bluuebunny/crossref_metadata_2025_split huggingface dataset:
n‐3 polyunsaturated fatty acid supplementation reduces insulin resistance in hepatitis C virus infected patients: a randomised controlled trial
Authors: Freire T. O. , Boulhosa R. S. S. B. , Oliveira L. P. M. , de Jesus R. P. , Cavalcante L. N. , Lemaire D. C. , Toralles M. B. P. , Lyra L. G. C. , Lyra A. C. 
Published: July 2015

AbstractBackgroundInsulin resistance promotes liver disease progression and may be associated with a lower response rate in treated hepatitis C virus (HCV) infected patients. n‐3 polyunsaturated fatty acid (PUFA) supplementation may reduce insulin resistance.The present study aimed to evaluate the effect of n‐3 PUFA supplementation on insulin resistance in these patients.MethodsIn a randomised, double‐blind clinical trial, 154 patients were screened. After applying inclusion criteria, 52 patients [homeostasis model assessment index of insulin resistance (HOMA‐IR ≥2.5)] were randomly divided into two groups: n‐3 PUFA (n = 25/6000 mg day−1 of fish oil) or control (n = 27/6000 mg day−1 of soybean oil). Both groups were supplemented for 12 weeks and underwent monthly nutritional consultation. Biochemical tests were performed at baseline and after intervention. Statistical analysis was performed using the Wilcoxon Mann–Whitney test for comparisons and the Wilcoxon test for paired data. Statistical package r, version 3.02 (The R Project for Statistical Computing) was used and P < 0.05 (two‐tailed) was considered statistically significant.ResultsComparisons between groups showed that n‐3 PUFA supplementation was more effective than the control for reducing HOMA‐IR (P = 0.015) and serum insulin (P = 0.016). The n‐3 PUFA group not only showed a significant reduction in HOMA‐IR 3.8 (3.2–5.0) versus 2.4 (1.8–3.3) (P = 0.002); serum insulin 17.1 (13.8–20.6) μIU mL−1 versus 10.9 (8.6–14.6) μIU mL−1 (P = 0.001); and glycated haemoglobin 5.4% (5.0–5.7%) versus 5.1% (4.8–5.6%) (P = 0.011), but also presented an increase in interleukin‐1 97.5 (0.0–199.8) pg mL−1 versus 192.4 (102.2–266.8) pg mL−1 (P = 0.003) and tumour necrosis factor 121.2 (0.0–171.3) pg mL−1 versus 185.7 (98.0–246.9) pg mL−1 (P = 0.003).Conclusionsn‐3 PUFA supplementation reduces insulin resistance in genotype 1 HCV infected patients.
Impact of school‐based dental program performance on the oral health‐related quality of life in children
Authors: Amalia Rosa , Schaub Rob M. H. , Stewart Roy E. , Widyanti Niken , Groothoff Johan W. 
Published: July 2015

AbstractObjectiveTo assess the association between the performance of school‐based dental programs (SBDPs) and oral health‐related quality of life (OHRQoL) in school children, in the province of Yogyakarta, Indonesia, taking into account untreated caries and sociodemographic factors.MethodsA cross‐sectional survey was administered with 1906 children aged 12 and participating in SBDPs. Four SBDPs were chosen to represent good and poor performance in urban and rural areas. Caries was assessed using World Health Organization (WHO) criteria, whereas the children were interviewed for the OHRQoL and sociodemographic data. The OHRQoL was assessed using the Condition‐Specific Child‐Oral Impact on Daily Performances (CS Child‐OIDP) index related to dental caries.ResultsThe mean CS Child‐OIDP score was 1.63 (SD ± 3.20) for good performance SBDP and 6.89 (SD ± 8.85) for poor performance SBDP. Analysis by negative binomial regression showed that being served by a poorly performing SBDP (RR = 4.45, 95% CI = 3.87–5.13), and to some extent living in a rural area and being a girl, were significantly associated with a greater risk of having a lower quality of life than were the counterparts. Untreated caries did not show an association with OHRQoL.ConclusionThere are substantial indications that SBDP performance is related to children's OHRQoL.
The Quality of Nurses’ Work Environment and Workforce Outcomes From the Perspective of Swiss Allied Healthcare Assistants and Registered Nurses: A Cross‐Sectional Survey
Authors: Lacher Stefanie , De Geest Sabina , Denhaerynck Kris , Trede Ines , Ausserhofer Dietmar 
Published: July 2015

