bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coping with an exulcerated breast carcinoma: an interpretative phenomenological study
Authors: Probst S. , Arber A. , Faithfull S. 
Published: May 2014

Objective: To explore how women living at home with a malignant fungating wound (MFW) cope with such wounds. Method: To explore coping through the lived experiences of patients a methodological framework, using Heideggerian hermeneutic phenomenology and semi-structured interviews. Nine patients were interviewed from January until November 2009. Results: The results are divided into two categories: ‘living with a MFW’ and ‘feeling different’. These categories demonstrate how it is to live with the unpredictability, and uncontrollability of a MFW due to symptoms such as malodour, bleeding, exudate, pain and itching. The loss of control of the body boundary due to uncontrollable symptoms led to significant levels of distress and suffering for the patients. Different coping strategies were used to live with this wound. Conclusion: This study demonstrates how difficult it is to live and cope with a malignant fungating wound. Coping strategies, including going into isolation, or denying any issues, were used. When taking care of patients with MFWs, strategies need to integrate a palliative, holistic, empathic approach. Declaration of Interest: There were no external sources of funding for this study. The authors have no additional conflicts of interest to declare.
A review of PU risk assessment and prevention in Scandinavia, Iceland and Ireland (Part II)
Authors: Moore Z. , Johansen E. , van Etten M. 
Published: May 2014

• Objective:To provide a critical appraisal of nurses risk assessment and pressure ulcer (PU) preventive practices across scandinavia, Iceland and Ireland. • Method:An integrative research review following Cooper's five stages. Studies published in peer-reviewed journals, involving any study design, but specifically exploring PU risk assessment or preventative practices, in any care setting, were included. • Results:Risk assessment practice was primarily investigated in the acute care setting and was found to be irregular, based on both numeric scales and clinical judgments. This irregular practice means that some vulnerable patients are not screened for pressure ulcer risk, conversely, when risk assessed, a care plan is not necessarily provided. A significant gap in nurse documentation, together with a lack of supporting evidence for repositioning and use of appropriate redistribution devices was also identified, indicating a lack of a standardised approach to pressure ulcer prevention. • Conclusion:Despite an abundance of literature exploring this subject, it is clear that current practice in pressure ulcer prevention is not embedded within best practice recommendations. Therefore, to address the potential patient safety implications, clinical practice could benefit from exploration and identification of practical methods for improving actual pressure ulcer preventive practice. • Declaration of interest:This work is partly funded by a research grant from the Norwegian College of Nursing (Norsk Sykepleierforbund NSF) in 2012. The authors have no conflict of interest to declare.
Physiological and appearance characteristics of skin maceration in elderly women with incontinence
Authors: Ichikawa-Shigeta Y. , Sugama J. , Sanada H. , Nakatani T. , Konya C. , Nakagami G. , Minematsu T. , Yusuf S. , Supriadi  , Mugita Y. 
Published: May 2014

Objective:To identify the physiological and appearance characteristics of skin maceration caused by urine and/or faeces and determine their suitability as risk indicators for incontinence-associated dermatitis.Method:This cross-sectional, comparative study involved sixty-nine elderly women with urinary and/or faecal incontinence who provided informed consent to participate. Exclusion criteria included serious medical problems, acute illness and the presence of damaged skin on the buttocks. The physiological and appearance characteristics of macerated skin on the buttocks of the patients were examined. Stratum corneum and dermis hydration levels, transepidermal water loss and skin pH were used to assess skin condition. Skin morphology (sulcus cutis) was confirmed using images at x15 magnification. The erythema index and white index were used to evaluate colour in the macerated skin areas.Results:Forty-four patients exhibited skin maceration. Stratum corneum and dermis hydration levels were significantly greater in the maceration group than in the non-maceration group, as were transepidermal water loss, skin pH and differences in sulcus cutis interval between the buttock of interest and the subumbilical region. Furthermore, differences in the erythema and white indices between these two regions were significantly higher and lower, respectively, in the maceration group than in the non-maceration group.Conclusion:To our knowledge, this is the first report to note that there are interesting changes not only in the epidermal layer but also in the dermis layer in patients with skin maceration. This finding confirmed that skin maceration caused by incontinence is a severe condition. Moreover, the erythema index was the best index for identifying skin maceration caused by incontinence, indicating that it can be used for precise and easy identification of the condition in clinical practice.Declaration of interest:Funding for this study was obtained from the Japan Society for the Promotion of Science (JSPS) KAKENHI (Grant-in-Aid for Young Scientists) under grant agreement number 21890217. The authors have no conflicts of interest to declare.
Negative pressure wound therapy for sternal wound infections following congenital heart surgery
Authors: Costello J.P. , Amling J.K. , Emerson D.A. , Peer S.M. , Afflu D.K. , Zurakowski D. , Jonas R.A. , Nath D.S. 
Published: May 2014

