bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Strunk Daniel R. , DeRubeis Robert J.
Published: December 2016

This volume provides what we believe to be the most comprehensive treatment of the range of mood disorders to date. In this introductory chapter, we present the organization and overarching themes of the volume. The volume’s coverage of mood disorders includes historical, cross-cultural, developmental, neuroscientific, etiological, and therapeutic issues. Following this introduction (Section I), Section II provides coverage of the phenomenology, classification, and assessment of mood disorders. A key theme of the section, the heterogeneity of mood disorders, is then carried through the volume. Section III addresses key etiologic, vulnerability and risk factors. Section IV covers key interpersonal and intra-personal factors, with several chapters focusing on neurobiological features. Section V examines variants of mood disorders as well as key sub-populations. Section VI addresses common comorbidities. Finally, Section VII surveys the wide array of commonly used and evidence-based treatment and prevention approaches.
Psychosocial Approaches to the Treatment and Prevention of Bipolar Disorder
Authors: Reilly-Harrington Noreen A.
Published: December 2016

Over the past two decades, adjunctive psychosocial treatments for bipolar disorder have been shown to hasten recovery, reduce relapse, and improve patients’ medication adherence, functioning, and quality of life. This chapter reviews four of the most widely studied psychosocial approaches for bipolar disorder: psychoeducation, cognitive-behavioral therapy (CBT), family-focused treatment (FFT), and interpersonal and social rhythm therapy (IPSRT). Core treatment strategies for each modality are presented, and key outcome studies are reviewed. The role of psychosocial treatment in pediatric bipolar disorder and in the prevention of bipolar disorder in youth at high risk for bipolar disorder is also presented. Suggestions for future research and the critical need for dissemination are also briefly discussed.
Safety of Perioperative Glucocorticoids in Elective Noncardiac Surgery
Authors: Toner Andrew J. , Ganeshanathan Vyhunthan , Chan Matthew T. , Ho Kwok M. , Corcoran Tomas B.
Published: December 2016

Background

Glucocorticoids are increasingly used perioperatively, principally to prevent nausea and vomiting. Safety concerns focus on the potential for hyperglycemia and increased infection. The authors hypothesized that glucocorticoids predispose to such adverse outcomes in a dose-dependent fashion after elective noncardiac surgery.

Methods

The authors conducted a systematic literature search of the major medical databases from their inception to April 2016. Randomized glucocorticoid trials in adults specifically reporting on a safety outcome were included and meta-analyzed with Peto odds ratio method or the quality effects model. Subanalyses were performed according to a dexamethasone dose equivalent of low (less than 8 mg), medium (8 to 16 mg), and high (more than 16 mg). The primary endpoints of any wound infection and peak perioperative glucose concentrations were subject to meta-regression.

Results

Fifty-six trials from 18 countries were identified, predominantly assessing dexamethasone. Glucocorticoids did not impact on any wound infection (odds ratio, 0.8; 95% CI, 0.6 to 1.2) but did result in a clinically unimportant increase in peak perioperative glucose concentration (weighted mean difference, 20.0 mg/dl; CI, 11.4 to 28.6; P < 0.001 or 1.1 mM; CI, 0.6 to 1.6). Glucocorticoids reduced peak postoperative C-reactive protein concentrations (weighted mean difference, −22.1 mg/l; CI, −31.7 to −12.5; P < 0.001), but other adverse outcomes and length of stay were unchanged. No dose–effect relationships were apparent.

Conclusions

The evidence at present does not highlight any safety concerns with respect to the use of perioperative glucocorticoids and subsequent infection, hyperglycemia, or other adverse outcomes. Nevertheless, collated trials lacked sufficient surveillance and power to detect clinically important differences in complications such as wound infection.
Sevoflurane Exposure during the Critical Period Affects Synaptic Transmission and Mitochondrial Respiration but Not Long-term Behavior in Mice
Authors: Chung Woosuk , Ryu Min Jeong , Heo Jun Young , Lee Soomin , Yoon Seunghwan , Park Haram , Park Sangil , Kim Yangsik , Kim Yoon Hee , Yoon Seok Hwa , Shin Yong Sup , Lee Won Hyung , Ju Xianshu , Kweon Gi Ryang , Ko Youngkwon
Published: December 2016

Background

Anesthesia during the synaptogenic period induces dendritic spine formation, which may affect neurodevelopment. The authors, therefore, evaluated whether changes in synaptic transmission after dendritic spine formation induced by sevoflurane were associated with long-term behavioral changes. The effects of sevoflurane on mitochondrial function were also assessed to further understand the mechanism behind spinogenesis.

