and consequently these mice have chronically increased plasma des‐acyl ghrelin. Plasma corticosterone was elevated in ghrelin‐O‐acyltransferase KO mice and with des‐acylated ghrelin administration. Overall, our studies suggest that acylated ghrelin is the isoform responsible for in vivo neuroprotection and that pharmacological approaches preventing plasma conversion from acyl ghrelin to des‐acyl ghrelin may have clinical efficacy to help slow or prevent the debilitating effects of PD.
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Ghrelin exists in the plasma as acyl and des‐acyl ghrelin. We determined the form responsible for in vivo neuroprotection in a mouse model of Parkinson's disease. Although exogenous acyl ghrelin is deacylated in situ to des‐acyl, only acyl ghrelin was neuroprotective by attenuating dopamine cell loss and glial activation. Acyl ghrelin is a therapeutic option to reduce Parkinson's Disease progression.Cover Image for this issue: doi: 10.1111/jnc.13316.
Nurses' role in medical error recovery: an integrative review
Authors: Gaffney Theresa A , Hatcher Barbara J , Milligan Renee 
Published: February 2016

Aims and objectivesThe aim of this study was to conduct an integrative review of the literature to fully understand nurses' role in medical error recovery.BackgroundDespite focused efforts on error prevention, the prevalence of medical errors occurring in the health care system remains a concern. Patient harm can be reduced or prevented by adequate recovery processes that include identifying, interrupting and correcting medical errors in a timely fashion. Both medical error prevention and recovery are critical components in advancing patient safety, yet little is known about nurses' role in medical error recovery.DesignAn integrative review of the literature, guided by Whittmore and Knafl's (Journal of Advanced Nursing, 5, 2005, 546) five‐step process, was conducted for the period between 2000–2015. A comprehensive search yielded twelve articles for this review.MethodsThe level and quality of evidence of the included articles was rated using a five‐level rating system and the Johns Hopkins Nursing Quality of Evidence Appraisal developed by ©The Johns Hopkins Hospital/The Johns Hopkins University.ResultsThe medical error recovery rate varied across specialty nursing populations with nurses recovering, on average, as many as one error per shift to as few as one error per week. Nurses rely on knowing the patient, environment and plan of care to aid in medical error recovery.ConclusionsNurses play a unique yet invisible role in identifying, interrupting and recovering medical errors. Individual and organisational factors influencing nurses' ability to recover medical errors remain unclear.Relevance to clinical practiceGreater understanding of nurse characteristics and organisational factors that influence error recovery can foster the development of effective strategies to detect and correct medical errors and enable organisations to reduce negative outcomes.
The perspectives of stakeholders of intellectual disability liaison nurses: a model of compassionate, person‐centred care
Authors: Brown Michael , Chouliara Zoë , MacArthur Juliet , McKechanie Andrew , Mack Siobhan , Hayes Matt , Fletcher Joan 
Published: February 2016

Aims and objectivesTo investigate the experiences of patients with intellectual disabilities, family and paid carers regarding the role of liaison nurses and the delivery of compassionate, person‐centred care. From this to propose a model of person‐centred care embedded in these experiences.BackgroundPeople with intellectual disabilities have a high number of comorbidities, requiring multidisciplinary care, and are at high risk of morbidity and preventable mortality. Provision of compassionate, person‐centred care is essential to prevent complications and avoid death.DesignA qualitative design was adopted with Interpretative Phenomenological Analysis for data analysis.MethodsSemistructured interviews and focus groups were conducted. Data were analysed with a focus on compassionate, person‐centred care elements and components. Themes were modelled to develop a clinically meaningful model for practice.ResultsThemes identified vulnerability, presence and the human interface; information balance; critical points and broken trust; roles and responsibilities; managing multiple transitions; ‘flagging up’ and communication.ConclusionsThe findings provide the first ‘anatomy’ of compassionate, person‐centred care and provide a model for operationalising this approach in practice. The applicability of the model will have to be evaluated further with this and other vulnerable groups.Relevance to clinical practiceThis is the first study to provide a definition of compassionate, person‐centred care and proposes a model to support its application into clinical practice for this and other vulnerable groups.
Long Coronary Lesions Treated With Thin Strut Bioresorbable Polymer Drug Eluting Stent: Experience From Multicentre Randomized CENTURY II Study
Authors: Lesiak Maciej , Araszkiewicz Aleksander , Grajek Stefan , Colombo Antonio , Lalmand Jacques , Carstensen Steen , Namiki Atsuo , Tobaru Tetsuya , Merkely Béla , Moreno Raul , Barbato Emanuele , Wijns William , Saito Shigeru 
Published: February 2016

