bluuebunny/crossref_metadata_2025 huggingface dataset:
Fidelity scales and performance measures to support implementation and quality assurance for first episode psychosis services
Authors: Addington Donald , Birchwood Maximillian , Jones Peter , Killackey Eoin , McDaid David , Melau Marianne , Mizuno Masafumi , Mueser Kim , Nordentoft Merete
Published: June 2018

Aim

The purpose of this paper is to review fidelity and outcome measures which can be used to support broad implementation of first episode psychosis services and ensure quality of existing services. First episode psychosis services use a combination of evidence‐based practices to improve the outcome of a first episode of psychosis and the early stages of schizophrenia. Now that there is an established international evidence base to show that they are effective, efforts are being made to make such services widely available as a routine part of health care.

Methods

We provide an overview of the literature from the perspective of an expert task force that was commissioned to report to the board of the International Early Psychosis Association IEPA. First, we examined the evidence‐based components that underpin first episode psychosis services and identified common elements. Next, we reviewed the availability of fidelity measures and outcome indicators, finally we reviewed how broadly these services are delivered internationally, and the barriers to ensuring broad access to quality services.

Results

There is a growing consensus about the elements required to deliver effective services. Fidelity scales and performance measures are available to assess quality, access, and outcome. First episode psychosis services are variably offered in high‐income countries and rarely with attention to access and quality of services. Several strategies to promote implementation are identified.

Conclusions

Fidelity scales and outcome measure are valuable resources to support widespread implementation and quality assurance for first episode psychosis services.
The strengths of the genetic approach to understanding neural systems development and function: Ray Guillery's synthesis
Authors: LaMantia Anthony‐Samuel
Published: June 2018

The organization and function of sensory systems, especially the mammalian visual system, has been the focus of philosophers and scientists for centuries—from Descartes and Newton onward. Nevertheless, the utility of understanding development and its genetic foundations for deeper insight into neural function has been debated: Do you need to know how something is assembled—a car, for example—to understand how it works or how to use it—to turn on the ignition and drive? This review addresses this issue for sensory pathways. The pioneering work of the late Rainer W. (Ray) Guillery provides an unequivocal answer to this central question: Using genetics for mechanistic exploration of sensory system development yields essential knowledge of organization and function. Ray truly built the foundation for this now accepted tenet of modern neuroscience. His work on the development and reorganization of visual pathways in albino mammals—all with primary genetic mutations in genes for pigmentation—defined the genetic approach to neural systems development, function and plasticity. The work that followed his lead in a variety of sensory systems, including my own work in the developing olfactory system, proceeds directly from Ray's fundamental contributions.
Heterogeneity of retinogeniculate axon arbors
Authors: Hong Y. Kate , Burr Eliza F. , Sanes Joshua R. , Chen Chinfei
Published: June 2018

The retinogeniculate synapse transmits information from retinal ganglion cells (RGC) in the eye to thalamocortical relay neurons in the visual thalamus, the dorsal lateral geniculate nucleus (dLGN). Studies in mice have identified genetic markers for distinct classes of RGCs encoding different features of the visual space, facilitating the dissection of RGC subtype‐specific physiology and anatomy. In this study, we examine the morphological properties of axon arbors of the BD‐RGC class of ON‐OFF direction selective cells that, by definition, exhibit a stereotypic dendritic arbor and termination pattern in the retina. We find that axon arbors from the same class of RGCs exhibit variations in their structure based on their target region of the dLGN. Our findings suggest that target regions may influence the morphologic and synaptic properties of their afferent inputs.
The Creation of a Hybrid and Innovative Model of Occupational Health Delivery through the Lens of Institutional Work
Authors: Valsecchi Raffaella , Anderson Neil , Balta Maria , Harrison John
Published: June 2018

By applying the lenses of institutional work, this study presents an empirical analysis on how agents create and manage a hybrid virtual organization to provide an innovative solution to the problem of the lack of occupational health (OH) services among small businesses. We specifically focus on how these actors exploit and balance the prescriptions of different logics within this hybrid organization. Our qualitative study showed that the funders manage this virtual social enterprise through two main strategies: ‘commitment to the social mission’ and ‘support for the social mission’. The first strategy shows how the social mission helped a diverse group of funders and employees to work together as a team. The second strategy assists these actors to grant the maintenance and justify the existence of this novel organization, which provides immense societal benefits but could not support itself financially. This article shows how a hybrid organizations’ capacity for innovation and societal advantages depends on the ability to rely on multiple logics and simultaneously to shift the attention on the social mission as a catalytic force for its survival.
Temporal dynamics of genetic clines of invasive European green crab (Carcinus maenas) in eastern North America
Authors: Lehnert Sarah J. , DiBacco Claudio , Jeffery Nicholas W. , Blakeslee April M. H. , Isaksson Jonatan , Roman Joe , Wringe Brendan F. , Stanley Ryan R. E. , Matheson Kyle , McKenzie Cynthia H. , Hamilton Lorraine C. , Bradbury Ian R.
Published: June 2018

