bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the get up and go test improve predictive accuracy of the Triage Risk Screening Tool or Rowland questionnaire in older patients admitted to the emergency department?
Authors: Devriendt Els , Deschodt Mieke , Delaere Maarten , Flamaing Johan , Sabbe Marc , Milisen Koen
Published: July 2016

Objectives

To assess the diagnostic characteristics of the get up and go test (GUGT) as a stand-alone test and in combination with the Flemish Triage Risk Screening Tool (fTRST) and Rowland questionnaire. One aim was to determine whether the diagnostic accuracy of these instruments could be improved for predicting unplanned emergency department (ED) readmission following ED discharge.

Methods

We carried out a prospective cohort study at the ED of the University Hospitals Leuven, Belgium. All patients aged at least 75 years (n=380) completed fTRST, Rowland, and GUGT testing at the index ED admission. Diagnostic characteristics for unplanned ED readmission were determined for hospitalized and discharged patients 1 and 3 months after the index ED visit.

Results

In both hospitalized and discharged patients, fTRST and Rowland (cut-off ≥2) had good to excellent sensitivity and negative predictive value (NPV) but low to moderate specificity and accuracy; GUGT had low sensitivity and good to excellent NPV and specificity. The combined fTRST/GUGT or Rowland/GUGT had moderate to excellent NPV (56.3–94.3%). The combined fTRST (cut-off ≥2)/GUGT had low sensitivity and moderate to excellent specificity. Sensitivity of the combined Rowland (cut-off ≥4)/GUGT was good at the 1-month follow-up and moderate at the 3-month follow-up for hospitalized patients; it was low for discharged patients. Specificity was low for hospitalized patients and good for discharged patients.

Conclusion

Neither the objective measure of mobility (GUGT) nor the combined fTRST/GUGT or Rowland/GUGT improved the results. Our analysis shows that the predictive accuracy of the stand-alone, self-reported screening instruments fTRST and Rowland (cut-off=2) is still good. This study also confirmed their previously known limitations.
Low Use of Oral Anticoagulant Prescribing for Secondary Stroke Prevention
Authors: Shah Reema , Li Shudong , Stamplecoski Melissa , Kapral Moira K.
Published: July 2016

Background:

Oral anticoagulation reduces the risk of stroke in atrial fibrillation but is often underused.

Objectives:

To identify factors associated with oral anticoagulant prescribing and adherence after stroke or transient ischemic attack (TIA).

Research Design:

Retrospective cohort study using linked Ontario Stroke Registry and prescription claims data.

Subjects:

Consecutive patients with atrial fibrillation and ischemic stroke/TIA admitted to 11 stroke centers in Ontario, Canada between 2003 and 2011.

Measures:

We used modified Poisson regression models to determine predictors of anticoagulant prescribing and multiple logistic regression to determine predictors of 1-year adherence.

Results:

Of the 5781 patients in the study cohort, 4235 (73%) were prescribed oral anticoagulants at discharge. Older patients were less likely to receive anticoagulation [adjusted relative risk (aRR) for each additional year=0.997; 95% confidence interval (CI), 0.995–0.998], as were those with TIA compared with ischemic stroke (aRR=0.904; 95% CI, 0.865–0.945), prior gastrointestinal bleed (aRR=0.778; 95% CI, 0.693–0.873), dementia (aRR=0.912; 95% CI, 0.856–0.973), and those from a long-term care facility (aRR=0.810; 95% CI, 0.737–0.891). After limiting the sample to those without obvious contraindications to anticoagulation, age, dementia, and long-term care residence continued to be associated with lower prescription of oral anticoagulants. One-year adherence to therapy was similar across most patient groups.

Conclusions:

Age, dementia, and long-term care residence are predictors of lower oral anticoagulant use for secondary stroke prevention and represent key target areas for quality improvement initiatives.
Influencing Patient Satisfaction Scores
Authors: Anderson Norman R.
Published: July 2016

With potential hospital reimbursement centered on patient satisfaction, limiting the number of invasive peripheral venipunctures may increase Press Ganey satisfaction scores. A prospective study compared published outcomes with conventional intravenous (IV) catheters against results using a newly designed IV catheter with a retractable, coiled-tip guidewire. The objectives were to determine whether successful first-attempt and IV complication rates might be altered using the new technology. In a small community hospital-based study of 95 patients, first-attempt success, complications, dwell time, and patient satisfaction results with the new technology scored significantly better, from insertion to removal, than published outcomes with conventional catheters.
Evolution of the Treatments for Hemophilia
Authors: Guelcher Christine J.
Published: July 2016

Although hemophilia has been recognized for centuries as an inherited disorder primarily affecting males, advances in treatments have been very recent. Initial availability of plasma-derived therapies offered significant improvements in morbidity and mortality, but the transmission of viruses quickly negated the benefit of early factor replacement products. After developing successful viral inactivation methods and subsequently developing recombinant technology, the manufacturing of factor concentrates became much safer. Access to safer factor products allowed for a shift from the treatment of bleeds to prevention, called prophylaxis. Although dosing and interval vary, prevention of joint disease is now a realistic goal. Unfortunately, despite advances in the safety of therapy, some patients are unable to use factor replacement products because they develop antibodies, known as inhibitors. Eradication of inhibitors is possible in the majority of patients, but it is expensive and takes time. Management of acute bleeding may require significantly higher doses of factor replacement or the use of a bypassing agent. As a result, patients with inhibitors are at increased risk for sequelae, including joint disease, life-threatening bleeding, infectious complications with central vascular access devices, and thrombotic complications.
Exploring the Lived Experience of Women Immediately Following Mastectomy
Authors: Davies Claire C. , Brockopp Dorothy , Moe Krista , Wheeler Peggy , Abner Jean , Lengerich Alexander
Published: July 2016

Background:

In 2014, it is estimated that 232,670 new cases of breast cancer occurred in the United States. Unilateral or bilateral mastectomy is a frequently chosen option for treating this disease.

