bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self‐management of medication during hospitalisation: Healthcare providers’ and patients’ perspectives
Authors: Vanwesemael Toke , Boussery Koen , Manias Elizabeth , Petrovic Mirko , Fraeyman Jessica , Dilles Tinne 
Published: September 2017

Aims and objectivesTo explore healthcare providers’ and patients’ perspectives on self‐management of medication during the patients’ hospital stay.BackgroundSelf‐administration of medications relates to the process in which hospitalised patients—instead of healthcare professionals—prepare and consume medications by themselves. Literature suggests possible advantages of medication self‐management such as increased patient satisfaction, adherence to pharmacotherapy and self‐care competence.DesignA qualitative descriptive study design was adopted, using semistructured interviews and qualitative content analysis to examine data.MethodsSix physicians, 11 nurses, six hospital pharmacists and seven patients were recruited from one regional hospital and two university hospitals, situated in Belgium. Interviews were conducted between October 2014–January 2015.ResultsStrengths of medication self‐management were described by participants, relating to benefits of self‐management for patients, time‐saving benefits for nurses and benefits for better collaboration between patients and healthcare providers. Weaknesses were also apparent for patients as well as for nurses and physicians. Opportunities for self‐management of medication were described, relating to the organisation, the patient and the process for implementing self‐management. Threats for self‐management of medication included obstacles related to implementation of self‐managed medications and the actual process of providing medication self‐management. A structured overview of conditions that should be fulfilled before allowing self‐management of medication concerned patient‐related conditions, the self‐managed medication and the organisation of self‐management of medication.ConclusionsThis study provides new insights on the strengths, weaknesses, opportunities and threats from the perspectives of key stakeholders. Interpretation of these findings resulted in an overview of adaptations in the medication management process to facilitate implementation of self‐management of medication.Relevance to clinical practiceA medication management process for self‐management of medication was proposed. Further interventional studies are needed to test and refine this process before implementing it in daily practice.
When holistic care is not holistic enough: The role of sexual health in mental health settings
Authors: Hendry Avril , Snowden Austyn , Brown Michael 
Published: September 2017

Aims and objectivesTo explore the preparation that mental health nurses receive to address sexual health in practice.BackgroundPeople who use the mental health services often have complex sexual health needs. Mental health nurses are well placed to offer support. However, this rarely happens in practice, and therefore, people's sexual health needs are not being routinely addressed. It is not known why this is the case.DesignSystematic review and meta‐ethnography.MethodsEBSCO, PsycINFO, MEDLINE and ASSIA databases were searched using Booleans with Mesh and key terms including “mental health nurse” and “sexual health”. Date range was June 2006 to June 2016. Discursive papers were excluded. Included papers (n = 7) were synthesised using a meta‐ethnographic approach.ResultsThe search yielded seven studies. Five key themes were identified: the (not so) therapeutic relationship; personal values dictating professional ones; institutionalised fear; being human; and education: the answer but where is it?ConclusionsThe findings illustrate the complexity of supporting people with mental health and sexual health needs. They show the discomfort many nurses have about broaching sexual health. Arguably more than with most issues, personal values impacted strongly on professional practice. Understanding the depth and multifaceted nature of these themes is important, because strategies can then be developed to mitigate the barriers to best practice. For example, the findings presented here offer a framework from which structured education and support can be built.Relevance to clinical practiceThere is a need for Mental health nurses to be more responsive to concerns around sexual health and it should be routinely included in their practice. This study illuminates why this is not currently the case. By understanding this, remedial action can be taken by nurse educators. Implications are also discussed in relation to policy, research and practice.
Postnatal ER visits within 30 days—Pattern, risk factors and implications for care
Authors: Vikström Anna , Johansson Sven‐Erik , Barimani Mia 
Published: September 2017

