bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized controlled trial comparing a standard postoperative diet with low‐volume high‐calorie oral supplements following colorectal surgery
Authors: Sharma M. , Wahed S. , O'Dair G. , Gemmell L. , Hainsworth P. , Horgan A. F. 
Published: February 2013

AbstractAimPostoperative oral nutritional supplementation is becoming a part of most patient care pathways. This study examined the effects of low‐volume high‐calorie prescribed supplemental nutrition on patient outcome following elective colorectal surgery.MethodPatients undergoing elective colorectal resections were randomized to a prescribed nutritional supplementation group (SG) [standard diet + 6 × 60 ml/day of Pro‐Cal (60 ml = 200 kcal + 4 g protein)] or conventional postoperative diet group (CG) (standard diet alone). Preoperative and daily postoperative hand‐grip strengths were measured using a grip dynamometer after randomization. Daily food intake, return of bowel activity, nausea score for the first 3 days and postoperative length of hospital stay (LOS) were prospectively recorded. Micro‐diet standardized software was used to analyse food diaries. Nonparametric tests were used to analyse the data.ResultsFifty‐five patients were analysed (SG 28, CG 27). There was no difference in median preoperative and postoperative handgrip strengths at discharge within each group (SG 31.7 vs 31.7 kPa, P = 0.932; CG 28 vs 28.1 kPa, P = 0.374). The total median daily calorie intake was higher in SG than CG (SG 818.5 kcal vs CG 528 kcal; P = 0.002). There was no difference in median number of days to first bowel movement (SG 3 days vs CG 4 days, P = 0.096). The median LOS was significantly shorter in SG than CG (6.5 vs 9 days; P = 0.037).ConclusionPrescribed postoperative high‐calorie, low‐volume oral supplements in addition to the normal dietary intake are associated with significantly better total daily oral calorie intake and may contribute to a reduced postoperative hospital stay.
Supporting the care of children with diabetes in school: a qualitative study of nurses in the UK
Authors: Marshall M. , Gidman W. , Callery P. 
Published: February 2013

AbstractAimsIntensification of diabetes management in children and young people has implications for schools. The aim of this study was to examine the role of nurses in supporting care of children with diabetes in schools and early years settings.MethodsThe qualitative design incorporated focus groups and individual telephone interviews with nurses who were unavailable to participate in focus groups. A purposive sample of 47 nurses from acute and community settings, participated in eight focus groups and eight telephone interviews. Data were analysed through a process of constant comparison.ResultsNurses identified an ambiguous and inadequate legal and policy framework. The responses of schools were variable and unpredictable because the views of head teachers determined the level of cooperation. School staff could lack basic knowledge about Type 1 diabetes. Relationships between school staff and parents could also affect their willingness to provide support for diabetes care. The skills of negotiating appropriate support for children with diabetes were learnt by experience rather than through formal training or evidence‐based guidance. Nurses' accounts demonstrated uncertainties about: what could be required of schools; how schools would respond; individual responsibilities; and about what constituted best practice.ConclusionsThere is a need for more evidence about how healthcare providers can influence schools and about the most cost‐effective use of nurses to support the management of children with diabetes in schools.
Provincial business cycles and fiscal policy in China
Authors: Carmignani Fabrizio , Laurenceson James S. 
Published: February 2013

AbstractWe characterize the cyclical properties of fiscal policy in China along two related dimensions. First, we estimate the sign and size of the fiscal policy multiplier. Second, we assess whether fiscal policy is conducted pro‐ or counter‐cyclically. To account for the challenges posed by China's vast geography, we use data at the provincial level. We find that (i) fiscal policy generally has ‘Keynesian’ effects, and (ii) fiscal policy is mostly conducted pro‐cyclically. This means that fiscal policy is more an element of destabilization than a tool for stabilization.
Chronic and Acute Pain and Pain Management for Patients in Methadone Maintenance Treatment
Authors: Eyler Elizabeth C.H. 
Published: February 2013