Objective:

The purpose of this study was to explore, through an in-depth interview process, the lived experience of women immediately following mastectomy when they see their scars for the first time.

Methods:

Purposeful sampling was used until saturation was reached. In-depth interviews were conducted with 10 women related to their mastectomy experience. The data were analyzed using a phenomenological approach.

Results:

The following 8 themes emerged from the data; lasting impact, personal impact, relational impact, gratitude, support system, coping strategies, timing, and discomfort.

Conclusions:

The results of the study provide evidence that women face ongoing challenges following seeing their mastectomy scars for the first time that is not adequately addressed by healthcare professionals.

Implications for Practice:

Nurses and other healthcare professionals need to gain a better understanding of the difficulties perceived by women following seeing the scars from mastectomy and implement strategies to assist in successful adaptation to the experience.
Variations in Clinical Presentation of Ocular Syphilis: Case Series Reported From a Growing Epidemic in the United States
Authors: Marx Grace E. , Dhanireddy Shireesha , Marrazzo Jeanne M. , Tuddenham Susan A. , Rompalo Anne M. , Leone Peter A. , Gaydos Charlotte A. , Rietmeijer Cornelis A.
Published: July 2016

Ocular syphilis, a form of neurosyphilis, has been increasingly diagnosed in the United States. This case series summarizes the course of 6 patients recently diagnosed with ocular syphilis, emphasizing the varied sociodemographic factors and the wide range of symptoms and outcomes that are seen in patients with this disease.
Trichomonas vaginalis Nucleic Acid Amplification Testing at an Urban HIV Clinic
Authors: Muzny Christina A. , Burkholder Greer A. , Fry Karen R. , Austin Erika L. , Schwebke Jane R.
Published: July 2016

Background

Trichomonas vaginalis is the most common nonviral sexually transmitted infection. T. vaginalis nucleic acid amplification testing (NAAT) recently became available at the University of Alabama at Birmingham human immunodeficiency virus (HIV) clinic. The objective of this study was to determine the uptake of T. vaginalis NAAT testing among clinic providers during the first year of test availability in addition to T. vaginalis prevalence and predictors based on NAAT results.

Methods

This was a retrospective review of HIV+ women and men ages ≥16 years at the University of Alabama at Birmingham HIV Clinic, including those receiving a T. vaginalis NAAT on a genitourinary specimen.

Results

Between August 2014 and August 2015, 3163 HIV+ patients were seen (768 women, 2395 men), of whom 861 (27.3%) received a T. vaginalis NAAT; 402 women (52.3%) and 459 men (19.2%). Among those with T. vaginalis NAAT results, 70 (17.4%) of 402 women and 12 (2.6%) of 459 men (9 men who have sex with women, 1 man who has sex with men, 2 unknown) tested positive. In adjusted analyses for women, age ≤40 years (odds ratio [OR], 2.93; 95% confidence interval [CI], 1.23–6.96), current cocaine use (OR, 4.86; 95% CI, 1.57–15.06), and CD4 < 200 cells/mm3 (OR, 6.09; 95% CI, 1.68–22.11) were significantly associated with increased odds of a positive T. vaginalis NAAT. For those with a positive T. vaginalis NAAT, treatment was prescribed for 65 (92.9%) of 70 women and 10 (83.3%) of 12 men.

Conclusions

Initial uptake of T. vaginalis NAAT testing was modest at this HIV clinic yet identified a high prevalence among women tested. Emphasis on the need for testing in HIV+ women is necessary.
Ocular and Environmental Factors Associated with Eye Growth in Childhood
Authors: Read Scott Andrew
Published: July 2016

Recent advances in measurement technology have improved our ability to quantify a range of ocular components and some environmental exposures that are relevant to myopia. In particular, environmental sensors now allow the dense sampling of personal ambient light exposure data, and advances in ocular imaging, such as developments in optical coherence tomography (OCT), enables high resolution measures of the choroid to be captured in human subjects. The detailed, objective information produced by these noninvasive measurement technologies has the potential to provide important new insights into the complex array of factors underlying eye growth, and myopia development and progression in childhood.