Objective: This study examines the efficacy of a comprehensive, multidisciplinary wound management team and negative pressure wound therapy (NPWT) for the treatment of sternal wound infections in congenital heart surgery patients. Method: A single-institution retrospective review of all congenital heart surgery patients with post-operative sternal wound infections who were treated with NPWT was performed. Patients were evaluated based on (a) whether NPWT occurred before or after the establishment of a multidisciplinary wound management team, and (b) whether NPWT was initiated early (within 2 days) or late (greater than 2 days) after diagnosis of a sternal wound infection. Results: The median duration of NPWT was 12 days (range 2–50 days). NPWT was successfully initiated in patients as young as 15 days of age. There was a trend toward shorter duration of both NPWT and antibiotic use following (a) the implementation of the multidisciplinary wound management team, and (b) in patients with early use of NPWT; however, these results did not achieve statistical significance. Conclusion: NPWT can be successfully utilised in congenital heart surgery patients, including young neonates, for the treatment of sternal wound infections. The trends observed in the reduction of wound therapy duration and antibiotic duration with early implementation of negative pressure therapy and multidisciplinary wound management require further investigation to verify their clinical efficacy in patient care. Declaration of interest: There were no external sources of funding for this study. The author has no conflicts of interest to declare.
A novel use of amniotic membrane for fingertip injuries
Authors: Fijan A. , Hashemi A. , Namazi H. 
Published: May 2014

Objective: Fingertip injuries, which are the most common hand injury, represent management challenges for hand surgeons. Full thickness skin grafts are routinely used to cover the fingertip site, but has significant donor site morbidity. As amniotic membranes (AM) are used as a dressing substitute in burns, we decided to evaluate the efficacy of AM as a biologic wound dressing material for coverage of these injuries. Method: In this clinical study, 30 patients with full-thickness zone 1 fingertip skin loss were included. The patients were divided into 2 groups using the block randomisation method. In the first group, a skin graft was used for coverage and in the second group, AM was used. All patients were operated on by the same hand surgeon between February 2012 to October 2012. The minimum follow-up period was 6 months. Two point discrimination (T.P.D), light touch, healing time, days lost from work and infection rate were evaluated and recorded. Result: This study recruited 30 patients with full-thickness zone 1 fingertip skin loss (age range 13–47 years). Fingertips in both groups were assessed. T.P.D, light touch and days lost from work were significantly lower in the AM group than in the skin graft group. Healing time was lower in the skin graft group. In the both groups, no infection was detected. Patients of both groups were satisfied of their treatment and healing progress. Conclusion: Our results showed the effectiveness and safety of AM for the treatment of fingertip amputation, which can produce better sensation and functional outcomes than skin graft transplantations. Declaration of interest: This paper was extracted from the thesis of Abouzar Fijan, MD. This study was supported by Shiraz University of Medical Sciences, grant number 4037. The authors have conflicts of interest to declare.
Does understanding words used by the breathless COPD patient enhance therapeutic care?
Authors: Harrison Susan 
Published: May 2014

Shortness of breath, dyspnea and breathlessness are collective terms to describe the awareness of inadequate gas exchange within the respiratory system.Varying mechanisms, behavioural and physiological changes are caused by this ventilation-perfusion mismatch. This complex sensation encompasses manydiverse concepts. The spectrum of language and words used as a consequence of this sensation varies from quality and intensity to emotions and feelings. Matching the phrases to the cause supports understanding. Current studies reviewed produced clusters of verbal descriptors which reflect the multi-dimensional input as a consequence of being out of breath. Using these clusters has produced a comprehensive list of twelve words known as ‘The Dyspnea 12’ which when used, quantifies the severity of this debilitating and extremely distressing symptom. Could these verbal descriptors be used to aid the assessment and treatment of their cause in service users and provide a more holistic view to a widespread problem?
Pre-hospital lactate testing in the identification of patients with sepsis: a review of the literature
Authors: Kirby Kim 
Published: May 2014

Sepsis is increasingly common and has a high mortality rate. Sepsis can be difficult to identify and patients with severe sepsis often initially present to the ambulance service. Lactate testing has been utilised successfully in other healthcare settings to assist with the identification of septic patients and stratification of illness severity. A focused literature review has revealed that pre-hospital lactate testing has shown benefits to clinicians pre-hospitally in the identification of septic patients presenting to the ambulance service. Only four pieces of primary research were identified and small sample sizes and variability of lactate testing limit the generalisation of the findings. Further research is required to fully investigate the potential benefits of using pre-hospital lactate testing to identify those patients with sepsis, severe sepsis and septic shock presenting to the ambulance service.
Essex and Herts Air Ambulance: a focused case series for pre-hospital practice
Authors: Ley Erica , Chesters Adam 
Published: May 2014

