bluuebunny/crossref_metadata_2025_split huggingface dataset:
The nursing profession in Sri Lanka: time for policy changes
Authors: Aluwihare‐Samaranayake D. , Ogilvie L. , Cummings G.G. , Gellatly Ian R. 
Published: August 2017

AimWe address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made.BackgroundIncreased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems.Sources of evidenceWe draw on first‐hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession.DiscussionPolicy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence‐based practice, research, leadership, and information systems.ConclusionThere is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders.Implications for nursing and health policyImplementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers.
Public, patient and carers’ views on palliative and end‐of‐life care in India
Authors: Ramasamy Venkatasalu M. , Sirala Jagadeesh N. , Elavally S. , Pappas Y. , Mhlanga F. , Pallipalayam Varatharajan R. 
Published: August 2017

AimTo systematically review the existing evidence on the Indian public, patient and carers’ perspectives on palliative and end‐of‐life care.BackgroundWith a growing population of terminally ill people across the world, there is also an increasing awareness among international health policy makers of the need to improve the quality of life for terminally ill patients. Understanding service users’ (patients, family and public) perspectives is crucial in developing and sustaining successful community‐centred palliative nursing policies and service models especially in countries like India with diverse population.MethodsAn integrative review was performed on five databases, using hand searches of key journals and reference citation tracking for empirical studies published in English from 1990 to 2015. A thematic analysis framework was used to analyse and identify key themes.ResultsAnalysis of the six eligible studies revealed five themes. Themes describe how social, economic, cultural, religious, spiritual and traditional factors influenced the palliative and end‐of‐life care perspectives and experiences among Indians. They also illustrated preferences relating to place of care, as well as benefits and challenges of family caregiving during the last days of life.ConclusionsAlthough we found minimal evidence on user perspectives, nurses need to aware of those unique components of context‐specific palliative and end‐of‐life care practices in India – socioeconomic, cultural and religious factors – on their nursing encounters. Nurses need to advocate same in policy development to enable accessibility and utility of palliative and end‐of‐life care services, which are scant in India.Implications for nursing and health policyNurses can be central in gathering the contextual evidence that advocate users’ perspectives to inform further studies and national palliative care policies in India. Emerging policies in nursing education need to focus on integrating family‐centred palliative and end‐of‐life care within curricula, whereas nursing practice may promote nurse‐led community models to address the patchy palliative and end‐of‐life service provision in India.
Modern Likelihood‐Frequentist Inference
Authors: Pierce Donald Alan , Bellio Ruggero 
Published: August 2017

SummaryWe offer an exposition of modern higher order likelihood inference and introduce software to implement this in a quite general setting. The aim is to make more accessible an important development in statistical theory and practice. The software, implemented in anRpackage, requires only that the user provide code to compute the likelihood function and to specify extra‐likelihood aspects of the model, such as stopping rule or censoring model, through a function generating a dataset under the model. The exposition charts a narrow course through the developments, intending thereby to make these more widely accessible. It includes the likelihood ratio approximation to the distribution of the maximum likelihood estimator, that is thep∗formula, and the transformation of this yielding a second‐order approximation to the distribution of the signed likelihood ratio test statistic, based on a modified signed likelihood ratio statisticr∗. This follows developments of Barndorff‐Nielsen and others. The software utilises the approximation to required Jacobians as developed by Skovgaard, which is included in the exposition. Several examples of using the software are provided.
Multiple social media in the workplace: Contradictions and congruencies
Authors: Forsgren Emma , Byström Katriina 
Published: August 2017

AbstractIn this paper, we report an investigation on the use of multiple social media in knowledge work and explore the contribution of activity theory for such a study. As social media are increasingly adopted at work, there is a demand to understand how they are being incorporated. This study focuses on how social media may improve or reduce coherence in work activities, and for this purpose, we use activity theory as an analytical lens to conceptualise social media usage in a Scandinavian software development company. The qualitative data, consisting of interviews and observations, were analysed to capture the mediating role of social media for information sharing within and across work activities. We found social media in general helpful to maintain coherence in terms of sharing work‐related information, improving ambient awareness, as well as for socialising, but they also caused inconsistencies in use and adoption. In addition, we found that social media served different purposes in different activity systems, causing both contradictions and congruencies; what was seen as a benefit for some work activities appeared as a limitation for others (eg, concerning pace and aims of information sharing). In our findings through the lens of activity theory, we observed how objects, although they were shared, were fractionalised in networked activities. Our conclusion is that despite the still unoptimised functionality, social media do bring coherence in work activities in a decentralised work environment.
Non‐adherence to treatment of chronic wounds: patient versus professional perspectives
Authors: Moffatt Christine , Murray Susie , Keeley Vaughan , Aubeeluck Aimee 
Published: August 2017