Methods

Postnatal day 16 to 17 mice were exposed to sevoflurane (2.5% for 2 h), and synaptic transmission was measured in the medial prefrontal cortex 6 h or 5 days later. The expression of postsynaptic proteins and mitochondrial function were measured after anesthesia. Long-term behavioral changes were assessed in adult mice.

Results

Sevoflurane increased the expression of excitatory postsynaptic proteins in male and female mice (n = 3 to 5 per group). Sevoflurane exposure in male mice transiently increased miniature excitatory postsynaptic current frequency (control: 8.53 ± 2.87; sevoflurane: 11.09 ± 2.58) but decreased miniature inhibitory postsynaptic current frequency (control: 10.18 ± 4.66; sevoflurane: 6.88 ± 2.15). Unexpectedly, sevoflurane increased miniature inhibitory postsynaptic current frequency (control: 1.81 ± 1.11; sevoflurane: 3.56 ± 1.74) in female mice (neurons, n = 10 to 21 per group). Sevoflurane also increased mitochondrial respiration in male mice (n = 5 to 8 per group). However, such changes from anesthesia during the critical period did not induce long-term behavioral consequences. Values are presented as mean ± SD.

Conclusions

Sevoflurane exposure during the critical period induces mitochondrial hyperactivity and transient imbalance of excitatory/inhibitory synaptic transmission, without long-lasting behavioral consequences. Further studies are needed to confirm sexual differences and to define the role of mitochondrial activity during anesthesia-induced spine formation.
Major unanswered questions in the clinical gout field
Authors: Stamp Lisa K.
Published: December 2016

Purpose of review

Although gout is one of the most common forms of inflammatory arthritis, it has been relatively neglected until recently. Despite progress in many areas of pathophysiology and genetics of gout and the development of new urate lowering therapies, there remain a number of unanswered clinical questions. With the resurgence of interest in gout it is important to recognize key aspects of gout management that remain challenging and require further research.

Recent findings

The unanswered clinical issues outlined in this review are basic aspects of gout management that clinicians treating people with gout face on a daily basis and include when urate lowering therapy should be commenced, the most appropriate target serum urate, use of prophylaxis when starting urate lowering therapy and the most appropriate urate lowering therapy, particularly for those with chronic kidney disease.

Some of the issues outlined in this article are the subject of ongoing clinical research and some, such as use of allopurinol in people with chronic kidney impairment, may be less relevant with the advent of potentially safer urate lowering therapies but until that time further understanding to aid clinical decision-making is required.
Diagnostic Accuracy of Central Venous Catheter Confirmation by Bedside Ultrasound Versus Chest Radiography in Critically Ill Patients: A Systematic Review and Meta-Analysis
Authors: Ablordeppey Enyo A. , Drewry Anne M. , Beyer Alexander B. , Theodoro Daniel L. , Fowler Susan A. , Fuller Brian M. , Carpenter Christopher R.
Published: December 2016

Objective:

We performed a systematic review and meta-analysis to examine the accuracy of bedside ultrasound for confirmation of central venous catheter position and exclusion of pneumothorax compared with chest radiography.

Data Sources:

PubMed, Embase, Cochrane Central Register of Controlled Trials, reference lists, conference proceedings and ClinicalTrials.gov.

Study Selection:

Articles and abstracts describing the diagnostic accuracy of bedside ultrasound compared with chest radiography for confirmation of central venous catheters in sufficient detail to reconstruct 2 × 2 contingency tables were reviewed. Primary outcomes included the accuracy of confirming catheter positioning and detecting a pneumothorax. Secondary outcomes included feasibility, interrater reliability, and efficiency to complete bedside ultrasound confirmation of central venous catheter position.

Data Extraction:

Investigators abstracted study details including research design and sonographic imaging technique to detect catheter malposition and procedure-related pneumothorax. Diagnostic accuracy measures included pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio.

Data Synthesis:

Fifteen studies with 1,553 central venous catheter placements were identified with a pooled sensitivity and specificity of catheter malposition by ultrasound of 0.82 (0.77–0.86) and 0.98 (0.97–0.99), respectively. The pooled positive and negative likelihood ratios of catheter malposition by ultrasound were 31.12 (14.72–65.78) and 0.25 (0.13–0.47). The sensitivity and specificity of ultrasound for pneumothorax detection was nearly 100% in the participating studies. Bedside ultrasound reduced mean central venous catheter confirmation time by 58.3 minutes. Risk of bias and clinical heterogeneity in the studies were high.