Two genetically distinct lineages of European green crabs (Carcinus maenas) were independently introduced to eastern North America, the first in the early 19th century and the second in the late 20th century. These lineages first came into secondary contact in southeastern Nova Scotia, Canada (NS), where they hybridized, producing latitudinal genetic clines. Previous studies have documented a persistent southward shift in the clines of different marker types, consistent with existing dispersal and recruitment pathways. We evaluated current clinal structure by quantifying the distribution of lineages and fine‐scale hybridization patterns across the eastern North American range (25 locations, ~39 to 49°N) using informative single nucleotide polymorphisms (SNPs; n = 96). In addition, temporal changes in the genetic clines were evaluated using mitochondrial DNA and microsatellite loci (n = 9–11) over a 15‐year period (2000–2015). Clinal structure was consistent with prior work demonstrating the existence of both northern and southern lineages with a hybrid zone occurring between southern New Brunswick (NB) and southern NS. Extensive later generation hybrids were detected in this region and in southeastern Newfoundland. Temporal genetic analysis confirmed the southward progression of clines over time; however, the rate of this progression was slower than predicted by forecasting models, and current clines for all marker types deviated significantly from these predictions. Our results suggest that neutral and selective processes contribute to cline dynamics, and ultimately, highlight how selection, hybridization, and dispersal can collectively influence invasion success.
Recent advances in conservation and population genomics data analysis
Authors: Hendricks Sarah , Anderson Eric C. , Antao Tiago , Bernatchez Louis , Forester Brenna R. , Garner Brittany , Hand Brian K. , Hohenlohe Paul A. , Kardos Martin , Koop Ben , Sethuraman Arun , Waples Robin S. , Luikart Gordon
Published: June 2018

New computational methods and next‐generation sequencing (NGS) approaches have enabled the use of thousands or hundreds of thousands of genetic markers to address previously intractable questions. The methods and massive marker sets present both new data analysis challenges and opportunities to visualize, understand, and apply population and conservation genomic data in novel ways. The large scale and complexity of NGS data also increases the expertise and effort required to thoroughly and thoughtfully analyze and interpret data. To aid in this endeavor, a recent workshop entitled “Population Genomic Data Analysis,” also known as “ConGen 2017,” was held at the University of Montana. The ConGen workshop brought 15 instructors together with knowledge in a wide range of topics including NGS data filtering, genome assembly, genomic monitoring of effective population size, migration modeling, detecting adaptive genomic variation, genomewide association analysis, inbreeding depression, and landscape genomics. Here, we summarize the major themes of the workshop and the important take‐home points that were offered to students throughout. We emphasize increasing participation by women in population and conservation genomics as a vital step for the advancement of science. Some important themes that emerged during the workshop included the need for data visualization and its importance in finding problematic data, the effects of data filtering choices on downstream population genomic analyses, the increasing availability of whole‐genome sequencing, and the new challenges it presents. Our goal here is to help motivate and educate a worldwide audience to improve population genomic data analysis and interpretation, and thereby advance the contribution of genomics to molecular ecology, evolutionary biology, and especially to the conservation of biodiversity.
Impact of supplementation on deleterious mutation distribution in an exploited salmonid
Authors: Ferchaud Anne‐Laure , Laporte Martin , Perrier Charles , Bernatchez Louis
Published: June 2018

Deleterious mutations have important implications for the evolutionary trajectories of populations. While several studies recently investigated the dynamics of deleterious mutations in wild populations, no study has yet explored the fate of deleterious mutations in a context of populations managed by supplementation. Here, based on a dataset of nine wild and 15 supplemented Lake Trout populations genotyped at 4,982 single nucleotide polymorphisms (SNP)s by means of genotype by sequencing (GBS), we explored the effect of supplementation on the frequency of putatively deleterious variants. Three main findings are consequential for the management of fish populations. First, an increase in neutral genetic diversity in stocked populations compared with unstocked ones was observed. Second, putatively deleterious mutations were more likely to be found in unstocked than in stocked populations, suggesting a lower efficiency to purge deleterious mutations in unstocked lakes. Third, a population currently used as a major source for supplementation is characterized by several fixed putatively deleterious alleles. Therefore, other source populations with lower abundance of putatively deleterious mutations should be favored as sources of supplementation. We discuss management implications of our results, especially pertaining to the joint identification of neutral and deleterious mutations that could help refining the choice of source and sink populations for supplementation in order to maximize their evolutionary potential and to limit their mutation load.
Ranking intuitionistic fuzzy numbers at levels of decision‐making and its application
Authors: Chutia Rituparna , Saikia Sunayana
Published: June 2018

