bluuebunny/crossref_metadata_2025_split huggingface dataset:
High expression of heat shock proteins and heat shock factor‐1 distinguishes an aggressive subset of clear cell renal cell carcinoma
Authors: Wu Pao‐Shu , Chang Yen‐Hwa , Pan Chin‐Chen 
Published: June 2017

AimsHeat shock proteins (HSPs) are a group of molecules induced by a variety of environmental and pathophysiological stresses, including cancer. HSPs are implicated in the regulation of apoptosis and immunity in neoplasm. Transcription factor heat shock factor 1 (HSF1) acts as the master regulator to control HSP expression, and is therefore involved in tumorigenesis. The purpose of this study was to evaluate the expression and clinicopathological relevance of HSPs and HSF1 in clear cell renal cell carcinoma (ccRCC).Methods and resultsThe expression of HSP27, HSP60, HSP70, HSP90 and HSF1 was assessed in 428 cases of ccRCC using immunohistochemistry. High expression of HSP60 and HSP70 was correlated positively with grade and stage. High expression of HSF1 was correlated positively with stage. Univariate and multivariate analyses demonstrated that 216 patients (52%) with tumour expressing three or four markers in a panel of HSP60, HSP70, HSP90 and HSF1 had a significantly heightened risk for cancer‐specific mortality than tumours expressing fewer than three markers (P < 0.0001; concordance index, 0.81).ConclusionsImmunohistochemical examination of HSPs and HSF1 provides useful prognostic information that may contribute to the design of therapeutic strategies for patients with ccRCC.
The prevalence and composition of asset poverty in Canada: 1999, 2005, and 2012
Authors: Rothwell David , Robson Jennifer 
Published: June 2017

A household is considered asset poor if its assets (financial assets or net worth, taken separately) are insufficient to maintain well‐being at a low‐income threshold for 3 months. We provide the first national‐level estimates of asset poverty for Canada, using the 1999, 2005, and 2012 cycles of the Survey of Financial Security, and juxtapose these estimates with income poverty. The analysis provides new insight into economic insecurity by showing that asset poverty rates are consistently two to three times higher than income poverty rates. In addition to the prevalence of asset poverty across socio‐demographic groups, we analyzed how the composition of the poor change over time. Age and geography shape the risk for asset poverty in distinct ways. We found that while education appears to play a comparable role in shaping both income poverty and asset poverty, immigration places Canadians at a relatively higher risk of income poverty but not asset poverty.Key Practitioner Message: • Practitioners ought to consider assets as well as income in assessing economic vulnerability; • Asset poverty levels are 2–3 times higher than income poverty levels; • Certain groups (e.g., immigrants) may be income poor but maintain sufficient assets.
T follicular regulatory cells in mice and men
Authors: Maceiras Ana Raquel , Fonseca Valter R. , Agua‐Doce Ana , Graca Luis 
Published: June 2017

SummaryIt has long been known that CD4 T cells are necessary to provide help to B cells, triggering a germinal centre (GC) reaction where affinity maturation and isotype switching occur. However, the nature of the dedicated CD4 helper T cells, known as T follicular helper (Tfh), was only recently described. Here, we review the biology and function of the recently described T follicular regulatory (Tfr) cells, another CD4 T‐cell population also found within GCs but with regulatory function and characteristics. Tfr cells have been identified in mice and humans as simultaneously presenting characteristics of T follicular cells (namely CXCR5 expression) and regulatory T cells (including Foxp3 expression). These Tfr cells have been implicated in the regulation of the magnitude of the GC reaction, as well as in protection from immune‐mediated pathology.
Psychometric assessment of the cultural capacity scale Spanish version in Chilean nursing students
Authors: Cruz J.P. , Machuca Contreras F.A. , Ortiz López J.E. , Zapata Aqueveque C.A. , Vitorino L.M. 
Published: June 2017