Objectivesto assess performance of new, bioresorbable polymer sirolimus‐eluting stent (BP‐SES), in patients with long coronary lesions (LL) and to compare it to permanent polymer everolimus‐eluting stent (PP‐EES).BackgroundLL have been associated with worse clinical outcomes in percutaneous coronary interventions (PCI). The impact of lesion length on the outcomes of drug eluting stent (DES) implantations is not as clear.MethodsIn the frame of a randomized, multicentre CENTURY II study, out of 1119 patients enrolled, 182 patients had LL (defined as ≥25 mm), and were assigned randomly to treatment with BP‐SES (101) or PP‐EES (81). Primary endpoint was target lesion failure (TLF, composite of cardiac death, target vessel related myocardial infarction [MI], and target lesion revascularization [TLR]) at 9 months. All data were 100% monitored and adverse events were adjudicated by an independent clinical event committee.ResultsThe baseline patient and lesion characteristics were similar in the 2 study arms. At 9‐months, the rates of cardiac death (2.0% vs 1.2%; P = 0.70), MI (3.0% vs 4.9%; P = 0.49) and clinically driven TLR (2.0% vs 3.7%; P = 0.48) and TLF (6.9% vs 8.6%; P = 0.67) were similar for BP‐SES and PP‐EES, respectively. There was no stent thrombosis (ST) in BP‐SES group up to 9 months, while 1 case (1.2%) of ST was recorded in PP‐EES group (P = 0.44).ConclusionsPatients with LL showed similar clinical outcomes when treated with Ultimaster BP‐SES and Xience PP‐EES. (J Interven Cardiol 2016;29:47–56)
Reduced thermal threshold in patients with Temporomandibular Disorders
Authors: Carvalho G. F. , Chaves T. C. , Florencio L. L. , Dach F. , Bigal M. E. , Bevilaqua‐Grossi D. 
Published: February 2016

SummaryBackgroundMany studies have demonstrated the presence of somatosensory modulation changes at different sites in patients with temporomandibular disorders (TMDs) using different modalities. However, the neck area, a well‐know condition related to TMD, remains unexplored.ObjectiveTo assess the thermal pain threshold in patients with TMD and controls at cephalic and extra‐cephalic areas, including the neck.MethodsTwenty female patients with TMDs diagnosed by the Research Diagnostic Criteria for TMD (RDC/TMD) and twenty age‐matched controls underwent a first interview about neck pain and disability (NDI questionnaire). A blinded evaluator assessed the thermal pain threshold for cold (CPT) and heat (HPT) stimuli in accordance with an ascending method of limits of the Quantitative Sensory Testing at the following sites: periorbital, masseter, cervical posterior and ventral forearm. The groups were compared using a t‐test with α = 5%.ResultsPatients with TMDs reported pain at higher temperature for cold stimuli in all sites (P < 0·05) and at lower temperature for heat stimuli in the right periorbital site (P < 0·05) than controls. Pain and disability due tothis symptom were reported more often in the TMD group (P < 0·05).ConclusionPatients with TMD have pain modulation changes in the neck area as well, especially for cold stimuli, associated with higher disability and a higher report of neck pain than controls. These findings reinforce the evidence regarding the relationship between TMDs and neck pain.
Strategies for parenting by mothers and fathers with a mental illness
Authors: van der Ende P. C. , van Busschbach J. T. , Nicholson J. , Korevaar E. L. , van Weeghel J. 
Published: February 2016

Accessible summaryWhat is known on the subject?

The combination of coping with their mental health problems and caring for children makes parents vulnerable.

Family‐centred practice can help to maintain and strengthen important family relationships, and to identify and enhance the strengths of a parent with a mental illness, all contributing to the recovery of the person with the mental illness.

What this paper adds to the existing knowledge?

Taking the strength and the opportunities formulated by parents themselves as a starting point is fairly new.

Parents with severe mental illness find strength for parenting in several ways. They feel responsible, and this helps them to stay alert while parenting, whereas parenthood also offers a basis for social participation through school contacts and the child's friendships.

Dedication to the parent role provides a focus; parents develop strengths and skills as they find a balance between attending to their own lives and caring for their children; and parenting prompts them to find adequate sources of social support.

In this study these strategies were found to be the fundamentals of recovery related to parenting.

What are the implications for practice?

Nurses can support and coach patients who are identified as parents, and self‐chosen parenting related goals are set and addressed.

A family‐focused approach by nurses can be used to prevent problems for children and their families, identify their strengths as well as vulnerabilities, and address the challenges to build resilience.