In this paper, a new method of ranking trapezoidal intuitionistic fuzzy numbers has been introduced based on the concept of value and ambiguity at different levels of decision‐making. The concept of decision levels α for the membership function and β for the non‐membership function called as the flexibility parameters have been introduced in ranking these types of fuzzy numbers. If the flexibility parameters α is close to maximum membership degree of the membership function and β close to minimum membership degree of non‐membership function, then a high‐level decision is made. Likewise, if the flexibility parameters α is close to minimum membership degree of membership function and β close to maximum membership degree of non‐membership function, then a low‐level decision is made. Again, if the flexibility parameters α and β lie between minimum membership degree of the membership function and maximum membership degree of the non‐membership function, then an intermediate decision is made. This phenomenon of the proposed method is an attractive feature as it allows the decision‐maker to make a choice on the levels of decision. Further, the rationality validation of the proposed method has been checked by proving some of the Wang and Kerre's reasonable properties on ordering fuzzy quantities.
Genetic interaction is associated with lower metabolic connectivity and memory impairment in clinically mild Alzheimer's disease
Authors: Chang Y.‐T. , Huang C.‐W. , Huang S.‐H. , Hsu S.‐W. , Chang W.‐N. , Lee J.‐J. , Chang C.‐C.
Published: June 2018

Metabolic connectivity as showed by [18F] fluorodeoxyglucose (FDG) positron emission tomography (FDG‐PET) reflects neuronal connectivity. The aim of this study was to investigate the genetic impact on metabolic connectivity in default mode subnetworks and its clinical‐pathological relationships in patients with Alzheimer's disease (AD). We separately investigated the modulation of 2 default mode subnetworks, as identified with independent component analysis, by comparing APOE‐ε4 carriers to noncarriers with AD. We further analyzed the interaction effects of APOE (APOE‐ε4 carriers vs noncarriers) with PICALM (rs3851179‐GG vs rs3851179‐A‐allele carriers) on episodic memory (EM) deficits, reduction in cerebral metabolic rate for glucose (CMRgl) and decreased metabolic connectivity in default mode subnetworks. The metabolic connectivity in the ventral default mode network (vDMN) was positively correlated with EM scores (β =0.441, P < .001). The APOE‐ε4 carriers had significantly lower metabolic connectivity in the vDMN than the APOE‐ε4 carriers (t(96) = −2.233, P = .028). There was an effect of the APOE‐PICALM (rs3851179) interactions on reduced CMRgl in regions of vDMN (P < .001), and on memory deficits (F3,93 =5.568, P = .020). This study identified that PICALM may modulates memory deficits, reduced CMRgl and decreased metabolic connectivity in the vDMN in APOE‐ε4 carriers. [18F] FDG‐PET‐based metabolic connectivity may serve a useful tool to elucidate the neural networks underlying clinical‐pathological relationships in AD.
The water–energy–food nexus at home: New opportunities for policy interventions in household sustainability
Authors: Foden Mike , Browne Alison L. , Evans David M. , Sharp Liz , Watson Matt
Published: June 2018

The nexus of water–energy–food (WEF) is as apparent at the household scale as it is anywhere else. We introduce the “Nexus at Home” as a starting point for exploring the dynamics of WEF resource use and household sustainability. Drawing on two research projects we focus specifically on domestic kitchens as a site where practices of cooking, eating, cleaning and disposing of waste come together. While these practices have long been targets for policy intervention, existing approaches draw on a limited range of perspectives from the social sciences. Reflecting on our work with four non‐academic partners (Defra, BEIS, FSA, Waterwise), we consider how social practice and geographies of household sustainability research might be combined with the dictum of “nexus thinking” to re‐imagine the framing of policy and intervention to reduce the resource intensity of everyday life. Synthesising existing “home practices” literature in the context of the “live” policy problems raised by our partners, we seek to provide clear guidance for intervening in kitchen practices. We draw on one topic which has not yet been the subject of social practices research: fats, oils and grease (FOG) going down the kitchen plughole and contributing to widespread sewer blockages. In doing so we document the sequence of interrelated food provisioning activities through which WEF is put to use in domestic kitchens and contributes to FOG blockages in sewers. We reflect upon the multiple ways these practices are shaped by the rhythms of daily life, dynamics within the home, wider cultural conventions, and infrastructures. This paper contributes to the nascent transdisciplinary research agenda of translating home practices research into wider conceptualisations of “intervention,” with a specific orientation towards academic and non‐academic stakeholders who are interested in influencing systems of sustainable consumption and production within, and across, the WEF sectors.
Influence of dental factors on oropharyngeal dysphagia among recipients of long‐term care
Authors: Brochier Cassiane Wigner , Hugo Fernando Neves , Rech Rafaela Soares , Baumgarten Alexandre , Hilgert Juliana Balbinot
Published: June 2018

Objective

The study evaluated the association of the sociodemographic, behavioural variables and the oral conditions with the presence of oropharyngeal dysphagia in long‐term care older persons.

Background

Due to the influence of ageing, swallowing may be altered both in people with natural teeth and in those who have dentures or tooth loss.

Materials and methods

This cross‐sectional study evaluated 115 individuals older than 60 years, living in long‐term care institutions of the State of Rio Grande do Sul in 2016. The diagnosis of dysphagia happen using a clinical speech evaluation, based on the research of signals and symptoms of alterations during deglutition, and on an oral sensory‐motor evaluation. The dental clinical evaluation examined the oral cavity, teeth and dental prostheses, including a Xerostomia assessment. Poisson Regressions with robust variance was calculated were used to estimate crude and adjusted Prevalence Ratios(PR) and their IC95%.