Aims and objectivesTo (i) reveal care‐seeking patterns of emergency room visits within 30 days following childbirth (i.e., identify risk factors that trigger contact with emergency room, visit rate and diagnoses) and (ii) suggest clinical implications for postnatal follow‐up.DesignThe study had a longitudinal design; it used anonymised data from a county council database on all women in Stockholm County, Sweden, who gave birth in 2013.MethodsDescriptive and inferential data analysis methods were used. Cox regression was applied to these variables: age when giving birth, diagnostic codes at birth, care encounters and types (e.g., visits or hospital admissions), day of discharge and care organisation and type. The data covered the period from childbirth through a 30‐day period following discharge from hospital.ResultsThe database contained 28,963 births and 59,202 healthcare or medical care encounters. Of these encounters, 50.3% (n = 29,774) were planned visits to hospital postnatal care units within 7 days following discharge and 1.2% (n = 681) were admissions to hospitals. Of all women who gave birth, 12.2% (n = 3,533) visited the emergency room at least once. The number of visits peaked at day 6 following discharge. These factors significantly increased risk for emergency room visits: caesarean, assisted birth and sphincter injury.ConclusionsEmergency room visits occurred most commonly immediately following discharge when there were no routine check‐ups. Greater risk of emergency room visits – following caesareans, assisted childbirths or sphincter injuries – indicated that early support for women with childbirth complications should be improved upon discharge from hospital. Other multiple risk factors for emergency room visits might exist.Relevance to Clinical PracticeMany emergency room visits could be prevented through early, more qualified, appropriate follow‐up via maternity care systems and effective midwifery interventions. These initiatives could enhance care continuity and facilitate postpartum recovery.
Preterm infants’ mothers’ initiation and frequency of breast milk expression and exclusive use of mother's breast milk in neonatal intensive care units
Authors: Ikonen Riikka , Paavilainen Eija , Helminen Mika , Kaunonen Marja 
Published: September 2017

Aims and objectivesTo describe preterm infants’ mothers’ expressing practices and exclusive use of mother's breast milk in neonatal intensive care settings, as well as to explore whether mothers’ and infants’ characteristics are predictors of the mother's inadequate expressing practices and nonexclusive use of mothers’ breast milk.BackgroundUse of their own mother's milk decreases preterm infants’ mortality and morbidity, but expression is exhausting for the mothers. Mothers’ and infants’ characteristics are associated with milk output and exclusive breastfeeding at discharge, as well as later in infancy.DesignCross‐sectional study.MethodsThe data were collected through questionnaires in two neonatal units. Multiple logistic regression was used to determine whether mothers’ and infants’ characteristics are predictors of late expression initiation (>6 hr from birth), inadequate expression frequency (≤6 times per a day) and nonexclusive use of own mother's milk.ResultsThe sample consisted of 129 mothers. One‐third of the mothers had adequate expression practices. Half of the infants exclusively received their mother's own breast milk. Previous neonatal intensive care unit experience, poor psychological well‐being, an infant's male gender, caesarean section and high gestational birth age were significant predictors of late expression initiation. None of the studied variables were significant predictors of inadequate expression frequency. Furthermore, lack of previous expression experience, financial woes and high gestational age were predictors of nonexclusive use of own mother's milk.ConclusionsExpression practices, as well as use of own mother's milk, were suboptimal. High gestational age was associated with both late expression initiation and nonexclusive breast milk use. The mothers maintained expression regardless of their well‐being.Relevance to clinical practiceCounselling and support are needed to avoid suboptimal expression practices. Special attention should be paid to mothers with moderately preterm infants, caesarean delivery, poor psychological well‐being and financial woes.
Comparison of Clinical, Radiographic, and Immunologic Inflammatory Parameters around Crestally and Subcrestally Placed Dental Implants: 5‐Year Retrospective Results
Authors: Al Amri Mohammad D. , Alfadda Sara A. , Labban Nawaf Y. , Alasqah Mohammed N. , Alshehri Fahad A. , Al‐Rasheed Abdulaziz S. 
Published: September 2017

