bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Psychological Empowerment and Intent to Stay Among Military Hospital Nurses: The Mediating Effects of the Practice Environment and Burnout
Authors: Jin Chaoying , Wang Juncheng , Du Juan , Shi Ruijie 
Published: September 2024

ABSTRACTAimsTo explore the impact of psychological empowerment on nurses' intent to stay in military hospitals as well as the mediating effects of the practice environment and burnout in this context.DesignThis study employed a cross‐sectional survey approach and followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting.MethodsA total of 1225 nurses from nine military hospitals were recruited via convenience sampling. Questionnaires were distributed and collected via the Questionnaire Star platform. The study variables, including psychological empowerment, the practice environment, burnout and intent to stay, were assessed via self‐report questionnaires. SPSS 23.0 software was used to conduct descriptive and correlation analyses. Additionally, PROCESS Model 6 was employed to examine the mediating effects.ResultsPsychological empowerment is positively associated with nurses' intent to stay. Mediation analysis revealed that the practice environment, burnout and the chain mediating effect of the practice environment and burnout accounted for 54.5%, 2.8% and 1.5% of the total effect respectively.ConclusionPsychological empowerment affects nurses' intent to stay not only directly but also indirectly via the practice environment and burnout.Implications for the ProfessionNursing managers may consider utilising psychological empowerment as a management strategy to enhance nurses' perceived practice environment, reduce burnout and ultimately increase nurses' intent to stay. This approach has the potential to lower turnover rates among nurses.Patient or Public ContributionQuestionnaires completed by nurses were used to explore the relationships among psychological empowerment, the practice environment, burnout and intent to stay in this context.
Co‐Designing Nurse Practitioner Roles in a Tertiary Hospital: A Qualitative Exploration of Patterns and Underlying Dynamics
Authors: Dehennin Laurence , Vermassen Frank , Decoene Elsie , Duprez Veerle , Kinnaer Lise‐Marie , Van Hecke Ann 
Published: September 2024

ABSTRACTAimsTo explore patterns and dynamics during the co‐design process of nurse practitioners' role development in three departments in a Belgian tertiary hospital.DesignParticipatory action research was utilised in conjunction with principles of a Grounded Theory approach to explore patterns and dynamics.MethodsSixteen meetings were conducted between January and June 2021 with interdisciplinary teams to develop the roles. Thirteen exploratory interviews were held with the stakeholders involved between March and June 2022. All meetings and interviews were recorded and transcribed verbatim. Data were systematically analysed using researcher triangulation and thematic analysis.ResultsStakeholders' initial conception of the nurse practitioner roles affected development. A dynamic interplay of individual, team‐related and contextual (e.g., financial and legal) factors shaped these conceptions. Through co‐design, stakeholders' conception evolved as insights were shared, misconceptions challenged and perspectives broadened. Physicians generally the developmental process, while nursing leadership was more fragmented.ConclusionThis study identifies patterns and dynamics in interdisciplinary teams during the developmental process. The key findings underpin the crucial role of stakeholders' conceptions, use of co‐design and leadership in this process. Therefore, a thorough understanding of initial conceptions is ess, and efforts should be directed towards providing sufficient knowledge and experience to prevent misconceptions. Additionally, this study emphasises the significance of a balanced team composition that incorporates diverse conceptions of the role. Finally, actions should be taken to empower leadership among nurses.ImpactIdentified dynamics offer insights for healthcare organisations developing nurse practitioner roles. Educational institutions can use these insights to enhance healthcare professionals' curricula, preparing healthcare professionals for evolving advanced nursing roles and leadership. Additionally, it emphasises the necessity for policy work to establish a legal framework for nurse practitioners in Belgium.Reporting MethodThe ‘Standards for Reporting Qualitative Research’ were used for reporting.Patient or Public ContributionThis study did not involve direct participation from patients or the public.
Job Characteristic Profiles and Presenteeism Among Shift Nurses: A Latent Profile Analysis Based on the Job Demands–Resources Model
Authors: Nam Song Yi , Lee Haeyoung , Ryu Eunjung , Hong Hye Chong , Kang Minkyung , Min Ari 
Published: September 2024

