bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unusual burn injury due to application of white vinegar and aspirin mixture
Authors: Irkoren Saime , Sivrioglu Nazan 
Published: October 2013

AbstractTraditional medicine remedies are believed to provide relief from pain; nevertheless, it can be a risky procedure if these remedies are prepared inappropriately. Here, we describe a patient who suffered from a split‐thickness leg burn after applying a self‐inflicted mixture consisting of white vinegar and aspirin prepared for knee pain. This case report highlights a rare cause of a chemical burn that could become more common with increasing use of traditional remedies worldwide.
Artificial dermis (Matriderm®) followed by skin graft as an option in dermatofibrosarcoma protuberans with complete circumferential and peripheral deep margin assessment
Authors: Bertolli Eduardo , Campagnari Mariane , Molina André S , Macedo Mariana P , Pinto Clovis AL , Cunha Isabela W , Duprat Neto João P 
Published: October 2013

AbstractDermatofibrosarcoma protuberans (DFSP) is a locally invasive neoplasia with a pattern of infiltrative growth that leads to extended resections. To avoid unnecessary resections and spare tissues, its treatment requires an adequate assessment of the margins. We present a case where artificial dermis (Matriderm®) was used followed by skin graft for reconstruction. We present a 50‐year‐old woman with a DFSP in the occipital region. She was referred to us after a first surgery with positive margins. A wide local excision with a 2‐cm margin was performed and periosteal tissue was also removed, which led to exposure of the skull. Matriderm was placed on the bone surface and dressings were changed every other day. Meanwhile, margins were evaluated by the complete circumferential and peripheral deep margin assessment (CCPDMA) and were positive for DFSP in the superior margin. After 4 weeks the area was completely covered by granulation tissue and a new resection followed by reconstruction with a skin graft was performed. With regard to the difficulties in the margin assessment in DFSP, we present artificial dermis (Matriderm) as an option for reconstructive surgery in these patients, especially when a skin graft cannot be performed as a first option.
Death preparedness: a concept analysis
Authors: McLeod‐Sordjan Renee 
Published: October 2013

AbstractAimTo report analysis of the concept death preparedness in the context of end‐of‐life shared decisions and communication.BackgroundForty percent of older people require decision‐making and communication in the final days of life. Elaborate defence mechanisms have yielded a public consciousness that no longer passively views death acceptance, but instead has a defensive orientation of preparedness. The term ‘death preparedness’ depicts this death attitude.DesignConcept analysis.Data sourcesData were collected over 3 months in 2013. A series of searches of scholarly peer‐reviewed literature published in English were conducted of multiple databases. Specific keywords included such phrases as: death acceptance, death avoidance, death rejection, death preparedness, resolution of life, breaking bad news and readiness to die.MethodsWalker and Avant's method was chosen as a deductive method to distinguish between the defining attributes of death preparedness and its relevant attributes.ResultsDeath preparedness involves a transition of facilitated communication with a healthcare provider that leads to awareness and/or acceptance of end of life, as evidenced by an implementation of a plan. An appraisal of attitudes towards death and one's mortality precedes the concept, followed by an improved quality of death and dignity at end of life.ConclusionThe concept of death preparedness in the process of dying should be the focus of research to explore areas to improve advanced directive planning and acceptance of palliation for chronic health conditions.
Swiss Nursing Homes Human Resources Project (SHURP): protocol of an observational study
Authors: Schwendimann René , Zúñiga Franziska , Ausserhofer Dietmar , Schubert Maria , Engberg Sandra , de Geest Sabina 
Published: October 2013