AbstractPurposeTo compare changes in clinical (bleeding on probing [BOP] and probing pocket depth [PPD]), radiographic (crestal bone loss [CBL]), and immunologic inflammatory (interleukin‐1beta [IL‐1β] and matrix metalloproteinase‐9 [MMP‐9]) parameters around crestally and subcrestally placed dental implants 5 years after implant placement.Materials and MethodsFifty‐two patients were divided into 2 groups: group 1 (n = 27): patients with single implants placed approximately 2 mm below the alveolar crest; group 2 (n = 25): patients with single implants placed at bone level. In both groups, peri‐implant BOP, PPD, and CBL were measured, and levels of IL‐1β and MMP‐9 were determined in duplicates using enzyme‐linked immunosorbent assay. Full‐mouth debridement was performed biannually in both groups. Statistical analysis was performed using the Mann‐Whitney U test (significance set at p < 0.05).ResultsAll measurements in groups 1 and 2 were performed 5.3 ± 0.2 and 5.2 ± 0.1 years after implant placement, respectively. The mean CBL was 1.2 ± 0.2 mm and 1.4 ± 0.2 mm in groups 1 and 2, respectively. There was no significant difference in mean BOP, PPD, CBL and in levels of IL‐1β, and MMP‐9 among implants in both groups.ConclusionClinical, radiographic, and immunologic inflammatory parameters are comparable around crestally and subcrestally placed single dental implants up to 5 years after placement. The depth of implant placement appears to have no effect on clinical status and performance of single dental implants.
Clinical Performance and Epidemiologic Aspects of Fractured Anterior Teeth Restored with a Composite Resin: A Two‐Year Clinical Study
Authors: Vural Uzay Koc , Kiremitçi Arlin , Gökalp Saadet 
Published: September 2017

AbstractPurposeTo investigate the etiologic factors, effect of age and gender on dental trauma, and to evaluate the performance of composite resin on the fractured crown of permanent anterior teeth.Materials and MethodsOver a 2‐year period, 73 permanent teeth from 51 patients with dental trauma were treated with direct composite resin restoration. Informed consent and standardized trauma forms were completed by the patient; teeth were restored with a submicron hybrid composite resin (Spectrum TPH) and respective adhesive system (Prime&Bond NT). Sixty‐nine teeth were directly restored without fiber posts, while four were treated with fiber posts. Two experienced clinicians, besides the operator, evaluated each restoration at 6‐, 12‐, and 24‐month follow‐ups according to US Public Health Service (USPHS) criteria for the following characteristics: anatomical form, marginal adaptation, color match, marginal discoloration, surface roughness, and caries. Data were analyzed using the Wilcoxon Signed Rank, Kruskal‐Wallis, Mann‐Whitney U, and Siegel and Castellan tests.ResultsA total of 73 traumatized teeth in 51 patients aged from 14 to 64 years (mean age 25.47 ± 14.058 years) were assessed according to the Ellis classification and restored over a 2‐year period. Crown fractures were more common in the maxilla (84.9%) and caused by falls (58.8%). At the end of 24 months, a total of ten restorations were lost. The survival rate after 24 months was 82.14%. There were statistically significant differences in marginal adaptation between the 6‐, 12‐, and 24‐month follow‐ups. Although changes in marginal discoloration over time were not significant (p = 0.194), changes in color match were significant (p = 0.029).ConclusionWithin the limitations of this study, direct composite restorations were accepted as clinically satisfactory.
Conservative post‐natal management of antenatally diagnosed congenital pulmonary airway malformations
Authors: Makhijani Allya V , Wong Flora Y 
Published: September 2017

AimManagement of congenital pulmonary airway malformations (CPAM) is controversial, especially for asymptomatic patients. We aim to describe the clinical manifestations and management of CPAM at a tertiary paediatric hospital using a retrospective audit.MethodsInfants with CPAM were identified on the Fetal Diagnostic Unit database from 2007 to 2014. Information on antenatal and post‐natal management was collected from medical record.ResultsThirty‐five infants with antenatally diagnosed CPAM were included. Fetal CPAM volume ratio (CVR) was calculated from antenatal ultrasound measurement and used to categorise the infants into three groups of large (CVR ≥ 1.6, n = 8), medium (CVR of 0.5–1.6, n = 12) and small CPAM (CVR of ≤0.5, n = 15), respectively. Ten infants (10/35 = 29%) were symptomatic in the neonatal period. Overall, nine infants (26%) had surgical resection, among whom eight had large or medium‐sized CPAM lesions as defined by the antenatal CVR. Three infants had neonatal emergency surgery and the remaining six had late elective surgery. Histology of eight cases showed CPAM, but one case showed congenital lobar emphysema. Criteria for surgery varied and included persistent symptoms after birth, complications during childhood and persistently abnormal chest X‐ray. Most asymptomatic infants with CPAM were safely managed using a conservative approach, with no significant increase in late symptoms or complications.ConclusionsConservative management of CPAM may be considered for infants/children who remain asymptomatic, especially those with a small lesion. For large and medium‐sized CPAM, delineation using computed tomography is required, and surgery may be beneficial to prevent late symptoms and the risk of emergency surgery.
Reference values for serum cystatin C in very low‐birthweight infants: From two centres of China
Authors: Yang Yang , Li Shu‐jun , Pan Jing‐Jing , Hu Yu‐Hua , Zhou Xiao‐Yu , Cheng Rui , Chen Xiao‐qing 
Published: September 2017