Wearable light sensors and enhanced depth imaging OCT were both employed in a recently completed prospective, observational longitudinal study examining factors associated with eye growth in myopic and non-myopic children. Personal light exposure, choroidal thickness, and axial eye growth were quantified in 101 children over an 18-month period. A significant association was found between objectively measured personal daily ambient light exposure and eye growth (independent of refractive status), consistent with greater light exposure protecting against rapid growth of the eye in childhood. Variations in the thickness of the choroid also appeared to be closely linked to the growth of the eye, with choroidal thinning typically being associated with more rapid eye growth, and choroidal thickening with a slowing of eye growth in childhood. The implications of these findings for our understanding of human eye growth regulation, along with their potential importance for our understanding of myopia control interventions, are discussed.
Adipocere—The Fat of Graveyards
Authors: Byard Roger W.
Published: July 2016

Adipocere is an unusual product of fatty tissue decomposition that may occasionally be found in bodies. Two cases of diving fatalities in a limestone cave filled with fresh water are reported to demonstrate the features of adipocere, with a literature review. The bodies of a 20-year-old male and 22-year-old female diver were retrieved 11 and 10 months after their deaths, respectively. Both bodies were putrefied with extensive adipocere formation characterized by the absence of epidermis with loss of cellular detail, with residual collagen fibers, and occasional hair follicles in the dermis. The most likely cause of death was accidental drowning possibly contributed to by equipment malfunction at depth. Adipocere formation is an unusual finding in bodies, particularly in Australia, that is facilitated by cold, wet, and anaerobic environments. If found at autopsy, it may give some indication of the environmental conditions that a body has been exposed to.
A Hanged From the Past
Authors: Gaeta Raffaele , Fornaciari Antonio
Published: July 2016

The medieval chapel of Notre Dame-des-Fontaines (Our Lady of the Fountains), in the French Maritime Alps, is entirely covered by the fresco cycle of the Passion (15th century) that depicts the last days of Jesus from the Last Supper to the Resurrection. Under a small window, there is the brutal representation of the suicide of Judas Iscariot, hanging from a tree, with the abdomen quartered from which his soul, represented by a small man, is kidnapped by a devil. The author, Giovanni Canavesio, represented the traitor's death with very detailed anatomical structures, differently thus from other paintings of the same subject; it is therefore possible to assume that the artist had become familiar with the human anatomy. In particular, the realism of the hanged man's posture, neck bent in an unnatural way, allows us to hypothesize that it probably comes from direct observation of the executions of capital punishment, not infrequently imposed by the public authorities in low medieval Italy.
Immunoreactivity of a Monoclonal Antibody to SS18-SSX Fusion Gene Product in Formalin-fixed Paraffin-embedded Synovial Sarcoma Tissue Section
Authors: Saigo Chiemi , Kito Yusuke , Takeuchi Tamotsu
Published: July 2016

Synovial sarcoma is an aggressive sarcoma with specific reciprocal chromosomal translocation of SS18 (also known as SYT) and SSX genes. In the present study, we aimed to detect the SS18-SSX fusion gene product in routinely processed pathologic synovial sarcoma tissue section. Monoclonal antibodies to peptide QRPYGYDQ-IMPKKPA, which covered the fusion region of SS18-SSX, were newly established and subsequently characterized by enzyme-linked immunosorbent assay, Western-immunoblotting, and immunohistochemical staining. A monoclonal antibody designated BG35, reacted with boundary region of SS18-SSX chimera protein in a specific manner, when C-terminal or neighboring region of QRPYGYDQ-IMPKKPA is structurally exposed. Immunoreactivity of BG35 was localized in nucleus of synovial sarcoma cells, but not in other sarcoma cells, examined. Interestingly, synovial sarcoma cells with epithelial differentiation exhibited much strong BG35 immunoreactivity than synovial sarcoma cells with sarcomatous differentiation. BG35 may be useful for evaluating molecular kinetics of SSX-SS18 gene product in situ.
Admission Plasma Troponin I Is Associated With Mortality in Pediatric Intensive Care*
Authors: Wilson Clare , Sambandamoorthy Ganesh , Holloway Paul , Ramnarayan Padmanabhan , Inwald David P.
Published: July 2016

Objectives:

Assessment of whether admission plasma troponin I level is associated with mortality or requirement for vasoactive drugs in pediatric intensive care.

Design:

Retrospective cohort study.

Setting:

Single centre, tertiary referral general PICU, without a cardiac surgical program.

Patients:

Three hundred and nineteen patients 0–18 years old in two cohorts. Cohort 1 was admitted between January 2009 and September 2012 and the cohort 2 between April 2014 and April 2015.

Interventions:

None.

Measurements and Main Results:

Plasma troponin I was measured in patients in cohort 1 only if the attending physician ordered the test due to clinical concern regarding myocardial injury. The second cohort had plasma troponin I routinely measured at admission. The primary outcome was death during PICU admission, and the secondary outcome was maximum inotrope requirement during PICU stay, measured by Vasoactive Inotrope Score. Plasma troponin I was a discriminator for mortality in both cohorts (area under the receiver-operating characteristic curve of 0.73 and 0.86 in cohorts 1 and 2, respectively). In an adjusted analysis using Cox regression, accounting for Pediatric Index of Mortality 2 risk of mortality and age, elevated plasma troponin I was significantly associated with death in both cohorts (hazard ratio, 4.99; p = 0.033; hazard ratio, 10.5; p = 0.026 in cohorts 1 and 2, respectively). Elevated plasma troponin I was only associated with increased Vasoactive Inotrope Score following multivariate analysis in the cohort 2.

