bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing visual and objective skin assessment with pressure injury risk
Authors: Borzdynski Caroline J , McGuiness William , Miller Charne 
Published: July 2015

AbstractContemporary approaches to pressure injury (PI) risk identification rely on the use of risk assessment tools and visual skin assessment. Objective biophysical measures that assess skin hydration, melanin, erythema and lipids have not been traditionally used in PI risk; however, these may prove useful as a risk assessment tool. The relationship between subjective visual assessments of skin condition, biophysical measures and PI risk warrants investigation. This study used a descriptive correlational design to examine the relationship between measures of skin hydration, colour (melanin and erythema) and lipids at PI‐prone areas amongst geriatric persons (n = 38), obtained using biophysical skin measures and visual skin assessment. Twice daily measures of epidermal hydration, colour and lipids were assessed using the SD202 Skin Diagnostic (Courage + Khazaka GmBH, Cologne, Germany) over pressure‐prone areas of the body of study participants over seven consecutive days. Concurrent visual assessment of skin hydration and colour was performed. Results obtained using the SD202 Skin Diagnostic were compared with results gathered from visual assessment and examined for their association with participants' PI risk based on scores of the Norton Risk Assessment Scale. While epidermal hydration and skin colour reading scores did not vary significantly over the data collection period, lipid readings could not be registered on any occasion. With the exception of skin dryness, skin parameters via both objective and subjective means had significant, positive correlations. Statistically significant correlations emerged between visual assessment of skin wetness at the sacrum (r = −0·441, P < 0·01) and ischia (r = −0·468, P < 0·01) and Norton Risk Assessment Scale scores. It was found that the objective assessment of epidermal hydration (skin wetness) was also significantly associated with PI risk at the sacrum (r = −0·528, P < 0·01), as well as the right ischia (r = −0·410, P < 0·05) and left ischia (r = −0·407, P < 0·05). Erythema, when assessed objectively, was significantly correlated with PI risk at the sacrum (r = −0·322, P < 0·05). Such findings indicating that the finer measures afforded by the SD202 Skin Diagnostic in the assessment of the subtle red hues displayed in erythematous skin may provide an additional advantage over traditional, clinician assessment.
Temporal fossa defects: techniques for injecting hyaluronic acid filler and complications after hyaluronic acid filler injection
Authors: Juhász Margit Lai Wun , Marmur Ellen S 
Published: July 2015

SummaryFacial changes with aging include thinning of the epidermis, loss of skin elasticity, atrophy of muscle, and subcutaneous fat and bony changes, all which result in a loss of volume. As temporal bones become more concave, and the temporalis atrophies and the temporal fat pad decreases, volume loss leads to an undesirable, gaunt appearance. By altering the temporal fossa and upper face with hyaluronic acid filler, those whose specialty is injecting filler can achieve a balanced and more youthful facial structure. Many techniques have been described to inject filler into the fossa including a “fanned” pattern of injections, highly diluted filler injection, and the method we describe using a three‐injection approach. Complications of filler in the temporal fossa include bruising, tenderness, swelling, Tyndall effect, overcorrection, and chewing discomfort. Although rare, more serious complications include infection, foreign body granuloma, intravascular necrosis, and blindness due to embolization into the ophthalmic artery. Using reversible hyaluronic acid fillers, hyaluronidase can be used to relieve any discomfort felt by the patient. Injectors must be aware of the complications that may occur and provide treatment readily to avoid morbidities associated with filler injection into this sensitive area.
Factors associated with rushed and missed resident care in western Canadian nursing homes: a cross‐sectional survey of health care aides
Authors: Knopp‐Sihota Jennifer A , Niehaus Linda , Squires Janet E , Norton Peter G , Estabrooks Carole A 
Published: July 2015

