bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding whistleblowing: qualitative insights from nurse whistleblowers
Authors: Jackson Debra , Peters Kath , Andrew Sharon , Edenborough Michel , Halcomb Elizabeth , Luck Lauretta , Salamonson Yenna , Wilkes Lesley 
Published: July 2010

jackson d., peters k., andrew s., edenborough m., halcomb e., luck l., salamonson y. & wilkes l. (2010) Understanding whistleblowing: qualitative insights from nurse whistleblowers. Journal of Advanced Nursing 66(10), 2194–2201.AbstractAim.  This paper is a report of a study conducted to explore the reasons behind the decision to blow the whistle and provide insights into nurses’ experiences of being whistleblowers.Background.  Whistleblowing is a stigmatized and hidden activity that carries considerable ramifications to all concerned. In the health sector, when episodes of poor practice or service provision are identified, it is frequently nurses who are the whistleblowers. Despite this, there is remarkably limited literature that explores nurses’ experiences of whistleblowing.Methods.  Qualitative narrative inquiry design. Data were collected in 2008 from 11 nurse whistleblowers using in‐depth semi‐structured interviews.Findings.  Participants were drawn from a range of general and specialty clinical areas and experienced whistleblowing as highly stressful. The findings were clustered into three main themes, namely: (i) Reasons for whistleblowing: I just couldn’t advocate, (ii) Feeling silenced: Nobody speaks out, and (iii) Climate of fear: You are just not safe.Conclusion.  The whistleblowing nurses believed they were acting in accordance with a duty of care. There is a need for greater clarity about the role nurses have as patient advocates. Furthermore, there is need to develop clear guidelines that create opportunities for nurses to voice concerns and to ensure that healthcare systems respond in a timely and appropriate manner, and a need to foster a safe environment in which to raise issues of concern.
Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic review
Authors: Chan Dorothy N.S. , Lui Liza Y.Y. , So Winnie K.W. 
Published: July 2010

chan d.n.s., lui l.y.y. & so w.k.w. (2010) Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic review. Journal of Advanced Nursing 66(9), 1902–1914.AbstractAim.  This article is a report of a review of the effectiveness of exercise programmes on shoulder mobility and lymphoedema in postoperative patients with breast cancer having axillary lymph node dissection, as revealed by randomized controlled trials.Background.  Breast cancer is the most common malignancy in women. After surgery, the most common postoperative complications are reduced range of motion in the shoulder, muscle weakness in the upper extremities, lymphoedema, pain and numbness. To reduce these impairments, shoulder exercises are usually prescribed. However, conflicting results regarding the effect and timing of such exercises have been reported.Data sources.  Studies were retrieved from a systematic search of published works over the period 2000–2009 indexed in the Cumulative Index to Nursing and Allied Health Literature, Ovid Medline, the British Nursing Index, Proquest, Science Direct, Pubmed, Scopus and the Cochrane Library, using the combined search terms ‘breast cancer’, ‘breast cancer surgery’, ‘exercise’, ‘lymphoedema’, ‘shoulder mobility’ and ‘randomized controlled trials’.Methods.  A quantitative review of effectiveness was carried out. Studies were critically appraised by three independent reviewers, and categorized according to levels of evidence defined by the Joanna Briggs Institute.Results.  Six studies were included in the review. Early rather than delayed onset of training did not affect the incidence of postoperative lymphoedema, but early introduction of exercises was valuable in avoiding deterioration in range of shoulder motion.Conclusion.  Further studies are required to investigate the optimal time for starting arm exercises after this surgery. Nurses have an important role in educating and encouraging patients to practise these exercises to speed up recovery.
Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units
Authors: Rochefort Christian M. , Clarke Sean P. 
Published: July 2010

rochefort c.m. & clarke s.p. (2010) Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units. Journal of Advanced Nursing 66(10), 2213–2224.AbstractAim.  This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses’ perceptions of care rationing, job outcomes, and quality of care.Background.  International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments.Methods.  Over a 6‐month period in 2007–2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada).Results.  A total of 339 nurses (61·3%) completed questionnaires. Overall, 18·6% were dissatisfied with their job, 35·7% showed high emotional exhaustion, and 19·2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction.Conclusion.  Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units.
Facial muscle activation during sleep and its relation to the rapid eye movements of REM sleep
Authors: RIVERA‐GARCÍA ANA PAULA , RAMÍREZ‐SALADO IGNACIO , CORSI‐CABRERA MARÍA , CALVO JOSÉ MARÍA 
Published: July 2010