Conclusions:

Detectable plasma troponin I at admission to PICU is independently associated with death. The utility of troponin I as a stratification biomarker requires further evaluation.
Development and Assessment of an Advanced Pediatric Airway Management Curriculum With Integrated Intubation Videos
Authors: Nagler Joshua , Nagler Alisa , Bachur Richard G.
Published: July 2016

Objectives

Opportunities to learn advanced airway management skills on pediatric patients in the emergency department are limited. Current strategies have focused largely on traditional didactics coupled with procedural skills training using simulation. However, these approaches are limited in their exposure to anatomic variation and realism. Here, we describe the development and assessment of an advanced airway curriculum that integrates videolaryngoscopic recordings obtained during actual patient intubations into a series of interactive educational sessions.

Methods

Trainees and attending physicians were surveyed anonymously to assess the impact of participation in the curriculum. A mixed methods approach to statistical analysis was used. Rating questions were used to evaluate the relative impact of this approach over other traditional strategies and recurrent themes within open-ended questions were identified.

Results

Participants reported this to be a highly effective means of learning about pediatric laryngoscopy and endotracheal intubation and regarded it more highly than other traditional educational approaches. Identified benefits included repetitive exposure, approaches to laryngoscopy, the realism of teaching using real and varied anatomy, and the opportunities to identify and troubleshoot difficulty in a learning environment.

Conclusions

An advanced pediatric airway curriculum that integrates intubation videos obtained during videolaryngoscopy was highly regarded by pediatric emergency medicine providers. Content emphasis can be shifted to meet the needs of pediatric emergency medicine providers with all levels of skill and experience.
A Prospective Randomized Controlled Trial of Nonpharmacological Pain Management During Intravenous Cannulation in a Pediatric Emergency Department
Authors: Miller Kate , Tan Xianghong , Hobson Andrew Dillon , Khan Asaduzzaman , Ziviani Jenny , O'Brien Eavan , Barua Kim , McBride Craig A. , Kimble Roy M.
Published: July 2016

Objectives

Intravenous (IV) cannulation is commonly performed in pediatric emergency departments (EDs). The busy ED environment is often not conducive to conventional nonpharmacological pain management. This study assessed the use of Ditto (Diversionary Therapy Technologies, Brisbane, Australia), a handheld electronic device which provides procedural preparation and distraction, as a means of managing pain and distress during IV cannulation performed in the pediatric ED.

Methods

A randomized controlled trial with 98 participants, aged 3 to 12 years, was conducted in a pediatric ED. Participants were recruited and randomized into 5 intervention groups as follows: (1) Standard Distraction, (2) PlayStation Portable Distraction, (3) Ditto Distraction, (4) Ditto Procedural Preparation, and (5) Ditto Preparation and Distraction. Children's pain and distress levels were assessed via self-reports and observational reports by caregivers and nursing staff across the following 3 time points: (1) before, (2) during, and (3) after IV cannulation.

Results

Caregivers and nursing staff reported significantly reduced pain and distress levels in children accessing the combined preparation and distraction Ditto protocol, as compared to standard distraction (P ≤ 0.01). This intervention also saw the greatest reduction in pain and distress as reported by the child.

Conclusions

Caregiver reports indicate that using the combined Ditto protocol was most effective in reducing children's pain experiences while undergoing IV cannulation in the ED. The use of Ditto offers a promising opportunity to negotiate barriers to the provision of nonpharmacological approaches encountered in the busy ED environment, and provide nonpharmacological pain-management interventions in pediatric EDs.
Point-Of-Care Ultrasound Findings Associated With Foreign Body Aspiration in the Pediatric Emergency Department
Authors: Weerdenburg Kirstin D. , Kwan Charisse W. , Fischer Jason W.
Published: July 2016

Point-of-care ultrasound (POCUS) continues to generate new and interesting clinical findings as its use expands in the pediatric emergency department. This case report describes the novel findings identified during a POCUS focused lung examination of a pediatric patient with suspected foreign body aspiration.
Diagnosis of a Peritonsillar Abscess by Transcutaneous Point-of-Care Ultrasound in the Pediatric Emergency Department
Authors: Halm Brunhild M. , Ng Carrie , Larrabee Yuna C.
Published: July 2016

We report a case of a pediatric patient with an initial diagnosis of peritonsillar cellulitis made by otolaryngology. The findings from a subsequent transcutaneous point-of-care ultrasound by a pediatric emergency physician directly affected the decision to perform needle aspiration. Sonographic characteristics of a peritonsillar abscess may be helpful in the prompt diagnosis of peritonsillar abscess.
Perceived Ethnic Discrimination and the Metabolic Syndrome in Ethnic Minority Groups: The Healthy Life in an Urban Setting Study
Authors: Ikram Umar Z. , Snijder Marieke B. , Agyemang Charles , Schene Aart H. , Peters Ron J. G. , Stronks Karien , Kunst Anton E.
Published: July 2016

Objective

Ethnic differences in the metabolic syndrome could be explained by perceived ethnic discrimination (PED). It is unclear whether PED is associated with the metabolic syndrome. We assessed this association and quantified the contribution of PED to the metabolic syndrome.