AimTo assess the psychometric properties of the Cultural Capacity Scale Spanish version in Chilean nursing students.BackgroundThe increased diversity in healthcare facilities and the current shortage of local nursing workforce in Chile present a significant challenge to the nursing education to train future competent local nurses. To facilitate cultural competence development among Chilean nursing students, it is necessary to regularly assess their cultural competence, which necessitates a culturally adapted valid and reliable tool.MethodsA convenience sample of 502 Chilean nursing students was surveyed in this cross‐sectional study using the culturally adapted scale. Reliability of the instrument was established by internal consistency and stability reliability, while validity was established by content and construct.ResultsThe Cronbach's α value of the entire scale was 0.95, and the test–retest reliability was 0.85. The Corrected Item‐Total Correlations ranged from 0.45 to 0.78. The tool manifested an excellent content and construct validity. The exploratory factor analysis confirmed a single factor of the scale.DiscussionThe tool demonstrated evidence of internal consistency, stability reliability, content validity and construct validity. The study provided cross‐cultural evidence for the potential application of this scale in Chile and other Spanish‐speaking countries.ConclusionThe Cultural Capacity Scale Spanish version demonstrated sound psychometric properties for assessing the cultural competence of Chilean nursing students.LimitationsThe sample was restricted to one university, and the tool was only used in Chilean nursing students.Implications for nursing policyThe establishment of the Spanish version of the tool will facilitate accurate and timely monitoring of the cultural competence among Chilean nursing students and other Spanish‐speaking nursing students and nurses, which can inform the creation of nursing policies aimed at ensuring cultural competence development.
Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single‐trial design
Authors: Hendriks Lotte , de Kleine Rianne A. , Heyvaert Mieke , Becker Eni S. , Hendriks Gert‐Jan , van Minnen Agnes 
Published: June 2017

BackgroundThe current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma.MethodsTen adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90‐min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90‐min booster sessions. In a single‐trial design, the participants were randomly allocated to one of five baseline lengths (4–8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self‐reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician‐administered PTSD diagnostic status and symptom severity (primary outcome), as well as self‐reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline‐to‐6‐month follow‐up).ResultsTime‐series analyses showed that self‐reported PTSD symptom severity significantly declined following treatment (p = .002). Pre‐postgroup analyses demonstrated significant reductions of clinician‐administered PTSD symptom severity and self‐reported comorbidity that persisted during the 3‐ and 6‐month follow‐ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events.ConclusionsThe results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial.
Effect of two different polishing systems on fluoride release, surface roughness and bacterial adhesion of newly developed restorative materials
Authors: Bayrak Gokcen Deniz , Sandalli Nuket , Selvi‐Kuvvetli Senem , Topcuoglu Nursen , Kulekci Guven 
Published: June 2017

AbstractObjectivesTo evaluate the effects of two different polishing systems on fluoride release, surface roughness and bacterial adhesion of five restorative materialsMaterials and MethodsThe study groups were comprised of five different restorative materials, Beautifil II (B); GCP Glass Fill (G); Amalgomer CR (A); Dyract XP (D); Fuji IX GP (F) and 21 specimens were prepared from each material. Each group was divided into three subgroups according to the polishing system: Mylar (control) (C), Sof‐lex (S), and Enhance‐Pogo (EP). The amount of fluoride release was measured using a fluoride ion‐selective electrode and surface roughness was investigated with a profilometer. Bacterial adhesion on the materials was evaluated by optical density readouts for S.mutans on a spectrophotometer.ResultsThe highest amount of fluoride was released from specimens in the S subgroup of group G during all measurement days. Surface roughness values were significantly lower in subgroup C than the other polishing systems in all study groups except group G (P < .05). Group A displayed significantly higher surface roughness values than the other material groups in both subgroups (S and EP) (P < .01). Highest bacterial adhesion was observed in the EP subgroup of group A.ConclusionsPolishing promoted a significant increase of fluoride release on restorative materials especially in glass ionomer‐based materials.CLINICAL SIGNIFICANCEThis article stated that polishing promoted a significant increase of fluoride release on restorative materials especially in glass ionomer‐based materials. Further, proper polishing systems must be chosen according to the structure and composition of materials to provide the best clinical benefits in terms of fluoride release, surface roughness and bacterial adhesion.
Soluble CD163 and mannose receptor associate with chronic hepatitis B activity and fibrosis and decline with treatment
Authors: Laursen Tea Lund , Wong Grace Lai‐Hung , Kazankov Konstantin , Sandahl Thomas , Møller Holger Jon , Hamilton‐Dutoit Stephen , George Jacob , Chan Henry Lik‐Yuen , Grønbæk Henning 
Published: June 2017

