bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work empowerment and burnout among registered nurses in two tertiary general hospitals
Authors: Wang Xu , Kunaviktikul Wipada , Wichaikhum Orn‐anong 
Published: July 2013

Aims and objectivesTo describe and explore the relationship between work empowerment and burnout as perceived by nurses in two tertiary general hospitals in China.BackgroundStudies conducted in Western countries show that work empowerment can negatively influence burnout. Review of literature indicates that currently, no study on the relationship between work empowerment and burnout has been conducted in China.DesignA correlational, cross‐sectional design was adopted using questionnaires for data collection.MethodsThis study used correlational and cross‐sectional designs to collect and analyse data. The demographic data were analysed using frequency and percentage distributions. Work empowerment and burnout as perceived by registered nurses were analysed using means and standard deviation. The relationship between work empowerment and burnout was analysed using Spearman's rank‐order coefficient after testing the normal distribution using the Kolmogorov–Smirnov test.ResultsThe registered nurses perceive work empowerment at a moderate level. Emotional exhaustion as determined in this study is higher than in other nursing studies. A negative correlation is indicated between work empowerment and emotional exhaustion. A statistically significant positive correlation is also indicated between work empowerment and personal accomplishment.ConclusionWhen the work environment provides empowerment, registered nurses are less likely to experience burnout. Nursing supervisors should empower staff nurses by giving them opportunities to study, actualise the hospital's vision and share information with other staff nurses.Relevance to clinical practiceNurse administrators can use the results of this study to develop policies, improve work empowerment programmes and decrease burnout so that staff nurses can work more effectively.
Determination of the relationship between adequacy of dialysis and quality of life and self‐care agency
Authors: Kalender Nurten , Tosun Nuran 
Published: July 2013

Aim and objectivesTo investigate the relationship between the dialysis adequacy and the quality of life and self‐care agency.BackgroundHaemodialysis (HD), which is the leading treatment option for chronic renal failure (CRF), leads to significant changes in the life of the patient. These changes affecting almost all the dimensions of life also negatively affect the quality of life and self‐care agency.DesignDescriptive study.MethodsThe research was conducted with a total of 112 patients who had been admitted to two private dialysis centres between May 2009 and September 2010, who met the research criteria. The Data Collection Form for the Socio‐demographic and Medical Characteristics, the Biochemical and Medical Parameters Form to determine the adequacy of dialysis, the SF‐36 Quality of Life Scale and the Self‐Care Agency Scale were used in the research.ResultsA significant relationship was found between Kt/V, one of the parameters used for the assessment of dialysis adequacy, and the emotional role scores of the SF‐36 Quality of Life Scale and between the URR level and physical functioning (r = +0·192, p = 0·045) and emotional role scores (r = +0·284, p = 0·003). No significant relationship could be found between the self‐care agency and the evaluated parameters.ConclusionsKt/V and URR, which have an effect on dialysis adequacy, may affect the quality of life. Our results are similar to those of previous studies, which showed that Kt/V and URR affect the quality of life.Relevance to clinical practiceIt was recommended to regularly control the parameters used for the assessment of dialysis adequacy and to evaluate their effects on the quality of life, to determine the most affected quality of life subparameters and to address these problems and solve them.
Clients with chronic conditions: community nurse role in a multidisciplinary team
Authors: Wilkes Lesley , Cioffi Jane , Cummings Joanne , Warne Bronwyn , Harrison Kathleen 
Published: July 2013

