bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Possibilities for Activity Scale (PActS): Development, validity, and reliability
Authors: Pergolotti Mackenzi , Cutchin Malcolm P. 
Published: December 2014

Background. Laliberte Rudman proposed the concept of occupational possibilities to represent what older adults feel they “should be” and “could be” doing. Purpose. This study aimed to develop and validate a measure of perceived occupational possibilities: the Possibilities for Activity Scale (PActS). Method. Two factors of the PActS, activity expectations and activity self-efficacy, were operationalized in a 14-item instrument. The instrument was then evaluated with a sample of older adults diagnosed with cancer ( n = 179). Findings. The PActS demonstrated promising internal consistency reliability (stratified coefficient α = .77) and construct-related ( r = .58; p < .0001), structural (chi-square = 61.57; CFI = .97; RMSEA = .05; TLI = .96; NFI = .91) and known-groups validity. Implications. The PActS appears to be a useful measure of internalized occupational possibilities for participation in activity for older adults with cancer. This scale can enhance the measurement of participation in activity by evaluating the perceptions of occupational possibilities.
Jasmine flower extract lowers prolactin
Authors: Finny Philip , Stephen Charles , Jacob Rajesh , Tharyan Prathap , Seshadri Mandalam S 
Published: December 2014

Background Antipsychotic drugs frequently cause amenorrhoea and galactorrhoea. Jasmine flowers used topically were as effective as oral Bromocriptine in suppressing puerperal lactation. This study aims to evaluate the efficacy and safety of intranasal jasmine flower extract (JFE) to reduce prolactin levels of patients on stable doses of antipsychotic drugs. Method This is a randomized, double blind, crossover clinical trial. An aqueous–ethanol extract of jasmine flowers was prepared and used as nasal drops. A decrease in serum prolactin of ≥25 ng/mL was considered a significant response. Results Ten out of 35 women had a significant drop in the serum prolactin while on the JFE. The non-responders to JFE were on higher doses of antipsychotic drugs. The main side effect was a transient and mild burning sensation in the nose. A cost analysis favoured JFE over dopamine agonists. Conclusion JFE contains a prolactin-lowering substance which needs further characterisation.
Challenges in the management of chronic HBV infection in West Africa: The clinician’s perspective
Authors: Okonkwo Uchenna C , Onyekwere Charles A 
Published: December 2014

Background Hepatitis B infection has become a public health issue in recent years. Approximately 350 million of the world’s population are chronically infected reaching endemic proportions in West Africa. Guidelines for treatment are continuously improving but are becoming more complex. Aim To determine the challenges hepatologists experience in the management of patients with chronic hepatitis B. Methods This was a cross-sectional descriptive study conducted among hepatologists in West Africa during a regional hepatitis conference in 2013. Results Forty-six hepatologists completed the questionnaire. When evaluating a patient for chronic hepatitis B, the preferred investigations were: LFT (100%); abdominal ultrasound (93.5%); HBeAg (93.5%); HBV DNA (78%); HBsAg measure (22%); HBV genotype (15.2%); and liver biopsy (34.8%). Most had their patients on nucleoside/nucleotide analogue but follow-up visits after 1 year were problematic. Conclusion The majority of hepatologists had good intentions regarding the evaluation of their patients, but only a small percentage of patients are properly investigated.
The inflammatory response between miniaturised and conventional cardiopulmonary bypass after cardiac surgery in an Asian population
Authors: Ng RRG , Chew STH , Liu W , Ong P , Caleb MG , Ti LK 
Published: December 2014

Introduction: We compared the systemic inflammatory response of the MCPB system to the CCPB system with cell salvage and phosphorylcholine-coated tubing amongst Asian patients undergoing coronary artery bypass grafting. Methods: Seventy-eight patients were randomly assigned to the MCPB or the CCPB groups equally and followed up in a prospective, single-blinded, randomised, controlled trial. Levels of TNF-α, IL-6, CRP and LDH were measured peri-operatively. Results: The systemic inflammatory response was similar in both groups (TNF-α: p=0.222; IL-6: p=0.991; CRP: p=0.258). Only haemolysis was significantly higher in the CCPB group (LDH: p=0.011). The MCPB system was twice more expensive, but had a near 4-fold cost saving in tranfusions. Overall, the MCPB system cost 20% more than the modified CCPB system. Conclusion: These results corroborate with studies that demonstrated the avoidance of cardiotomy suction rather than the MCPB system, itself, leads to an attenuated inflammatory response. The absence of obvious clinical benefit and the higher costs involved with the MCPB system would preclude its routine use.
Antinociceptive and anti-inflammatory potential of Rhododendron arboreum bark
Authors: Nisar Muhammad , Ali Sajid , Muhammad Naveed , Gillani Syed N , Shah Muhmmad R , Khan Haroon , Maione Francesco 
Published: December 2014

