bluuebunny/crossref_metadata_2025_split huggingface dataset:
Making sense of varying standards of care: the experiences of staff working in residential care environments for adults with learning disabilities
Authors: Hutchison Andrew , Kroese Biza Stenfert 
Published: June 2015

Accessible summary

To find out why standards of care might vary in residential homes for adults with learning disabilities, this study describes the experiences of six care workers currently working in residential homes.

Each care worker took part in an interview where they were asked to talk about their jobs in detail.

Three things were found to be important aspects of care workers experiences: the quality of their relationships with others; their levels of motivation for their work; and their feelings about the environments they worked in.

The study discusses how each of those things can lead to variations in care standards.

SummaryResearch evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have been made to understand variations in care standards, there remains a need for more research in this area. Additionally, little attention has been paid to understanding support staff experiences of working in residential services and to developing a more theoretical understanding of the role they fulfil. Using interpretive phenomenological analysis (IPA), this study aimed to examine front‐line staff members' experiences of working in residential care for people with learning disabilities. Six experienced front‐line care workers (four female, two male) took part in semi‐structured interviews. Data were analysed according to the principles of IPA, and three superordinate themes were identified as being central to participants' experiences of their work roles: Degree of Positive Relationship Reciprocity; Value Congruence and Intrinsic Motivation; and Experiences of Environmental and Organisational Constraints. Results are discussed in relation to the existing literature on care standards and the factors associated with abusive or neglectful practices, and in terms of their contribution to theory and applied practice.
Fracture resistance of weakened bovine teeth after long‐term use of calcium hydroxide
Authors: Valera Marcia Carneiro , Albuquerque Maria Tereza Pedrosa , Yamasaki Mayra Cristina , Vassallo Flávia Nicolle Stefani , da Silva Denise Almeida e Silva Alves , Nagata Juliana Yuri 
Published: June 2015

AbstractBackground/AimIn some parts of the world, revascularization may not be the most feasible treatment option for necrotic immature teeth. Therefore, apexification remains the most widely utilized treatment option for these cases. This study aimed to evaluate the fracture resistance of weakened bovine tooth roots treated with various irrigant solutions as well as long‐term application of calcium hydroxide intracanal medication (ICM).Material and methodsOne hundred seventy bovine teeth were randomly divided into three experimental groups (n = 50) and two control groups (n = 10). Group SS was irrigated with physiologic solution; group CHX was treated with 2% chlorhexidine gel and group NaOCl was irrigated with 1% sodium hypochlorite. After instrumentation, root canals were dressed with calcium hydroxide and evaluated at different periods (15, 60, 90, 180, and 360 days). The specimens were loaded at a 45° angle to measure fracture resistance through the use of an EMIC test machine.ResultsA decrease in fracture resistance was observed during the time of ICM dressing. The highest values of fracture resistance were observed in group SS with 15 days of ICM, not differing from the control group. Irrigation with NaOCl associated with ICM for 15 days presented the lowest fracture resistance; however, a statistically significant difference was not observed when compared with SS and CHX in the same time period. In longer periods of exposure to ICM (180 and 360 days), root canals irrigated with NaOCl and CHX showed significantly lower fracture resistance than SS (P < 0.05).ConclusionApexification with periodic changes of calcium hydroxide medicament leads to weakness of the teeth independent of the irrigation solution used.
Mammals, freshwater reference states, and the mitigation of climate change
Authors: Moss Brian 
Published: June 2015