Results

The sample was mostly comprised of older women (67.0%), with more than 81 years of age (44.3%) and edentulous (54.3%). Diagnosis of oropharyngeal dysphagia was verified in 60.9% of the participants. In the final model, older persons who presented no pair (PR=1.52(CI95%=1.02‐2.40)) had a highest prevalence of oropharyngeal dysphagia, when compared to older persons who presented 8 to 14 mixed pairs, as well as those older persons who had more complaints related to symptoms of Xerostomia (PR=2.86(CI95% 1.58‐5.18)).

Conclusion

Institutionalised older persons with a poor oral health condition are associated with a higher prevalence of oropharyngeal dysphagia, as well as with the presence of Xerostomia.
Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016
Authors: Minakuchi Shunsuke , Tsuga Kazuhiro , Ikebe Kazunori , Ueda Takayuki , Tamura Fumiyo , Nagao Kan , Furuya Junichi , Matsuo Koichiro , Yamamoto Ken , Kanazawa Manabu , Watanabe Yutaka , Hirano Hirohiko , Kikutani Takeshi , Sakurai Kaoru
Published: June 2018

Background

There is growing international interest in identifying the effects of ageing on oral health and on appropriate strategies for managing oral disorders. The Japanese Society of Gerodontology (JSG), as the official representative of researchers and clinicians interested in geriatric dentistry in Japan, makes several recommendations on the concept of “oral hypofunction.”

Aims

This study proposes diagnostic criteria and management strategies to reduce the risk of oral hypofunction among older people.

Conceptual Framework

We define oral hypofunction as a presentation of 7 oral signs or symptoms: oral uncleanness; oral dryness; decline in occlusal force; decline in motor function of tongue and lips; decline in tongue pressure; decline in chewing function; and decline in swallowing function. The criteria of each symptom were determined based on the data of previous studies, and oral hypofunction was diagnosed if the criteria for 3 or more signs or symptoms were met.

Conclusions

We recommend that more evidence should be gathered from clinical studies and trials to clarify our diagnostic criteria and management strategies.
Disturbing the AcademicConferenceMachine: Post‐qualitative re‐turnings
Authors: Benozzo Angelo , Carey Neil , Cozza Michela , Elmenhorst Constanse , Fairchild Nikki , Koro‐Ljungberg Mirka , Taylor Carol A.
Published: June 2018

Author 1:

They say they want to disturb the AcademicConferenceMachine.

Author 34:

What is an AcademicConferenceMachine?

Author 2:

Please do not go in that direction. Ask, for example, what does an AcademicConferenceMachine do?

Author 51:

Ok, so what does it do?

Author 6:

AcademicConferenceMachines are becoming so regulated and standardized that they might lose the possibility to produce different knowledge and to produce knowledge differently.

Author 227:

Do you think they succeeded?

Author 9999:

I do not know.
Imagining new feminist futures: How feminist social movements contest the neoliberalization of feminism in an increasingly corporate‐dominated world
Authors: Grosser Kate , McCarthy Lauren
Published: June 2018

Increasingly it is argued that feminism has been co‐opted by neoliberal agendas: becoming more individualistic and losing touch with its wider social change objectives. The neoliberalization of feminism is driven in part by increased corporate power, including the growing role of corporations in governance arenas, and corporate social responsibility agendas. However, we turn to social movement theory to elucidate strategies that social movements, including feminist social movements, are adopting in such spaces. In so doing, we find that feminist activists are engaging with new political opportunities, mobilizing structures and strategic framing processes that emerge in the context of increasingly neoliberal and privatized governance systems. We suggest that despite the significant challenges to their agendas, far from being co‐opted by neoliberalism, feminist social movements remain robust, existing alongside and developing new strategies to contest the neoliberalization of feminism in a variety of innovative ways.
Legitimizing leisure experiences as emotional work: A post‐humanist approach to gendered equine encounters
Authors: Finkel Rebecca , Danby Paula
Published: June 2018

Due to changes in lifestyle and work patterns, education and values associated with wellbeing, non‐human animals are now incorporated into a range of human experiences and environments. This research specifically focuses on human–equine relations, examining blurred boundaries between therapeutic and recreational interspecies encounters. It is acknowledged that human–equine relations are often gendered and this research focuses mainly on women's narratives. Viewed through the post‐humanist lens, horses now form kinship and companionship roles, particularly for women, where relations have become mutually emotionally dependent as a result of interspecies communication and embodied encounters. Research utilizes feminist post‐humanist and cultural politics of emotion frameworks associate with the co‐agency on the co‐agency of animals. Embedded in the concept of equiscapes, or post‐humanist leisure spaces, research methods employ qualitative approaches, including in‐depth interviews, participant diaries and multispecies ethnography. Findings reveal how women make considerable investments in equine activities, which develops mutual welfare and wellbeing. Yet, despite these benefits, emotional and other expenditures are justified in work discourses to legitimize them as valuable to themselves, their families and their communities.
The interactions between iron and copper in genetic iron overload syndromes and primary copper toxicoses in Japan
Authors: Tatsumi Yasuaki , Kato Ayako , Kato Koichi , Hayashi Hisao
Published: June 2018