AbstractBackgroundAnticipating nursing shortages, the Swiss healthcare system recently introduced the position of allied healthcare assistant (AHA). However, indicators of AHAs’ integration and stability, particularly their perceptions of their work environment quality and related outcomes (i.e., burnout, job satisfaction, and intention to leave), remain unclear.Aims(a) To describe AHAs’ ratings of the quality of the nurse work environment, job satisfaction, burnout, and intention to leave their workplaces; (b) to compare AHAs’ and registered nurses’ (RNs’) work environment quality ratings and related outcomes; and (c) to assess links between AHAs’ work environment quality ratings and related workforce outcomes.DesignA secondary analysis of RN4CAST data (October 2009 to June 2010) on 61 AHAs and 466 RNs in 13 Swiss acute care hospitals.MethodsWe used descriptive statistics to summarize data of AHAs and RNs on their units and hospitals. Via binary logistic regression models, we compared AHAs and RNs and identified associations between work environment ratings and workforce outcomes.FindingsAHAs’ work environment quality ratings were significantly higher than those of RNs, and were associated with lower odds of burnout and intention to leave their current job and higher odds of reported job satisfaction.ConclusionsThis study provides primary evidence linking AHAs’ work environment quality ratings to burnout, job satisfaction, and intention to leave in acute care hospitals.Clinical RelevanceGiven the increasing importance of AHAs for nursing care provision, hospitals should assess the quality of nurse work environment and nurse outcomes from the perspective of all nurses.
Newly Graduated Nurses' Competence and Individual and Organizational Factors: A Multivariate Analysis
Authors: Numminen Olivia , Leino‐Kilpi Helena , Isoaho Hannu , Meretoja Riitta 
Published: July 2015

AbstractObjectiveTo study the relationships between newly graduated nurses’ (NGNs’) perceptions of their professional competence, and individual and organizational work‐related factors.MethodsA multivariate, quantitative, descriptive, correlation design was applied. Data collection took place in November 2012 with a national convenience sample of 318 NGNs representing all main healthcare settings in Finland. Five instruments measured NGNs’ perceptions of their professional competence, occupational commitment, empowerment, practice environment, and its ethical climate, with additional questions on turnover intentions, job satisfaction, and demographics. Descriptive statistics summarized the demographic data, and inferential statistics multivariate path analysis modeling estimated the relationships between the variables.ResultsThe strongest relationship was found between professional competence and empowerment, competence explaining 20% of the variance of empowerment. The explanatory power of competence regarding practice environment, ethical climate of the work unit, and occupational commitment, and competence's associations with turnover intentions, job satisfaction, and age, were statistically significant but considerably weaker. Higher competence and satisfaction with quality of care were associated with more positive perceptions of practice environment and its ethical climate as well as higher empowerment and occupational commitment.ConclusionsApart from its association with empowerment, competence seems to be a rather independent factor in relation to the measured work‐related factors. Further exploration would deepen the knowledge of this relationship, providing support for planning educational and developmental programs. Research on other individual and organizational factors is warranted to shed light on factors associated with professional competence in providing high‐quality and safe care as well as retaining new nurses in the workforce.Clinical RelevanceThe study sheds light on the strength and direction of the significantly associated work‐related factors. Nursing professional bodies, managers, and supervisors can use the findings in planning orientation programs and other occupational interventions for NGNs.
Symptom Experience Associated With Immunosuppressive Medications in Chinese Kidney Transplant Recipients
Authors: Teng Sha , Zhang Shuping , Zhang Wenxin , Lin Xiaohong , Shang Yabin , Peng Xiao , Liu Hongxia 
Published: July 2015