ABSTRACTAim(s)To investigate job characteristic profiles based on the job demands–resources (JD‐R) model and the association between job characteristic profiles and presenteeism.DesignCross‐sectional study.MethodsData were collected from shift nurses in South Korea in January 2023 using an online survey. This study included 544 nurses working in tertiary and general hospitals in South Korea. The participants were classified into four job characteristic profiles based on the JD‐R model using latent profile analysis. Multiple logistic and linear regression analyses were performed to examine the association between job characteristic profiles and presenteeism.ResultsFour profiles were derived from the latent profile analysis: low strain–low motivation, high strain–low motivation, low strain–high motivation and high strain–high motivation. The high strain–low motivation, low strain–high motivation and high strain–high motivation groups were 1.74, 1.37 and 3.51 times more likely to experience presenteeism than the low strain–low motivation group respectively. The number of days worked while sick and the level of reduced job productivity was also the highest in the high strain–high motivation group. In addition, general health, multimorbidities and insomnia were significant factors affecting presenteeism, number of days worked while sick and productivity loss among shift nurses.ConclusionsThis study found that even with higher levels of job resources, work environments with high levels of job demands were associated with higher rates of presenteeism.ImpactStudy findings suggest that various strategies are needed to improve the physical and mental health of shift nurses, and create a healthy organisational environment by reducing excessive job demands to reduce presenteeism and increase productivity.Reporting MethodSTROBE guidelines.Patient or Public ContributionNo patient or public contribution.
The Impact of the COVID‐19 Pandemic on Nurses' and Junior Doctors' Workloads
Authors: Doleman Gemma , Leo Annemarie De , Bloxsome Dianne 
Published: September 2024

ABSTRACTAimsTo explore the impact of the COVID‐19 pandemic on nurses' and junior doctors' workload, changes to direct care and the impact of workload on resource allocation.DesignMixed‐method design was used.MethodsData were collected from direct observation, hospital administrative database and a survey. Nurses and junior doctors were observed on two COVID‐19 wards and one non‐COVID‐19 ward using a semi‐structured observation schedule. Survey data were collected from nurses and junior doctors that had worked on the COVID‐19 ward during the pandemic. Patient data were collected from Web Patient Administration System during the period of March–August 2021 and compared to March–August 2022.ResultsThe results of this study indicated that the workloads of nurses and junior doctors changed on the COVID‐19 wards. Nurses on the COVID‐19 ward spent less time on administration, communication and documentation compared to nurses working on the non‐COVID‐19 ward. For junior doctors, less time was being spent on direct care activities and administrative work compared to the non‐COVID ward. On the COVID‐19 wards, patients were older and had a shorter length of stay compared to the year before. Five themes were identified from the surveys, staffing shortages resulting in higher workloads and the need for overtime, unforeseen time to undertake tasks, lack of support and physical health and patient care compromised.ConclusionThe study highlights the need for systemic changes to staffing shortages and elevated workloads to improve the compromised mental and physical health caused during the pandemic and to retain the workforce for future sustainability.ImplicationsAs we collectively reflect on the lessons learned from this unprecedented period, it is imperative to address the challenges experienced proactively, fostering a healthcare environment that prioritises the well‐being of its front line heroes and, by extension, the quality of patient care.Reporting MethodSTROBE.Patient or Public ContributionNo patient or public contribution.
Melanism in Polymorphic Terrestrial Snakes: A Meta‐Analysis and Systematic Review
Authors: Sahlean Tiberiu Constantin , Martin Ryan A. , Spaseni Petronel , Gherghel Iulian , Strugariu Alexandru 
Published: September 2024