Iron and copper are trace elements essential for health, and iron metabolism is tightly regulated by cuproproteins. Clarification of the interactions between iron and copper may provide a better understanding of the pathophysiology and treatment strategy for hemochromatosis, Wilson disease, and related disorders. The hepcidin/ferroportin system was used to classify genetic iron overload syndromes in Japan, and ceruloplasmin and ATP7B were introduced for subtyping Wilson disease into the severe hepatic and classical forms. Interactions between iron and copper were reviewed in these genetic diseases. Iron overload syndromes were classified into pre‐hepatic iron loading anemia and aceruloplasminemia, hepatic hemochromatosis, and post‐hepatic ferroportin disease. The ATP7B‐classical form with hypoceruloplasminemia has primary hepatopathy and late extra‐hepatic complications, while the severe hepatic form is free from ATP7B mutation and hypoceruloplasminemia, and silently progresses to liver failure. A large amount of iron and trace copper co‐exist in hepatocellular dense bodies of all iron overload syndromes. Cuproprotein induction to stabilize excess iron should be differentiated from copper retention in Wilson disease. The classical form of Wilson disease associated with suppressed hepacidin25 secretion may be double‐loaded with copper and iron, and transformed to an iron disease after long‐term copper chelation. Iron disease may not be complicated with the severe hepatic form with normal ferroxidase activity. Hepatocellular dense bodies of iron overload syndromes may be loaded with a large amount of iron and trace copper, while the classical Wilson disease may be double‐loaded with copper and iron.
Steroidogenesis in ovarian‐like mesenchymal stroma of hepatic and pancreatic mucinous cystic neoplasms
Authors: Kumata Hiroyuki , Murakami Keigo , Ishida Kazuyuki , Miyagi Shigehito , Arakawa Atsushi , Inayama Yoshiaki , Kinowaki Keiichi , Ochiai Atsushi , Kojima Motohiro , Higashi Michiyo , Moritani Suzuko , Kuwahara Kyoko , Nakatani Yukio , Kajiura Dai , Tamura Gen , Kijima Hiroshi , Yamakawa Mitsunori , Shiraishi Taizo , Inadome Yukinori , Murakami Kazuhiro , Suzuki Hiroyoshi , Sawai Takashi , Unno Michiaki , Kamei Takashi , Sasano Hironobu
Published: June 2018

Steroidogenesis in hepatic mucinous cystic neoplasm

Aim

Mucinous cystic neoplasms (MCNs) occur in the ovary, pancreas, and retroperitoneum but very rarely in the liver. Mucinous cystic neoplasms are known to harbor ovarian‐like mesenchymal stroma (OLS) expressing progesterone and estrogen receptors. In this study we evaluated steroidogenesis in OLS of 25 hepatic MCNs and 24 pancreatic MCNs.

Methods

Both steroid receptors and steroidogenic factors were immunohistochemically evaluated using H‐scores and results were compared with those in 15 ovarian MCNs and 10 normal ovaries.

Results

Androgen receptor (AR) H‐scores in OLS were significantly higher in hepatic, pancreatic, and ovarian MCN than those in normal ovaries. H‐scores of cytochrome P450 17α‐hydroxylase/c17–20 lyase (P450c17) and 5α‐reductase‐1 (5αRED‐1) in the stroma were significantly higher in OLS of hepatic and pancreatic MCN than in the stroma of ovarian MCN and normal ovary. In tumor epithelium, AR H‐scores were significantly higher in hepatic and pancreatic MCN than in ovarian MCN. In both hepatic and pancreatic MCN, a significant positive correlation was detected between AR H‐score in the epithelium and P450c17 H‐score in OLS (hepatic MCN: Pearson's r = 0.446, P = 0.025; pancreatic MCN: r = 0.432, P = 0.035). In pancreatic MCN, a significantly positive correlation was detected between AR H‐score in the tumor epithelium and 5αRED‐1 H‐score in OLS (Pearson's r = 0.458, P = 0.024).

Conclusions

These results indicated that locally produced androgens in OLS could be pivotal for tumorigenesis of both hepatic and pancreatic MCN and influence epithelial cells, possibly in a paracrine fashion, which could represent biological significance of OLS in these neoplasms.
Ultrasound‐guided microfoam sclerotherapy with polidocanol for symptomatic giant hepatic cyst: Initial experience
Authors: Eso Yuji , Furuta Akihiro , Takai Atsushi , Takahashi Ken , Ueda Yoshihide , Marusawa Hiroyuki , Seno Hiroshi
Published: June 2018

Aim

In cases of symptomatic giant hepatic cysts, appropriate treatment is required to relieve symptoms. Ethanol, minocycline hydrochloride, and ethanolamine oleate have been conventionally used for ultrasound (US)‐guided sclerotherapy. However, liquid sclerosing agents could mix with the residual fluid in the cyst and reduce their sclerotic effects. We carried out US‐guided microfoam sclerotherapy using polidocanol for three patients and evaluated its efficacy and safety.