Methods

Baseline data were used from the Healthy Life in an Urban Setting study collected in the Netherlands from 2011 to 2014. The population-based sample included South-Asian Surinamese, African Surinamese, Ghanaian, Turkish, and Moroccan participants (aged 18 to 70 years). PED was measured using the Everyday Discrimination Scale. The metabolic syndrome was determined according to the harmonized definition of the International Diabetes Federation, American Heart Association, and others. Logistic regression was used for analysis. population-attributable fraction was used to calculate the contribution of PED.

Results

PED was positively associated with the metabolic syndrome in South-Asian Surinamese, African Surinamese, and Moroccan participants (odds ratio [95% confidence interval] = 1.13 [0.99–1.30], 1.15 [1.00–1.32], and 1.19 [1.03–1.38], respectively) after adjusting for potential confounders and mediators. No significant association was observed among Ghanaian and Turkish participants. For the individual components, the associations were statistically significant for blood pressure, fasting glucose, and waist circumference among Surinamese participants. PED was associated with dyslipidemia in Moroccan participants. The population-attributable fractions were 5% for South-Asian Surinamese and Moroccan participants, and 7% for African Surinamese participants.

Conclusions

We found a positive association of PED with the metabolic syndrome in some ethnic groups, with PED contributing around 5% to 7% to the metabolic syndrome among Surinamese and Moroccans. This suggests that PED might contribute to ethnic differences in the metabolic syndrome.
Impact of Maternal Lifetime Interpersonal Trauma on Children's Asthma: Mediation Through Maternal Active Asthma During Pregnancy
Authors: Brunst Kelly J. , Rosa Maria José , Jara Calvin , Lipton Lianna R. , Lee Alison , Coull Brent A. , Wright Rosalind J.
Published: July 2016

Objective

Traumatic stressors, including child abuse and/or interpersonal violence over a woman's lifecourse, can affect the health of her children. This study examines the associations between maternal lifetime interpersonal trauma (IPT) and children's asthma by age 6 years (n = 857).

Methods

Pregnant women completed the Revised Conflict Tactics Scale; IPT exposure was categorized as unexposed (55%), early (childhood and/or teen years only, 25%), late (adulthood and/or index pregnancy, 7%), and chronic (early and late, 13%). Clinician-diagnosed asthma in children was reported by mothers at each follow-up visit until the child reached age 6 years. We examined the effects of maternal IPT categories and child's asthma using logistic regression. Using structural equation models, we also examined indirect relationships between maternal chronic IPT and child asthma operating through active asthma in pregnancy, prepregnancy BMI, prenatal smoking, and/or increased exposure to other adverse life events or environmental toxins prenatally. Effect modification by the child's sex was examined.

Results

Mothers were primarily Hispanic (55%) or black (30%) with less than high school education (62%). In logistic regression models, chronic maternal IPT (compared with unexposed) was associated with asthma in boys (odds ratio = 2.87, 95% confidence interval = 1.48–5.57) but not girls (odds ratio = 0.69, 95% confidence interval = 0.23–2.12; p
interaction = .042). In structural equation models, chronic IPT was associated with maternal active asthma in pregnancy (β = 0.59, p < .001), maternal active asthma was associated with children's asthma (β = 0.20, p = .009), and the total indirect effect for this path was significant (β = 0.12, p = .031). Associations were most evident among boys.

Conclusions

Mothers' history of chronic IPT was associated with asthma in boys. This association was mediated through active maternal asthma in pregnancy.
The Association Between Psychiatric Disorders and Telomere Length: A Meta-Analysis Involving 14,827 Persons
Authors: Darrow Sabrina M. , Verhoeven Josine E. , Révész Dóra , Lindqvist Daniel , Penninx Brenda W.J.H. , Delucchi Kevin L. , Wolkowitz Owen M. , Mathews Carol A.
Published: July 2016

Objective

This study examined the relationship between leukocyte telomere length (LTL), a marker of cell aging, and psychiatric disorders in adults compared with controls using meta-analytic methods.

Methods

Data were abstracted from studies examining the relationship between LTL and adult psychiatric disorders. In addition to an overall estimate of effect size, subgroup analyses and meta-regression were performed to examine whether covariates (including psychiatric diagnoses) moderated the estimate.

Results

A significant overall effect size showing LTL shortening was found across all psychiatric disorders (Hedge g = −0.50, p < .001). Subgroup analyses did not demonstrate significant differences in effect size based on individual covariates (psychiatric disorder, sex, age, or assay method). The meta-regression indicated that although type of disorder and, likely, age moderate the overall effect size, the heterogeneity between studies could not be explained by a model that included these variables as well as sex and assay method. Although not significantly different, posttraumatic stress disorder, anxiety disorders, and depressive disorders had comparatively larger effect sizes (−1.27, −0.53, and −0.55), and psychotic and bipolar disorders had comparatively smaller ones (−0.23 and −0.26).