Aims and objectivesTo describe the nature, frequency and factors associated with care that was rushed or missed by health care aides in western Canadian nursing homes.BackgroundThe growing number of nursing home residents with dementia has created job strain for frontline health care providers, the majority of whom are health care aides. Due to the associated complexity of care, health care aides are challenged to complete more care tasks in less time. Rushed or missed resident care are associated with adverse resident outcomes (e.g. falls) and poorer quality of staff work life (e.g. burnout) making this an important quality of care concern.DesignCross‐sectional survey of health care aides (n = 583) working in a representative sample of nursing homes (30 urban, six rural) in western Canada.MethodsData were collected in 2010 as part of the Translating Research in Elder Care study. We collected data on individual health care aides (demographic characteristics, job and vocational satisfaction, physical and mental health, burnout), unit level characteristics associated with organisational context, facility characteristics (location, size, owner/operator model), and the outcome variables of rushed and missed resident care.ResultsMost health care aides (86%) reported being rushed. Due to lack of time, 75% left at least one care task missed during their previous shift. Tasks most frequently missed were talking with residents (52% of health care aides) and assisting with mobility (51%). Health care aides working on units with higher organisational context scores were less likely to report rushed and missed care.ConclusionHealth care aides frequently report care that is rushed and tasks omitted due to lack of time.Relevance to clinical practiceConsidering the resident population in nursing homes today—many with advanced dementia and all with complex care needs—health care aides having enough time to provide physical and psychosocial care of high quality is a critical concern.
Medication communication during handover interactions in specialty practice settings
Authors: Braaf Sandra , Rixon Sascha , Williams Allison , Liew Danny , Manias Elizabeth 
Published: July 2015

Aims and objectivesTo investigate what and how medication information is communicated during handover interactions in specialty hospital settings.BackgroundEffective communication about patients’ medications between health professionals and nurses at handover is vital for the delivery of safe continuity of care.DesignAn exploratory qualitative design and observational study.MethodsParticipant observation was undertaken at a metropolitan Australian public hospital in four specialty settings: cardiothoracic care, intensive care, emergency care and oncology care. A medication communication model was applied to the data and thematic analysis was performed.ResultsOver 130 hours of observational data were collected. In total, 185 (predominately nursing) handovers were observed across the four specialty settings involving 37 nurse participants. Health professionals communicated partial details of patients’ medication regimens, by focusing on auditing the medication administration record, and through the handover approach employed. Gaps in medication information at handover were evident as shown by lack of communication about detailed and specific medication content. Incoming nurses rarely posed questions about medications at handover.ConclusionsHandover interactions contained restricted and incomplete medication information. Improving the transparency, completeness and accuracy of medication communication is vital for optimising patient safety and quality of care in specialty practice settings.Relevance to clinical practiceFor nurses to make informed and rapid decisions regarding appropriate patient care, information about all types of prescribed medications is essential, which is communicated in an explicit and clear way. Jargon and assumptions related to medication details should be minimised to reduce the risk of misunderstandings. Disclosure of structured medication information supports nurses to perform accurate patient assessments, make knowledgeable decisions about the appropriateness of medications and their doses, and anticipate possible adverse events associated with medications. In addition, benefits of patient and family member contributions in communicating about medications at handover should also be considered.
Nurses' attitudes towards professional containment methods used in psychiatric wards and perceptions of aggression in Turkey
Authors: Keser Özcan Neslihan , Bilgin Hülya , Akın Münevver , Badırgalı Boyacıoğlu Nur Elçin 
Published: July 2015