Background and ObjectivesMany individuals receiving methadone maintenance treatment (MMT) for opioid addiction also require treatment for acute or chronic pain, and the presence of pain is known to have a negative impact on patient health and function. However, effective pain management in this population is complicated by many factors, including heightened pain sensitivity, high opioid tolerance, illicit substance use, and variable cross‐tolerance to opioid pain medications. This article reviews the recent literature on acute and chronic pain among, and pain treatment of, patients receiving MMT for opioid addiction and discusses the implications for effective pain management. Acute pain management among women maintained on methadone during and after labor and delivery is also discussed, as well as common concerns held by patients and providers about appropriate pain management strategies in the context of methadone maintenance and addiction treatment.MethodsOne hundred nine articles were identified in a PubMed/MEDLINE electronic database search using the following search terms: methadone, methadone maintenance, methadone addiction, pain, pain management, chronic pain, and acute pain. Abstracts were reviewed for relevance, and additional studies were extracted from the reference lists of articles identified in the original search.ResultsThe pain sensitivity and pain responses of MMT patients differ significantly from those of patients not maintained on opioids, and few data are available to guide patient care.Conclusions and Scientific SignificanceRigorous studies are needed to identify and evaluate effective pain management approaches for this unique patient population and to improve patient treatment outcomes. (Am J Addict 2012;XX:000–000) (Am J Addict 2013;22:75‐83)
Adjunctive photodynamic therapy to non‐surgical treatment of chronic periodontitis: a systematic review and meta‐analysis
Authors: Sgolastra Fabrizio , Petrucci Ambra , Severino Marco , Graziani Filippo , Gatto Roberto , Monaco Annalisa 
Published: February 2013

AbstractAimTo investigate the efficacy of antimicrobial photodynamic therapy (aPDT) adjunctive to scaling root planing (SRP) in patients with chronic periodontitis.MethodsA meta‐analysis was conducted according to the PRISMA statement and Cochrane Collaboration recommendations. Two independent reviewers performed an extensive literature search and manual search on seven databases. Mean differences (MD) and 95% confidence intervals (CI) were calculated for clinical attachment level (CAL) gain and probing depth (PD) reduction. The I2 test was used for inter‐study heterogeneity. Publication bias was examined by Egger's regression test and the trim‐and‐fill method.ResultsSensitivity analysis of 14 randomized clinical trials (RCTs) revealed differences in PD reduction (MD 0.19, 95% CI 0.07–0.31, p = 0.002) and CAL gain (MD 0.37, 95% CI 0.26–0.47, p < 0.0001) in favour of SRP + aPDT, with no evidence of heterogeneity. Subgroup analysis revealed the absence of heterogeneity in RCTs, with high risk of bias for PD reduction and CAL gain. No evidence of publication bias was detected.ConclusionsThe use of adjunctive aPDT to conventional SRP provides short‐term benefits. The evidence to support its clinical medium/long‐term efficacy is insufficient. Further high‐quality RCTs are needed to investigate the influence of potential confounders on the efficacy of adjunctive aPDT.
TDP‐43 associates with stalled ribosomes and contributes to cell survival during cellular stress
Authors: Higashi Shinji , Kabuta Tomohiro , Nagai Yoshitaka , Tsuchiya Yukihiro , Akiyama Haruhiko , Wada Keiji 
Published: February 2013