Methods

Between May 2016 and March 2017, three female patients with symptomatic giant hepatic cysts were referred to our hospital. All of them were prospectively included in this study.

Results

The maximum diameters of the hepatic cysts in the three patients were 92 × 89 × 86 mm, 155 × 119 × 140 mm, and 223 × 195 × 123 mm, respectively. Polidocanol microfoam was successfully administered through an 8.5‐Fr pigtail catheter for all patients. One, two, and three microfoam sclerotherapy sessions were undertaken according to the initial cyst volume for cases 1, 2, and 3, respectively. The mean reduction rates of the cyst volume were 90.1% (85.5–98.9%) at 3 months, 96.3% (91.9–99.9%) at 6 months, and 99.5% (99.1–99.9%) at 9 months after treatment. No significant treatment‐induced adverse effects were observed.

Conclusion

Ultrasound‐guided microfoam sclerotherapy using polidocanol could be an effective and safe method for the treatment of symptomatic giant liver cysts.
Innovation, engagement and development: moving forward in health information settings
Authors: Spring Hannah
Published: June 2018

The current trends influencing change in health information and library settings are presenting some exciting new opportunities for health information specialists. Increasingly, knowledge specialists are playing a pivotal role in the effective mobilisation of knowledge and evidence. The focus for our profession will continue to be on demonstrating the value and impact of our services, but a shift in expectations about how those services are delivered will need to be underpinned by new tools and skill sets. These issues are reflected in the themes of the Health Libraries Group 2018 conference, and in conjunction with the event, this virtual issue draws together a collection of articles reflecting those themes. Topics covered in the virtual issue include the following: Toolkits, online systems and emergent technologies to support health information practice; Continuing professional development; Community projects, engagement, outreach and public health; Value and impact and evidence‐based practice; Service improvement and library management; and Digital and health literacy. The papers selected for this issue provide some excellent examples of how we, as a profession, are initiating change in creative ways and rising to the exciting challenges of the future.
Corrective effects of maternal extreme flexure and hip abduction combined with contralateral side‐lying on persistent foetal occipito‐posterior position
Authors: Liu Lan‐ping , Chen Jiu‐hong , Yang Zhi‐juan , Zhu Jun
Published: June 2018

Aims

To observe the corrective effects of maternal extreme flexure and hip abduction combined with contralateral side‐lying on persistent foetal occipito‐posterior position.

Background

Digital rotation and other methods are used for correction of a persistent foetal occipito‐posterior position. However, digital rotation readily causes damage to mother and foetus, and the correction rates of other methods are low.

Design

In this observational study, pregnant women were randomly divided into 2 groups according to different postures and their outcomes were compared.

Methods

A total of 238 women with persistent foetal occipito‐posterior position gave birth in our hospital between January 2015 and June 2017. Of these 238 cases, 12 women declined to participate. The 226 pregnant women were divided into study group (maternal extreme flexure and hip abduction combined with contralateral side‐lying,n = 114) and control group (contralateral side‐lying alone,n = 112).

Results

The correction and spontaneous labour rates were higher in the study group than in the control group (P < .05). The duration between initial and successful correction and birth process were shorter in the study group than in the control group (P < .05).

Conclusion

Maternal extreme flexure and hip abduction combined with contralateral side‐lying has better correction effect on persistent foetal occipito‐posterior position.
Short‐term external ureter stenting shows significant benefit in comparison to routine double‐J stent placement after ureterorenoscopic stone extraction: A prospective randomized trial – the Fast track stent study (FaST)
Authors: Bach Peter , Reicherz Alina , Teichman Joel , Dahlkamp Lisa , von Landenberg Nicolas , Palisaar Rein‐Jueri , Noldus Joachim , von Bodman Christian
Published: June 2018

Objectives

To determine whether short‐term stenting using an external ureter catheter following ureterorenoscopic stone extraction provides a better outcome in comparison to double‐J stent ureteral stenting.

Methods

Between August 2014 and August 2015, 141 patients initially managed with a double‐J stent insertion were prospectively randomized to ureter catheter for 6 h vs double‐J stent insertion for 5 days after stone extraction via ureteroscopy retrograde surgery (including flexible ureteroscopy retrograde surgery) in a single academic center. Endoscopic procedures were performed by nine surgeons. Exclusion criteria were acute urinary tract infection, a solitary kidney, or a stone mass more than 25 mm. Study endpoints were ureter‐stent related symptoms and pain assessed by a validated questionnaire (ureteral stent symptom questionnaire) and visual analogue scale before and 4 weeks after surgery.