AbstractPurposeKidney transplant recipients require lifelong treatment with immunosuppressive medications to avoid graft rejection and graft loss. Symptoms experienced may influence recipients’ perceived quality of life and medication adherence. The purpose of this study was to evaluate the symptom experience associated with immunosuppressive medications in adult kidney transplant recipients and to explore the association between the symptom experience and adherence to immunosuppressive medications.DesignA cross‐sectional design was used. The study was conducted in a general hospital in China from October 2013 to September 2014. A total of 231 recipients with a follow‐up of at least 1 year after kidney transplantation were included.MethodsSymptom experience associated with immunosuppressive medications was measured by the 13‐item Symptom Experience of Immunosuppressive‐related Side Effects Scale. Self‐reported adherence to immunosuppressive medications was assessed using the Adherence with Immunosuppressive Medication Scale. Ridit analysis was used to rank symptom distress items.FindingsA proportion of 60.6% of recipients were male; the time after kidney transplantation was arbitrarily divided into a short‐term cohort (1–4 years) and a long‐term cohort (4–16 years) according to the median duration of follow‐up (4 years). High blood pressure, hair loss, and tiredness were the three most distressing symptoms over all items of the whole sample. High blood pressure was the most distressing symptom for the 1‐ to 4‐year cohort and the 4‐ to 16‐year cohort. For men high blood pressure was the most distressing symptom, whereas for women hair loss was the most distressing symptom. Recipients in the 4‐ to 16‐year cohort perceived a higher level of symptom distress compared with those in the 1‐ to 4‐year cohort, especially in excess hair growth and difficulty sleeping. A negative relationship was found between symptom distress and adherence to immunosuppressive medications (r = ‐.541, p = .000).ConclusionsRecipients in the 4‐ to 16‐year cohort perceived a higher level of symptom distress compared with those in the 1‐ to 4‐year cohort, especially in excess hair growth and difficulty sleeping. No significant difference was found between gender groups. Recipients who reported a higher level of symptom distress were more likely to be nonadherent.Clinical RelevanceUnderstanding symptom experience of immunosuppressive medications is of importance for healthcare providers to offer sophisticated education and develop strategies to improve quality of life and medication adherence during follow‐up post‐transplantation.
The human medial amygdala: structure, diversity, and complexity of dendritic spines
Authors: Dall'Oglio Aline , Dutra Ana Carolina L. , Moreira Jorge E. , Rasia‐Filho Alberto A. 
Published: July 2015

AbstractThe medial nucleus of the amygdala (Me) is a component of the neural circuit for the interpretation of multimodal sensory stimuli and the elaboration of emotions and social behaviors in primates. We studied the presence, distribution, diverse shape, and connectivity of dendritic spines in the human Me of adult postmortem men. Data were obtained from the five types of multipolar neurons found in the Me using an adapted Golgi method and light microscopy, the carbocyanine DiI fluorescent dye and confocal microscopy, and transmission electron microscopy. Three‐dimensional reconstruction of spines showed a continuum of shapes and sizes, with the spines either lying isolated or forming clusters. These dendritic spines were classified as stubby/wide, thin, mushroom‐like, ramified or with an atypical morphology including intermediate shapes, double spines, and thorny excrescences. Pleomorphic spines were found from proximal to distal dendritic branches suggesting potential differences for synaptic processing, strength, and plasticity in the Me neurons. Furthermore, the human Me has large and thin spines with a gemmule appearance, spinules, and filopodium. The ultrastructural data showed dendritic spines forming monosynaptic or multisynaptic contacts at the spine head and neck, and with asymmetric or symmetric characteristics. Additional findings included en passant, reciprocal, and serial synapses in the Me. Complex long‐necked thin spines were observed in this subcortical area. These new data reveal the diversity of the dendritic spines in the human Me likely involved with the integration and processing of local synaptic inputs and with functional implications in physiological and various neuropathological conditions.
Assessment of tissue levels of dickkopf‐1 in androgenetic alopecia and alopecia areata
Authors: Fawzi Marwa M T , Mahmoud Sara B , Shaker Olfat G. , Saleh Marwah A 
Published: July 2015