AbstractThe reasons for the non‐adherence to treatment for wound healing are complex and fall into unintentional and intentional categories. This study explored intentional and unintentional non‐adherence to treatment from patient/carer and health care professional perspectives. Patients with wounds receivingALLEVYNLife dressings (n= 20) and patients not receivingALLEVYNLife dressings who were deemed to be non‐adherent to treatment regimes (n= 6) took part in semi‐structured interviews to explore their experiences of living with a wound, treatment and intentional and unintentional non‐adherence. Three focus groups of health care professionals explored issues surrounding non‐adherence to treatment regimes. Groups included nurses and doctors (n= 25). We found that relationships between participants and health care professionals varied in character across the groups. All participants expressed reasons for both intentional and unintentional adherence. Many reasons for intentional non‐adherence are related to comfort and working the regime around patients' lives. Health care professionals considered the most common form of non‐adherence to be unintentional. However, patients describe the most common form of non‐adherence as being intentional. The relationship between patients and health care professionals varied in character between the groups. Discrepancies between professional and patient perspectives need to be reconciled and addressed to improve adherence to treatment regimes.
Quantum molecular resonance technology in hard‐to‐heal extremity wounds: histological and clinical results
Authors: Fraccalvieri Marco , Salomone Marco , Di Santo Claudia , Ruka Erind , Morozzo Umberto , Bruschi Stefano 
Published: August 2017

AbstractChronic wounds are commonly associated with high morbidity rates due to the patient's need of frequent dressing changes and repeated visits to the outpatient wound clinic. Furthermore, chronic wounds are often characterised by severe pain, which can cause significant disability to the patient. New technologies aim to develop an optimal device to reduce discomfort of the patient and to heal wounds. The device Rexon‐age® is introduced for the first time in wound healing, and preliminary data on clinical and histological results are shown.From April 2014 to April 2015, 11 patients – 7 females and 4 males – were enrolled in the present study. The study was conducted at the Plastic and Reconstructive Institute of the Università degli Studi di Torino, Città della Salute e della Scienza of Torino, Italy. For histological characterisation, pre‐ and post‐treatment biopsies on the wound bed were performed. Data regarding age, gender, weight, height, comorbidity, drug therapy and topical pre‐treatment and dressings of the wound were collected as well. Moreover, local factors regarding the wound data were as follows: aetiology, time of the wound formation until first Rexon‐age treatment, wound dimensions, wound bed, moisture, margins and anatomical region of the wound. A visual analogue scale (VAS) was used to monitor the pain before and after each treatment.Rexon‐age treatment resulted in improvement in granulation tissue and wound contraction. Moreover, a significant reduction of pain was observed with the reduction of painkillers drug usage. Among these Rexon‐age‐treated patients, three patients displayed 60–80% reduction in pain intensity, and two patients showed complete pain relief. In outpatient follow‐up appointments, we registered long‐term durability of pain relief.As assessed by histological analyses, post‐treatment biopsies of all nine patients revealed a decreased amount of inflammatory cells and lower expression levels of metalloproteinases (e.g. MMP9). We observed increased capillary thrombosis as well as up‐regulation of vascular endothelial growth factor (VEGF) expression.The current study presents the first evidence that Rexon‐age‐based therapy can significantly ameliorate and accelerate the healing process of chronic wounds. Although this study analysed only a small number of patients, we could consistently observe positive effects on both the clinical aspect of the lesions, which underwent size reduction and wound reactivation, and the quality of life of our patients due to long‐term pain relief.
Parameters for spray drying ZnO nanopowders as spherical granules
Authors: Yıldız Ömer , Soydan Ali Murat 
Published: August 2017

AbstractSpray drying is a versatile method to perform atomization, drying, and granulation. Spray dryers enable agglomeration of particles into a spherical granule form with a nano‐meter size and thus very high specific surface areas (SSA). For this, the synthesized Zn(OH)2 precipitate should be concurrently atomized and dried under desired spray drying conditions. The drying process has many complex and critical parameters. In order to obtain ZnO nanopowders in a spherical granule form the inlet temperature and the flow rate of the hot air, the feeding rate and the solid‐liquid ratio of the suspension, need to be optimized for 150°C ≤ ITHA ≤ 180°C, 5 mL/min ≤ FRS ≤ 15 mL/min, 50 g/L ≤ SLRS ≤ 200 g/L, 0.4 m3/min ≤ FRHA ≤ 0.6 m3/min and 60°C ≤ OTDC ≤ 90°C, respectively. The powders synthesized by these modifications have a range of 5‐200 nm (TEM) and high SSA of 21‐114 m2·g−1 (average particle size: 9‐51 nm according to the SSA analyses) depending on the drying process parameters. The ZnO nanopowders have a soft granule structure according to the SSA analyses. Therefore, there is no need to grind the powders. They can be easily processed at all of the mixing and forming steps. In addition, they do not contain any contamination coming from grinding.
Cytotoxicity, chemical stability, and surface properties of ferroelectric ceramics for biomaterials
Authors: Acosta Matias , Detsch Rainer , Grünewald Alina , Rojas Virginia , Schultheiß Jan , Wajda Aleksandra , Stark Robert W. , Narayan Suman , Sitarz Maciej , Koruza Jurij , Boccaccini Aldo R. 
Published: August 2017