Results

Overall stone‐free rate was more than 90%. Mean operative time was 24 min (range 5–63). Groups did not differ in terms of age, body mass index, and stone size. Patients who received short‐term ureter catheter showed a significantly higher quality of life. In the ureter catheter group, the urinary index score (16.8 vs 27.8; P < 0.0001), the pain score (9.7 ± 1.3 vs 20.2 ± 1.5; P < 0.0001), and general health index (15.3 ± 0.7 vs 8.5 ± 0.6; P < 0.0001) were significantly lower. Consultation of a physician and antibiotic treatment were rarely needed (1.3 ± 0.1 vs 1.6 ± 0.1; P = 0.017).

Conclusion

A short‐term ureter catheter insertion for 6 h following ureteroscopy retrograde surgery stone removal is a safe procedure and superior to double‐J stent insertion with regard to urinary symptoms, pain, quality of life, and stent related symptoms. Patients treated with a short‐term ureter catheter recover more quickly, return to work earlier, and need less doctor visits. Most patients would recommend a ureter catheter, and would prefer this strategy in case of future stone treatments.
When trade unions turn to litigation: ‘getting all the ducks in a row’
Authors: Guillaume Cécile
Published: June 2018

Driven by their members' demands and the need to adopt more combative legal strategies in order to oppose the deterioration of working and employment conditions, British trade unions have developed in‐house legal expertise and supported many individual and multiple claims. This article investigates the variation in unions' legal practices and examines their organisational responses to law and the role of compliance professionals in the regulation of employment litigation. It provides a nuanced account of the influence of legal rationality on the framing of union strategies and shows that, under certain conditions, trade unions are able to build multi‐pronged tactics by using litigation as a complement to other forms of action.
Part 1: Historical and Theoretical Underpinnings
Authors: Rosenblatt Roger A.
Published: June 2018

This set of six manuscripts describes the content and impact of the WAMI Rural Hospital Project (RHP), a research and development effort supported by the W.K. Kellogg Foundation, designed to improve the delivery of health services in six rural communities in the Pacific Northwest and Alaska. The major objective of the RHP—an activity which spanned a four‐year period from 1985 through 1988—was to assist the project communities in improving the financial stability and quality of care of their local health care systems. Special attention was directed at helping the communities determine and implement an appropriate scope of health services, improve management and governance of the local health care enterprise, recruit and retain additional health personnel, and increase the extent to which community residents used local health services.

In this first section we discuss the historical antecedents and conceptual underpinnings of the RHP and describe the five principal phases of the project. Theseinclude: (1) selection of communities for participation in the RHP, (2) comprehensive analysis of the health care system in each community, (3) community health services planning, including the development of comprehensive strategic plans, (4) implementation of techniques to improve local health services, and (5) project dissemination and evaluation. A pre‐test, post‐test model was employed to assess qualitative and quantitative changes in a variety of key measures of health system performance, including organization and management, scope of services, fiscal viability of the rural hospital, and utilization and patient satisfaction with health services in each community. The results of this evaluation constitute the balance of this report.
Part 2: Changes in the Availability and Utilization of Health Services
Authors: Lishner Denise M. , Amundson Bruce A. , Hart L. Gary
Published: June 2018

A major goal of the Rural Hospital Project (RHP) was to assist communities in defining an optimal scope of hospital and community health services. It was hypothesized that a rational basis for service planning would result in an expansion of locally provided health services, increased local hospital and physician market share, improved hospital workload performance, and higher levels of consumer satisfaction with community‐based services. However, given the recent decline in performance of many small rural hospitals in general and in RHP hospitals in particular, at a minimum, stabilization of these troubled facilities could be considered a successful outcome.

Data were collected from the six rural communities participating in the RHP both before and after the intervention (1985 and 1989) to assess changes in community scope of health services and utilization patterns. Comparative data were also compiled from peer group hospitals when available.

Results generally demonstrated stabilization or expansion in: (1) the range of community and hospital services, (2) the availability of community physicians and visiting specialties, and (3) physician and hospital market share. While findings were mixed for patient days, average daily census, and number of births, substantial increases were documented for the number of surgical procedures, emergency room visits, and x‐rays over the study period. RHP hospitals generally outperformed peer group hospitals on market share measures.
Part 3: Building Health Care Leadership in Rural Communities
Authors: Elder William G. , Amundson Bruce A.
Published: June 2018

The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses.

The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.
Part 5: Community Perception of Local Health Care Services
Authors: Hart L. Gary , Lishner Denise M. , Amundson Bruce A.
Published: June 2018

Rural health care facilities commonly employ community health care surveys as marketing research instruments to assess consumer utilization of and satisfaction with local services. However, there is little information on the use of survey findings as a way to design interventions to enhance consumer satisfaction and hospital viability. A community survey was administered in six Northwest rural communities as part of the Rural Hospital Project (RHP) to identify weaknesses in local health care services, guide remedial activities, act as a catalyst for change, and assess changes in community perceptions following project interventions.

Descriptive findings revealed problems typically observed in small rural communities, including relatively low hospital and physician market share, outmigration for certain types of health care not available locally, and dissatisfaction with some aspects of hospital and physician services. Satisfaction with various aspects of care tended to be lower among males, the uninsured, and younger respondents.