ABSTRACTBackground and AimColour polymorphic populations constitute excellent model systems for testing ecological and evolutionary hypotheses, as alternate colourations are associated with differences in various biological, behavioural and life‐history traits. Melanism is the most common and most obvious form of polymorphism. In reptiles in general (and snakes in particular), thermal melanism has been a popular hypothesis used to explain the appearance of black individuals. It suggests that a trade‐off exists between superior thermoregulation and reduced protection through the loss of crypsis. Surprisingly, despite the growing body of literature available, to date, there are only two qualitative reviews on the evolutionary significance of melanism in reptiles and no quantitative synthesis. We conducted the first systematic review and meta‐analysis summarising the current knowledge on melanism in polymorphic terrestrial snakes and synthesised the evidence for an adaptive advantage of the melanistic morph.LocationNorthern Hemisphere.TaxonPolymorphic terrestrial snakes.ResultsMean prevalence of melanism is 31% with no significant differences between species. Annual precipitation was a significant moderator of melanism prevalence. Our results revealed no significant differences in odds ratios of melanism between sexes or in mean body size.Main ConclusionsEnvironmental plasticity can be considered the primary cause of melanism, possibly as a result of seasonal climatic variations, a result corroborated by the formal meta‐analysis conducted. Conclusions from the meta‐analysis are that melanism in snakes follows Gloger's rule, as is the case in birds and mammals, and as opposed to the thermal melanism hypothesis. Further, our findings do not lend support for other predictions from the thermal melanism hypothesis, such as skewed frequency of melanistics in favour of males or females, or larger body sizes in black individuals. Our results hold implications for the future diversity of animal populations, as climate change is predicted to decrease the degree of colour variation.
The Interaction Between the Linnean and Darwinian Shortfalls Affects Our Understanding of the Evolutionary Dynamics Driving Diversity Patterns of New World Coralsnakes
Authors: Frateles Lívia Estéfane Fernandes , Tavares Guilherme Rogie Gonçalves , Nakamura Gabriel , da Silva Nelson Jorge , Terribile Levi Carina , Diniz‐Filho José Alexandre F. 
Published: September 2024

ABSTRACTAimIn this study, we sought to understand how the Linnean shortfall (i.e., the lack of knowledge about species taxonomy) interacts with the Darwinian shortfall (i.e., the lack of knowledge about phylogenetic relationships among species), which potentially jeopardises geographical patterns in estimates of speciation rates.LocationNew World.TaxonCoralsnakes (Serpentes: Elapidae).MethodsWe created an index of taxonomic uncertainty (ITU) that measures the likelihood of current species being split after undergoing future taxonomic revisions. The ITU was used in simulations where species with higher taxonomic uncertainty had a higher likelihood of having their phylogenetic branches split, generating new hypothetical species along their geographic ranges. We estimated the speciation rates before and after the split of taxonomically uncertain species.ResultsWe found that a high number of coralsnake species display substantial taxonomic uncertainty, positively correlated with the latitude of the species' geographical range centroid. The estimated speciation rates based on currently available data have a weak relationship with latitude. However, after incorporating taxonomic uncertainty into the phylogeny, we detect a higher positive correlation between speciation rate and latitude.Main ConclusionsThe observed change in speciation rates following the incorporation of taxonomic uncertainty highlights how such uncertainty can undermine the empirical evaluation of geographical patterns in speciation rates, revealing an interaction between the latitudinal taxonomic gradient and the latitudinal diversity gradient. Given that taxonomic changes can alter the number of species recognised as valid over time, our study highlights the need to incorporate taxonomic uncertainty into macroecological and macroevolutionary studies, enhancing the robustness of patterns inferred from these data.
First Report of Root Rot Caused by Fusarium avenaceum and Fusarium flocciferum on Astragalus membranaceus var. mongholicus in China
Authors: Qi Hexing , Qi Xiangxing , Xu Wenhua , An Zhouluo , Fan Taiyan 
Published: September 2024

ABSTRACTAstragalus membranaceus var. mongholicus (Mongolian milkvetch) is one of the most important traditional Chinese medicinal plants. In July 2021, root rot of A. membranaceus var. mongholicus was found in a field in Tongren City, Huangnan Tibetan Autonomous Prefecture, Qinghai Province, China. The aboveground part of the plants exhibited yellowing, wilting and defoliation in severe cases. Seven fungal isolates were obtained, and their pathogenicity, morphology and phylogeny were analysed. A pathogenicity test was performed using the scratch and root irrigation methods, and the results showed that all seven isolates caused root rot on inoculated plants. Based on morphological characteristics and phylogenetic analysis of multi‐locus sequences (ITS, translation elongation factor [TEF‐1α], and RNA polymerase II beta subunit [RPB2] genes), two isolates were identified as Fusarium avenaceum, and five isolates were identified as F. flocciferum. To the best of our knowledge, this is the first report of F. avenaceum and F. flocciferum causing root rot of A. membranaceus var. mongholicus in China.
Strengthening Relationships Within Intensive Psychiatric Care: Staff Perceptions of an Attachment Training Intervention
Authors: Duffy Aiden , Goodall Karen , Carmichael David , Harper Sean , Sivyer Katy , Carnelley Kathy , Maguire Tess , Newman‐Taylor Katherine 
Published: September 2024