Conclusions:

Bedside ultrasound is faster than radiography at identifying pneumothorax after central venous catheter insertion. When a central venous catheter malposition exists, bedside ultrasound will identify four out of every five earlier than chest radiography.
Higher Fluid Balance Increases the Risk of Death From Sepsis: Results From a Large International Audit*
Authors: Sakr Yasser , Rubatto Birri Paolo Nahuel , Kotfis Katarzyna , Nanchal Rahul , Shah Bhagyesh , Kluge Stefan , Schroeder Mary E. , Marshall John C. , Vincent Jean-Louis
Published: December 2016

Objectives:

Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis.

Design:

Observational cohort study.

Setting:

Seven hundred and thirty ICUs in 84 countries.

Patients:

All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission.

Measurements and Main Results:

ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (–90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (–951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock.

Conclusions:

In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death.
Oocyte vitrification for elective fertility preservation: the past, present, and future
Authors: Gunnala Vinay , Schattman Glenn
Published: December 2016

Purpose of review

Oocyte cryopreservation is no longer experimental and one of its rapidly growing indications is elective fertility preservation. Currently there is no sufficient evidence to support its practice and therefore its place in IVF remains uncertain.

Recent findings

Vitrification has superior post-thaw survival and fertilization outcomes compared with oocytes that were frozen with the slow-freeze technique. Oocyte vitrification produces similar IVF outcomes compared with fresh oocytes and is not associated with further obstetrical or perinatal morbidity. Undergoing elective oocyte cryopreservation between ages 35 and 37 will optimize live birth rates as well as cost effectiveness from mathematical models.

In women who delay child bearing, elective oocyte cryopreservation in the mid 30s may be beneficial in terms of live birth rates and cost effectiveness. Prospective studies of women who have undergone oocyte cryopreservation and are now attempting conception are needed before official recommendations can be made regarding elective egg freezing.
Impact of menopausal status on negative mood and depressive symptoms in a longitudinal sample spanning 20 years
Authors: Campbell Katherine E. , Dennerstein Lorraine , Finch Sue , Szoeke Cassandra E.
Published: December 2016

Objective:

Studies examining depressive symptoms and negative mood across the postmenopause are lacking, particularly those that examine prevalence in early and late postmenopause. This study examines negative mood and depressive occurrence in the menopausal stages to provide a better understanding of prevalence of mood disturbance during this period.

Methods:

This study was a longitudinal assessment of variables drawn from an epidemiological prospective study of women's healthy aging. Scores were analyzed using general linear mixed models to determine whether there were reductions in negative mood across the stages of the menopausal transition, including the substages of the early and late postmenopause, as defined by Stages of Reproductive Ageing Workshop+10 criteria. Negative mood scores, derived from the Affectometer 2, were obtained at 11 time points between 1992 and 2012 in a group of 438 Melbourne-based, community-dwelling women aged between 45 and 55 years at baseline (n = 234; 53% retention in 2012). Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale administered at three time points for 10 years.

Results:

Women's experience of negative mood and depressive symptoms was highest during the menopausal transition and lowest in the late postmenopause. Increasing age was associated with a reduction in depressive symptoms F(1,559) = 14.83, P < 0.001 and negative mood F(1,935) = 14.97, P < 0.001. When controlling for age, there was no difference found between the early and late postmenopause stage mean scores.

Conclusions:

Although there were differences found between negative mood and depressive symptom scores in relation to categories of reproductive aging, age was found to be the driving influence to their association.
Exercise training ameliorates glucosamine-induced insulin resistance in ovariectomized rats
Authors: Chen Chung-Hwan , Huang Tsang-Hai , Cheng Tsung-Lin , Chang Chi-Fen , Wang Chau-Zen , Wu Meng-Hsing , Kang Lin
Published: December 2016

Objective:

Glucosamine (GlcN), which has been reported to induce insulin resistance (IR), is a popular nutritional supplement used to treat osteoarthritis in menopausal women. We previously demonstrated that GlcN treatment caused IR in ovariectomized rats by reducing the expression of glucose transport protein subtype 4 (GLUT-4) in skeletal muscle. In the present study, we hypothesized that endurance exercise training can reverse GlcN-induced IR.

Methods:

Fifty female rats were randomly divided into five groups with 10 rats in each group: (1) sham-operated group; (2) sham-operated group with GlcN treatment for 14 days; (3) ovariectomy (OVX) group; (4) OVX with GlcN treatment; and (5) OVX with GlcN treatment followed by exercise training (running program) for 8 weeks.