Comparisons of survey responses before (1985) and after (1989) the RHP generally demonstrated stability in hospital and physician market share, with project hospitals performing well in 1989 in comparison to other rural hospitals of similar size. The percentage of respondents who rated overall quality of local hospital and physician care positively generally increased or remained stable over the study period. Substantial decreases in satisfaction levels were found for access to care. Importantly, gains were made in those areas and services which received particular emphasis in the project.
The Structure and Characteristics of Rural Hospital Consortia
Authors: Moscovice Ira , Johnson Judy , Finch Michael , Grogan Colleen , Kralewski John
Published: June 2018

Rural hospital consortia are relatively new organizations that have been developed to help improve the viability of participating hospitals. This paper describes the characteristics of rural hospital consortia in the United States and develops and tests a measurement model of their underlying structure. The measurement model, which characterized consortia structure in terms of degree of member commitment, degree of complexity, scale of operations, and degree of formalization, provided a good fit to the sample data. Most consortia appear to have followed a relatively conservative course that involved the development of programs that had limited sensitivity and financial risk for individual hospitals. This suggests that rural hospital consortia may not become a model for major structural change in the rural health care system. Future research should examine the evolution of rural hospital consortia from an organizational life cycle perspective.
Book Reviews
Authors: Wald Marlena M.
Published: June 2018

CARTER CENTER OF EMORY UNIVERSITY AND THE PARK RIDGE CENTER FOR THE STUDY OF HEALTH, FAITH, AND ETHICS. Healthy People 2000: A Role for America's Religious Communities. Edited by Micah Marty. Chicago, IL: Park Ridge Center, 1991. 42 pp.—$4.

STOTO, MICHAEL A., BEHREN, RUTH, AND ROSEMONT, CONNIE, editors. Healthy People 2000: Citizens Chart the Course. Washington, DC: National Academy Press, 1990, 228 pp.—$24.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, PUBLIC HEALTH SERVICE. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: Government Printing Office, 1990. 2 volumes. (SUDOC no. HE20.2 D63/8) (DHHS Publication nos. 9150212 and 91‐50213) Vol. 1, 692 pp.—$31; Vol. 2,154 pp.—$9.
Motherwort injection for preventing postpartum hemorrhage in pregnant women with cesarean section: A systematic review and meta‐analysis
Authors: Chen Wenwen , Yu Jiajie , Tao Huan , Cai Yujia , Li Youping , Sun Xin
Published: June 2018

Objective

To assess the impact of motherwort injection alone or combined with oxytocin for preventing postpartum hemorrhage in pregnant women with caesarean section.

Methods

A systematic review and meta‐analysis of randomized trials were performed. PubMed, EMbase, The Cochrane Central Register of Controlled Trials (CENTRAL), Chinese database Sino‐Med, Chinese National Knowledge Infrastructure Database (CNKI), VIP Chinese Science and Technique Journals Database, WanFang, and ClinicalTrials.gov were searched. Randomized controlled trials (RCTs) that compared motherwort injection alone or motherwort injection combined with oxytocin in pregnant women receiving cesarean section were included. Paired reviewers independently screened abstracts and full texts for eligibility, assessed risk of bias, and extracted data. We performed random‐effects meta‐analyses of RCTs along with a limited number of prespecified subgroup hypotheses, and sensitivity analyses were carried out with other statistical approaches.

Results

Forty‐six RCTs (n = 7359) proved eligible. Compared with oxytocin, both motherwort injection and motherwort injection combined with oxytocin had a significantly lower blood loss within 2 hours (MD = −21.81, 95% CI −37.05 to −6.58 and MD = −53.04, 95% CI −61.68 to −44.39); lower blood loss within 24 hours (MD = −25.44, 95% CI −39.38 to −11.51 and MD = −67.81, 95% CI −78.02 to −57.60); and lower the risk of adverse events (ORPeto 0.40, 95% CI 0.16 to 0.96 and ORPeto 0.50, 95% CI 0.35 to 0.71). Motherwort injection combined with oxytocin also decreased the risk of postpartum hemorrhage (OR 0.22, 95% CI 0.14 to 0.35.)

Conclusions

In pregnant women with cesarean section, motherwort injection suggests an obvious benefit and less adverse event.
Calendar synchronization of gasoline price increases
Authors: Noel Michael D.
Published: June 2018

In many retail gasoline markets with Edgeworth price cycles, large and regular price increases occur on the same day of the week every week, that is, they are calendar synchronized. In this article, I test whether calendar synchronization leads to higher or lower consumer expenditures on gasoline compared to a world with cycles but without calendar synchronization. On one hand, firms may attempt to trigger price increases just prior to periods of normally high demand. On the other, consumers may be better able to predict and shift purchases to low price days of the cycle. Using high‐frequency gasoline volume data and matching it to high‐frequency price data, I find that the latter effect dominates. All else equal, consumer expenditures on gasoline fall with calendar synchronization in the study markets. I also calculate intertemporal price elasticities and find them to be high.