SummaryBackgroundAndrogenetic alopecia (AGA) is the commonest form of hair loss in men. Alopecia areata (AA) is an organ‐specific autoimmune disease. Studies revealed that Dickkopf 1 (DKK‐1), a powerful suppressor of the Wnt/β‐catenin signaling pathway, induced anagen‐to‐catagen transition in mice. Moreover, in vitro studies suggested that DKK‐1 played a role in dihydrotestosterone (DHT)‐induced balding.AimTo evaluate the tissue levels of DKK‐1 in patients with AGA and AA, to assess its possible role as a pathogenetic mechanism in both disorders.MethodsThis study included 24 patients with AGA, 31 patients with AA, and 33 healthy controls. Scalp biopsies were taken from all participants for the detection of tissue DKK‐1 levels.ResultsTissue DKK‐1 levels were significantly higher in patients with AGA than in controls (P = 0.000) as well as in patients with AA than in controls (P = 0.001). In addition, they were significantly higher in patients with AGA than in patients with AA (P = 0.000). DKK‐1 was higher in male than in female patients with AGA. DKK‐1 was negatively correlated with disease duration in AGA.ConclusionIn conclusion, this study suggests an important role for DKK‐1 in the pathogenesis of AGA and AA through documenting higher tissue DKK‐1 levels in patients with both hair disorders compared to controls and suggests that DKK‐1 may be a promising therapeutic target for these hair diseases.
Discerning the healing path – how nurses assist patient spirituality in diverse health care settings
Authors: Giske Tove , Cone Pamela H 
Published: July 2015

Aims and objectivesTo examine nurses' experiences in spiritual care in diverse clinical settings, preferably not palliative care.BackgroundSpirituality is part of holistic nursing care. The concept of spiritual literacy is introduced as the nurse's ability to read the spiritual signs of the human experience.DesignClassical grounded theory methodology with open and selective coding was used to identify the participants' main concern and the strategies they used to resolve it, and to develop a substantive grounded theory.MethodData were collected in 2008 and 2014 during eight focus group interviews with a total of 22 nurses recruited from a master's programme, postgraduate programmes and a local hospital. Data were analysed through constant comparison until the grounded theory emerged.ResultsThe participants' main concern was how to assist the patient to alleviation. The participants resolved this by Discerning the healing path, which comprises three stages: Tuning in on spirituality, Uncovering deep concerns and Facilitating the healing process. These three stages are accompanied all the way by the participants' Willingness to overcome own comfort zone and Building a trusting relationship.ConclusionSpirituality is of relevance for all areas of nursing care, not just dying patients or those in palliative care. Spirituality relates to the deep and important things in life and affects how patients face health issues. Nurses attend to spirituality in patients because the pain of the soul touches them and the calmness of spiritual peace amazes them.Relevance to clinical practiceThe professional culture in the health care team socialises nurses into the workplace, and leaders need to pay close attention to how they can foster openness to spiritual matters. The personal and professional maturity of the nurse is fundamental to his or her willingness and ability to overcome own comfort zone.
Learning to ensure patient safety in clinical settings: comparing Finnish and British nursing students’ perceptions
Authors: Tella Susanna , Smith Nancy‐Jane , Partanen Pirjo , Jamookeeah David , Lamidi Marja‐Leena , Turunen Hannele 
Published: July 2015