AbstractAimTo explore the relationships among various nursing homes characteristics including work environment, careworker outcomes and resident outcomes in Swiss nursing homes.BackgroundIn Switzerland, a growing number of older people live in nursing homes. Although research has addressed the issue of quality of nursing care in such facilities, few have integrated a range of interrelated factors that may influence the quality and safety of residential care. The Swiss Nursing Homes Human Resources Project will comprehensively assess key organizational factors, their interrelationships and the associations between these factors and careworker and resident outcomes.DesignCross‐sectional design.MethodsThree‐year multi‐centre study (2011–2013) including a representative sample of approximately 160 nursing homes across the three language regions in Switzerland. Survey data will come from approximately 6000 careworkers and 160 administrators. Survey questionnaires will include variables on organizational facility characteristics and resident outcomes, careworker socio‐demographic and professional characteristics, the quality of their work environments, resident safety climates and careworker outcomes. Appropriate descriptive and comparative analysis will be used and multivariate and multilevel analyses will be applied to examine the relationships among the various factors including quality of the work environment, safety climate, work stressors, rationing of care, workload, careworker and resident characteristics, as well as resident and careworker outcomes.DiscussionThe study results will contribute to a comprehensive understanding of the interrelationships between key organizational factors and resident/careworker outcomes and will also support planning and conducting interventions to improve quality of care concerning organizational factors affecting careworkers in daily practice.
‘He's hard work, but he's worth it’. The Experience of Caregivers of Individuals with Intellectual Disabilities and Challenging Behaviour: A Meta‐Synthesis of Qualitative Research
Authors: Griffith G. M. , Hastings R. P. 
Published: October 2013

BackgroundThe purpose of this review is to synthesize the qualitative literature on the perspectives of those caring for a family member with intellectual disabilities and challenging behaviour, with a focus on their experiences of support services.Materials and MethodsA thorough literature search resulted in 17 studies being selected for inclusion in the meta‐synthesis.ResultsFive primary themes were identified: (i) love, (ii) altered identity, (iii) crisis management, (iv) support is not just ‘challenging behaviour’ services, and (v) the future: low expectations, high hopes.ConclusionsCarers spoke of the deep love for their family member and of the chronic strain the demands of caregiving placed upon them. Support services often caused additional problems and high levels of stress for caregivers, although there were also reports of good practice. The findings may inform clinicians and service providers about how best to support families of individuals with challenging behaviour.
Endocavitary Structures in the Outflow Tract: Anatomy and Electrophysiology of the Conus Papillary Muscles
Authors: HAI JO JO , DESIMONE CHRISTOPHER V. , VAIDYA VAIBHAV R. , ASIRVATHAM SAMUEL J. 
Published: October 2013

Ablation and Mapping of the Conus Papillary MuscleCatheter ablation is an increasingly used and successful treatment choice for right ventricular outflow tract (RVOT) arrhythmias. While the role of endocavitary structures and the regional morphology of the ventricular inflow tract and the right atrium as a cause for difficulty with successful ablation are well described, similar issues within the RVOT are not well understood. It is also not commonly appreciated that one of the papillary muscles is located within the proximal RVOT. We report 3 patients in which ventricular arrhythmia was targeted and ablated in the conus papillary muscle. The anatomic features, potential role of the fascicular conduction system, and unique challenges with mapping arrhythmia arising from this structure are discussed.
Suicide Attempt by Complete Self‐Removal of a 12‐Year‐Old Permanent Pacemaker System: Case Report
Authors: NORGAARD METTE LYKKE , MELCHIOR THOMAS , WAGNER THOMAS , HAUGAN KETIL 
Published: October 2013

Suicide Attempt by Complete Self‐Removal of a 12‐Year‐Old Permanent Pacemaker SystemIntroductionPsychological adaption after pacemaker implantation can be challenging in patients with psychiatric disease. Suicide by self‐removal of a permanent pacemaker system is a rare phenomenon described in a few cases in patients with psychiatric disorders.Methods and ResultsWe describe a case of attempted suicide by complete self‐removal of a 12‐year‐old permanent pacemaker system in a 70‐year‐old male patient with a bipolar disorder and a history of previous suicide attempts.ConclusionsSuicide attempt by self‐removal of a permanent pacemaker system is very rare. In patients with a history of psychiatric disease and previous suicide attempts, careful information about the function of a pacemaker should be given.
Progression of Aortic Pulse Wave Velocity in Patients With Chronic Kidney Disease
Authors: Tholen Susanne , Klofat Katharina , Pan Cheng Rui , Schmaderer Christoph , Lutz Jens , Heemann Uwe , Baumann Marcus 
Published: October 2013