Rhododendron arboreum Smith. (Ericaceae), an evergreen small tree, is one of the 1000 species that belongs to genus Rhododendron distributed worldwide. In folk medicine, as various parts of this plant exhibit medicinal properties, it is used in the treatment of different ailments. The present study was designed to evaluate the potential anti-inflammatory and antinociceptive effects of methanolic extract of R. arboreum bark, followed by activity-guided fractionation of n-hexane, n-butanol, chloroform, ethyl acetate and aqueous fractions. The ethyl acetate fraction (200 mg/kg i.p.) showed the maximum analgesic effect (82%) in acetic acid-induced writhing, followed, to a less extent, by crude extract and chloroform fraction both at a dose of 200 mg/kg i.p. (65.09% and 67.89%, respectively). In carrageenan-induced mouse paw oedema, the crude extract and its related fractions displayed in a dose-dependent manner (50–200 mg/kg i.p.) an anti-inflammatory activity for all time-courses (1–5 hrs). For the active extract/fractions (200 mg/kg i.p.), the maximum effect was observed 5 h after carrageenan injection. These evidences were also supported by in vitro lipoxygenase inhibitory properties. In conclusion, R. arboreum crude methanolic extract and its fractions exhibited anti-inflammatory and antinociceptive effects. For these reasons, this plant could be a promising source of new compounds for the management of pain and inflammatory diseases.
Nursing students’ perceptions of patient dignity
Authors: Papastavrou Evridiki , Efstathiou Georgios , Andreou Christos 
Published: December 2014

Background: Respecting patients’ dignity has been described as a fundamental part of nursing care. Many studies have focused on exploring the concept of patients’ dignity from the patient and nurse perspective, but knowledge is limited regarding students’ nursing perceptions and experiences. Objective: To explore the issue of patients’ dignity from the perspective of nursing students. Research design: A qualitative study was employed with the formation of four focus groups and the participation of nursing students. Data were analysed via a thematic content analysis of the discussions. Participants and research context: Thirty-four nursing students of a Cyprus University participated in the four focus groups. Each group was homogenous in terms of the year of study and heterogeneous in terms of clinical practice in various wards. Ethical consideration: The study’s protocol was reviewed and approved by the Cyprus National Bioethics Committee. Ethical standards were followed throughout the study. Findings: Several factors that maintain or compromise patients’ dignity emerged. These factors were grouped into five themes: (a) patients’ preferences, verbal abuse and regarding a patient as a unique person; (b) privacy and confidentiality; (c) loss of autonomy and need for help; (d) discrimination and (e) attribution and reciprocity. Discussion: Different understandings of the perceived concept of dignity and the factors that maintain or compromise patient’s dignity were expressed through the eyes and the feelings of nursing students. Students highlighted the importance of promoting patient dignity as an important component of nursing care. Conclusion: Nurse educators can use the findings of this study in order to tailor nursing programmes to emphasise the importance of respecting patients’ dignity. In addition, nurse ward managers can use the findings as means for persuading nurses to change current behaviour.
Moral distress
Authors: McCarthy Joan , Gastmans Chris 
Published: December 2014