SummaryFacial muscle contractions (FMC) are a commonly observed feature during sleep stages in human subjects. Previous studies have associated FMC to emotional expression during waking. Phasic features of rapid eye movement (REM) sleep, such as REMs have also been linked to an increase in limbic structure activity with a subsequent relation to emotional dream content. We hypothesized that FMC would be more frequent during REM sleep, and that FMC would correlate with the characteristic REMs of this sleep stage. The present study was designed to evaluate the density per minute of the phasic and sustained FMC of five facial muscles (frontalis, corrugator, orbicularis oculi, zygomatic major left and right) during all sleep stages, and to explore their relation with REMs density in six healthy participants during an 8 h sleep recording. Results showed a significant increase in FMC of all recorded muscles during REM sleep, both in frequency and duration. Additionally, as expected, during REM sleep there was a positive correlation among the facial muscles and between these and REMs. Nevertheless, although associated in number, both features (FMC and REMs) were never simultaneous. Our results suggest that limbic activation during REM sleep may be responsible for the enhancement of facial muscle activity, which may be consistent with the theoretical perspective of a higher emotional activity during REM sleep.
Self‐reported sleep duration and falls in older adults
Authors: MESAS ARTHUR EUMANN , LÓPEZ‐GARCÍA ESTHER , RODRÍGUEZ‐ARTALEJO FERNANDO 
Published: July 2010

SummaryWhether the association between sleep duration and accidental falls is independent of sleep quality is uncertain. It is also unclear if this association varies with age and sex among older adults. Data were collected through telephone interviews of 1542 community‐dwelling individuals aged ≥68 years in Spain. Analyses were performed with logistic regression and adjusted for the main confounders, including lifestyle, health status, comorbidity and sleep quality, as measured by nighttime and daytime sleep complaints. Analyses were also stratified by age and sex. In total, 449 (29.1%) participants fell in the previous year; of these, 57.7% had one fall and 42.3% had recurrent (≥2) falls. As compared with those who usually slept 7–8 h, those sleeping ≥11 h were more likely to suffer recurrent falls [odds ratios (OR) 2.75; 95% confidence intervals (CI) 1.32–5.62]. In the stratified analysis, there was no association between sleep duration and falls in those aged ≤75 years and in men. In contrast, among those aged >75 years, the percentage of individuals with ≥1 falls was higher in those sleeping ≤5 h (OR 2.15; 95% CI 1.20–3.87) and ≥11 h (OR 2.34; 95% CI 1.17–4.68) than in those sleeping 7–8 h; also, women who slept ≥11 h were more likely to fall ≥1 times (OR 3.89; 95% CI 1.74–8.69). In conclusion, long sleep duration was associated with higher frequency of falls in older adults, even after adjustment for a wide range of sleep quality indicators. The association is clearer in women and the oldest adults. Assessment of sleep duration can help identify older adults who might benefit from interventions aimed at fall prevention.
Detection of human papillomavirus DNA in feline premalignant and invasive squamous cell carcinoma
Authors: O’Neill Sarah H. , Newkirk Kimberly M. , Anis Eman A. , Brahmbhatt Rupal , Frank Linda A. , Kania Stephen A. 
Published: July 2010

AbstractSquamous cell carcinoma (SCC) is the most common malignant cutaneous and oral neoplasm of cats. Papillomavirus (PV) DNA has been identified in a proportion of feline Bowenoid in situ carcinomas (BISCs), cutaneous SCCs and a single oral SCC, but its exact role in the pathogenesis remains unknown. In humans, it has been suggested that ultraviolet (UV) light and human PV (HPV) may act as cofactors in cutaneous SCC carcinogenesis. Little is known about the influence of UV light on PV prevalence in feline cutaneous lesions, including actinic keratosis (AK). Additionally, PV prevalence in noncutaneous feline lesions, including oral SCC, is largely not known. This study aimed to determine the presence of PV in 84 cats with premalignant and invasive SCC from cutaneous and noncutaneous sites using polymerase chain reaction and to investigate an association with UV light. Papillomaviral DNA was amplified from two of 12 cases of AK, seven of 22 BISCs, nine of 39 cutaneous SCCs and two of 35 non‐cutaneous SCCs. Of the PV DNA sequenced, 50% was most similar to HPV of the genus Betapapillomavirus, while the other 50% was most similar to Felis domesticus PV type 2. Exposure to UV was not associated with an increase in PV for cutaneous SCC. The results of this study suggest that in the cat, HPV DNA may be detectible within a higher percentage of squamous lesions than previously demonstrated, UV exposure may not be a confounder for PV presence, and noncutaneous lesions may have a low prevalence of PV.
Functional biodiversity in the agricultural landscape: relationships between weeds and arthropod fauna
Authors: BÀRBERI P , BURGIO G , DINELLI G , MOONEN A C , OTTO S , VAZZANA C , ZANIN G 
Published: July 2010