AbstractTAR DNA‐binding protein 43 (TDP‐43) has emerged as an important contributor to amyotrophic lateral sclerosis and frontotemporal lobar degeneration. To understand the physiological roles of TDP‐43 in the complex translational regulation mechanisms, we exposed cultured cells to oxidative stress induced by sodium arsenite (ARS) for different periods of time, leading to non‐lethal or sublethal injury. Polysome profile analysis revealed that ARS‐induced stress caused the association of TDP‐43 with stalled ribosomes via binding to mRNA, which was not found under the steady‐state condition. When the cells were exposed to short‐term/non‐lethal stress, TDP‐43 associating with ribosomes localized to stress granules (SGs); this association was transient because it was immediately dissolved by the removal of the stress. In contrast, when the cells were exposed to long‐term/sublethal stress, TDP‐43 was excluded from SGs and shifted to the heavy fractions independent of any binding to mRNA. In these severely stressed cells, biochemical alterations of TDP‐43, such as increased insolubility and disulfide bond formation, were irreversible. TDP‐43 was finally phosphorylated via the ARS‐induced c‐jun N‐terminal kinase pathway. In TDP‐43‐silenced cells, stalled mRNA and poly (A)+ RNA stability was disturbed and cytotoxicity increased under sublethal stress. Thus, TDP‐43 associates with stalled ribosomes and contributes to cell survival during cellular stress.
Are adaptive loci transferable across genomes of related species? Outlier and environmental association analyses in Alpine Brassicaceae species
Authors: Zulliger Deborah , Schnyder Elvira , Gugerli Felix 
Published: February 2013

AbstractLocal adaptation is one possible response of organisms to survive in a changing environment. However, the genetic basis of adaptation is not well understood, especially in nonmodel species. To infer recurrent patterns of local adaptation, we investigated whether the same putative adaptive loci reoccur in related species. We performed genome scans using amplified fragment length polymorphism (AFLP) markers on populations of five Alpine Brassicaceae species sampled across a wide range of environmental conditions. To identify markers potentially under directional selection, we performed outlier and environmental association analyses using a set of topo‐climatic variables available as GIS layers. Several AFLP loci showed signatures of adaptation, of which one, found in Cardamine resedifolia (Cre_P1_212.5), was associated with precipitation. We sequence‐characterized this candidate locus and genotyped single nucleotide polymorphisms (SNPs) found within this locus for all species. Testing for environmental associations of SNPs revealed the same association of this locus in Arabis alpina but not in other study species. Cumulative statistical evidence indicates that locus Cre_P1_212.5 is environmentally relevant or is linked to a gene under selection in our study range. Furthermore, the locus shows an association to the same potentially selective factor in at least one other related species. These findings help to identify trends in plant adaptation in Alpine ecosystems in response to particular environmental parameters.
Understanding and encouraging feedback‐seeking behaviour: a literature review
Authors: Crommelinck Michiel , Anseel Frederik 
Published: February 2013

Objectives  The goals of this paper are to review the literature on feedback‐seeking behaviour using a self‐motives framework and to provide practical recommendations for medical educators on how to encourage feedback‐seeking behaviour.Methods  To gain a better understanding of feedback‐seeking behaviour, we apply a self‐motives framework. Through this conceptual lens, we define feedback‐seeking behaviour and review its antecedents and consequences. We provide an overview of the key findings and answer to a number of unresolved issues in the literature.Results  On the basis of the literature review, we present six evidence‐based insights to encourage feedback‐seeking behaviour in practice.Conclusions  The literature review shows that feedback‐seeking behaviour is a valuable resource for individuals in work and educational settings as it aids their adaptation, learning and performance. Several individual and contextual factors that promote the seeking of feedback are presented. Although feedback‐seeking behaviour has been a subject of research for over 25 years, some unresolved issues remain. We present a self‐motives framework to resolve those issues and to stimulate future research. We conclude this paper with six actionable insights for medical educators based on the evidence reviewed.
Exploration of perceived effects of innovations in postgraduate medical education
Authors: Fokkema Joanne P I , Teunissen Pim W , Westerman Michiel , van der Lee Nadine , van der Vleuten Cees P M , Scherpbier Albert J J A , Dörr P Joep , Scheele Fedde 
Published: February 2013