AbstractBackground and AimLiver macrophages are activated in chronic hepatitis B virus (CHB) infection and play a pivotal role in hepatic inflammation and fibrosis. However, their role during antiviral treatment is unclear. The soluble (s) macrophage activation markers, sCD163 and mannose receptor (sMR), are released during liver damage, and their serum levels reflect liver disease severity and portal hypertension. We aimed to investigate associations between sCD163 and sMR and histopathological activity and fibrosis and changes in sCD163, sMR, and hepatic CD163‐expression following antiviral treatment in CHB patients.MethodsWe assessed Ishak histological necroinflammatory activity and fibrosis scores in liver biopsies from 254 CHB patients and serially in 71 patients before and after nucleoside‐analogue treatment. Liver CD163‐expression was semi‐quantitatively determined by immunohistochemistry and serum sCD163 and sMR measured by enzyme‐linked immunosorbent assays.ResultsBefore treatment, the mean levels of sCD163 and sMR were 3.57 (SD 1.72) mg/L and 0.35 (0.12) mg/L. sCD163 and sMR increased with histological inflammatory activity (sCD163: r = 0.46, P < 0.00001; sMR: r = 0.48, P < 0.00001) and correlated positively with fibrosis (sCD163: OR 1.16, 95% CI:1.03–1.31; sMR: OR 1.34, 95% CI:1.13–1.59); both were markers of fibrosis independent of other biochemical parameters and risk factors. Antiviral treatment significantly reduced sCD163 (3.76 [1.46] vs 2.31 [0.95], P < 0.00001), sMR (0.37 [0.1] vs 0.29 [0.07], P < 0.00001) and hepatic CD163‐expression (P = 0.0002).ConclusionThe macrophage activation markers sCD163 and sMR were associated with activity and fibrosis in liver biopsies from CHB patients. Both serum markers decreased with antiviral treatment, along with decreased hepatic CD163 expression.
Clinical validation of the nursing diagnosis of ineffective protection in haemodialysis patients
Authors: de Sá Tinôco Jéssica Dantas , de Paiva Maria das Graças Mariano Nunes , de Queiroz Frazão Cecília Maria Farias , Lucio Kadyjina Daiane Batista , Fernandes Maria Isabel da Conceição Dias , de Oliveira Lopes Marcos Venicios , de Carvalho Lira Ana Luisa Brandão 
Published: June 2017