Aortic pulse wave velocity (aPWV) is elevated in patients with chronic kidney disease (CKD) and predicts cardiovascular risk. However, the natural progression of arterial stiffness in these patients remains uncertain. Therefore, the main aim of this study was to investigate the development of aPWV and to identify potential factors associated with its progression. aPWV measurement was carried out in 70 CKD patients at baseline and after 12 months. Correlations to several variables, in particular annual glomerular filtration rate reduction and diabetes mellitus, were studied. In the cohort, aPWV significantly increased in 1 year by 1.1 m/s (P<.01). Dividing the group into patients with stable and progressive aPWV, factors associated with accelerated progression were age, systolic blood pressure, and diabetes, whereas loss of renal function had no significant impact. The annual aPWV progression in CKD patients reached 1 m/s, which predicts an increased cardiovascular risk. Variables involved with progressive arterial stiffness need further evaluation.
Increased Epicardial Adipose Tissue Thickness as a Predictor for Hypertension: A Cross‐Sectional Observational Study
Authors: Dicker Dror , Atar Eli , Kornowski Ran , Bachar Gil N. 
Published: October 2013

The aim of the study was to determine whether epicardial adipose tissue thickness (EAT), a new cardiometabolic risk factor, is associated with essential hypertension. The sample included 127 asymptomatic patients with one or more cardiovascular risk factors consecutively referred for cardiac computed tomography angiography. Data were collected retrospectively and compared between hypertensive (n=39) and normotensive (n=88) patients. The hypertensive patients had a significantly higher mean EAT thickness than the normotensive group (2.81±1.6 mm vs 2.07±1.43 mm; P=.011) and a significantly elevated mean coronary artery calcium score (316.8±512.6 vs 108.73±215; P=.0257). The odds ratio for a patient with tissue thickness ≥2.4 mm having hypertension was 1.396 (95% confidence interval, 1.033–1.922). Factors independently associated with hypertension were body mass index, low‐density lipoprotein, and age. A model score was developed using the logistic regression coefficients for calculation of individual risk. Hypertensive patients have significantly higher than normal EAT thickness. Epicardial adipose tissue thickness may serve as a risk indicator for hypertension and cardiovascular morbidity.
Fracture Resistance of Premolar Teeth Restored with Silorane‐Based or Dimethacrylate‐Based Composite Resins
Authors: Akbarian Golsa , Ameri Hamideh , Chasteen Joseph E. , Ghavamnasiri Marjaneh 
Published: October 2013

AbstractStatement of ProblemTo restore posterior teeth using low‐shrinkage composite to minimize microleakage.PurposeTo compare the fracture resistance of mesio‐occlusal‐distal (MOD) cavity preparations restored with either low‐shrinkage composite or with dimethacrylate‐based composite in conjunction with cavity liners and without them.The null hypothesis of the study is that there are no differences in either fracture resistance or fracture mode between the silorane group and dimethacrylate groups with and without the use of cavity liners.Method and MaterialsSixty maxillary premolars were divided into six groups of 10. MOD cavities were prepared in four groups: F: posterior composite (FiltekTM P60); GF: 0.5‐mm Glass Ionomer (Fuji LC) + posterior composite; FF: 0.5‐mm flowable composite (FiltekTM Supreme XT) + posterior composite; and S: low‐shrinkage composite (FiltekTM P90). Negative (N) and positive (P) control groups consisted of unrestored and sound teeth, respectively. The specimens were thermocycled and loaded. Data were analyzed using analysis of variance, Tukey, and chi‐square tests (α = 0.05).ResultsGroups FF (1643.09 ± 187/80 N) and GF (1596.80 ± 163/93 N) (p = 0.06 > 0.05) were statistically identical, although less than group P (1742/33 ± 110/08 N), but still demonstrated greater fracture resistance than the other groups. The fracture resistance of group S (1434/69 ± 107/62 N) was identical to GF and FF (p = 0.06 > 0.05). The fracture resistance of F (1353/19 ± 233/90 N) was less than GF and FF, and statistically identical to S (p = 0.87 > 0.05).ConclusionSilorane‐based composite showed a resistance to fracture similar to methacrylate‐based composite restorations regardless of whether cavity liners were used.Clinical SignificanceThe findings of this study support the selection of silorane‐based composite for the restoration of maxillary premolars with standardized Class II cavity preparations in order to strengthen the resistance to fracture to the same extent as do dimethacrylate composites using cavity liners or without them.
Epigenetic activation of mouse ganglioside synthase genes: implications for neurogenesis
Authors: Tsai Yi‐Tzang , Yu Robert K. 
Published: October 2013