Results:

Fasting plasma glucose increased in the OVX + GlcN group, and fasting plasma insulin and the homeostasis model assessment-insulin resistance (HOMA-IR) were significantly higher only in this group. After the rats received exercise training for 8 weeks, no increase in the fasting plasma glucose, insulin, or HOMA-IR was observed. In an intraperitoneal glucose tolerance test, the plasma glucose, plasma insulin, HOMA-IR, and glucose-insulin index were significantly elevated only in the OVX with GlcN treatment group. However, the plasma glucose, plasma insulin, HOMA-IR, and glucose-insulin index decreased after exercise training for 8 weeks, implying that GlcN-induced IR in OVX rats could be reversed through exercise. A histological analysis revealed that exercise training can reduce islet hypertrophy and maintain GLUT-4 in skeletal muscle.

Conclusions:

Exercise training can alleviate IR in OVX rats treated with GlcN. Islet hyperplasia was subsequently prevented. Preserving GLUT-4 expression may be one of the mechanisms by which exercise prevents IR.
Investigation of Key Circuit Constituents Affecting Drug Sequestration During Extracorporeal Membrane Oxygenation Treatment
Authors: Park Jiheum , Shin Dong Ah , Lee Saram , Cho Young-Jae , Jheon Sanghoon , Lee Jung Chan , Kim Hee Chan
Published: December 2016

We quantified the influence of the elements of the extracorporeal oxygenation (ECMO) circuit on drug sequestration by focusing on the interactions between materials and drugs. Tubing of three different brands (Tygon/Maquet/Terumo) and oxygenators of two different brands (Maquet/Terumo) were used. Drugs included dexmedetomidine, meropenem, and heparin, which were dissolved in deionized water. Tubing was cut into approximately 7 cm sections and allowed drug solutions enclosed inside by clamping both ends. The oxygenator housing, gas membrane, and heat exchanger were dissected into approximately 1 g pieces and submerged into drug solutions. The experimental samples were then immersed in a water bath at 37°C for 1, 6, 12, and 24 h. After 24 h, the dexmedetomidine concentration was significantly reduced in all three types of tubing (<30.1%), the oxygenator heat exchanger from Maquet Inc. (41.8%), and the gas exchanger from Terumo Inc. (8.6%), while no significant losses were found for meropenem and heparin compared with the control group. The heparin concentration within the Maquet gas exchanger, on the contrary, increased significantly compared with the control group at 1 and 12 h (p < 0.05). Our in vitro study reveals that material selection is a vital part of ECMO development.
Continued under-recognition of acute respiratory distress syndrome after the Berlin definition: what is the solution?
Authors: Laffey John G. , Pham Tài , Bellani Giacomo
Published: December 2016

Purpose of review

Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS.

Recent findings

ARDS continues to be under-recognized – even in the era of the more recent ‘Berlin’ definition, and significant delay in its recognition is common. Factors contributing to under-recognition may include the complexity of ARDS biology, low specificity of the consensus (diagnostic) criteria, and concerns about reliable interpretation of the chest radiograph. Understandably, ‘external’ factors are also at play: ICU occupancy and higher patient to clinician ratio impair recognition of ARDS. Timely recognition of ARDS appears important, as it is associated with the use of higher PEEP, prone positioning and neuromuscular blockade which can lower mortality. Computer-aided decision tools seem diagnostically useful, and together with the integration of reliable biomarkers, may further enhance and speed recognition of this syndrome.

Significant numbers of patients with ARDS are still unrecognized by clinicians in the era of the Berlin definition of ARDS, with potentially important consequences for patient management and outcome.
Update on nonmalignant lesions of the inferior turbinate
Authors: Goldfarb Jared M. , Goldfarb David , Rosen Marc R.
Published: December 2016

Purpose of review

The inferior turbinates are routinely examined by otolaryngologists on anterior rhinoscopy and nasal endoscopy. Most lesions of the inferior turbinate are benign but can often be confused with malignancy. This review highlights the broad differential of nonmalignant lesions of the inferior turbinates and their management.

Recent findings

A variety of infectious, inflammatory, neoplastic, and vascular lesions may affect the inferior turbinates. The most common nonmalignant lesions of the sinonasal region are nasal polyps, inverted papillomas, hemangiomas, and angiofibromas. Early lesions are often asymptomatic and discovered incidentally on routine examination. As these lesions grow they present with nonspecific signs that can be seen in benign, malignant, and infectious etiologies. The most common signs and symptoms are nasal obstruction, rhinorrhea, epistaxis, sinusitis, and hyposmia. Most nonmalignant lesions have characteristic appearances but definitive diagnosis is achieved with biopsy or culture. If the lesions are small the biopsy itself is often curative.