Aims and objectivesTo evaluate the clinical validity of indicators of the nursing diagnosis of “ineffective protection” in haemodialysis patients.BackgroundHaemodialysis patients have reduced protection. Studies on the nursing diagnosis of “ineffective protection” are scarce in the literature. The use of indicators to diagnose “ineffective protection” could improve the care of haemodialysis patients. The clinical usefulness of the indicators requires clinical validation.DesignThis was a diagnostic accuracy study.MethodThis study assessed a sample of 200 patients undergoing haemodialysis in a reference clinic for nephrology during the first half of 2015. Operational definitions were created for each clinical indicator based on concept analysis and content validation by experts for these indicators. Diagnostic accuracy measurement was performed with latent class analysis with randomised effects.ResultsThe clinical indicator of “fatigue” had high sensitivity (p = .999) and specificity (p = 1.000) for the identification of “ineffective protection.” Additionally, “maladaptive response to stress” (p = .711) and “coagulation change” (p = .653) were sensitive indicators. The main indicators that showed high specificity were “fever” (p = .987), “increased number of hospitalisations” (p = .911), “weakness” (p = .937), “infected vascular access” (p = .962) and “vascular access dysfunction” (p = .722).ConclusionA set of nine clinical indicators of “ineffective protection” were accurate and statistically significant for haemodialysis patients. Three clinical indicators showed sensitivity, and six indicators showed specificity.Relevance to clinical practiceAccurate measures for nursing diagnoses can help nurses confirm or rule out the probability of the occurrence of “ineffective protection” in patients undergoing haemodialysis.
The impact of aspiration pneumonia and nasogastric feeding on clinical outcomes in stroke patients: A retrospective cohort study
Authors: Schwarz Maria , Coccetti Anne , Murdoch Allison , Cardell Elizabeth 
Published: June 2017

Aims and objectivesTo determine presence of clinical complications related to dysphagia and to explore their operational outcomes.BackgroundDysphagia is a common complication of stroke. The management of poststroke dysphagia is multidisciplinary with nurses playing a key role in screening for dysphagia risk, monitoring tolerance of food and fluids and checking for the development of complications such as fever, dehydration and change in medical status. Dysphagia often results in further complications including aspiration pneumonia and the need for nasogastric feeding. Dysphagia‐related complications have been shown to have a significant impact on morbidity and mortality, length of stay and cost of admission.DesignRetrospective cohort study.MethodsA total of 110 patients presenting with an ischaemic stroke were chart‐audited.ResultsAspiration pneumonia poststroke was found to be significantly associated with increased overall length of stay, poorer functional outcomes poststroke as well as being associated with a high risk of mortality. The presence of a nasogastric tube was also associated with reduced functional outcomes poststroke and increased risk of death.ConclusionHigh prevalence and cost of complications associated with stroke highlight the complexity of providing nursing and allied health care to this patient population. This provides a snapshot of dysphagia‐related complications experienced by stroke patients.Relevance to clinical practiceThis paper highlights that poststroke complications can significantly impact on patient outcomes and operational factors such as cost of admission; therefore, poststroke care requires a multidisciplinary approach to management. Furthermore, preventing and managing complications poststroke is a key element of nursing care and has the potential to significantly reduce incidence of mortality, length of stay and cost of hospital admission.
To break the weight gain—A qualitative study on the experience of school nurses working with overweight children in elementary school
Authors: Thorstensson Stina , Blomgren Carola , Sundler Annelie J. , Larsson Margaretha 
Published: June 2017

Aims and objectivesTo describe the experiences of school nurses working with overweight schoolchildren.BackgroundSchool nurses play an important role in health promotion of overweight children. Lifestyle changes and interventions to address being overweight can improve health outcomes and decrease the risk for future health problems.DesignA descriptive and qualitative design with a phenomenological approach was used. Data were gathered through interviews with school nurses working with overweight schoolchildren in Swedish elementary school; the data were subsequently analysed for meanings.ResultsWorking with overweight children was perceived as demanding and challenging by the school nurses who found conversations on this topic emotionally loaded and complex. In addition, the school nurses needed to be sensitive and supportive to succeed in their support for a healthier everyday life for the schoolchildren. It was stated as important to find ways to break the child's weight gain and to cooperate with the parents in this work. The children's decrease in weight was experienced to be more successful when making small, step‐by‐step changes together with the child and his or her parents.ConclusionsThis study concludes that health talks about being overweight may be a challenge for school nurses. Strategies used to manage and succeed in this work included engaging in motivational conversations, working step by step and cooperating with the child's parents. Furthermore, the nurses experienced that they needed to provide emotional support for overweight children during school time.Relevance to clinical practiceThe school nurses’ health promotion needs to focus on how to break weight gain in overweight children. In this work, the nurses’ sensitiveness seems pivotal. Further research is needed on school nurses’ work with health promotion and support of overweight children concerning how to perform efficient communication and cooperation with the children and their parents.
Older patients with late‐stage COPD: Their illness experiences and involvement in decision‐making regarding mechanical ventilation and noninvasive ventilation
Authors: Jerpseth Heidi , Dahl Vegard , Nortvedt Per , Halvorsen Kristin 
Published: June 2017