Aim: The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. Data sources: CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers’ Index and Socindex. Review methods: A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. Results: We found that like the empirical literature, most authors in this review draw on Jameton’s original definition and describe moral distress in psychological–emotional–physiological terms. They also agree that moral distress is linked to the presence of some kind of constraint on nurses’ moral agency, and that it is best understood as a two-staged process that can intensify over time. There is also consensus that moral distress has an important normative meaning, although different views concerning the normative meaning of moral distress are expressed. Finally, the authors generally agree that moral distress arises from a number of different sources and that it (mostly) affects negatively on nurses’ personal and professional lives and, ultimately, harms patients. However, despite this consensus, many authors take issue with the way in which moral distress is conceptualized and operationalized. Moreover, while some worry that identifying nurses as a group of health professionals whose voices are ignored or marginalized might disempower nurses and encourage them to avoid their moral responsibilities, others take situations involving moral distress as indicative of more fundamental, structural inequities at the heart of contemporary healthcare provision. Conclusion: We conclude that research on moral distress in nursing is timely and important because it highlights the specifically moral labour of nurses. However, we suggest that significant concerns about the conceptual fuzziness and operationalization of moral distress also flag the need to proceed with caution.
Getting started in research: designing and preparing to conduct a research study
Authors: Macfarlane Matthew D , Kisely Steve , Loi Samantha , Macfarlane Stephen , Merry Sally , Parker Stephen , Power Brian , Siskind Dan , Smith Geoff , Looi Jeffrey C 
Published: December 2014

Objective: To discuss common pitfalls and useful tips in designing a quantitative research study, the importance and process of ethical approval, and consideration of funding. Conclusions: Through careful planning, based on formulation of a research question, early career researchers can design and conduct quantitative research projects within the framework of the Scholarly Project or in their own independent projects.
Getting started in research: systematic reviews and meta-analyses
Authors: Kisely Stephen , Chang Alice , Crowe Jim , Galletly Cherrie , Jenkins Peter , Loi Samantha , Looi Jeffrey C , Macfarlane Matthew D , McVie Ness , Parker Stephen , Power Brian , Siskind Dan , Smith Geoff , Merry Sally , Macfarlane Stephen 
Published: December 2014

Objectives: Systematic reviews are one of the major building blocks of evidence-based medicine. This overview is an introduction to conducting systematic reviews and meta-analyses. Conclusions: Systematic reviews and meta-analyses of randomised controlled trials (RCTs) represent the most robust form of design in the hierarchy of research evidence. In addition, primary data do not have to be collected by the researcher him/herself, and there is no need for approval from an ethics committee. Systematic reviews and meta-analyses are not as daunting as they may appear to be, provided the scope is sufficiently narrow and an appropriate supervisor available.
Patterns of Antiplatelet Therapy in Patients Who Have Experienced an Acute Coronary Event
Authors: Sáez María E. , González-Pérez Antonio , Johansson Saga , Nagy Péter , Rodríguez Luis A. García 
Published: December 2014

Background: Antiplatelet (AP) therapy is well established for the secondary prevention of acute coronary events. However, patients may discontinue treatment, often owing to gastrointestinal (GI) complications, leaving them at elevated risk of recurrent cardiovascular events. Objectives: This descriptive retrospective study assessed trends in prescription of AP agents and coprescription of gastroprotective therapy, after an acute coronary event. Discontinuation of AP therapy within 2 years of an event and factors predicting discontinuation were investigated. Methods: The study was conducted in a UK primary care setting from 2000 to 2008; a total of 27 351 patients aged 50 to 84 years were included in the analysis. Main outcome measures were exposures to low-dose acetylsalicylic acid (ASA), clopidogrel, and proton pump inhibitors (PPIs). Results: At 90 days after an acute coronary event, 85.9% of patients had been prescribed some form of AP therapy and 33.6% of patients who were issued at least 1 ASA prescription in this period were also issued a PPI prescription. The use of dual antiplatelet therapy (DAT) 90 days after an event increased from 2% in 2000 to over 50% in 2008. An estimated 15.1% of patients on ASA monotherapy and 37.5% on DAT discontinued treatment within 1 year. A bleeding event during follow-up, including upper GI bleeding or hemorrhagic stroke, was the strongest predictor of discontinuation. Conclusion: Although most patients were prescribed AP therapy in the 90 days following an acute coronary event, a substantial proportion discontinued DAT or ASA monotherapy within 1 year. It is essential that physicians consider strategies to reduce the risk of discontinuation of AP therapy.
Inhibition of local aldosterone by eplerenone reduces renal structural damage in a novel model of chronic cyclosporine A nephrotoxicity
Authors: Sun Qiao-Ling , Li Meng , Rui Hong-Liang , Chen Yi-Pu 
Published: December 2014