SummaryFreshwater habitats have been severely altered by human activities, and legislation has variously been passed requiring assessment of the damage in preparation for its repair. The current condition is generally measured against a reference state, which may be ‘natural’, meaning pre‐Columbian, in the United States, pre‐European in Australia or, in Europe, a habitat with ‘no, or negligible human influence’. Such standards are mostly unachievable at present because of a current economic philosophy that promotes exploitation of nature, but they are also nebulous. Even pristine habitats naturally change, so that there can be no single immutable reference state. Nonetheless, in Europe at least, the concept of the reference state has been particularly compromised, compared with the aspirations of the legislation.Apart from a very liberal approach to setting reference standards, there has been a major omission in contemplating the general nature of the reference state. The potential former roles of large herbivorous land mammals, such as horses, bovines, deer and, early in the Holocene, elephants and rhinoceri, and their predators, in nutrient transfers, have been ignored. The effects of such large mammals, particularly in influencing lakes, are assessed in the light of major losses of much of the Pleistocene fauna during the hunter‐gatherer phase of human colonisation, and then subsequent near‐complete attrition when agriculture, husbandry and forestry converted the majority of biomes to ‘anthromes’.Animals, and particularly large herbivorous mammals, transfer nutrients across catchments. Large mammals are likely to have maintained a state of turbid water and algal blooms in pristine, poorly flushed, shallow floodplain lakes. In contrast, we currently perceive these to be in a reference state when dominated by submerged plant communities in clear water. Although of conceptual interest, this may seem to have little practical relevance because the reference state has become a pragmatic and political construct rather than an ecological one.I counter such a view by arguing that mitigation of climate change must require replacement of substantial carbon sinks that have been lost, that ecological sinks within restored biomes are likely to be the most effective and that restoration of such systems must involve the important roles of large mammals, with the implications these have for our concepts of lake restoration.
Species composition of coastal dune vegetation in Scotland has proved resistant to climate change over a third of a century
Authors: Pakeman Robin J. , Alexander Jim , Beaton Joan , Brooker Rob , Cummins Roger , Eastwood Antonia , Fielding Debbie , Fisher Julia , Gore Sarah , Hewison Richard , Hooper Russell , Lennon Jack , Mitchell Ruth , Moore Emily , Nolan Andrew , Orford Katy , Pemberton Clare , Riach Dave , Sim Dave , Stockan Jenni , Trinder Clare , Lewis Rob 
Published: June 2015

AbstractClimate change is expected to have an impact on plant communities as increased temperatures are expected to drive individual species' distributions polewards. The results of a revisitation study after c. 34 years of 89 coastal sites in Scotland, UK, were examined to assess the degree of shifts in species composition that could be accounted for by climate change. There was little evidence for either species retreat northwards or for plots to become more dominated by species with a more southern distribution. At a few sites where significant change occurred, the changes were accounted for by the invasion, or in one instance the removal, of woody species. Also, the vegetation types that showed the most sensitivity to change were all early successional types and changes were primarily the result of succession rather than climate‐driven changes. Dune vegetation appears resistant to climate change impacts on the vegetation, either as the vegetation is inherently resistant to change, management prevents increased dominance of more southerly species or because of dispersal limitation to geographically isolated sites.
Leapfrog migration and habitat preferences of a small oceanic seabird, Bulwer's petrel (Bulweria bulwerii)
Authors: Ramos Raül , Sanz Víctor , Militão Teresa , Bried Joël , Neves Verónica C. , Biscoito Manuel , Phillips Richard A. , Zino Francis , González‐Solís Jacob 
Published: June 2015