AbstractThe quantity and expression pattern of gangliosides in mammalian brain change drastically during development and are mainly regulated through stage‐specific expression of ganglioside synthase genes. Despite extensive investigations in the past, it remains largely unclear how the transcriptional activation of the genes encoding glycosyltransferases is regulated. Here, we show that in the neuronogenic cultures of mouse embryonic brain‐derived neuroepithelial cells, histone modifications including acetylated histone H3 and histone H4, but not histone H3 trimethylation at lysine 27 of two genes encoding two key regulatory GTs, namely, N‐acetylgalactosaminyltransferase I and sialyltransferase II, were extensively and gradually enhanced, respectively. As a consequence, the level of each GT mRNA was increased correspondingly. Hyperacetylation of histones on the GalNAcT promoter resulted in recruitment of the trans‐activation factors Sp2 and AP‐1 when cellular histone deacetylases 1 and 2 were knocked down with RNA interference or inhibited by treatment with valproic acid. Moreover, epigenetic activation of GalNAcT was also detected, as accompanied by a pronounced induction of neural differentiation in primary neuroepithelium culture responding to an exogenous supplement of ganglioside GM1, a downstream product of the gene's encoding enzyme. Our findings thus provide direct evidence of novel pathways for ganglioside expression via the epigenetic up‐regulation of ganglioside synthase genes during neural development.
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Perceived support from healthcare professionals, shock anxiety and post‐traumatic stress in implantable cardioverter defibrillator recipients
Authors: Morken Ingvild M , Bru Edvin , Norekvål Tone M , Larsen Alf I , Idsoe Thormod , Karlsen Bjørg 
Published: October 2013

Aims and objectivesTo investigate (1) the extent to which shock anxiety and perceived support from healthcare professionals are related to post‐traumatic stress disease (PTSD) symptoms and (2) the extent to which perceived support from healthcare professionals moderates the relationship between shock anxiety and PTSD symptoms in implantable cardioverter defibrillator recipients. An additional aim was to describe the level of PTSD symptoms and perceptions of support from healthcare professionals.BackgroundStudies examining PTSD symptoms among implantable cardioverter defibrillator recipients are still sparse. In addition, little is known about how perceived support from healthcare professionals is related to PTSD symptoms.DesignCross‐sectional survey design.MethodsRecipients (n = 167) with implantable cardioverter defibrillator attending an outpatient device clinic completed questionnaires assessing shock anxiety, PTSD symptoms and perceived support from healthcare professionals.ResultsThe results indicated that between ten and 15% of the recipients experienced moderate to severe symptoms of PTSD. Although a majority perceived constructive support from healthcare professionals, 12% perceived nonconstructive support. Regression analysis demonstrated that shock anxiety and perceived nonconstructive support from healthcare professionals had a statistically significant (p < 0·01) association with PTSD symptoms. Moreover, the results suggest that associations between shock anxiety and PTSD symptoms were significantly (p < 0·01) moderated by perceived nonconstructive support from healthcare professionals. Young age, short time since implantation and secondary prevention indication were also significantly associated with PTSD symptoms.ConclusionsThe results indicate that nonconstructive support from healthcare professionals can increase the tendency to develop PTSD symptoms, particularly in those who experience shock anxiety.Relevance to clinical practiceHealthcare professionals should pay more attention to the way in which they communicate information to the recipients during follow‐up visits. Clinically based strategies and interventions targeting shock anxiety and PTSD symptoms should be carried out.
Evaluating an holistic assessment tool for palliative care practice
Authors: McIlfatrick Sonja , Hasson Felicity 
Published: October 2013