Burns and scalds are relatively common in children and can be distressing for all involved. General principles of early management are to limit the progression of the burn through cooling, and to manage pain in order to perform a thorough assessment and improve the patient's experience. Assessment of burns includes an estimation of body surface area involved, an appreciation of the depth of burn, and the consideration of ‘special areas’ affected. A number of tools and guides exist that help standardise this assessment. However, it is impossible to truly know the size and extent of the burn during the first contact meeting in the pre-hospital environment as a burn matures and develops over the course of 72 hours. Treatment regimes are focused upon improving blood flow to the area of stasis, a fragile circumferential area between the zone of coagulation, in which the tissue is already unsalvageable, and the zone of hyperaemia, where blood flow to the surrounding tissues in increased. We report the case of a 2-year-old boy who sustained a scald to the abdomen after pulling over a freshly made cup of tea. We describe an approach to burns in children, in collaboration with parents. This case highlights the need for early adequate analgesia, thorough assessment, and triage to the correct hospital where the patient's injury can be appropriately managed. We also highlight areas in which an extended care service such as a helicopter emergency medical service (HEMS) team can help, particularly in terms of supplementary analgesia and transfer to specialist units.
How to… Cope with a computer 2
Authors: Ashurst Allan 
Published: May 2014

In the first part of this article: ▪ I tried to dispel computerphobia ▪ I told you how useful a computer had proved to us ▪ I explained what a computer is ▪ I introduced you to Windows® (an interface program which displays icons on the screen from which you can select the programs you want to use). ▪ I advised you of the computer's usefulness in the caring profession (doing finances, records, correspondence, e-mails, newsletters and marketing).
Commonly used dietary supplements in canines
Authors: Harvey Natalie 
Published: May 2014

Almost 30% of pet owners in the UK fed supplements to their pets in 2008, however, the feeding of supplements in Australia and the USA is lower, with approximately 10–13% of owners giving supplements to their pets. Fatty acids, probiotics and glucosamine with chondroitin have been reported as among the most common supplements fed to dogs.Efficacy studies for these supplements show promise, however, further research is required to determine more accurate dosing schedules and safety data. It is advisable to contact the company producing a supplement for their quality control data as well as their safety and efficacy studies to evaluate the supplement prior to use. Where possible, improve the diet before considering use of a supplement, and always ask owners about supplement use for their pet when taking a diet history.
Preventative dental care: educating the client
Authors: Milella Lisa , Wilks Lauren 
Published: May 2014

Many pets seen every day in general practice have dental diseases requiring treatment. Most owners are unaware that their pet has a problem so it is up to veterinary professionals to recognize and treat these diseases to ensure that pets have an infection free and pain free mouth.The role of the veterinary nurse is vital in educating clients about dental problems and helping to prevent them occurring, or helping to prevent the disease progressing further. This article discuss common dental diseases and how the nurse can get the owner engaged in dental clinics
Prevention and Management of Scale and Polish Damage to Resin Composite Restorations
Authors: Wilson Nairn HF , Lynch Christopher D 
Published: May 2014

Background The use of resin composite in the restoration of, in particular, posterior teeth is increasing. This trend is set to continue, with the momentum-gathering shift towards minimal-intervention direct approaches to the restoration of diseased, damaged and worn teeth, and subsequent to the signing of the Minamata Convention, aimed, amongst other measures, at ‘phasing down’ the use of dental amalgam.1–3 As a result, members of the dental team should, it is suggested, give consideration to the prevention and management of the damage that routine scaling and polishing may cause to the margins and surfaces of restorations of resin composite, or indeed restorations of other tooth-coloured restorative systems. Such damage may compromise the aesthetic qualities and reduce the life expectancy of tooth-coloured restorations. This article focuses on the prevention and management of scale and polish damage to resin composite restorations.
Periodontal Health – Challenges in Restorative Dentistry
Authors: Reeves J 
Published: May 2014

As the population ages and life expectancy increases, clinicians today find themselves in the wake of an ever-growing demand for high-quality aesthetic dental treatment, by increasingly informed patients. The long-term success of both cosmetic and restorative dentistry is dependent on well designed restorations and the health of the periodontal tissues. Overhanging restorations, full crown restorations with poor marginal fit, and implant-supported prosthetics with inadequate hygiene access all increase the risk for periodontal sequelae and interproximal caries. When planning restorative treatment, consideration should be given to the restorative design, the need for hygiene access and the location of intended implants. In addition, the patient's manual dexterity and ability to manipulate oral hygiene aids is a crucial consideration, as is adequate access for the hygienist to manually debride and maintain the restorations.
Microfinance Regulation and Market Development in Latin America
Authors: Trujillo Veronica , Rodriguez-Lopez Fernando , Muriel-Patino Victoria 
Published: May 2014