ABSTRACTIntroductionIntensive psychiatric care units can be challenging environments in which to build strong staff‐patient relationships. Attachment theory may provide a useful model for strengthening relationships in this setting.AimThe aim of this study was to explore staff perceptions of the utility of attachment theory for understanding patient behaviour in the intensive psychiatric care setting.MethodsSemi‐structured interviews were conducted with 11 multi‐disciplinary staff members. Interviews focused on the staff member's experience of learning about attachment theory and applying this perspective to their work on the ward. Transcripts were analysed using reflexive thematic analysis.ResultsThe analysis led to the development of three themes: engaging the reflective self, new perspective on others and cohesive ward culture.ConclusionStaff reported that learning about attachment theory supported them to better understand patient distress and associated behaviours. Notably, staff also used attachment theory to reflect on both their own internal states and the internal states of their colleagues. These reflections were suggested to bolster staff wellbeing and improve the ward milieu.Implications for PracticeIntegrating attachment theory into team formulation, ward rounds and reflective practice groups could have a benefit for clinical practice, staff wellbeing and team cohesion in this setting.
Smartphone‐based scans of palate models of newborns with cleft lip and palate: Outlooks for three‐dimensional image capturing and machine learning plate tool
Authors: Santos José Wittor de Macêdo , Mueller Andreas Albert , Benitez Benito K. , Lill Yoriko , Nalabothu Prasad , Muniz Francisco Wilker Mustafa Gomes 
Published: September 2024

AbstractObjectivesTo evaluate the performance of smartphone scanning applications (apps) in acquiring 3D meshes of cleft palate models. Secondarily, to validate a machine learning (ML) tool for computing automated presurgical plate (PSP).Materials and MethodsWe conducted a comparative analysis of two apps on 15 cleft palate models: five unilateral cleft lip and palate (UCLP), five bilateral cleft lip and palate (BCLP) and five isolated cleft palate (ICP). The scans were performed with and without a mirror to simulate intraoral acquisition. The 3D reconstructions were compared to control reconstructions acquired using a professional intraoral scanner using open‐source software.ResultsThirty 3D scans were acquired by each app, totalling 60 scans. The main findings were in the UCLP sample, where the KIRI scans without a mirror (0.22 ± 0.03 mm) had a good performance with a deviation from the ground truth comparable to the control group (0.14 ± 0.13 mm) (p = .653). Scaniverse scans with a mirror showed the lowest accuracy of all the samples. The ML tool was able to predict the landmarks and automatically generate the plates, except in ICP models. KIRI scans' plates showed better performance with (0.22 ± 0.06 mm) and without mirror (0.18 ± 0.05 mm), being comparable with controls (0.16 ± 0.08 mm) (p = .954 and p = .439, respectively).ConclusionsKIRI Engine performed better in scanning UCLP models without a mirror. The ML tool showed a high capability for morphology recognition and automated PSP generation.
Wearing the mandibular advancement orthosis and dental movements: Contribution of a digital monitoring protocol
Authors: Gay M. , Ducret M. , Richert R. , Buiret G. 
Published: September 2024