Aims and objectivesTo evaluate a holistic assessment tool for palliative care practice. This included identifying patients' needs using the holistic tool and exploring the usability, applicability and barriers and facilitators towards implementation in practice.BackgroundThe delivery of effective holistic palliative care requires a careful assessment of the patients' needs and circumstances. Whilst holistic assessment of palliative care needs is advocated, questions exist around the appropriateness of tools to assist this process.DesignMixed‐method research design.MethodsData collection involved an analysis of piloted holistic assessments undertaken using the tool (n = 132) and two focus groups with healthcare professionals (n = 10).ResultsThe tool enabled health professionals to identify and gain an understanding of the needs of the patients, specifically in relation to the physical healthcare needs. Differences, however, between the analysis of the tool documentation and focus group responses were identified in particular areas. For example, 59 (68·8%) respondents had discussed preferred priorities of care with the patient; however, focus group comments revealed participants had concerns around this. Similarly, whilst over half of responses (n = 50; 57·5%) had considered a prognostic clinical indicator for the patient as an action, focus group results indicated questions around healthcare professionals' knowledge and perceived usefulness of such indicators. Positive aspects of the tool were that it was easy to understand and captured the needs of individuals. Negative aspects of the tool were that it was repetitive and the experience of assessors required consideration.ConclusionThe tool evaluation identified questions regarding holistic assessment in palliative care practice and the importance of communication.Relevance to clinical practiceA holistic assessment tool can support patient assessment and identification of patients' needs in the ‘real world’ of palliative care practice, but the ‘tool' is merely an aid to assist professionals to discuss difficult and sensitive aspects of care.
Nurse‐sensitive indicators suitable to reflect nursing care quality: a review and discussion of issues
Authors: Burston Sarah , Chaboyer Wendy , Gillespie Brigid 
Published: October 2013

Aims and objectivesTo review nurse‐sensitive indicators that may be suitable to assess nursing care quality.BackgroundPatient safety concerns, fiscal pressures and patient expectation create a demand that healthcare providers demonstrate the quality of nursing care delivered. As a result, nurse managers are increasingly encouraged to provide evidence of nursing care quality. Nurse‐sensitive indicators are being proposed as a means of meeting this need.DesignLiterature review.MethodsA review of the literature was conducted using CINAHL and MEDLINE from 2002–2011. Key search terms were nurs* and sensitive indicators, outcome measures, indicators, metrics and patient outcomes.ResultsMost of the research has examined the relationship between nursing structural variables and patient outcomes in acute care settings and have explored potential indicators for specific patient groups and nursing roles. When using nurse‐sensitive indicators, issues concerning the selection, reporting and sustained use are important for nurse managers to consider.ConclusionEvidence for the nurse‐sensitivity of some commonly used indicators is inconsistent due to the disparity in definitions used, data collection and analysis methods. Further research on the application and implementation of these indicators is required to assist nurse managers in attempting to quantify the quality of nursing care. Nurses need to continue to strive to achieve agreement on the definitions of indicators, gather strong consistent evidence of nurse‐sensitivity, resolve issues of regular data collection and consider selection, reporting and sustainment when implementing nurse‐sensitive indicators.Relevance to clinical practiceOnce identified, nurse‐sensitive indicators can be applied for quality improvement purposes, but consensus is required to fully realise their potential. Nurse managers need to be aware of the factors that can influence the use of indicators at unit level. Strategies need to be implemented to promote these indicators becoming integrated with routine nursing care.