Abstract
The evolution and development of microfinance markets is conditioned by external factors such as macroeconomic variables, institutional country level, availability of conflict resolution mechanisms, informal sector features, and applicable regulation. A careful design of the latter aspect is needed because it can either be a tool for promotion (by facilitating and making flexible microfinance institutions activities) or a restriction to market development by setting unnecessary limits or requirements. Considering these ideas, this paper analyzes the relationship between regulatory frameworks for microfinance in 17 Latin American countries and the level of development and specific features in its corresponding microfinance markets.
Swelling of Crosslinked Polymers in Liquids and Vapors. Rational Explanation of Thermodynamic Paradoxes
Authors: Davankov Vadim A. , Pastukhov Alexander V. 
Published: May 2014

Abstract
Schroeder's paradox, stronger swelling of gelatin in liquid water compared to swelling in saturated water vapor, did not
receive any acceptable thermodynamic explanation for more than 100 years. By an automatic registration of the growing size of
a single polymeric sphere (of less than 1 mm in diameter) placed first into saturated vapor atmosphere and then into
corresponding liquid, we showed that the above effect is a general phenomenon characteristic of all crosslinked polymers and
all types of aqueous or organic media. Explanation of the paradox is presented in terms of higher activity and chemical
potential of the bulk liquid compared to saturated vapor over it, due to the unidirectional attraction of the surface molecules
toward the condensed liquid phase. Also, it was found that saturated vapor can exist in a prolonged equilibrium with polymer
samples which incorporate any amount of the sorbate within the broad range from the vapor-equilibrated to liquid-equilibrated
extremes. This paradox is explained by the dependence of the system of inter-chain interactions within the network on the
pre-history of the sample.
Large magnetic permeability and resonant frequency of CoFe nanofilms electrodeposited via optimizing plating solution parameters based on electrochemistry mechanisms
Authors: Zong BaoYu , Wu YuPing , Phuoc Nguyen Nguyen , Ho Pin , Ma FuSheng 
Published: May 2014

ABSTRACTA simple methodology to electrodeposit thin soft CoFe films with desirable microwave properties from simple salt solutions at room temperature is demonstrated. Plating solution parameters have diverse influences on real potentials of ion reductions and deposition behavior of the FeCo crystals, consequently affecting largely the particle size, crystal structure and chemical composition of the film fabricated. This in turn determines their static magnetism and dynamic microwave properties. Through optimizing solution additive, concentration and temperature from electrodeposition mechanism, the as-prepared nanofilms possess a low coercivity of < 30 Oe, moderate anisotropy of 60-90 Oe, high crystallinity and magnetic moment of ≥ 2.0 T, and hence readily display an ultrahigh magnetic permeability (up to 1128) and resonant frequency (up to 2.1 gigahertz) simultaneously, as well as other desirable physico-chemical properties. Thus the nanofilms can be applied to high gigahertz frequency applications.
A New Transfer Technique for Graphene Deposited by CVD on Metal Thin Films
Authors: Amato G. , Simonetto E. , Croin L. , Vittone E. 
Published: May 2014

ABSTRACTChemical Vapor Deposition of graphene on metallic substrates is one of the most attracting techniques for large area graphene production. The technique widely employed for transferring graphene to other substrates involves deposition of a polymer support with subsequent etching of the metal substrate. Here we report a safer transfer process, which requires a two-step PMMA deposition and bonding under pressure. Sheets of graphene before and after transfer have been both characterized by Raman spectroscopy, and show comparable quality, indicating that the proposed technique does not introduce additional defects in graphene.
A City-Based Design That Attempts to Improve National Representativeness of Asians
Authors: Pedlow Steven 
Published: May 2014

Abstract
This article describes a case study on the potential of using smaller geographical units in an area probability design, and reports the challenges of collecting a nationally representative sample for this hard-to-reach population. The Census Integrated Communications Program Evaluation (CICPE) was designed to evaluate the promotional campaign’s effect on Decennial Census participation for six race/ethnicity groups of interest. A nationally representative Core sample was designed to collect interviews for Hispanics, non-Hispanic African-Americans, and non- Hispanic Whites. However, it was impractical to include the rarer Asian, American Indian and Alaska Native (AIAN), and Native Hawaiian and Other Pacific Islander (NHOPI) populations in the Core design. For the Asian sample, we designed a separate area probability sample.
Traditional area probability sampling designs use counties or metropolitan areas as first-stage units, but smaller geographical units can better target hard-to-reach populations. The CICPE Asian sample used cities as the first-stage units.