AbstractSurface chemistry and topo‐physical properties determine the interactions of biomaterials with their physiological environment. Ferroelectrics hold great promise as the next generation of scaffolds for tissue repair since they feature tunable surface electrical charges, piezoelectricity, and sensing capabilities. We investigate the topography, wettability, chemical stability, and cytotoxicity in salient ferroelectric systems such as (1−x) (Na1/2Bi1/2)TiO3–xBaTiO3, (1−x)Ba(Zr0.2Ti0.8)O3−x(Ba0.7Ca0.3)TiO3, and Pb(Zr,Ti)O3 to test their suitability as biomaterials. The lead‐free ferroelectrics promote in vitro cell viability and proliferation to a considerably high extent. 0.94 mol % (Na1/2Bi1/2)TiO3–0.06 mol% BaTiO3 showed the greatest potential leading to a cell viability of (149 ± 30)% and DNA synthesis of (299 ± 85)% in comparison to the reference. Lead leaching from Pb(Zr,Ti)O3 negatively affected the cultured cells. Wettability and chemical stability are key factors that determine the cytotoxicity of ferroelectrics. These variables have to be considered in the design of novel electroactive scaffolds based on ferroelectric ceramics.
Spousal concordance for hypertension: A meta‐analysis of observational studies
Authors: Wang Zhancheng , Ji Wenhui , Song Yanqiu , Li Jin , Shen Yan , Zheng Hongchao , Ding Yueyou 
Published: August 2017

The authors performed a meta‐analysis of observational studies to estimate the magnitude of spousal concordance for hypertension and to examine whether the concordance varied by important study methodological aspects. PubMed and Embase were searched up to June 2017 for cross‐sectional, case‐control, and cohort studies that investigated the concordance/association of hypertension between spouse pairs. A meta‐analysis with random‐effects models was performed by pooling adjusted odds ratios. Eight studies with a total number of 81 928 spouse pairs were eligible. The pooled results showed that spouses of individuals with hypertension had 41% (odds ratio, 1.41; 95% confidence interval, 1.21–1.64) increased odds of having hypertension themselves. The association applied to both men and women, and was not significantly different between studies with adjustment for body mass index and those without. The findings highlighted the importance of environmental factors in the development of hypertension.
Ecological and phylogenetic variability in the spinalis muscle of snakes
Authors: Tingle J. L. , Gartner G. E. A. , Jayne B. C. , Garland T. 
Published: August 2017

AbstractUnderstanding the origin and maintenance of functionally important subordinate traits is a major goal of evolutionary physiologists and ecomorphologists. Within the confines of a limbless body plan, snakes are diverse in terms of body size and ecology, but we know little about the functional traits that underlie this diversity. We used a phylogenetically diverse group of 131 snake species to examine associations between habitat use, sidewinding locomotion and constriction behaviour with the number of body vertebrae spanned by a single segment of the spinalis muscle, with total numbers of body vertebrae used as a covariate in statistical analyses. We compared models with combinations of these predictors to determine which best fit the data among all species and for the advanced snakes only (N = 114). We used both ordinary least‐squares models and phylogenetic models in which the residuals were modelled as evolving by the Ornstein–Uhlenbeck process. Snakes with greater numbers of vertebrae tended to have spinalis muscles that spanned more vertebrae. Habitat effects dominated models for analyses of all species and advanced snakes only, with the spinalis length spanning more vertebrae in arboreal species and fewer vertebrae in aquatic and burrowing species. Sidewinding specialists had shorter muscle lengths than nonspecialists. The relationship between prey constriction and spinalis length was less clear. Differences among clades were also strong when considering all species, but not for advanced snakes alone. Overall, these results suggest that muscle morphology may have played a key role in the adaptive radiation of snakes.
An esthetic evaluation of unilateral canine substitution for a missing maxillary lateral incisor
Authors: Thierens Laurent A. M. , Verhoeven Bavo , Temmerman Liesbeth , De Pauw Guy A. M. 
Published: August 2017