AbstractAimOur current understanding of migratory strategies and the reasons for their high variability along the phylogenetic tree remains relatively poor. Most of the hypotheses relating to migration have been formulated for terrestrial taxa; classically, oceanic migrations were considered as merely dispersive because of the scarcity of observations in the open ocean. We describe for the first time, the migration strategy of a small seabird, the Bulwer's petrel (Bulweria bulwerii), and provide new insights into the ecology and evolution of long‐distance marine migrations.LocationSubtropical and tropical Atlantic Ocean.MethodsUsing cutting‐edge geolocators, we examined the year‐round distribution and at‐sea activity patterns of adult Bulwer's petrels sampled at five localities throughout the species' breeding range in the Atlantic, within the Azores, Salvages, Canary and Cape Verde archipelagos. We assessed the migratory connectivity of the species and its habitat use at population and metapopulation scales.ResultsOur results provide the first evidence of an oriented leapfrog migration in oceanic seabirds. Ecological niche models based on breeding‐season data effectively predicted that subtropical waters of the South Atlantic would be the preferred habitat for the northern populations of Bulwer's petrels during the non‐breeding season. Habitat modelling also highlighted similarities in distributions between the breeding and non‐breeding periods for the southern populations. Data on at‐sea activity patterns suggested that birds from the northern and southern populations behave differently during the breeding season, as well as in the northern and southern non‐breeding ranges during the non‐breeding period.Main conclusionsThese results indicate that specific habitat preferences, presumably related to differences in prey availability, explain the observed distributions and hence the pattern of leapfrog migration described for Bulwer's petrel. Our study demonstrates the utility of integrating diverse tracking data from multiple populations across international boundaries, and habitat modelling, for identifying important areas common to many marine species in the vast oceanic environments.
Do oral bacteria alter the regenerative potential of stem cells? A concise review
Authors: Chatzivasileiou Kyriaki , Kriebel Katja , Steinhoff Gustav , Kreikemeyer Bernd , Lang Hermann 
Published: June 2015

AbstractMesenchymal stem cells (MSCs) are widely recognized as critical players in tissue regeneration. New insights into stem cell biology provide evidence that MSCs may also contribute to host defence and inflammation. In case of tissue injury or inflammatory diseases, e.g. periodontitis, stem cells are mobilized towards the site of damage, thus coming in close proximity to bacteria and bacterial components. Specifically, in the oral cavity, complex ecosystems of commensal bacteria live in a mutually beneficial state with the host. However, the formation of polymicrobial biofilm communities with pathogenic properties may trigger an inadequate host inflammatory‐immune response, leading to the disruption of tissue homoeostasis and development of disease. Because of their unique characteristics, MSCs are suggested as crucial regulators of tissue regeneration even under such harsh environmental conditions. The heterogeneous effects of bacteria on MSCs across studies imply the complexity underlying the interactions between stem cells and bacteria. Hence, a better understanding of stem cell behaviour at sites of inflammation appears to be a key strategy in developing new approaches for in situ tissue regeneration. Here, we review the literature on the effects of oral bacteria on cell proliferation, differentiation capacity and immunomodulation of dental‐derived MSCs.
Treatment of adult female acne: a new challenge
Authors: Dréno B. 
Published: June 2015

AbstractAcne is affecting an increasing number of adult females and so can no longer be considered as a disease of adolescence. The disease has a greater negative impact on the quality of life of adult females than their younger counterparts. Adult female acne may persist from adolescence or may have its first occurrence once adulthood has been reached. The clinical presentation and pathogenesis of adult female acne may be somewhat different to that of adolescent acne and this may require a different treatment approach. Genetic and hormonal factors are thought to play key roles in the pathogenesis of adult female acne and the disease is characterized by a chronic evolution with frequent relapses requiring long‐term maintenance therapy. Fixed‐dose retinoid/antimicrobial combinations may be of interest for the treatment of adult female acne given that subgroup analysis of clinical trials has indicated that they are effective against both inflammatory and non‐inflammatory lesions in these patients. These treatments may also be of interest, given the chronic course of the disease in adult females, the high likelihood of the presence of antibiotic‐resistant P. acnes and the poor adherence of patients to other long‐term therapies. Oral hormonal treatment or isotretinoin may be required in patients with severe acne or disease that is refractory to other treatments. Additional clinical studies of acne treatments specifically conducted in adult female patients are required to increase the evidence base on which future treatment recommendations can be based.
Making reasonable decisions: a qualitative study of medical decision making in the care of patients with a clinically significant haemoglobin disorder
Authors: Crowther Helen J. , Kerridge Ian 
Published: June 2015