AbstractIntroductionUnderstanding of the problems of parents with mental illness is growing. Gaining insight into strategies for parenting, while taking the opportunities formulated by these parents themselves as a starting point is fairly new.QuestionWhat are the strategies of parents with a mental illness to be successful?MethodExperiences of 19 mothers and eight fathers with a mental illness were explored with in‐depth interviews. Data were content analysed, using qualitative methods.ResultsNext to feelings of inadequacy, interviewees also describe how children enrich and structure their lives and are not only a burden but serve as distraction from problems. Developing activities that interest both child and parent provides avenues for emerging strength. Mental illness constrains fathers, but also gives opportunities to develop a meaningful relation with their children.DiscussionStrategies like being fully dedicated to the parental role, finding a balance between attention for one's own life and parenting and finding adequate sources of support are found to be fundamental for recovery in the parent role.Implications for practicePeer groups can be of valuable help and mental health workers can support parents to set self‐chosen parenting related goals.
Effects of forage offering method on performance, rumen fermentation, nutrient digestibility and nutritional behaviour in Holstein dairy calves
Authors: EbnAli A. , Khorvash M. , Ghorbani G. R. , Mahdavi A. H. , Malekkhahi M. , Mirzaei M. , Pezeshki A. , Ghaffari M. H. 
Published: February 2016

SummaryThe potential effect of dietary forage supplementation on the performance and rumen development in dairy calves is well established. However, limited research has been directed to the comparative effects of forage offering methods on calf performance. The objective of the present study was to determine the effects of forage provision methods (total mixed ration or free choice) on the performance, nutrient digestibility, rumen fermentation and nutritional behaviour in newborn calves. Forty‐five Holstein dairy calves (3 days of age and 41 ± 2 kg of body weight) were assigned to the following three groups (n = 15): (i) starter without forage provision (CON), (ii) starter supplemented with 10% alfalfa hay (AH) as a total mixed ration (AH‐TMR) and (iii) starter and AH as a free‐choice provision (AH‐FC) for a period of 70 days. All the calves were offered 5 l of milk/day from day 3 to 50, and 2.5 l/day from day 50 until weaning on day 56. Dry matter intake (DMI) was greater (p < 0.01) in the AH‐TMR and AH‐FC treatments than in the CON during the pre‐ and post‐weaning periods. Calves fed the AH‐FC diet showed the highest post‐weaning DMI among the treatments. The calves receiving ad libitum forage tended (p = 0.08) to increase crude protein digestibility and overall volatile fatty acids (VFA) concentrations in the rumen. No differences were observed among the treatments at the time spent on standing, lying, eating and performing non‐nutritive oral behaviours. Compared to CON calves, animals in the AH‐TMR treatment spent more time (p < 0.05) ruminating. In conclusion, our data suggest that forage supplementation in both forage offering methods increased total DMI, ruminal pH and ruminating time in dairy calves. Hence, there is no benefit in the free‐choice provision of AH in dairy calves.
Prevalence of insomnia‐related symptoms continues to increase in the Finnish working‐age population
Authors: Kronholm Erkki , Partonen Timo , Härmä Mikko , Hublin Christer , Lallukka Tea , Peltonen Markku , Laatikainen Tiina 
Published: February 2016

SummaryIn 2008, we published epidemiological data from 1972 to 2005 that suggested an increase in insomnia‐related symptoms among the working‐age population. The results were based on the National FINRISK (FR) Study samples of the Finnish adult population aged 25–64, and on the Finnish Quality of Work Life Surveys (FQWLS), carried out among Finnish salary earners. Both of these ongoing studies have since provided two new estimates of insomnia‐related symptoms. Chronic insomnia‐related symptoms were 9.0% (95% CI 8.3–9.7), 9.6% (95% CI 8.8–10.4) in FR 2007 and 2012, respectively; and 9.1% (95% CI 8.3–10.0), 9.2% (95% CI 8.4–10.1) in FQWLS 2008 and 2013, respectively. Occasional insomnia‐related symptoms were 45.3% (95% CI 44.1–46.6), 42.5% (95% CI 41.1–43.9) in FR 2007 and 2012, respectively; and 40.3% (95% CI 38.8–41.7), 44.8% (95% CI 41.1–43.9) in FQWLS 2008 and 2013, respectively. The new estimates further strengthen the interpretation of the ongoing increase in occasional insomnia‐related symptoms among the Finnish general adult population. The increase in occasional symptoms was most prominent among employees. However, chronic insomnia symptoms showed no further increase.