Lesions of the inferior turbinates are rarely isolated to these structures alone. Careful examination can noninvasively assist in early diagnosis of extensive lesions. Once malignancy and processes such as invasive fungal sinusitis or inverted papillomas have been ruled out, treatment of these lesions is ordinarily noncomplicated and definitive.
How Menopause Symptoms and Attitude Impact Korean Women's Quality of Life After Adjuvant Treatment for Breast Cancer
Authors: Gang Moonhee , Jung Mi Sook , Park Sunyoung , Park Younghee , Oh Kyongok
Published: December 2016

Background:

Attitudes toward menopause vary across cultures and influence women's experiences of menopausal symptoms, possibly leading to reduced posttreatment quality of life in breast cancer survivors.

Objective:

The aim of this study is to examine the effects of menopausal symptoms and attitudes on health-related quality of life in breast cancer survivors who were premenopausal at the time of diagnosis.

Methods:

A total of 139 women receiving chemotherapy with/without endocrine therapy were assessed with self-report questionnaires of established reliability and validity. Hierarchical regression was conducted to assess the impact of menopausal symptoms and attitudes on quality of life, while controlling for demographic characteristics.

Results:

Overall, participants endorsed more than half of 46 symptoms, most at the level of mild symptoms, and most reported a less positive attitude toward menopause. Lower quality of life was significantly predicted by more menopausal symptoms endorsed and more negative attitudes when controlling for demographic factors associated with quality of life (R
2 = 26.1%). Most participants experienced change from premenopause to postmenopause after the completion of adjuvant chemotherapy with or without tamoxifen.

Conclusions:

The results suggest that more menopausal symptoms and negative attitudes toward menopause may affect health-related quality of life considerably in chemotherapy-treated Asian breast cancer survivors.

Implications for Practice:

Healthcare professionals should develop a better understanding of the effects of menopausal symptoms and attitudes on quality of life by using a culturally relevant perspective based on patients' sociocultural backgrounds. Furthermore, these findings help healthcare professionals communicate with their Asian clients in a more informed way and provide culturally appropriate and individualized care.
Longitudinal Trends in Anxiety, Depression, and Quality of Life During Different Intermittent Periods of Adjuvant Breast Cancer Chemotherapy
Authors: Zhang Jiayuan , Zhou Yuqiu , Feng Ziwei , Xu Yong , Zeng Guangchun
Published: December 2016

Background:

Chemotherapy (CT) is an important adjuvant treatment that has been widely used for breast cancer (BC) patients. However, no research has focused on trends in emotions and quality of life (QOL) during intermittent periods between CT sessions that are critical for recovery.

Objective:

The aim of this study was to investigate longitudinal trends in anxiety, depression, and QOL during the different intermittent periods between adjuvant CT for BC.

Methods:

A longitudinal study design was adopted. Eighty-eight women undergoing CT for BC were selected using a purposive sampling method, and they completed the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Functional Assessment of Cancer Therapy–Breast (FACT-B) at 5 points. A repeated-measures analysis-of-variance model was used to compare anxiety, depression, and QOL at different time points.

Results:

The results showed a significant difference in SAS (F = 187.78, P < .00), SDS (F = 263.07, P < .00), and FACT-B (F = 140.82, P < .00) scores at the 5 time points. The SAS and SDS scores were highest at T3, whereas the FACT-B score was lowest at T3.

Conclusions:

The BC patients had psychological distress during intermittent periods between adjuvant CT, as evidenced by anxiety and depression, which were highest in the third cycle. Meanwhile, QOL was lowest at the third CT cycle and highest at the first CT cycle.

Implications for Practice:

Clinical staff should focus on critical time periods during CT, particularly during the third cycle, and provide additional support to patients to ensure that CT is delivered in an optimal fashion.
Real-time Fatigue and Free-Living Physical Activity in Hematopoietic Stem Cell Transplantation Cancer Survivors and Healthy Controls
Authors: Hacker Eileen Danaher , Kim Inah , Park Chang , Peters Tara
Published: December 2016

Background:

Fatigue and physical inactivity, critical problems facing cancer survivors, impact overall health and functioning. Our group designed a novel methodology to evaluate the temporal, dynamic patterns in real-world settings.

Objective:

Using real-time technology, the temporal, dynamic relationship between real-time fatigue and free-living is described and compared in cancer survivors who were treated with hematopoietic stem cell transplantation (n = 25) and age- and gender-matched healthy controls (n = 25).

Methods:

Subjects wore wrist actigraphs on their nondominant hand to assess free-living physical activity, measured in 1-minute epochs, over 7 days. Subjects entered real-time fatigue assessments directly into the subjective event marker of the actigraph 5 times per day. Running averages of mean 1-minute activity counts 30, 60, and 120 minutes before and after each real-time fatigue score were correlated with real-time fatigue using generalized estimating equations,

Results:

A strong inverse relationship exists between real-time fatigue and subsequent free-living physical activity. This inverse relationship suggests that increasing real-time fatigue limits subsequent physical activity (B range= −0.002 to −0.004; P < .001). No significant differences in the dynamic patterns of real-time fatigue and free-living physical activity were found between groups.