Aims and objectiveThe aim of this study was to determine nurses' attitudes towards professional containment methods and to explore the relationship between those attitudes and nurses' perception of aggression.BackgroundDifferent containment methods are used in psychiatric wards when patients behave aggressively towards others or exhibit self‐harm. It is known that in addition to patient‐specific and environmental influences, many factors related to the staff influence the choice of containment method. One of these factors is the perception of aggression.DesignA cross‐sectional descriptive design was used and the sample consisted of 144 nurses who are employed in a psychiatric hospital in Istanbul and who volunteered to participate in the study.MethodData were collected using a questionnaire addressing the socio‐demographic and professional features of nurses and using the attitudes to professional containment methods and Perception of Aggression Scale.ResultsWhile pro re nata medication was used commonly, time‐out was infrequently used in the wards. Intermittent observation, pro re nata medication and containment in the psychiatric intensive care unit were the most approved methods. The use of net beds was the least approved method. Nurses who perceive aggression as dysfunctional/undesirable are more likely to approve compulsory intramuscular medication and mechanical restraint.ConclusionThese results showed that nurses' perception of aggression is an important factor influencing the choice of a professional containment method.Relevance to clinical practiceThis study might lead to closer critiquing of psychiatric ward nurses' attitudes towards professional containment methods, leading to a decrease in the usage of these methods.
A multidisciplinary approach to reducing spurious hyperkalemia in hospital outpatient clinics
Authors: Loh Tze Ping , Sethi Sunil K 
Published: July 2015

Aims and objectivesTo describe a multidisciplinary effort to investigate and reduce the occurence of outpatient spurious hyperkalaemia.BackgroundSpurious hyperkalemia is a falsely elevated serum potassium result that does not reflect the in vivo condition of a person. A common practice of fist clenching/pumping during phlebotomy to improve vein visualisation is an under‐appreciated cause of spurious hyperkalemia.DesignPre‐ and postinterventional study.MethodObjective evidence of spurious hyperkalaemia was sought by reviewing archived laboratory results. A literature review was undertaken to summarise known causes of spurious hyperkalaemia and develop a best practice in phlebotomy. Subsequently, nurses from the Urology Clinic were interviewed, observed and surveyed to understand their phlebotomy workflow and identify potential areas of improvement by comparing to the best practice in phlebotomy. Unexplained (potentially spurious) hyperkalaemia was defined as a serum potassium of >5·0 mmol/l in a patient without stage 5 chronic kidney disease or haemolysed blood sample.Results and conclusionNurses from the Urology Clinic showed significant knowledge gap regarding causes of spurious hyperkalaemia when compared to the literature review. Direct observation revealed patients were routinely asked to clench their fists, which may cause spurious hyperkalaemia. Following these observations, several educational initiatives were administered to address the knowledge gap and stop fist clenching. The rate of unexplained hyperkalaemia at the Urology clinic reduced from a baseline of 16·0–3·8%, 58 weeks after intervention. Similar education intervention was propagated to all 18 other specialist outpatient clinic locations, which saw their rate of unexplained hyperkalaemia decrease from 5·4 to 3·7%. To ensure sustainability of the improvements, the existing phlebotomy standard operating protocol, educational and competency testing materials at variance with the best practice were revised.Relevance to clinical practiceA simple intervention of avoiding fist clenching/pumping during phlebotomy produced significant reduction in the rate of spurious hyperkalemia.
Imaging in Endovascular Stroke Trials
Authors: Malhotra Konark , Liebeskind David S. 
Published: July 2015

ABSTRACTIschemic stroke remains a leading cause of death and disability worldwide. Various endovascular trials have addressed clinical outcomes without elucidating the impact of imaging studies in patient selection. The success of recent endovascular trials was bolstered by the use of advanced imaging techniques for optimal selection of reperfusion candidates. This seminal juncture in the history of stroke trials warrants further consideration on the use of imaging to guide future refinements in the treatment of acute stroke. In this article, we systematically review the imaging methodology and key facets used in all published endovascular stroke trials to date, discuss the success of recent trials using latest advanced imaging techniques and focus on the importance of imaging studies for future patient selection.
MANAGING FINANCIALLY DISTRESSED PENSION PLANSINTHE INTERESTOF BENEFICIARIES
Authors: Inkmann Joachim , Blake David , Shi Zhen 
Published: July 2015