Context  Many studies have examined how educational innovations in postgraduate medical education (PGME) impact on teaching and learning, but little is known about effects in the clinical workplace outside the strictly education‐related domain. Insights into the full scope of effects may facilitate the implementation and acceptance of innovations because expectations can be made more realistic, and difficulties and pitfalls anticipated. Using workplace‐based assessment (WBA) as a reference case, this study aimed to determine which types of effect are perceived by users of innovations in PGME.Methods  Focusing on WBA as a recent instance of innovation in PGME, we conducted semi‐structured interviews to explore perceptions of the effects of WBA in a purposive sample of Dutch trainees and (lead) consultants in surgical and non‐surgical specialties. Interviews conducted in 2011 with 17 participants were analysed thematically using template analysis. To support the exploration of effects outside the domain of education, the study design was informed by theory on the diffusion of innovations.Results  Six domains of effects of WBA were identified: sentiments (affinity with the innovation and emotions); dealing with the innovation; specialty training; teaching and learning; workload and tasks, and patient care. Users’ affinity with WBA partly determined its effects on teaching and learning. Organisational support and the match between the innovation and routine practice were considered important to minimise additional workload and ensure that WBA was used for relevant rather than easily assessable training activities. Dealing with WBA stimulated attention for specialty training and placed specialty training on the agenda of clinical departments.Conclusions  These outcomes are in line with theoretical notions regarding innovations in general and may be helpful in the implementation of other innovations in PGME. Given the substantial effects of innovations outside the strictly education‐related domain, individuals designing and implementing innovations should consider all potential effects, including those identified in this study.
Qualitative synthesis and systematic review in health professions education
Authors: Bearman Margaret , Dawson Phillip 
Published: February 2013

Context  Formal qualitative synthesis is the process of pooling qualitative and mixed‐method research data, and then drawing conclusions regarding the collective meaning of the research. Qualitative synthesis is regularly used within systematic reviews in the health professions literature, although such use has been heavily debated in the general literature. This controversy arises in part from the inherent tensions found when generalisations are derived from in‐depth studies that are heavily context‐dependent.Methods  We explore three representative qualitative synthesis methodologies: thematic analysis; meta‐ethnography, and realist synthesis. These can be understood across two dimensions: integrative to interpretative, and idealist to realist. Three examples are used to illustrate the relative strengths and limitations of these approaches.Discussion  Against a backdrop of controversy and diverse methodologies, readers must take a critical stand when reading literature reviews that use qualitative synthesis to derive their findings. We argue that notions of qualitative rigour such as transparency and acknowledgment of the researchers’ stance should be applied to qualitative synthesis.
Workplace‐based assessments in Foundation Programme training: do trainees in difficulty use them differently?
Authors: Mitchell Colin , Bhat Sarita , Herbert Anne , Baker Paul 
Published: February 2013

Context  Trainee‐led workplace‐based assessment (WPBA) is increasingly used in postgraduate medical training. Trainees in difficulty are known to behave differently from their peers; these differences may be reflected in their use of WPBAs and may give new insights into the behaviour and assessment of struggling trainees.Methods  Data were extracted for 76 115 assessments, completed by 1900 UK Foundation Programme (FP) trainees. Of these 1900 trainees, 95 (5%) were FP trainees in difficulty (FTiDs). We analysed aspects of the use of WPBAs, using multiple logistic regressions, to compare the behaviours of FTiDs with those of their peers.Results  Of 48 possible comparisons, only two (i.e. the rate expected to occur by chance) showed statistically significant differences: relative to their peers, FTiDs were more likely to choose nurse assessors in direct observations of procedural skills (odds ratio [OR] 7.05, 95% confidence interval [CI] 1.23–40.43) and more likely to choose non‐clinical assessors for assessments using the mini‐peer assessment tool (OR 30.44, 95% CI 1.34–689.29).Conclusions  Key features of assessor choice for FTiDs are familiarity and likelihood of receiving a positive assessment. This analysis has not demonstrated that FTiDs use WPBAs any differently from their peers who are not in difficulty, although it does suggest associations and trends that require further exploration. These null results are interesting and raise hypotheses for prospective confirmation or disproof, and for further qualitative work investigating how struggling trainees use WPBAs in order to guide the future implementation of WPBAs in postgraduate training.
Implementing behaviour change for healthier lifestyles in obese children
Authors: Gately P. J. , Curtis C. 
Published: February 2013