Conclusions

We observed a robust effect size of LTL shortening for psychiatric disorders as a whole compared with controls. The results were less straightforward regarding relative differences in the strength of this association by specific disorder. Future studies should focus on mechanisms explaining accelerated cell aging with psychiatric illness, defining directions (if any) of causality and elucidating possible differences in this association between disorders.
Effects of a Home-Based DVD-Delivered Physical Activity Program on Self-Esteem in Older Adults: Results From a Randomized Controlled Trial
Authors: Awick Elizabeth Ann , Ehlers Diane , Fanning Jason , Phillips Siobhan M. , Wójcicki Thomas , Mackenzie Michael J. , Motl Robert , McAuley Edward
Published: July 2016

Objective

Although center-based supervised physical activity interventions have proved to be successful in attenuating health declines in older adults, such methods can be costly and have limited reach. In the present study, we examined the effects of a DVD-delivered exercise intervention on self-esteem and its subdomains and the extent to which these effects were maintained. In addition, we examined whether psychological, demographic, and biological factors acted as determinants of self-esteem.

Methods

Low-active, older adults (n = 307; mean [standard deviation] age =71.0 [5.1] years) were randomly assigned to a 6-month, home-based exercise program consisting of a DVD-delivered exercise intervention focused on increasing flexibility, toning, and balance (FlexToBa) or an attentional control DVD condition focused on healthy aging. Physical self-worth and three subdomains of self-esteem, global self-esteem, and self-efficacy were assessed at baseline, 6 months, and 12 months.

Results

There was a differential effect of time for the two groups for physical self-worth (F interaction(2,530.10) = 4.17, p = .016) and perception of physical condition (F interaction(1,630.77) = 8.31, p = .004). Self-efficacy, sex, body mass index, and age were significant predictors of changes in physical self-worth and perception of physical condition.

Conclusion

Our findings suggest that a DVD-delivered exercise intervention is efficacious for improving and maintaining subdomain and domain levels of self-esteem in older adults. In addition, self-efficacy was the strongest predictor of changes in physical self-worth and perceptions of physical condition. This innovative method of delivering an exercise training program via DVD is practical and effective and has the potential for broad reach and dissemination.

Trial Registration

Clinicaltrials.gov identifier: NCT01030419.
Effects of Moderate Exercise on Cortical Resilience: A Transcranial Magnetic Stimulation Study Targeting the Dorsolateral Prefrontal Cortex
Authors: Lowe Cassandra J. , Staines William R. , Hall Peter A.
Published: July 2016

Objective

The beneficial effects of exercise on the brain regions that support cognitive control and memory are well documented. However, examination of the capacity of acute exercise to promote cortical resilience—the ability to recover from temporary pertubation—has been largely unexplored. The present study sought to determine whether single session of moderate-intensity aerobic exercise can accelerate recovery of inhibitory control centers in the dorsolateral prefrontal cortex after transient perturbation via continuous theta burst stimulation (cTBS).

Methods

In a within-participants experimental design, 28 female participants aged 18 to 26 years (mean [standard deviation] = 20.32 [1.79] years) completed a session each of moderate-intensity and very light-intensity exercise, in a randomized order. Before each exercise session, participants received active cTBS to the left dorsolateral prefrontal cortex. A Stroop task was used to quantify both the initial perturbation and subsequent recovery effects on inhibitory control.

Results

Results revealed a significant exercise condition (moderate-intensity exercise, very light-intensity exercise) by time (prestimulation, poststimulation, postexercise) interaction (F(2,52) = 5.93,p= .005,d= 0.38). Specifically, the proportion of the cTBS-induced decrement in inhibition restored at 40 minutes postexercise was significantly higher after a bout of moderate-intensity exercise (101.26%) compared with very light-intensity exercise (18.36%;t(27) = −2.17,p= .039,d= −.57, 95% confidence interval = −161.40 to −4.40).

Conclusion

These findings support the hypothesis that exercise promotes cortical resilience, specifically in relation to the brain regions that support inhibitory control. The resilience-promoting effects of exercise have empirical and theoretical implications for how we conceptualize the neuroprotective effects of exercise.
Positive Self-Perceptions of Aging and Lower Rate of Overnight Hospitalization in the US Population Over Age 50
Authors: Sun Jennifer K. , Kim Eric S. , Smith Jacqui
Published: July 2016

Objective

The aging of the baby boomer generation has led to an unprecedented rise in the number of US adults reaching old age, prompting an urgent call for innovative and cost-effective ways to address the increasing health care needs of the aging population. Studying the role of psychosocial factors on health care use could offer insight into how to minimize hospitalizations among older adults.

Methods

We use prospective data from a subsample of 4735 participants (mean [standard deviation] age = 69 [8.79] years, 61% women) from the Health and Retirement Study, a nationally representative study of US adults over age 50, to examine the association between self-perceptions of aging (SPA) and self-reported overnight hospitalizations after adjusting for a comprehensive list of sociodemographic, health-related, and behavioral factors.

Results

Over the 4-year follow-up period, there were a total of 5196 overnight hospitalizations, and 44% of the sample reported being hospitalized overnight at least once. After adjusting for sociodemographic factors, each standard deviation increase in positive SPA was associated with a lower rate of overnight hospitalization (incidence rate ratio = 0.75; 95% confidence interval = 0.71–0.80, p < .001). After dividing respondents into quartiles of SPA, we observed a dose-response relationship with individuals in higher quartiles showing increasingly lower rates of overnight hospitalization.