AbstractObjectivesThe aim of this study is to determine whether variation in size, morphology, and color of a unilateral substituted maxillary canine has influence on the dentogingival attractiveness perceived by dental professionals and laypeople.Materials and MethodsA frontal clinical photograph of a patient with unilateral canine substitution was used as standard picture. Five different series were created by modification of following parameters with a raster graphics editor (Photoshop CS 6): (1) width, (2) color, (3) gingival margin height, and (4) crown tip morphology of the substituted canine and (5) the gingival margin height of the neighboring first premolar. For each parameter, the photograph deviating the most from the standard photograph, was combined into a final series. Four groups of examiners (orthodontists, periodontists, dentists, and laypeople) were asked to rank the photographs from most to least attractive.ResultsOne hundred seventy‐four examiners ranked the photographs in order of attractiveness. Overall, a darker canine color (mean rank 4.36 ± 1.03) and a more pronounced canine tip morphology (mean rank 3.47 ± 1.11) were significantly ranked as most unattractive (P < .05). The gingival height of the neighboring premolar was ranked as least unattractive by all groups of examiners (mean rank 1.30 ± 0.74).ConclusionsDarker canine color and a pronounced tip morphology of a substituted canine are rated as the most unattractive by dental professionals and laypeople.CLINICAL SIGNIFICANCEThe present study showed that the canine color and crown tip morphology are important parameters when considering unilateral canine substitution, both for professionals and laypeople. There is a general preference in favor of canines with a light color and a reduced incisal tip.
Development of a real‐time PCR assay for rapid detection and quantification of Photobacterium damselae subsp. piscicida in fish tissues
Authors: Carraro R , Dalla Rovere G , Ferraresso S , Carraro L , Franch R , Toffan A , Pascoli F , Patarnello T , Bargelloni L 
Published: August 2017

AbstractThe availability of a rapid and accurate method for the diagnosis of Photobacterium damselae subsp. piscicida (Phdp), able to discriminate its strictly correlated subsp. damselae (Phdd), formally known as Vibrio damsela, is essential for managing fish pasteurellosis outbreaks in farmed fish. A single‐step, high‐sensitivity real‐time PCR assay for simultaneous detection and quantification of P. damselae was designed targeting partial of the sequence of the bamB gene and tested for specificity and sensitivity on laboratory‐generated samples as well as on experimentally infected seabream tissue samples. With a limit of detection (LOD) of one copy in pure bacterial DNA, the sensitivity was higher than all methods previously reported. Validation in target and non‐target bacterial species proved the assay was able to discriminate Phdd‐Phdp subspecies from diverse hosts/geographical origins and between non‐target species. In addition, two SNPs in the target amplicon region determine two distinctive qPCR dissociation curves distinguishing between Phdp‐Phdd. This is the first time that a molecular method for P. damselae diagnosis combines detection, quantification and subspecies identification in one step. The assay holds the potential to improve the knowledge of infection dynamics and the development of better strategies to control an important fish disease.
High Symptom Burden and Low Functional Status in the Setting of Multimorbidity
Authors: Portz Jennifer D. , Kutner Jean S. , Blatchford Patrick J. , Ritchie Christine S. 
Published: August 2017

ObjectivesTo enhance understanding of the relationship between multimorbidity, symptom burden, and functional status in individuals with life‐limiting illness.DesignSecondary analysis of baseline data from a randomized clinical trial conducted in the Palliative Care Research Cooperative Group. Group differences were tested using a t‐test; multivariate regression analysis was used to determine the effect of multiple variables on functional status and symptom burden.SettingFifteen Palliative Care Research Cooperation sites.ParticipantsAdults who participated in a parent statin‐discontinuation clinical trial were included in the analysis (N = 381). Inclusion criteria were diagnosis of a life‐limiting illness, statin use for 3 months or longer, life expectancy longer than 1 month, and declining functional status.MeasurementsCancer diagnosis (solid organ and hematologic malignancies), multimorbidity (Charlson Comorbidity Index (CCI) score), symptom burden (Edmonton Symptom Assessment Scale (ESAS) score, number of symptoms with ESAS severity score >4), functional status (Australia‐modified Karnofsky Performance Scale (AKPS)).ResultsFifty‐one percent had a primary diagnosis of cancer; mean age 74.1 ± 11.6. Participants had multiple comorbid illnesses (CCI score 4.9 ± 2.8), multiple symptoms (ESAS score 27.2 ± 15.9), and poor functional status (AKPS = 53 ± 13). In univariate and multivariate analyses, multimorbidity was associated with greater symptom burden (4.2 vs 3.1 moderate or severe symptoms (t = −3.2, P = .002), 12% vs 6% with severe symptoms (t = −3.7, P < .001)), but cancer diagnosis was not. In univariate and multivariate analyses, higher symptom burden was associated with poorer functional status (F = 11.6, P < .001), but multimorbidity was not.ConclusionSymptoms cannot be attributed solely to a diagnosis of cancer. The association between symptom burden and functional status underscores the importance of clinical attention to symptoms in individuals with multimorbidity.