Background and objective: The fact that mineralocorticoid receptor antagonists reduce structural and functional alterations induced by cyclosporine A (CsA) indicates that aldosterone plays a key role in chronic CsA nephrotoxicity. We and other researchers have reported local renal aldosterone synthesis. To investigate local renal aldosterone’s role in chronic CsA nephrotoxicity, we evaluated the effect of eplerenone (Epl) on renal structural damage and renal dysfunction in adrenalectomized (ADX) rats, and assessed whether the therapeutic benefit was associated with reduction of transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), plasminogen activator inhibitor type 1 (PAI-1) and collagen I (COL-I) expression. Methods: Male Sprague-Dawley rats fed a normal-sodium diet were divided in four groups: sham-ADX, ADX, CsA, or Epl. Rats in the ADX, CsA and Epl groups were adrenalectomized first. Aldosterone, sodium and potassium levels in serum and urine were measured on the second day. Two weeks later, vehicle (sham-ADX and ADX group), CsA (25mg/kg/d), or CsA and Epl (100 mg/ kg/d) combination was administrated, respectively. After six weeks, urinary protein, creatinine clearance (Ccr), tubulointerstitial fibrosis (TIF), aldosterone level in kidney, and renal aldosterone synthase CYP11B2, COL-I, TGF-β1, CTGF and PAI-1 gene expression levels were determined. Results: On the second day after surgery, adrenalectomized rats showed undetectable aldosterone with natriuresis, hyponatremia, decreased urinary potassium excretion and hyperpotassemia. CsA reduced Ccr, induced urinary proteins and up-regulated COL-I, TGF-β1, CTGF and PAI-1 gene expression with a significant development of TIF. Eplerenone administration prevented TIF and COL-I, TGF-β1 and PAI-1 up-regulation but did not improve renal function. Conclusion: Our results suggest local renal aldosterone is an important mediator of renal injury induced by CsA.
Evaluation of the response to vaccination with hepatitis B vaccine in pediatric patients diagnosed with celiac disease
Authors: Walkiewicz-Jedrzejczak Dorota , Egberg Matthew , Nelson Catherine , Eickoff Jens 
Published: December 2014

Background: A gap exists in the literature on celiac disease populations and the response to hepatitis B vaccination. Objective: To identify pediatric patients with celiac disease who received the primary hepatitis B vaccination and investigate their response to vaccine. Design/Methods: Patients underwent blood draw for hepatitis B surface antibody titers. Patients with undetectable or non-protective HBsAb titers were contacted. Study outcome measures and patient characteristics variables were summarized by means, standard deviations, medians, and ranges. A two-sample t-test was used to compare normally distributed continuous variables between responders and non-responders. Results: In all, 58% of patients did not meet the threshold for “protective” antibody titers. The mean time between completion of hepatitis B vaccination and diagnosis of celiac disease was 8.1 years for responders versus 10.5 years for non-responders. In a multivariate analysis, time between completion of vaccine and diagnosis of celiac disease was statistically significant predictor of response with an adjusted odds ratio of 0.69 (95% confidence interval: 0.50–0.95; p = 0.021). Conclusion: Our celiac disease population shows a high hepatitis B vaccine failure. The time between completion of vaccine series and diagnosis of celiac disease is an independent predictor for response.
Results of Operative and Nonoperative Treatment of Rockwood Types III and V Acromioclavicular Joint Dislocation
Authors: Joukainen Antti , Kröger Heikki , Niemitukia Lea , Mäkelä E. Antero , Väätäinen Urho 
Published: December 2014