Conclusions

Positive self-perceptions of aging are associated with a lower rate of hospitalization among older adults over a 4-year period. Future research should examine the factors that contribute to older adults' SPA and explore the pathways through which attitudes toward aging influence the use of health care resources.
What Factors Influence Employee Service Recovery Performance and What Are the Consequences in Health Care?
Authors: Nadiri Halil , Tanova Cem
Published: July 2016

Objectives:

We analyzed the extent to which the service recovery performance of frontline employees in private health care institutions is influenced by employee perceptions of manager attitudes toward service quality, workplace support, and manager fairness and organizational commitment. We also examined the relationship of service recovery performance to employee job satisfaction and turnover intentions.

Methods:

Partial least square path modeling of data from 178 frontline employees in private health care institutions in North Cyprus was utilized.

Results:

Although empowerment and role clarity were positively related to service recovery performance, perceived managerial attitudes toward hospital customer service, teamwork, and customer service-oriented training as indicators of workplace support were not related to frontline employees' service recovery performance. Organizational justice was related to affective commitment, which in turn was related to service recovery performance. Although service recovery performance was not related to employee turnover intentions, it was related to job satisfaction.

Conclusion:

Managerial implications of these study findings are presented in the light of the cognitive evaluation theory. Health services differ from other service organizations in the way that intrinsic and extrinsic rewards influence the service recovery efforts of frontline employees. To ensure high quality services, managers should focus on intrinsic rewards, empower and give more autonomy to staff.
The Effects of Preoperative Endoscopic Tattooing on Distal Surgical Margin and Ileostomy Rates in Laparoscopic Rectal Cancer Surgery: A Prospective Randomized Study
Authors: Cipe Gokhan , Cengiz Merve B. , Idiz Ufuk O. , Yardimci Erkan , Malya Umit , Firat Deniz , Muslumanoglu Mahmut
Published: July 2016

Aim:

This study aimed to evaluate the effect of endoscopic marking on the distal surgical margin and ileostomy rates in laparoscopic rectal cancer surgery.

Materials and Methods:

Forty patients, who underwent surgery between September 2012 and December 2013 for rectal cancer limited to or with invasion of the upper rectum, were included in the study. The distal tumor margin was marked with purified carbon particles by colonoscopy before surgery in one group (n=20); no marking was performed in the second group (n=20). Patients were assigned randomly to each group. Laparoscopic anterior or low-anterior resection was performed in all patients. Demographic and operative data, pathology results, morbidity, and ileostomy rates were measured.

Results:

There was no statistically significant difference in the demographic data, the tumor size, the amount of bleeding, the specimen length, the harvested lymph node number, postoperative complications, the length of hospital stay, rehospitalization, and the operation duration between groups 1 and 2, respectively. The distal surgical margin was significantly shorter in the marked group. The protective ileostomy rates were also lower in the marked group; however, the difference did not reach statistical significance.

Conclusions:

Preoperative endoscopic tattooing decreases distal resection margins and may reduce protective ileostomy rates in laparoscopic rectal surgery.
Comparison of the Effect of Instrument Type on Transanal Endoscopic Surgery Learning Curves
Authors: Teitelbaum Ezra N. , Arafat Fahd O. , Boller Anne-Marie
Published: July 2016

Background:

Transanal endoscopic surgery (TES) can be technically difficult due to the constraints of operating through a narrow proctoscope channel. In this study, we compared the performance of surgical novices using instruments with and without articulating shafts to perform a simulated TES task.

Methods:

Medical students each performed 10 repetitions of the Fundamentals of Laparoscopic Surgery circle-cut task. Participants were randomized into 3 groups: 2 performed the task through a TES proctoscope using scissors with either a rigid (TES-R) or articulating (TES-A) shaft. The third group performed the task laparoscopically (LAP).

Results:

A total of 31 medical students participated. The LAP group had a faster mean task time than both the TES-R and TES-A groups (LAP 201±120 s vs. TES-R 362±212 s and TES-A 405±212 s, both P <0.001). The TES-R group made more errors (ie, deviation from a perfect circle) than both the other groups. The TES-R group adjusted the proctoscope position during more repetitions than the TES-A group.

Conclusions:

Students had faster task times when operating laparoscopically than through a TES protoscope. Task times were similar between the TES groups using scissors with articulating and rigid shafts; however, use of the articulating instruments resulted in fewer errors and less need to adjust proctoscope position.
Prevention and management of osteonecrosis of the jaw secondary to bone-targeted therapy in patients with kidney cancer
Authors: Ripamonti Carla I. , Lucchesi Maurizio , Giusti Raffaele
Published: July 2016

Purpose of review

The aim of this revision is prevention and management of osteonecrosis of the jaw (ONJ) secondary to bone-targeted therapy in patients with kidney cancer.

Recent findings

Patients with kidney cancer treated with zoledronate suffered from ONJ earlier compared with patients with breast cancer or multiple myeloma; among men, ONJ occurred at 24 months of zoledronic acid treatment in more than 80% of the patients and much earlier, in respect to patients with prostate cancer or multiple myeloma. Protective factors against an ONJ can be sequential prescription of different bisphosphonates and female sex. Less data are available on ONJ secondary to denosumab administration in patients with kidney cancer.