Conclusions:

To our knowledge, this is the first study to document the temporal and potentially causal relationship between real-time fatigue and free-living physical activity in real-world setting. These findings suggest that fatigue drives the subsequent physical activity and the relationship may not be bidirectional.

Implications for Practice:

Understanding the temporal, dynamic relationship may have important health implications for developing interventions to address fatigue in cancer survivors.
Effectiveness of a Natural Family Planning Service Program
Authors: Fehring Richard J. , Schneider Mary
Published: December 2016

Purpose:

The aims of this study were to determine and compare extended use-effectiveness of an online nurse-managed fertility education service program among women (and subgroups of women) seeking to avoid pregnancy.

Study Design and Methods:

This was a 24-month prospective study of a university-based online Web site with 663 nonbreastfeeding women using an online charting system to avoid pregnancy. Participants tracked their fertility online with either cervical mucus monitoring, electronic hormonal fertility monitoring, or both fertility indicators. Unintended pregnancies were validated by professional nurses.

Results:

Participants had a mean age of 30.4 years (SD = 6.3) and mean 1.7 children (SD = 2.0). Among the 663 nonbreastfeeding participants there were 2 unintended pregnancies per 100 at 24 cycles of correct use and 15 pregnancies at 24 cycles of typical use. However, the 212 women using the electronic fertility monitor had a typical use unintended pregnancy rate of 6 at 24 cycles of use in comparison with the 118 women using cervical mucus monitoring that had a typical use pregnancy rate of 19 at 24 cycles and with the 333 women using both fertility indicators that had a pregnancy rate of 18 at 24 cycles of use.

Clinical Implications:

Use of the fertility monitor to estimate fertility among nonbreastfeeding women provides the most secure method of avoiding pregnancy.
Supporting Rural Women During Pregnancy
Authors: Evans Emily C. , Bullock Linda F.C.
Published: December 2016

Purpose:

The aim of this study was to characterize nursing care provided by the research nurses from the Baby Behavioral Educational Enhancement of Pregnancy (Baby BEEP) study as they delivered a telephone social support intervention to low-income, pregnant women in the Midwestern United States.

Study Design and Methods:

This was a descriptive qualitative study that used Peplau's Theory of Interpersonal Relations to frame and interpret the analysis.

Results:

Research nurses from the Baby BEEP study found a novel way to reach a vulnerable population through weekly telephone interactions. Acting in several of Peplau's nursing roles, the care they provided led to a remarkable retention rate and therapeutic nurse–patient relationships. The Baby BEEP study demonstrated the provision of a well-received psychosocial support intervention that can be used to help underserved women throughout pregnancy.

Clinical Implications:

Telenursing care provided to low-income, rural women was well received and reflected the principles in Peplau's Theory of Interpersonal Relations. Nurses may use this type of nursing care to support women who are difficult to reach and typically experience low levels of support. This article describes the nursing care provided by the Baby BEEP nurses and provides a model for future, novel approaches to social support in a vulnerable and difficult-to-reach population.
Mothers' Weaning Practices when Infants Breastfeed for More Than One Year
Authors: Cunniff Addie , Spatz Diane
Published: December 2016

The American Academy of Pediatrics and the World Health Organization recommend that infants receive human milk exclusively for the first 6 months of life and that breastfeeding continue beyond the first or second year of life for as long as a family deems appropriate. More infants in the United States and around the world are meeting this recommendation. As more infants breastfeed beyond the first year of life, best practices for weaning toddlers come into question. Little is known about concerns and practices of breastfeeding mothers weaning their children from feedings. Current evidence on weaning from an evolutionary, social, and practical perspective is presented. Four case exemplars are provided to illustrate complexities of weaning. Implications for practice and suggestions for future research are provided.
Functional Deficits and Aggressive Behaviors in an Inpatient Psychiatric Hospital
Authors: Jones Nicole Tuomi , McGill Amanda C. , Vogler Jason E. , Oxley Stephen
Published: December 2016