BàrberiP, BurgioG, DinelliG, MoonenAC, OttoS, VazzanaC & ZaninG (2010). Functional biodiversity in the agricultural landscape: relationships between weeds and arthropod fauna.Weed Research50, 388–401.SummaryWe reviewed studies aimed at understanding functional relationships between weeds and arthropods in agroecosystems as influenced by biodiversity at different scales, with the main goal of highlighting gaps in knowledge, research methods and approaches. We first addressed: (i) the regulation of arthropod communities by weed diversity at genetic, species and habitat levels, (ii) the regulation of weed communities by arthropods through seed predation and dispersal and (iii) below‐ground weed‐insect interactions. We then focussed on methodologies to study weed–arthropod interactions in agricultural landscapes and discuss techniques potentially available for data analysis and the importance of joint weed–arthropod trend detection. Lastly, we discuss the implications of research findings for biodiversity conservation policies (agri‐environmental schemes) and suggest some priorities for future work. Results showed that to date research has largely ignored weed–arthropod interactions in agricultural landscapes. No information is available on the role of weed genetic diversity as driver of weed–arthropod interactions, whereas studies on effects of species and habitat diversity often lack a functional perspective and/or a spatial component. Also, information on how management of the wider agricultural biotope might express positive weed–arthropod functional interactions is scarce. Another area worth being explored is the relationship between weed‐leaf/root herbivores and beneficial arthropods. Tools for spatial data analysis might be useful for elucidating weed–arthropod interactions in agricultural landscapes, but some methodological aspects, e.g. the definition of the most appropriate experimental design and sampling scale/frequency, must be refined. New studies on weed–arthropod interactions should encompass an explicit spatial component; this knowledge is particularly important for improving IPM/IWM systems and designing more targeted agri‐environmental schemes.
Attitude of health care professionals to brain death: influence on the organ donation process
Authors: Cohen Jonathan , Ami Sharona Ben , Ashkenazi Tamar , Singer Pierre 
Published: July 2010

Abstract: Background:  The acceptance and application of the concept that brain death is a valid determination of death is the central issue in organ donation. However, whether attitude to brain death of health care professionals influences the organ procurement process has not been systematically studied.Methods:  Questionnaires were distributed to health care professionals involved in the organ procurement process (intensive care, internal medicine, emergency room, anesthesia) in all hospitals in Israel. Attitude to brain death (defined as positive if the respondent accepted brain death as a valid determination of death, negative or do not know) and level of comfort in performing key donor‐related tasks were analyzed.Results:  A total of 2366 completed questionnaires were returned (629 doctors and 1737 nurses; response rate 60.3%). Overall, 78.9% of respondents had a positive attitude to brain death. This was significantly associated with increasing age, higher professional status and was most prevalent amongst intensive care unit staff (p < 0.001 for all variables). These respondents felt significantly more comfortable informing the transplant coordinator of a potential donor, explaining brain death to the family, raising the subject of organ donation, approaching the family about donation and providing support to the grieving family. In addition, they believed the transplant coordinator should be involved early in the donation process.Conclusions:  The understanding and acceptance of brain death as a valid determination of death was associated with a positive effect on the level of comfort of health care professionals in performing key donor‐related tasks. Reinforcing a positive attitude to brain death among health care professionals may facilitate the procurement process.
Clinical pharmacology of methadone for pain
Authors: FREDHEIM O. M. S. , MOKSNES K. , BORCHGREVINK P. C. , KAASA S. , DALE O. 
Published: July 2010

Background: This topical review addresses methadone's pharmacology, its application in malignant and non‐malignant pain conditions, practical issues related to methadone for the treatment of pain and its influence on QTc time.Methods: Relevant papers were identified in PubMed and EMBASE.Results: Methadone is advocated by experts as a second line opioid when first line opioids fail to provide a satisfactory balance between pain control and side effects (opioid switching). Although randomized‐controlled studies are lacking, current evidence suggests that switching to methadone in this situation reduces pain intensity. However, interindividual variability in its pharmacokinetics make its application challenging and metabolism by CYP 3A4 and 2B6 implies a substantial risk of drug–drug interactions. Several ways of switching to methadone have been presented, with a gradual switch during 3 days or ‘stop and go’ as the dominating strategies. Episodes of torsade de pointes arrhythmia during methadone treatment have been reported in patients with other risk factors for arrhythmia, while small prospective studies have reported a small, lasting and stable increase in QTc time. The extensive use of methadone for opioid replacement in addicts has added additional patient barriers to its use for pain control.Conclusion: In spite of challenges related to the variable pharmacokinetics and concerns regarding increase in QTc time, current evidence indicates that opioid switching to methadone improves pain control in a substantial proportion of patients who are candidates for opioid switching. Measures must be instituted to secure that patients receiving methadone for pain are not considered opioid addicts.
Early Cretaceous palynofloral provinces in China: western additions
Authors: Li Jianguo , Batten David J. 
Published: July 2010