Aims and objectivesTo define and validate the role of the community nurse in a multidisciplinary team caring for clients with chronic and complex needs.BackgroundA key factor in optimising care for clients with chronic and complex conditions in the community is the use of multidisciplinary teams. A team approach is more effective as it enables better integration of services. The role of the community nurse in the multidisciplinary team has as yet not been delineated.DesignA modified Delphi technique was used in this study.MethodsA group of 17 volunteer registered nurses who were experienced in the care of clients with chronic conditions and complex care needs in the community formed a panel of experts. Experts were emailed a series of three questionnaires.ResultsMain findings show that the role of the community nurse in a multidisciplinary team for clients with chronic conditions has six main domains – advocate, supporter, coordinator, educator, team member and assessor.ConclusionA consensus on the role of the community nurse in the multidisciplinary team is described. The six key role domains reaffirm the generic role of the nurse and the validation of the role clarifies and reinforces the centrality of the community nurse in the team. Further refinement of the community nurse role is indicated to increase comprehensiveness of role descriptors particularly for the role domain, advocate.Relevance to clinical practiceCommunity nurses working in multidisciplinary teams caring for clients with chronic conditions can define their role as a team member. The working relationship of the community nurse with other health professionals in the multidisciplinary team as a key approach to more integrated care for clients and carers enables the use of this approach to be better understood by all team members. With this increased understanding, community nurses are in a position to build stronger and more effective care teams.
Patients’ lived seclusion experience in acute psychiatric hospital in the United States: a qualitative study
Authors: Ezeobele I. E. , Malecha A. T. , Mock A. , Mackey‐Godine A. , Hughes M. 
Published: July 2013

Accessible summary
The findings revealed that the patients perceived seclusion as an intervention that is punitive and a means used by the staff to exert control.
Patients perceived that staff incitements and lack of communication skills led to their being secluded.
The findings provided recommendations and strategies for seclusion reduction that were based on the patients’ first‐hand seclusion experiences.
AbstractThis phenomenological study used Husserlian's philosophy to explore and describe the lived experiences of psychiatric patients who were secluded at a free‐standing acute care hospital located in South‐western United States (US). The study is crucial because very few studies have been conducted in this area in the US. The study examined a purposive sample of 20 patients, 3 days post‐seclusion. Data were generated through face‐to‐face, semi‐structured interviews incorporating open‐ended questions and probes to facilitate discussion until saturation was reached. Interviews were transcribed verbatim and data analysed using Colaizzi's seven steps method. Results were described according to the themes and subthemes identified. Findings uncovered four themes: (1) alone in the world; (2) staff exert power and control; (3) resentment towards staff; and (4) time for meditation. The findings from this study illuminated the views surrounding patients’ seclusion experience. It provided first‐hand information on the patients’ seclusion experience that might be helpful to the mental health professionals in the seclusion reduction process.
Radiologic response to transcatheter hepatic arterial chemoembolization and clinical outcomes in patients with hepatocellular carcinoma
Authors: Kim Chang Joon , Kim Hong Joo , Park Jung Ho , Park Dong Il , Cho Yong Kyun , Sohn Chong Il , Jeon Woo Kyu , Kim Byung Ik , Kim Min‐Ji 
Published: July 2013

AbstractBackground & AimsThe current study analysed the association between radiologic tumour response and survival times of patients with hepatocellular carcinoma (HCC) who were treated with transcatheter hepatic arterial chemoembolization (TACE).MethodsAmong 493 consecutive patients presenting to our institution between July 2002 and June 2010 with radiologically (n = 398) or histologically (n = 95) confirmed HCC, 368 patients who met inclusion criteria, underwent TACE and had confirmed survival data were retrospectively reviewed. The radiologic response was assessed using RECIST 1.1, EASL and mRECIST criteria at 1 month after the initial TACE.ResultsBy univariate analysis, higher Child–Turcotte–Pugh (CTP) score, bilobar and multifocal distribution of tumours, larger tumour size (>5 cm), higher serum alpha‐foetoprotein (AFP) level (>200 ng/ml), no subsequent radiofrequency ablation, advanced ECOG, UNOS and BCLC staging, absence of complete necrosis and non‐responder (SD or PD) in RECIST 1.1, EASL and mRECIST response assessment were significantly associated with shorter overall survival times. By Cox proportional hazards model, advanced age, presence of ascites, higher MELD score, advanced BCLC staging, absence of complete necrosis and non‐responder by RECIST 1.1, EASL and mRECIST criteria were independent and significant prognosticators for overall survival times in patients with HCC who underwent TACE. By time‐dependent ROC curve analysis, mRECIST response criteria showed greatest accuracy in predicting survival (AUROC = 0.8676), followed by EASL (AUROC = 0.8471) and RECIST 1.1 (AUROC = 0.7986).ConclusionmRECIST and EASL criteria for assessing radiologic response 1 month after initial TACE more consistently predict the differences in overall survival between responders and non‐responders than conventional RECIST 1.1 criteria.
In Defense of Anti‐Archimedean Moral Realism: A Response to Recent Critics
Authors: Clipsham Patrick 
Published: July 2013