The primary goals of compulsory, inpatient, psychiatric treatment are to decrease dangerous behaviors and help improve functioning so that a safe discharge to a less restrictive environment can be obtained. This study examined the aggression rates, levels of functioning, and treatment adherence for persons treated for schizophrenia (N = 506) compared with persons treated for borderline personality disorder (BPD) (N = 98) in an inpatient psychiatric facility. Over half of persons engaged in at least one incident of aggressive behavior during hospitalization. Differences in the types of aggression and functional deficits between these two clinical sub-groups were found. In addition, overall impairment increased the likelihood of aggressive behavior for persons diagnosed with schizophrenia, whereas irritability and social dependence increased the risk of aggression for persons diagnosed with BPD. Treatment interventions that target the improvement of these deficits may help reduce the intensity and severity of aggressive behaviors and help improve functioning and discharge readiness.
Simulation Using TeamSTEPPS to Promote Interprofessional Education and Collaborative Practice
Authors: Reed Trent , Horsley Trisha Leann , Muccino Keith , Quinones Donna , Siddall Viva Jo , McCarthy Janet , Adams William
Published: December 2016

Effective interprofessional collaborative practice is critical to maximizing patient safety and providing quality patient care; incorporating these strategies into the curriculum is an important step toward implementation. This study assessed whether TeamSTEPPS training using simulation could improve student knowledge of TeamSTEPPS principles, self-efficacy toward interprofessional collaborative practice, and team performance. Students (N = 201) demonstrated significant improvement in all of the targeted measurements.
Fixation Stability Recording: How Long for Eyes with Central Vision Loss?
Authors: Tarita-Nistor Luminita , Gill Ishrat , González Esther G. , Steinbach Martin J.
Published: December 2016

Purpose

Fixation examination with the MP-1 microperimeter (Nidek Technologies Srl., Vigonza, PD, Italy) determines the preferred retinal loci and fixation stability in patients with central vision loss. It is typically done for periods of 15 to 30 s as per the manual’s recommendations, which are arbitrary. In this study, we examined (1) whether fixation stability depends on the duration of recording and (2) whether fixation stability changes over time.

Methods

Raw eye-position data from 76 patients with bilateral central vision loss (mean age = 80 ± 9.6 yrs) who had fixation examination recordings with the MP-1of at least 15 s were used. Bivariate contour ellipse areas (BCEAs) were calculated and compared for intervals of 0 to 5 s, 0 to 10 s, and 0 to 15 s and for three consecutive 5-s intervals (0–5 s, 5–10 s, and 10–15 s). Ellipse’s centroid location, axes extent, and tilt angle were also evaluated for each of these intervals.

Results

BCEA worsened significantly with increasing the time of fixation recording (P < .001). Compared to the BCEA during the first 5 s of examination recording, median BCEA increased by a factor of 1.4 for the first 10 s and of 1.6 for the first 15 s of recording. However, the bivariate ellipses for the three consecutive 5-s intervals were the same in terms of area, centroid location, and axes extent, but differed significantly in tilt angle (P = .005). Fixation stability (BCEAs) results were also confirmed with an additional analysis performed on shorter sampling intervals.

Conclusions

Fixation stability deteriorates with increasing duration of the fixation recording, but when fixation is evaluated in shorter consecutive 5-s intervals, only a difference in ellipse’s tilt angle is found. These results suggest that the current recommendations for fixation stability recording with the MP-1 can be shortened to a less demanding duration.
A Framework for Health Communication Across the HIV Treatment Continuum
Authors: Babalola Stella , Van Lith Lynn M. , Mallalieu Elizabeth C. , Packman Zoe R. , Myers Emily , Ahanda Kim Seifert , Harris Emily , Gurman Tilly , Figueroa Maria-Elena
Published: December 2016

Background:

As test and treat rolls out, effective interventions are needed to address the determinants of outcomes across the HIV treatment continuum and ensure that people infected with HIV are promptly tested, initiate treatment early, adhere to treatment, and are virally suppressed. Communication approaches offer viable options for promoting relevant behaviors across the continuum.

Conceptual Framework:

This article introduces a conceptual framework, which can guide the development of effective health communication interventions and activities that aim to impact behaviors across the HIV treatment continuum in low- and medium-income countries. The framework includes HIV testing and counseling, linkage to care, retention in pre-antiretroviral therapy and antiretroviral therapy initiation in one single-stage linkage to care and treatment, and adherence for viral suppression. The determinants of behaviors vary across the continuum and include both facilitators and barriers with communication interventions designed to focus on specific determinants presented in the model. At each stage, relevant determinants occur at the various levels of the social–ecological model: intrapersonal, interpersonal, health services, community, and policy. Effective health communication interventions have mainly relied on mHealth, interpersonal communication through service providers and peers, community support groups, and treatment supporters.