AbstractTwo distinct palynofloral provinces have been recognized for the Early Cretaceous of western China, including Xizang (Tibet): one indicated by the presence of the cheirolepidiacean pollen grain Dicheiropollis and the other by abundant representatives of different gymnospermous pollen, especially Araucariacites and Callialasporites. The boundary between them coincides with the Yarlung Zangbo Suture. To the north of the suture, the Xizang–Tarim Dicheiropollis Province occupies a wide region from southern Xinjiang through the central and northern Qinghai–Xizang Plateau to the west of Yunnan. South of the suture, the Southern Xizang Araucariacites‐Callialasporites Province appears to have affinities with the South Gondwanan (floral) Realm. Despite some similarities with the composition of assemblages from other palynofloral provinces, both are distinct and considered to reflect different climates. Hot arid to semi‐arid conditions are indicated by the Dicheiropollis Province, whereas a more humid and somewhat cooler climate is suggested for the Araucariacites‐Callialasporites Province.
Toxicity biomarkers in autism spectrum disorder: A blinded study of urinary porphyrins
Authors: Kern Janet K. , Geier David A. , Adams James B. , Mehta Jyutika A. , Grannemann Bruce D. , Geier Mark R. 
Published: July 2010

AbstractBackground:  Recent studies suggest that children diagnosed with an autism spectrum disorder (ASD) have significantly increased levels of urinary porphyrins associated with mercury (Hg) toxicity, including pentacarboxyporphyrin (5cxP), precoproporphyrin (prcP), and coproporphyrin (cP), compared to typically developing controls. However, these initial studies were criticized because the controls were not age‐ and gender‐matched to the children diagnosed with an ASD.Methods:  Urinary porphyrin biomarkers in a group of children (2–13 years of age) diagnosed with an ASD (n= 20) were compared to matched (age, gender, race, location, and year tested) group of typically developing controls (n= 20).Results:  Participants diagnosed with an ASD had significantly increased levels of 5cxP, prcP, and cP in comparison to controls. No significant differences were found in non‐Hg associated urinary porphyrins (uroporphyrins, hexacarboxyporphyrin, and heptacarboxyporphyrin). There was a significantly increased odds ratio for an ASD diagnosis relative to controls among study participants with precoproporphyrin (odds ratio = 15.5, P < 0.01) and coproporphyrin (odds ratio = 15.5, P < 0.01) levels in the second through fourth quartiles in comparison to the first quartile.Conclusion:  These results suggest that the levels of Hg‐toxicity‐associated porphyrins are higher in children with an ASD diagnosis than controls. Although the pattern seen (increased 5cxP, prcP, and cP) is characteristic of Hg toxicity, the influence of other factors, such as genetics and other metals cannot be completely ruled out.
Maintenance intravesical bacillus Calmette‐Guérin instillation for Ta, T1 cancer and carcinoma in situ of the bladder: Randomized controlled trial by the BCG Tokyo Strain Study Group
Authors: Koga Hirofumi , Ozono Seiichiro , Tsushima Tomoyasu , Tomita Kyoichi , Horiguchi Yutaka , Usami Michiyuki , Hirao Yoshihiko , Akaza Hideyuki , Naito Seiji ,   BCG Tokyo Strain Study Group
Published: July 2010

Objectives:  We carried out a prospective, randomized, controlled trial to investigate the efficacy and safety of both induction and maintenance therapy with intravesical instillation of bacillus Calmette‐Guérin (BCG) for high‐risk non‐muscle invasive bladder cancer (NMIBC).Methods:  Intravesical instillation of 80 mg Tokyo strain was given to patients with high‐risk NMIBC, including carcinoma in situ (CIS), once weekly for eight consecutive weeks as induction therapy. Patients who achieved complete response (CR) were randomly assigned to either the maintenance group or the observation group.Results:  A total of 90 patients were enrolled. After induction therapy, 75% of the patients achieved CR and 53 of them were enrolled in the randomized comparative phase. A total of four maintenance instillations were given. Median follow‐up was 26.5 and 28.7 months after randomization in the maintenance and the observation group, respectively. Although it was not statistically significant, the 2‐year recurrence‐free survival rate in the maintenance group (95.8%) was higher than that in the observation group (74.1%, P = 0.078). Univariate analysis identified maintenance therapy as a significant factor influencing recurrence. During induction therapy, 82.2% of patients experienced urination‐related adverse drug reactions, but most events were not serious. There were fewer adverse drug reactions with maintenance therapy than with induction therapy. Neither induction therapy nor maintenance therapy reduced patients’ quality of life (QOL).Conclusions:  These findings show high levels of efficacy and safety of BCG induction treatment for high‐risk NMIBC, and suggest that the number of maintenance instillations could probably be reduced without reducing treatment efficacy or influencing QOL.