AbstractRationale, aims and objectivesTherapies utilized in patients with clinically significant haemoglobin disorders appear to vary between clinicians and units. This study aimed to investigate the processes of evidence implementation and medical decision making in the care of such patients in NSW, Australia.MethodsUsing semi‐structured interviews, 11 haematologists discussed their medical decision‐making processes with particular attention paid to the use of published evidence. Transcripts were thematically analysed by a single investigator on a line‐by‐line basis.ResultsDecision making surrounding the care of patients with significant haemoglobin disorders varied and was deeply contextual. Three main determinants of clinical decision making were identified – factors relating to the patient and to their illness, factors specific to the clinician and the institution in which they were practising and factors related to the notion of evidence and to utility and role of evidence‐based medicine in clinical practice.ConclusionsClinicians pay considerable attention to medical decision making and evidence incorporation and attempt to tailor these to particular patient contexts. However, the patient context is often inferred and when discordant with the clinician's own contexture can lead to discomfort with decision recommendations. Clinicians strive to improve comfort through the use of experience and trustworthy evidence.
Developing an Internet‐Based Decision Aid for Women Choosing Between Vaginal Birth After Cesarean and Planned Repeat Cesarean
Authors: Shorten Allison , Fagerlin Angela , Illuzzi Jessica , Kennedy Holly P. , Lakehomer Hannah , Pettker Christian M. , Saran Allison , Witteman Holly , Whittemore Robin 
Published: June 2015

IntroductionIn response to the call to develop strategies to engage women and providers in shared decision making, this article outlines a framework and process used to create an Internet‐based decision aid about birth choices after previous cesarean. Recognizing the potential benefits of mobile health information technology, a paper‐based decision aid was transformed into a secure, interactive Web site to meet the diverse needs of women and providers in this often challenging health care decision.MethodsAn iterative and participatory research approach was used, engaging targeted users (pregnant women and pregnancy care providers) in the design and development process.ResultsWomen recommended that features and functions of the decision aid should include individualized information, trustworthy evidence, a secure and private site, quizzes to check knowledge, and a way to share values and preferences with their providers. Providers recommended individualized information for women, a process for women to share and document values and preferences with providers, and balanced, straightforward and complete information about the risks and benefits of each option.DiscussionThere is great potential for direct linkage between Internet‐based decision aids and the electronic medical record. Work is currently underway to integrate and evaluate the Internet‐based decision aid within busy practice settings to support shared decision making. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
Rivaroxaban for the treatment and prevention of thromboembolic disease
Authors: Antoniou Sotiris 
Published: June 2015

Abstract

Objectives
A number of direct oral anticoagulants are now available and offer alternative strategies for anticoagulation therapy. Rivaroxaban, a direct oral Factor Xa inhibitor, is approved for use across several thromboembolic indications. This article aims to provide an overview of the key pharmacological characteristics of rivaroxaban and the rationale and evidence for the use of different dose regimens across its licenced indications, and offer practical guidance to healthcare professionals on responsible use. References were sourced via PubMed searches using the search string (rivaroxaban AND (pharmacokinetics OR pharmacodynamics OR (clinical studies) OR (drug interaction)) NOT review NOT (children OR pediatrics OR paediatrics OR adolescent)).

Key findings
Rivaroxaban exhibits predictable pharmacokinetics and pharmacodynamics, and thus does not require routine coagulation monitoring, unlike vitamin K antagonists (e.g. warfarin). Rivaroxaban also has a lower potential for drug–drug and food–drug interactions compared with warfarin; however, co-administration with strong inhibitors of both cytochrome P450 3A4 and P-glycoprotein is not recommended. The data indicate that dose adjustment is not necessary for age, gender or body weight. The dosing regimens of rivaroxaban vary depending on the indication, and phase III studies have demonstrated a favourable benefit–risk profile of rivaroxaban compared with traditional standard of care.