AbstractRonaldDworkin famously argued that many putatively nonmoral metaethical theories can only be understood as being internal to the moral domain. If correct, this position, referred to as anti‐archimedeanism, has profound implications for the methodology of metaethics. This is particularly true for skeptical metaethical theories. This article defends a version of anti‐archimedeanism that is true to the spirit rather than the letter ofDworkin's original thesis from several recent objections. First, it addressesKennethEhrenberg's recent attempt to demonstrate how certain metaethical theories can be understood in a morally neutral manner. It then discussesCharlesPigden's claim thatDworkin begs the question against error theorists and nihilists by assuming a conceptual space that error theorists and nihilists would reject. It concludes that the anti‐archimedean methodology originally proposed byDworkin is defensible, and can be used to support a robust form of moral realism.
Epistemic Responsibility and Critical Thinking
Authors: Vaidya Anand Jayprakash 
Published: July 2013

AbstractShould we always engage in critical thinking about issues of public policy, such as health care, gun control, and LGBT rights? Michael Huemer (2005) has argued for the claim that in some cases it is not epistemically responsible to engage in critical thinking on these issues. His argument is based on a reliabilist conception of the value of critical thinking. This article analyzes Huemer's argument against the epistemic responsibility of critical thinking by engaging it critically. It presents an alternative account of the value of critical thinking that is tied to the notion of forming and deploying a critical identity. And it develops an account of our epistemic responsibility to engage in critical thinking that is not dependent on reliability considerations alone. The primary purpose of the article is to provide critical thinking students, or those that wish to reflect on the value of critical thinking, with an opportunity to think metacritically about critical thinking by examining an argument that engages the question of whether it is epistemically responsible for one to engage in critical thinking.
Woronin bodies, their impact on stress resistance and virulence of the pathogenic mould Aspergillus fumigatus and their anchoring at the septal pore of filamentous Ascomycota
Authors: Beck Julia , Echtenacher Bernd , Ebel Frank 
Published: July 2013

SummaryHyphae of filamentous Ascomycota consist of compartments that are connected via septal pores. To avoid a dramatic loss of cellular content after wounding, fungi developed mechanisms to occlude their septal pores. In most Pezizomycotina, so‐called Woronin bodies are anchored in proximity to the pore. This is a prominent example for precise spatial positioning of organelles, but so far the underlying molecular organization has remained largely unknown. Using the pathogenic mould Aspergillus fumigatus, we provide evidence that Woronin bodies are important for stress resistance and virulence. Furthermore the molecular machinery anchoring them at the septum is described. Namely, we have identified Lah as the tethering protein and provide evidence that the Woronin body protein HexA binds to the septal pore in a Lah‐dependent manner. Moreover, we demonstrate that a striking poly‐histidine motif targets HexA to the septal cell wall. Thus, the axis HexA‐Lah is an excellent candidate for the tether linking Woronin bodies to the septum. This model applies to A. fumigatus, but most likely also to the vast majority of the Pezizomycotina. Our findings shed light on the evolution of Woronin body anchoring and provide a basis for the development of novel strategies to combat fungal pathogens like A. fumigatus.
Intrinsicality and Grounding
Authors: Marshall Dan 
Published: July 2013