Aims and objectivesTo explore the illness experiences of older patients with late‐stage chronic obstructive pulmonary disease and to develop knowledge about how patients perceive their preferences to be taken into account in decision‐making processes concerning mechanical ventilation and/or noninvasive ventilation.BackgroundDecisions about whether older patients with late‐stage chronic obstructive pulmonary disease will benefit from noninvasive ventilation treatment or whether the time has come for palliative treatment are complicated, both medically and ethically. Knowledge regarding patients' values and preferences concerning ventilation support is crucial yet often lacking.DesignQualitative design with a hermeneutic–phenomenological approach.MethodsThe data consist of qualitative in‐depth interviews with 12 patients from Norway diagnosed with late‐stage chronic obstructive pulmonary disease. The data were analysed within the three interpretative contexts described by Kvale and Brinkmann.ResultsThe participants described their lives as fragile and burdensome, frequently interrupted by unpredictable and frightening exacerbations. They lacked information about their diagnosis and prognosis and were often not included in decisions about noninvasive ventilation or mechanical ventilation.ConclusionFindings indicate that these patients are highly vulnerable and have complex needs in terms of nursing care and medical treatment. Moreover, they need access to proactive advanced care planning and an opportunity to discuss their wishes for treatment and care.Relevance to clinical practiceTo provide competent care for these patients, healthcare personnel must be aware of how patients experience being seriously ill. Advanced care planning and shared decision‐making should be initiated alongside the curative treatment.
Jordanian nurses’ perception and interventions related to promoting smoking cessation
Authors: Khalaf Inaam A , Abu‐Moghli Fathieh A , LaRocco Susan A , Al‐Maharma Dua’ Y 
Published: June 2017

Aims and objectivesTo determine nurses’ perceptions related to smoking cessation, health promotion and interventions provided to hospitalised patients.BackgroundSmoking is a major health problem in Jordan. The cost for treating smoking‐related health conditions is a significant strain on the healthcare system. Nurses are in an ideal position to encourage smoking cessation. Little is known about Jordanian nurses’ perceptions related to smoking cessation issues.MethodsA qualitative design was used to collect data from 22 Jordanian nurses using focus groups. Purposive sampling was used to select the study participants. Content analysis was conducted, to determine themes related to the research questions.ResultsNurses indicated that smoking cessation counselling is important. However, they did not feel that their counselling was very effective. Nurses indicated that the presence of a well‐defined hospital policy regarding smoking was a facilitator to smoking cessation and antismoking clinics would also help to decrease smoking. Challenges to nurses’ interventions included lack of hospital policy, lack of time and nurses who smoke could not be role models or provide effective counselling. Regarding decreasing smoking in Jordan, nurses had suggestions that included scare techniques and increasing taxes on cigarettes as well as enforcing policies that prevent cigarette sales to children under 16.ConclusionsNurses are well aware of the hazards of smoking and indicate a belief that encouraging smoking cessation is an appropriate activity. Changes in smoking rules and the enforcement of rules, as well as increased public health efforts related to smoking cessation, are necessary to decrease smoking prevalence in Jordan.Relevance to clinical practiceTraining in smoking cessation counselling and increased awareness of the resources may increase nurses’ ability to have an impact on decreasing the smoking prevalence in Jordan.