Summary
Rivaroxaban may offer an anticoagulant option that could simplify and improve the management of patients with thromboembolic disorders.
Cardiac response to centrally administered echinocandin antifungals
Authors: Stover Kayla R , Cleary John D 
Published: June 2015

Abstract

Objectives
The purpose of this study was to determine the effect of the echinocandin antifungals on the cardiac system, including cardiac output, blood pressure and heart rate, when administered in an in-vivo model.

Methods
The echinocandin antifungals were administered via central line to male Sprague–Dawley rats. Cardiac imaging and functional measurements were made using a high-resolution in-vivo imaging system. Statistical comparisons of the experimental antifungals versus saline control were made using a Student's t-test.

Key findings
In cardiac output (CO) measurements, caspofungin was associated with a bimodal distribution in results at 3 mg/kg. Those with little response, termed ‘non-vulnerable’ animals (n = 3) had no significant change in CO from baseline (−4.6 ± 10.7%). Other animals, termed ‘vulnerable’ animals (n = 3 at 3 mg/kg and those dosed at 6 mg/kg (n = 6)), experienced greater than 60% decrease in CO (−66.4 ± 13.1% at 3 mg/kg and −62.9 ± 13.0% at 6 mg/kg, P &lt; 0.05). A dose of 5 mg/kg anidulafungin was associated with no significant changes in CO (−16.1 ± 26%), while 11.5 mg/kg decreased CO by 62.7 ± 19.4% from baseline (P &lt; 0.05). With micafungin 1 mg/kg and 5 mg/kg doses, changes in CO were not significant (−16.7 ± 2.1% and −18.2 ± 1.9%, respectively).

Conclusions
These studies provide substantial evidence to support ex-vivo Langendorff and in-vitro mitochondrial studies demonstrating a similar pharmacological event. Clinical reports of similar effects also support these findings.
Seasonal synchronization of seed release phenology promotes long‐distance seed dispersal by wind for tree species with medium wind dispersal potential
Authors: Heydel Felix , Cunze Sarah , Bernhardt‐Römermann Markus , Tackenberg Oliver 
Published: June 2015

AbstractQuestionsHow does the seasonal variability of wind affect the seed release phenology of plant species from different vegetation types? Do wind‐dispersed species show a seasonal synchronization of seed release timing with meteorological conditions that promote long‐distance dispersal (LDD) by wind?LocationGermany, Central Europe.MethodsWe combined empirical observations of seed release phenology with simulations of LDD by wind. We simulated LDD by wind for species differing in seed terminal velocity for open and forested habitats using a broad set of measured meteorological conditions. In order to investigate the extent of seasonal synchronization of seed release with LDD, we compared species' LDD throughout the year with phenological data on timing of seed release for herbaceous species from open and tree species from forested habitats.ResultsFor tree species with winged seeds and medium seed terminal velocity (e.g. Acer platanoides, Tilia cordata) we found a pronounced seasonal synchronization of seed release timing with high LDD by wind. These species showed an extended ripening duration together with both the highest rate of seed release and high LDD in winter. Species with low seed terminal velocity (i.e. high wind dispersal potential) from open habitats (mainly species from the Asteraceae with plumed seeds) and forested habitats (e.g. tree species of the genera Populus, Salix) both showed high LDD but lacked seasonal synchronization of seed release timing with LDD.ConclusionsFor forest species with medium seed terminal velocity, the seasonal timing of seed release during winter and strong winds could be evidence for phenological adaptations to timing of wind dispersal within periods with favourable conditions. Our finding that species with low seed terminal velocity and high LDD throughout the year did not show seasonal seed release synchronization tentatively suggests that selection for other mechanisms such as synchronization with short‐term weather events might promote LDD of these species. Our results provide insights into how seasonal seed release timing of plant species from different vegetation types affects LDD by wind and shows that seed release phenology should be considered while assessing species' wind dispersal potential.