AbstractA number of philosophers have recently claimed that intrinsicality can be analysed in terms of the metaphysical notion of grounding. Since grounding is a hyperintensional notion, accounts of intrinsicality in terms of grounding, unlike most other accounts, promise to be able to discriminate between necessarily coextensive properties that differ in whether they are intrinsic. They therefore promise to be compatible with popular metaphysical theories that posit necessary entities and necessary connections between wholly distinct entities, on which it is plausible that there are such properties. This paper argues that this promise is illusory. It is not possible to give an analysis of intrinsicality in terms of grounding that is consistent with these theories. Given an adequate analysis should be compatible with these theories, it follows that it is not possible to analyse intrinsicality in terms of grounding.
Characterization of resistance mechanisms activated by Trichoderma harzianum T39 and benzothiadiazole to downy mildew in different grapevine cultivars
Authors: Banani H. , Roatti B. , Ezzahi B. , Giovannini O. , Gessler G. , Pertot I. , Perazzolli M. 
Published: July 2013

Downy mildew, caused by Plasmopara viticola, is one of the most destructive diseases of grapevine and is controlled with intense application of chemical fungicides. Treatment with Trichoderma harzianum T39 (T39) or benzothiadiazole‐7‐carbothioic acid S‐methyl ester (BTH) has been previously shown to activate grapevine resistance to downy mildew and reduce disease symptoms in the Pinot noir cultivar. However, enhancement of plant resistance can be affected by several factors, including plant genotype. In order to further extend the use of resistance inducers against downy mildew, the physiological and molecular properties of T39‐ and BTH‐activated resistance in different cultivars of table and wine grapes were characterized under greenhouse conditions. T39 treatment reduced downy mildew symptoms, but the degree of efficacy differed significantly among grapevine cultivars. However, efficacy of BTH‐activated resistance was consistently high in the different cultivars. Expression profiles of defence‐related genes differed among cultivars in response to resistance inducers and to pathogen inoculation. T39 treatment enhanced the expression of defence‐related genes in the responsive cultivars, before and after P. viticola inoculation. A positive correlation between the efficacy of T39 and the expression level of defence‐related genes was found in Primitivo and Pinot noir plants, while different genes or more complex processes were probably activated in Sugraone and Negroamaro. The data reported here suggest that the use of a responsive cultivar is particularly important to maximize the efficacy of resistance inducers and new natural inducers should be explored for the less responsive cultivars.
Incidence, Risk Factors, and Consequences of Amniotic Fluid Embolism
Authors: Kramer Michael S. , Abenhaim Haim , Dahhou Mourad , Rouleau Jocelyn , Berg Cynthia 
Published: July 2013

AbstractBackgroundAmniotic fluid embolism (AFE) is a rare but serious cause of maternal mortality whose aetiology remains obscure. Previous population‐based studies have reported associations with labour induction and caesarean delivery.MethodsWe updated a previous analysis based on the US Nationwide Inpatient Sample from 1999 to 2008. We adapted a diagnostic validation algorithm to minimise false‐positive diagnoses, along with statistical methods that account for the stratified random sampling design.ResultsOf the 8 571 209 deliveries recorded in the database, 276 met our case definition of AFE, of which 62 (22.9% of the 274 with known vital status) were fatal. Significant associations with AFE were observed for medical induction {adjusted odds ratio [aOR] = 1.7 [95% confidence interval (CI) 1.2, 2.5]}, caesarean delivery [aOR = 15.0; 95% CI 9.4, 23.9], instrumental vaginal delivery [aOR = 6.6; 95% CI 4.0, 11.1], and cervical/uterine trauma [aOR = 7.4; 95% CI 3.6, 14.9]. AFE was associated with increases in risk of stillbirth, hysterectomy, maternal death, and prolonged maternal length of delivery hospital stay.ConclusionsAFE remains an extremely serious obstetric complication with high risks of maternal and fetal mortality. The increased risks of AFE associated with labour induction and caesarean delivery have implications for elective use of these interventions.
What's Religious about the Iliad?
Authors: Kitts Margo 
Published: July 2013