Bone metastases, developing in about 30% of the patients with metastatic renal cell carcinoma, are typically osteolytic on imaging and cause significant morbidity and poor quality of life. Incidence of skeletal-related events has been reported to reach 3.38 per year in such patients. To decrease the incidence of ONJ, a maxillofacial examination must be performed in all patients before treatment with bisphosphonates, in particular in patients with metastatic renal cell carcinoma treated with sunitinib alone or in association with zoledronate. The management of ONJ consider a conservative approach.
Hard and soft sustainability disclosures: Australia’s resources industry
Authors: Ong Tricia , Trireksani Terri , Djajadikerta Hadrian Geri
Published: July 2016

Purpose

Although studies in corporate sustainability have been vastly growing, there has been an increasing demand for more industry-specific sustainability reporting studies to develop a greater understanding of industry differences in sustainability reporting practice. This study aims to measure the quality of sustainability disclosures in the current leading environmentally sensitive industry in Australia – the resources industry.

Design/methodology/approach

A scoring index was developed to measure economic, social and environmental aspects of sustainability by integrating the fundamental principles of the hard and soft disclosure items from Clarkson et al.’s (2008) environmental index into the social and economic aspects of the Global Reporting Initiative framework. Subsequently, the index was used to assess sustainability disclosures in the annual and sustainability reports of resources companies in Australia.

Findings

The main findings show that companies report more of soft disclosure items than the hard ones. It is also found that companies report most sustainability information in the economic aspect rather than the social and the environmental aspects of sustainability. Most companies disclose sustainability information in their annual reports with few companies producing stand-alone sustainability reports.

Originality/value

This study addresses the need for more industry-specific sustainability studies by focusing on Australia’s resources industry. It also contributes to the lack of an existing tool to measure disclosures based on companies’ true contributions to sustainability by developing a new scoring index for hard and soft sustainability disclosures, which includes all three aspects of sustainability (i.e. economic, environmental and social).
Delay-independent stabilization of nonlinear systems with multiple time-delays and its application in chaos synchronization of Rössler system
Authors: He Ping , Fan Tao
Published: July 2016

Purpose

– The purpose of this paper is with delay-independent stabilization of nonlinear systems with multiple time-delays and its application in chaos synchronization of Rössler system.

Design/methodology/approach

– Based on linear matrix inequality and algebra Riccati matrix equation, the stabilization result is derived to guarantee asymptotically stable and applicated in chaos synchronization of Rössler chaotic system with multiple time-delays.

Findings

– A controller is designed and added to the nonlinear system with multiple time-delays. The stability of the nonlinear system at its zero equilibrium point is guaranteed by applying the appropriate controller signal based on linear matrix inequality and algebra Riccati matrix equation scheme. Another effective controller is also designed for the global asymptotic synchronization on the Rössler system based on the structure of delay-independent stabilization of nonlinear systems with multiple time-delays. Numerical simulations are demonstrated to verify the effectiveness of the proposed controller scheme.

Originality/value

– The introduced approach is interesting for delay-independent stabilization of nonlinear systems with multiple time-delays and its application in chaos synchronization of Rössler system.
AASB 138: catalyst for managerial decisions reducing R&D spending?
Authors: Steenkamp Natasja , Steenkamp Shaun
Published: July 2016

Purpose

This paper aims to investigate if the more stringent requirements of AASB 138, effective 1 January 2005, regarding capitalising research and development (R&D) spending could have been a catalyst for changes in managerial decisions that consequently resulted in reduced R&D spending in Australian companies.

Design/methodology/approach

Financial data of 31 Australian listed firms for financial years from 2001 to 2010 were used. Companies were classified as either capitalisers or non-capitalisers. A regression model was used to ascertain whether managers reduced R&D spending to manage earnings to attain short-term goals. Also, the research intensity ratios were calculated to determine trends in R&D spending of the two groups.

Findings

The pursuit of choosing short-term earnings targets to the detriment of long-term returns is referred to as short-termism. This study found a marked increase in the significance of short-termism in explaining changes in R&D of capitalisers before 2005. Furthermore, the median research intensity ratio of capitalisers declined almost three times that of non-capitalisers after the introduction of AASB 138. These findings suggest that AASB 138 could have been a catalyst for changes in managerial decisions in pursuit of short-termism, resulting in reduced R&D spending as a means to manage earnings.

Originality/value

This study is useful to standard setters and board of directors as it alerts them about the potential adverse effect AASB 138 might have on the survivability and competitiveness of Australian companies and hence the Australian economy.
The relationship between adherence of internal audit with standards and audit fees
Authors: Alzeban Abdulaziz , Sawan Nedal
Published: July 2016

Purpose

This study aims to examine the relationship between external audit fees and the adherence of internal audit with the International Standards for the Professional Practice of Internal Auditing (ISPPIA), i.e. whether such adherence has a relation with lower or higher audit fees.

Design/methodology/approach

Data were gathered from the annual reports and 229 chief internal auditors (CIAs) from UK companies listed on the London Stock Exchange.

Findings

The result suggests that, in fact, higher external audit fee is related with adherence with both attribute and performance standards. Also, there is an association between audit fees and budget for the internal audit with longer tenure of the CIA.

Originality/value

Given the lack of attention to the potential impact of the ISPPIA on audit fees by previous researchers, any insight provided by the study in this regard will represent a valuable contribution to the literature in complementing what already exists and pointing the way to further research opportunities.