Background: The optimal treatment of acute, complete dislocation of the acromioclavicular joint (ACJ) is still unresolved. Purpose: To determine the difference between operative and nonoperative treatment in acute Rockwood types III and V ACJ dislocation. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: In the operative treatment group, the ACJ was reduced and fixed with 2 transarticular Kirschner wires and ACJ ligament suturing. The Kirschner wires were extracted after 6 weeks. Nonoperatively treated patients received a reduction splint for 4 weeks. At the 18- to 20-year follow-up, the Constant, University of California at Los Angeles Shoulder Rating Scale (UCLA), Larsen, and Simple Shoulder Test (SST) scores were obtained, and clinical and radiographic examinations of both shoulders were performed. Results: Twenty-five of 35 potential patients were examined at the 18- to 20-year follow-up. There were 11 patients with Rockwood type III and 14 with type V dislocations. Delayed surgical treatment for ACJ was used in 2 patients during follow-up: 1 in the operatively treated group and 1 in the nonoperatively treated group. Clinically, ACJs were statistically significantly less prominent or unstable in the operative group than in the nonoperative group (normal/prominent/unstable: 9/4/3 and 0/6/3, respectively; P = .02) and in the operative type III ( P = .03) but not type V dislocation groups. In operatively and nonoperatively treated patients, the mean Constant scores were 83 and 85, UCLA scores 25 and 27, Larsen scores 11 and 11, and SST scores 11 and 12 at follow-up, respectively. There were no statistically significant differences in type III and type V dislocations. In the radiographic analysis, the ACJ was wider in the nonoperative than the operative group (8.3 vs 3.4 mm; P = .004), and in the type V dislocations (nonoperative vs operative: 8.5 vs 2.4 mm; P = .007). There was no statistically significant difference between study groups in the elevation of the lateral end of the clavicle. Both groups showed equal levels of radiologic signs of ACJ osteoarthritis and calcification of the coracoclavicular ligaments. Conclusion: Nonoperative treatment was shown to produce more prominent or unstable and radiographically wider ACJs than was operative treatment, but clinical results were equally good in the study groups at 18- to 20-year follow-up. Both treatment methods showed statistically significant radiographic elevations of the lateral clavicle when compared with a noninjured ACJ.
The Problem of Overbite in Class II, Division 2 Malocclusion
Authors: Mills J. R. E. 
Published: December 2014

The paper studies 60 Class II, Division 2 malocclusions, from lateral skull radiographs taken before treatment and at least 1 year after the end of retention. In the first part of the paper the nature of the malocclusion is analysed. It usually exhibits a Class II skeletal pattern, and while this is on average milder than for Class II, Division I, there is a marked variation between individuals. Other factors are a high inter-incisal angle, a high lip-line, and in some cases a small lower facial height. The upper and lower facial heights, on the other hand, are not appreciably greater than normal. The results of treatment are then analysed. Successful overbite reduction would seem to be associated with a reduction in inter-incisal angle and a relative lowering of the lower lip-line. Growth appears to be important in achieving overbite reduction. It is suggested that favourable rotation of the mandible may be a factor in overbite reduction in some cases, and this would repay further study. Finally attention is turned to the effect of incisor proclination. This was usually more successful in the lower jaw, but again there was wide individual variation.
Mantle cell lymphoma: evolving management strategies
Authors: Campo Elias , Rule Simon 
Published: December 2014

AbstractMantle cell lymphoma (MCL) is a rare and aggressive form of non-Hodgkin’s lymphoma that generally affects older individuals and continues to have one of the worst outcomes of all the lymphomas. Over the last decade, there has been a widespread adoption of cytarabine-based therapy in younger patients, and the incorporation of rituximab into chemotherapeutic regimens has become an evidence-based standard of care. However MCL remains a largely incurable disease, and following relapse, it can be a challenge to manage. Although it is possible to define prognosis reliably, there are, as yet, no clear diagnostic or response-adjusted parameters that can help to guide therapeutic decisions. However, there are a number of highly active targeted therapies that are moving into the clinic that are set to transform the therapeutic paradigm for this disease in the very near future. This review will explore the molecular pathogenesis of MCL and the current and evolving therapeutic strategies for this disease.
Type II NKT-TFH cells against Gaucher lipids regulate B-cell immunity and inflammation
Authors: Nair Shiny , Boddupalli Chandra Sekhar , Verma Rakesh , Liu Jun , Yang Ruhua , Pastores Gregory M. , Mistry Pramod K. , Dhodapkar Madhav V. 
Published: December 2014

Key PointsA new subset of human and murine type II NKT-TFH cells against Gaucher lipids that regulate B-cell immunity. A novel pathway for B-cell help providing a mechanism underlying chronic B-cell activation and gammopathy in metabolic lipid disorders.