AbstractThe disconnection between contemporary understandings and ancient experiences of “religion,” “theology,” and the “supernatural” has plagued attempts to understand Homeric imagination for more than a century. The chasm might be measured by judgments that the theomachy of Iliad 20 and 21, for instance, must be “bad art,” “black comedy,” or represents a “comic agon” imitative of Near Eastern creation stories. In other words, it is not to be taken seriously. This paper defends religious sensibilities in the Iliad. It summarizes the problems of uncovering these sensibilities with an ear toward some basic issues in hermeneutics: the difficulties posed by the poem's diachronic development, conceivably over centuries, but more importantly difficulties internal to the poem, such as fickle Muses and the world they open for us. Finally, the tools of poetic extension and catachresis help to grasp the poem's sophistication in its representations of divine violence.
Distribution-free Prediction Bands for Non-parametric Regression
Authors: Lei Jing , Wasserman Larry 
Published: July 2013

SummaryWe study distribution-free, non-parametric prediction bands with a focus on their finite sample behaviour. First we investigate and develop different notions of finite sample coverage guarantees. Then we give a new prediction band by combining the idea of ‘conformal prediction’ with non-parametric conditional density estimation. The proposed estimator, called COPS (conformal optimized prediction set), always has a finite sample guarantee. Under regularity conditions the estimator converges to an oracle band at a minimax optimal rate. A fast approximation algorithm and a data-driven method for selecting the bandwidth are developed. The method is illustrated in simulated and real data examples.
Model Selection Principles in Misspecified Models
Authors: Lv Jinchi , Liu Jun S. 
Published: July 2013

SummaryModel selection is of fundamental importance to high dimensional modelling featured in many contemporary applications. Classical principles of model selection include the Bayesian principle and the Kullback–Leibler divergence principle, which lead to the Bayesian information criterion and Akaike information criterion respectively, when models are correctly specified. Yet model misspecification is unavoidable in practice. We derive novel asymptotic expansions of the two well-known principles in misspecified generalized linear models, which give the generalized Bayesian information criterion and generalized Akaike information criterion. A specific form of prior probabilities motivated by the Kullback–Leibler divergence principle leads to the generalized Bayesian information criterion with prior probability, GBICp, which can be naturally decomposed as the sum of the negative maximum quasi-log-likelihood, a penalty on model dimensionality, and a penalty on model misspecification directly. Numerical studies demonstrate the advantage of the new methods for model selection in both correctly specified and misspecified models.
Confidence Intervals for Low Dimensional Parameters in High Dimensional Linear Models
Authors: Zhang Cun-Hui , Zhang Stephanie S. 
Published: July 2013

SummaryThe purpose of this paper is to propose methodologies for statistical inference of low dimensional parameters with high dimensional data. We focus on constructing confidence intervals for individual coefficients and linear combinations of several of them in a linear regression model, although our ideas are applicable in a much broader context. The theoretical results that are presented provide sufficient conditions for the asymptotic normality of the proposed estimators along with a consistent estimator for their finite dimensional covariance matrices. These sufficient conditions allow the number of variables to exceed the sample size and the presence of many small non-zero coefficients. Our methods and theory apply to interval estimation of a preconceived regression coefficient or contrast as well as simultaneous interval estimation of many regression coefficients. Moreover, the method proposed turns the regression data into an approximate Gaussian sequence of point estimators of individual regression coefficients, which can be used to select variables after proper thresholding. The simulation results that are presented demonstrate the accuracy of the coverage probability of the confidence intervals proposed as well as other desirable properties, strongly supporting the theoretical results.
Semiparametric Inference for Data with A Continuous Outcome from A Two-Phase Probability-Dependent Sampling Scheme
Authors: Zhou Haibo , Xu Wangli , Zeng Donglin , Cai Jianwen 
Published: July 2013

SummaryMultiphased designs and biased sampling designs are two of the well-recognized approaches to enhance study efficiency. We propose a new and cost-effective sampling design, the two-phase probability-dependent sampling design, for studies with a continuous outcome. This design will enable investigators to make efficient use of resources by targeting more informative subjects for sampling. We develop a new semiparametric empirical likelihood inference method to take advantage of data obtained through a probability-dependent sampling design. Simulation study results indicate that the sampling scheme proposed, coupled with the proposed estimator, is more efficient and more powerful than the existing outcome-dependent sampling design and the simple random sampling design with the same sample size. We illustrate the method proposed with a real data set from an environmental epidemiologic study.