Aims and objectivesTo explore and compare Finnish and British nursing students’ perceptions of their learning about patient safety in clinical settings.BackgroundPatient safety culture and practices in different health care organisations and clinical units varies, posing challenges for nursing students’ learning about patient safety during their clinical placements. Patient safety as a growing international concern has challenged health care professionals globally requiring a comprehensive review. International studies comparing nursing education about patient safety are lacking.DesignA cross‐sectional comparative study.MethodThe participants were final year preregistration nursing students from two universities of applied sciences in Finland (n = 195) and from two universities in England, UK (n = 158). The data were collected with the Patient Safety in Nursing Education Questionnaire and analysed with principal component analysis, Pearson Chi‐Square and Mann–Whitney U tests and logistic regression.ResultsFinnish nursing students had significantly more critical perceptions on their learning about patient safety in clinical settings than their British peers. A strong predictor for differences was supportive and systems‐based approaches in learning to ensure patient safety. Notably, fewer Finnish students had practiced reporting of incidents in clinical settings compared to British students. In both countries, the students held learning about patient safety in higher esteem compared to their learning experiences in clinical settings.ConclusionsNursing students appear to want more learning opportunities related to patient safety compared to the reality in clinical settings. Learning systematically from errors in a supportive environment and having systems‐based approaches to ensure patient safety are essential elements for nursing students’ learning about safe practice. Finnish students seem to experience more barriers in learning about safe practices and to report errors than the British students.Relevance to clinical practiceHealth care organisations and professionals with responsibilities for patient safety should seek to standardise the preparation of nursing students incorporating requisite international standards and benchmarks.
Compassion: a critical review of peer‐reviewed nursing literature
Authors: McCaffrey Graham , McConnell Shelagh 
Published: July 2015

Aims and objectivesTo provide a critical review of nursing literature about compassion, identifying major themes, questions arising and directions for future investigation of the topic.BackgroundCompassion has emerged as a topic of broad social concern in recent years and is particularly pertinent to nurses.DesignCritical review was selected as the most appropriate way of analysing literature from both qualitative research studies and conceptual articles.MethodsAn electronic database search was conducted, discovering articles published between 1952 and 2013. The search was then limited to publications since 2000 to capture recent development of the concept. The search was limited to peer‐reviewed literature, excluding a large body of editorial material, resulting in 20 relevant articles. Two books were also added that contributed important perspective to the analysis. Critical analysis of the resulting material was undertaken to identify themes, tensions and implications in the literature.ResultsMajor themes were compassion as practice and compassion as a moral virtue, holding implications for how nurses can demonstrate compassion in relation to contemporary healthcare values. A third major theme was the influence of institutional environments in facilitating or limiting the expression of compassion.ConclusionsCompassion is a human experience of deep significance to nursing and needs understanding in the context of healthcare environments dominated by discourses of efficiency and rationalisation. There is an emergent literature about how compassion may be understood, taught and sustained among nurses but it is a topic that requires continued attention.Relevance to clinical practiceMore precise understanding of compassion will support nurses in advocating for compassionate care, participating in interdisciplinary dialogue, and contributing to the design of healthcare environments that are conducive to compassionate care.
Perceptions of reporting practices and barriers to reporting incidents among registered nurses and physicians in accredited and nonaccredited Jordanian hospitals
Authors: AbuAlRub Raeda F , Al‐Akour Nemeh A , Alatari Nour H 
Published: July 2015

Aims and objectivesTo explore the awareness of the incident reporting system, incident reporting practices and barriers to reporting incidents among Jordanian staff nurses and physicians in accredited and nonaccredited hospitals.BackgroundReporting medical incidents is an important element of patient safety enhancement and quality of care improvement and it should be an integral part of the organisational culture.DesignA descriptive exploratory survey was used for the present study.MethodsA modified version of the Incident Reporting Questionnaire was used to collect data from 307 nurses and 144 physicians at seven hospitals (four accredited and three not accredited) in Jordan. The response rate was 28·8% for nurses and 58·8% for physicians.ResultsNurses were more aware of the incident reporting system than physicians. Physicians were less likely to report any incident on 50% or more of occasions. The major three barriers to reporting incidents were believing that there was no point in reporting near misses, lack of feedback and fear of disciplinary actions.ConclusionThe study showed significant differences between nurses in accredited and nonaccredited hospitals regarding barriers to reporting incidents and reporting practices.Relevance to clinical practiceNurse administrators should modify existing systems for reporting incidents to overcome the barriers as shown in the present study.