SummaryObesity is a major public health issue, the scale and consequences of which suggest the need for comprehensive action. It would appear that there is an imbalance between the investment in primary prevention and in secondary prevention in the form of obesity treatment. It is possible that this imbalance has contributed to our lack of progress in treating obese children effectively and at scale. We propose that an obesity centre of excellence that focuses resources on practice‐based evidence on obesity treatment can contribute to progress in this field. Such a model would also provide the necessary capability to build a national scale solution. While limited, there is an evidence base that shows weight loss and weight loss maintenance and broader health and wellbeing outcomes can be achieved in children and young people. As part of the centre of excellence, a broad range of research aligned to key issues, which include poor awareness of weight issues, poor communication and marketing, greater understanding of the key ingredients of successful weight management (especially in different groups), improved methods to assess the impact of interventions and improved translation research to scale up services to meet the significant demand that exists, would all contribute to a more comprehensive solution to the issue of obesity.
Crucial information needs of ICU charge nurses in Finland and Greece
Authors: Lundgrén‐Laine Heljä , Kalafati Maria , Kontio Elina , Kauko Tommi , Salanterä Sanna 
Published: February 2013

ABSTRACTAimsTo describe crucial information needs of ICU charge nurses, and to compare these needs in two countries in Europe.BackgroundICU charge nurses are on the front line for ensuring that the activities of their units are running smoothly. They are accountable for making sure that the right tasks are performed under the right circumstances, with the right people, at the right time.Design and participantsAn online survey based on a previous observation study regarding the ad hoc decision‐making of ICU shift leaders. A total of 257 Finnish and 50 Greek ICU charge nurses participated in this study, from 17 Finnish and 16 Greece ICUs for adults.MethodsOur survey incorporated 122 statements divided into six dimensions (patient admission, organization and management of work, allocation of staff, allocation of material, special treatments and patient discharge) with a rating scale from 0 to 10. Analysis involved descriptive statistics. Mann–Whitney U and Kruskal–Wallis tests were used to compare the answers of the two countries. Validity was verified with confirmatory factor analysis and the reliability was tested with Cronbach's α values.ResultsThe most crucial information needs of ICU charge nurses concerned the overall organization and management of work. Both staff‐related and individual patient‐related information was needed. Information needs of Finnish and Greek charge nurses concerned similar kinds of situations in ICUs. However, there were some differences that might depend on the cultural differences between the countries.ConclusionsAccurate and real‐time information is a prerequisite for ICU charge nurses' ad hoc decision‐making during daily care management. Identification of the most crucial information is needed when tools for information management are developed.Relevance to clinical practice:The results of this study indicated that a major portion of immediate information needs of ICU charge nurses are internationally common in similar settings.
Influence of sieving time on the efficiency and accuracy of grain‐size analysis of beach and dune sands
Authors: Román‐Sierra Jorge , Muñoz‐perez Juan j. , Navarro‐Pons Marina 
Published: February 2013

AbstractGrain size is a fundamental property of sediments and is commonly used to describe sedimentary facies and classify sedimentary environments. Among the various conventional techniques utilized to determine grain‐size frequency distributions, sieving is the most widely applied procedure. The accuracy of such analyses is, among other factors, strongly dependent on the sieving time. However, despite a substantial amount of research in this field, optimal sieving times for different types of sediments have, to date, not been established. In this article, the influence of sieving time on grain‐size analyses of medium‐grained microtidal and mesotidal beach and dune sands has been determined. To assess the precision of important textural parameters, such as median grain size, sorting, skewness and kurtosis, an error analysis was carried out for different sieving times (2, 5, 10, 15 and 20 minutes). After calibrating the analytical and sampling methodologies, significant deviations were registered when sieving time was less than 10 minutes. However, such deviations were very small and grain‐size distributions remained almost identical for sieving times of 10 minutes and longer, relative errors being as low as 0% in some cases.