AbstractThe beneficiaries of a corporate defined benefit pension plan in financial distress care about the security of their promised pensions. We propose to value the pension obligations of a corporate defined benefit plan using a discount rate that reflects the funding ability of the pension plan and its sponsoring company, and therefore depends, in part, on the chosen asset allocation. An optimal valuation is determined by a strategic asset allocation that is optimal given the risk premium a representative pension plan member demands for being exposed to funding risk. We provide an empirical application using the General Motors pension plan.
Melatonin induces the transcripts of CBF/DREB1s and their involvement in both abiotic and biotic stresses in Arabidopsis
Authors: Shi Haitao , Qian Yongqiang , Tan Dun‐Xian , Reiter Russel J. , He Chaozu 
Published: July 2015

AbstractMelatonin (N‐acetyl‐5‐methoxytryptamine) is a naturally occurring small molecule that acts as an important secondary messenger in plant stress responses. However, the mechanism underlying the melatonin‐mediated signaling pathway in plant stress responses has not been established. C‐repeat‐binding factors (CBFs)/Drought response element Binding 1 factors (DREB1s) encode transcription factors that play important roles in plant stress responses. This study has determined that endogenous melatonin and transcripts level of CBFs (AtCBF1, AtCBF2, and AtCBF3) in Arabidopsis leaves were significantly induced by salt, drought, and cold stresses and by pathogen Pseudomonas syringe pv. tomato (Pst) DC3000 infection. Moreover, both exogenous melatonin treatment and overexpression of CBFs conferred enhanced resistance to both abiotic and biotic stresses in Arabidopsis. Notably, AtCBFs and exogenous melatonin treatment positively regulated the mRNA expression of several stress‐responsive genes (COR15A, RD22, and KIN1) and accumulation of soluble sugars content such as sucrose in Arabidopsis under control and stress conditions. Additionally, exogenous sucrose also conferred improved resistance to both abiotic and biotic stresses in Arabidopsis. Taken together, this study indicates that AtCBFs confer enhanced resistance to both abiotic and biotic stresses, and AtCBF‐mediated signaling pathway and sugar accumulation may be involved in melatonin‐mediated stress response in Arabidopsis, at least partially.
Computational Models of Reading: A Primer
Authors: Reichle Erik D. 
Published: July 2015

AbstractThis article briefly reviews four computational models of reading and the types of empirical findings that they are designed to explain: (1) theDual‐Route modelof word identification (Coltheart et al., 2001); (2) theSimple‐Recurrent Network modelof sentence processing (Elman, 1990); (3) theConstruction–Integration modelof discourse representation (Kintsch, 1988); and (4) theE‐Z Reader modelof eye‐movement control in reading (Reichle et al., 2012). These particular models are reviewed because they provide comprehensive accounts of a large number of empirical findings in each of their respective domains, and because they have advanced our understanding of the cognitive processes involved in reading by motivating new empirical studies. Future models of reading will build upon the success of their predecessors by integrating models from two or more of the aforementioned domains, thereby providing a means to examine the compatibility of their theoretical assumptions and more comprehensive accounts of the cognitive processes involved in reading.
In Physics Education, Perception Matters
Authors: Sattizahn Jason R. , Lyons Daniel J. , Kontra Carly , Fischer Susan M. , Beilock Sian L. 
Published: July 2015

ABSTRACTStudent difficulties in science learning are frequently attributed to misconceptions about scientific concepts. We argue that domain‐general perceptual processes may also influence students' ability to learn and demonstrate mastery of difficult science concepts. Using the concept of center of gravity (CoG), we show how student difficulty in applying CoG to an object such as a baseball bat can be accounted for, at least in part, by general principles of perception (i.e., not exclusively physics‐based) that make perceiving the CoG of some objects more difficult than others. In particular, it is perceptually difficult to locate the CoG of objects with asymmetric‐extended properties. The basic perceptual features of objects must be taken into account when assessing students' classroom performance and developing effective science, technology, engineering, and mathematics (STEM) teaching methods.
What are the factors that influence the delivery of smoking cessation advice in critical care?
Authors: Lang Markus , Waterworth Susan , O'Brien Anthony 
Published: July 2015