AimTo determine the level of cystatin C (Cys‐C) values in preterm babies for the purpose of becoming a good endogenous marker of renal function.MethodsA total of 366 very low‐birthweight infants (including 70 extremely low‐birthweight babies) with gestational age <37 weeks born in two centres were studied.ResultsIn very low‐birthweight infants, the mean level of Cys‐C was 1.96 ± 0.44 mg/L in blood samples taken on day 1, 1.78 ± 0.49 mg/L on day 7 and 1.71 ± 0.47 mg/L on day 28. In extremely low‐birthweight infants, the mean level of Cys‐C was 2.00 ± 0.49 mg/L on day 1, 1.63 ± 0.38 mg/L on day 7 and 1.62 ± 0.55 mg/L on day 28, respectively. Compared to serum creatinine and blood urea nitrogen, Cys‐C level was independent of birthweight and gestational age.ConclusionCys‐C is regarded as an alternative for assessing renal function in very low‐birthweight infants, but its advantages over serum creatinine and blood urea nitrogen has not been fully proved yet. Hence, larger sample study is still necessary.
The roles of stochasticity and biotic interactions in the spatial patterning of plant species in alpine communities
Authors: Bowman William D. , Swatling‐Holcomb Samantha 
Published: September 2017

AbstractQuestionsPlant community composition can be influenced by multiple biotic, abiotic, and stochastic factors acting on the local species pool to determine their establishment success and abundance and subsequently the diversity of the community. We asked if the influences of biotic interactions on the composition of plant species in communities, as indicated by patterns of plant species spatial associations (independent, positive or negative), vary across a productivity gradient within a single ecosystem type. Do dominant species of communities show spatial patterning suggestive of competitive interactions with interspecific neighbors? Do species that span multiple community types exhibit the same heterospecific interactions with neighbours in each community?LocationThree alpine communities in the southern Rocky Mountains.MethodsWe measured the occurrence of species in a 1‐cm spatial grid within 2 m × 2 m plots to determine the spatial patterns of species pairs in the three communities. A null model of independent species spatial arrangements was used to determine whether species pairs were positively, negatively or independently associated, and how these patterns differed among the communities across the gradient of resource supply and environmental stress.ResultsPositive associations, indicative of facilitation between species, were most common in the most resource‐poor and least productive community. However negative associations, suggestive of competitive interactions among species, were not more common in the two more resource‐rich, productive communities. The dominant species of these communities did exhibit higher negative than positive associations with neighbours relative to positive patterning. Independent interspecific patterning was equally common relative to positive and negative patterns in all communities. Species that previously were shown to either facilitate other species or compete with neighbours exhibited spatial patterning consistent with the earlier experimental work.ConclusionsA large number of species exhibit a lack of net biotic interactions, and stochastic factors appear to be as important as competition and facilitation in shaping the structure of the three alpine plant communities we studied.
Tuskedness in African elephants – an anatomical investigation of laterality
Authors: Bielert C. , Costo N. , Gallup A. 
Published: September 2017