AbstractObjectivesOral appliance (OA) has been increasingly used for the treatment of obstructive sleep apnoea hypopnea syndrome (OSAHS). OAs work by propelling the mandible, increasing the upper airway calibre and reducing collapsibility. While they have shown efficacy in reducing OSAHS, long‐term use can lead to adverse effects, such as dental displacement. The present study focuses on the impact on dental displacements of the NARVAL® computer‐aided design and manufacturing OA from the ResMed laboratory.Materials and MethodsThe study included 39 patients aged 18 or older who were treated for OSAHS using OAs initiated between 2019 and 2021 and had initial digital dental impressions. A new digital print was taken for each patient using the TRIOS 4 Wireless intra‐oral scanner from 3SHAPE. Dental displacement was measured using a 3D system's GEOMAGIC design X 3D reverse engineering software. The study analysed different blocks of teeth in both the maxillary and mandibular arches. Statistical analysis was conducted to determine the significance of dental displacements.ResultsPatients had been wearing the OA for an average of 2.5 years. The study found dental displacements in both the maxillary and mandibular arches. However, these displacements were not statistically significant. Qualitative analysis revealed palatoversion and vestibuloversion, while quantitative analysis showed minor dental displacements.ConclusionThis study on patients wearing the NARVAL® OA for an average of 2.5 years found dental displacements in both the maxillary and mandibular arches. However, these displacements were not statistically significant. The results suggest that the OA, designed using a complete digital workflow, did not significantly impact dental positions. To confirm the impact, further investigations with larger sample sizes, an exclusively digital protocol and a control group are required.
The effect of intraoperative methadone on postoperative opioid requirements in children undergoing orchiopexy: A randomized clinical trial
Authors: Uhrbrand Camilla G. , Gadegaard Karsten H. , Aliuskeviciene Asta , Ahlburg Peter , Nikolajsen Lone 
Published: September 2024

AbstractBackgroundChildren undergoing outpatient surgery are at risk of inadequate postoperative pain control. Methadone has a long duration of action and an intraoperative dose may provide stable analgesia throughout the postoperative period. Intraoperative methadone has been shown to improve pain control in adolescents but its use for postoperative pain in pediatric patients undergoing outpatient surgery has not been studied before. Therefore, we conducted a double‐blind randomized placebo‐controlled trial to investigate the effects of a single dose of intraoperative methadone in children aged less than 5 years undergoing orchiopexy for undescended testis.MethodsA total of 68 children were randomized to receive either methadone (0.1 mg/kg) or isotonic saline following induction of anesthesia. Exclusion criteria included preterm birth, previous scrotal surgery, and parents' inability to consent. Primary outcomes were opioid requirements (first primary outcome) and pain intensity in the post‐anesthesia care unit. Secondary outcomes included episodes of desaturation and time until readiness to discharge from the post‐anesthesia care unit, sleep on the first postoperative night, pain intensity, and opioid requirements at home until the evening on the first postoperative day. Follow‐up was 4 days.ResultsSixty children completed the study (age, mean ± SD, 26.2 ± 13.9 months), 29 children received methadone, and 31 children received placebo. Eighteen children required opioids in the post‐anesthesia care unit, five children in the methadone group (proportion = 0.17, 95% confidence interval (CI): 0.07, 0.36) compared to thirteen patients in the placebo group (0.42, 95% CI: 0.26, 0.60) (mean difference = −0.24 and 95% CI: −0.03, −0.47) (p = 0.037). Five children in the methadone group (0.17, 95% CI: 0.03, 0.31) versus ten in the placebo group (0.32, 95% CI: 0.16, 0.49) had a face, legs, activity, cry, consolability score of ≥5 in the post‐anesthesia care unit (mean difference = −0.15, 95% CI: −0.36, 0.06) (p = .179). More children in the placebo group woke up due to pain the first night following surgery (seven children vs. one child). The methadone group had a longer stay in the post‐anesthesia care unit. There were no differences between the two groups regarding the other secondary outcomes.ConclusionA single dose of intraoperative methadone reduces short‐term postoperative opioid requirements in children after orchiopexy for nondescended testes but prolongs the duration of their stay in the post‐anesthesia care unit.
Moral expertise as skilled practice
Authors: Stroud Sarah 
Published: September 2024

AbstractContemporary discussions of moral expertise have raised a host of problems for the very idea of a “moral expert.” This article interrogates the conception of moral expertise that such discussions seem to assume and proposes instead that we understand moral expertise as a species of practical skill. On this model, a skilled moral agent is more similar to a skilled pianist than she is to a theoretical expert (for instance, an expert on the War of 1812). The article argues both that it is more natural to understand the moral “expert” as excelling in a form of skilled practice and that such a conception would render moot many of the concerns which preoccupy contemporary discussions.