ABSTRACTBackgroundThe world's leading cause of preventable deaths, diseases and disabilities is smoking. Hospitalization can provide an opportunity for smokers to quit. Previous research found that smokers make up a high percentage of patients admitted to intensive care. Health care professionals working in critical care environments can make a valuable contribution to this public health issue by providing smoking cessation advice.AimTo identify factors that inhibit and facilitate the delivery of smoking cessation advice by nurses and doctors in critical care settings.DesignQuantitative design using an online survey.MethodsThis research was a single centre study carried out in a large tertiary hospital. Study sites were two adult critical care departments including a 14‐bed general intensive care and a 16‐bed cardiovascular intensive care unit. The target population for this research was the nursing and medical staff working in adult critical care environments.ResultsThe data suggests that doctors and nurses have a good understanding of the complications related to tobacco use and also have education on smoking cessation. Additionally the data suggest that doctors and nurses at the study sites generally have positive attitudes towards smoking cessation. Patient acuity and competence were concerns raised in relation to the delivery and effectiveness of smoking cessation advice in critical care environments.ConclusionsThe recovery phase following critical illness might be an opportunity to provide cessation advice. This could include focusing cessation advice efforts on awake, orientated and extubated patients. Further research might be required to confirm this.Relevance to clinical practiceThe provision of smoking cessation advice is an on‐going World Health Organization and New Zealand Government priority and all parts of the health sector need to provide responses. However, responses need to be adapted to the specific context such as the unique challenges of critical care.
Demographic and Clinical Characteristics to Predict Paroxysmal Atrial Fibrillation: Insights from an Implantable Loop Recorder Population
Authors: FRONTERA ANTONIO , CARPENTER ALEXANDER , AHMED NAUMAN , FASIOLO MATTEO , NELSON MARTIN , DIAB IHAB , CRIPPS TIM , THOMAS GLYN , DUNCAN EDWARD 
Published: July 2015

BackgroundThere is growing interest in detecting paroxysmal atrial fibrillation (PAF) to identify patients at high risk of thromboembolic stroke. The implantable loop recorder (ILR) is emerging as a powerful new tool in the diagnosis of PAF. Widespread implantation has significant cost implications and their use must be targeted at those patients at most risk.MethodsWe retrospectively studied a population of 200 adult patients who underwent ILR implantation for the investigation of syncope or palpitations. Clinical data, baseline electrocardiogram (ECG) characteristics, and echocardiographic data were collected. All ECGs and electrograms (EGMs) were scrutinized by two blinded investigators. PAF incidence was defined as episodes lasting >30 seconds on EGMs recorded in ILR memory.ResultsOur ILR population consists of 200 patients, 111 (56%) male, with a mean age of 61.4 years (range 19–95). PAF was detected in 42 patients. The following factors were significant predictors of PAF by multivariate logistic regression analysis: cigarette smoking (odds ratio [OR] = 3.73, 95% confidence interval [CI] = 1.40–10.24, P = 0.009) and incomplete right bundle branch block (IRBBB; OR = 9.04, 95% CI = 2.51–34.64, P = 0.00088). Significant differences included incidence of IRBBB (P = 0.012), cigarette smoking (P = 0.026), hypercholesterolemia (P = 0.015), age (P = 0.002), estimated glomerular filtration rate (P = 0.031), left atrial volume (P = 0.019), and PR interval (P = 0.031). The PAF group had significantly higher CHA2DS2‐VASc scores (P = 0.01).ConclusionsOur study reports predictive factors for PAF in an ILR population. We suggest that cigarette smoking and IRBBB are independently associated with paroxysmal AF in patients presenting with palpitations or syncope.