AbstractEvidence for brain and behavioral laterality is ubiquitous across the animal kingdom, ranging from invertebrates to humans. The elephant (Elephas maximus, Loxodonta africana and Loxodonta cyclotis) serves as an interesting model for the study of lateralization given its unique morphology and behavioral repertoire in foraging, and previous reports have documented side preferences in the use of the trunk among Asian elephants (E. maximus). Some authors have even discussed the potential laterality of tusk use among elephants; yet, there are no empirical studies of actual tusk use or appropriate tusk measurements. Here, we undertake an anatomical investigation of laterality in the tusk weights from 683 African elephants (L. africana and L. cyclotis). The vast majority of individuals (94.29%) showed asymmetries in tusk weight, with the left tusk being significantly heavier than the right on average (30.65 vs. 30.24 kg; P < 0.05). Although the age of the individuals in our sample was unknown, the tusks of African elephants continue to grow throughout life and thus individuals with larger tusks should experience greater opportunities for disproportionate wear. Consistent with the view that the reported asymmetries result from behavioral lateralization, that is, side preferences in tusk use in rooting, stripping bark and during agonist interactions, we show that individuals with larger overall tusk pairs had a higher degree of tusk laterality (P < 0.001). The restricted nature of the dataset limited a number of questions that could be examined, but follow‐up research in this area could study differential tusk use in the wild and how this relates to trunk side preferences.
Willingness to pay for small‐quantity lipid‐based nutrient supplements for women and children: Evidence from Ghana and Malawi
Authors: Adams Katherine P. , Vosti Stephen A. , Ayifah Emmanuel , Phiri Thokozani E. , Adu‐Afarwuah Seth , Maleta Kenneth , Ashorn Ulla , Arimond Mary , Dewey Kathryn G. 
Published: September 2017

AbstractSmall‐quantity lipid‐based nutrient supplements (SQ‐LNS) are designed to enrich maternal and child diets with the objective of preventing undernutrition during the first 1,000 days. Scaling up the delivery of supplements such as SQ‐LNS hinges on understanding private demand and creatively leveraging policy‐relevant factors that might influence demand. We used longitudinal stated willingness‐to‐pay (WTP) data from contingent valuation studies that were integrated into randomized controlled nutrition trials in Ghana and Malawi to estimate private valuation of SQ‐LNS during pregnancy, postpartum, and early childhood. We found that average stated WTP for a day's supply of SQ‐LNS was more than twice as high in Ghana than Malawi, indicating that demand for SQ‐LNS (and by extension, the options for effective delivery of SQ‐LNS) may be very context specific. We also examined factors associated with WTP, including intervention group, household socioeconomic status, birth outcomes, child growth, and maternal and child morbidity. In both sites, WTP was consistently negatively associated with household food insecurity, indicating that subsidization might be needed to permit food insecure households to acquire SQ‐LNS if it is made available for purchase. In Ghana, WTP was higher among heads of household than among mothers, which may be related to control over household resources. Personal experience using SQ‐LNS was not associated with WTP in either site.
Peptidoglycan O‐acetylation is functionally related to cell wall biosynthesis and cell division in Streptococcus pneumoniae
Authors: Bonnet Julie , Durmort Claire , Jacq Maxime , Mortier‐Barrière Isabelle , Campo Nathalie , VanNieuwenhze Michael S. , Brun Yves V. , Arthaud Christopher , Gallet Benoit , Moriscot Christine , Morlot Cécile , Vernet Thierry , Di Guilmi Anne Marie 
Published: September 2017

SummaryThe peptidoglycan is a rigid matrix required to resist turgor pressure and to maintain the cellular shape. It is formed by linear glycan chains composed of N‐acetylmuramic acid‐(β‐1,4)‐N‐acetylglucosamine (MurNAc‐GlcNAc) disaccharides associated through cross‐linked peptide stems. The peptidoglycan is continually remodelled by synthetic and hydrolytic enzymes and by chemical modifications, including O‐acetylation of MurNAc residues that occurs in most Gram‐positive and Gram‐negative bacteria. This modification is a powerful strategy developed by pathogens to resist to lysozyme degradation and thus to escape from the host innate immune system but little is known about its physiological function. In this study, we have investigated to what extend peptidoglycan O‐acetylation is involved in cell wall biosynthesis and cell division of Streptococcus pneumoniae. We show that O‐acetylation driven by Adr protects the peptidoglycan of dividing cells from cleavage by the major autolysin LytA and occurs at the septal site. Our results support a function for Adr in the formation of robust and mature MurNAc O‐acetylated peptidoglycan and infer its role in the division of the pneumococcus.