Discussion:

The conceptual framework and evidence presented highlight areas across the continuum where health communication can significantly impact treatment outcomes to reach the 90-90-90 goals by strategically addressing key behavioral determinants. As test and treat rolls out, multifaceted health communication approaches will be critical.
Potential Impact of Integrated Stigma Mitigation Interventions in Improving HIV/AIDS Service Delivery and Uptake for Key Populations in Senegal
Authors: Lyons Carrie E. , Ketende Sosthenes , Diouf Daouda , Drame Fatou M. , Liestman Benjamin , Coly Karleen , Ndour Cheikh , Turpin Gnilane , Mboup Souleymane , Diop Karim , Toure-Kane Coumba , Castor Delivette , Leye-Diouf Nafissatou , Baral Stefan
Published: December 2016

Background:

Men who have sex with men (MSM) and female sex workers (FSW) are consistently shown to have a higher burden of HIV compared with other adults in Senegal. This study, HIV Prevention 2.0, evaluates the impact of the 3-tiered integrated stigma mitigation interventions (ISMIs) approach to optimizing HIV service delivery for key populations in Senegal.

Methods:

Baseline assessment includes a questionnaire and biological testing for HIV. A proportion of participants enrolled into a 24-month longitudinal cohort with questionnaires and biological testing every 3 months. In these preliminary analyses, ISMIs are evaluated from participants in the cohort through uptake of HIV services and implementation outcomes.

Results:

Overall, 724 MSM and 758 FSW participated in the baseline assessment. HIV prevalence is 30.2% (n = 219/724) among MSM and 5.3% (n = 40/758) among FSW. Fear of seeking health services among MSM is 17.7% (n = 128/724) at baseline, 10.5% (n = 18/172) at month 3, and 9.8% (n = 10/102) at month 6 (P < 0.004); and among FSW is 21.9% (n = 166/758) at baseline, 8.1% (n = 15/185) at month 3, and 10.7% (n = 18/168) at month 6 (P < 0.001). Overall, 63.9% (n = 62/97) of MSM and 82.5% (n = 118/143) of FSW agreed that the intervention is effective in addressing stigma; however, loss to follow-up was 41.1% among MSM and 10% among FSW.

Conclusion:

Baseline data reinforce the need for stigma mitigation interventions, combined with enhanced linkage and retention to optimize HIV treatment. Preliminary results show high levels of HIV-related risk determinants and suggest the potential utility of the ISMI to decrease perceived stigma relating to engagement in HIV prevention, treatment, and care services among key populations in Senegal.
Health Communication and the HIV Continuum of Care
Authors: Vermund Sten H. , Mallalieu Elizabeth C. , Van Lith Lynn M. , Struthers Helen E.
Published: December 2016

Health communication is a broad term that applies to the fundamental need for practitioners, policy makers, patients, and community members to understand one another around health promotion and health care issues. Whether in a consultation between nurse and patient, a health clinic director's engagement with the health ministry, or a community campaign for encouraging HIV testing, all have critical health communication elements. When people's needs are not perceived by them to be addressed or clients/patients do not understand what is being communicated, they are unmotivated to engage. Health communication may be deployed at multiple levels to encourage positive behavior change and affect HIV treatment outcomes. As countries move to treatment for all as soon as possible after testing, health communication can help address significant losses at each stage of the HIV continuum of care, thereby contributing to achieving the 90-90-90 global treatment goals. This JAIDS supplement presents compelling studies that are anchored on the health communication exigencies in highly diverse HIV and AIDS contexts in low and middle income settings. Our special focus is health communication needs and challenges within the HIV continuum of care. We introduce the supplement with thumbnails summaries of the work presented by an experienced array of public health, behavioral, and clinical scientists.
Measuring quality of life in advanced heart failure
Authors: MacIver Jane , Wentlandt Kirsten , Ross Heather J.
Published: December 2016

Purpose of review

Patients with Stage D heart failure can benefit from palliative care consultation to help them manage unpleasant symptoms and improve quality of life. Although guidelines describe how to manage symptoms, very little direction is provided on how to evaluate the effectiveness of those interventions.

Recent findings

Numerous studies have used the measurement of symptoms, emotional distress, functional capacity and quality of life to evaluate the effectiveness of interventions in heart failure. There is limited evidence on the use of these instruments in heart failure palliative care. Four studies were identified that evaluate the effectiveness of palliative care consultation for patients with advanced heart failure. All four studies measured symptom severity, emotional distress, and quality of life. The application of appropriate instruments is discussed. Suggestions for scores that should trigger palliative care consultation are identified.

The routine administration of standardized instruments to measure symptom severity and quality of life may improve the assessment and management of patients with Stage D heart failure. Ongoing discussion and research is needed to determine if these instruments are the best tools to use with heart failure palliative care patients.
Reprogramming protein kinase substrate specificity through synthetic mutations
Authors: Lubner Joshua M. , Church George M. , Chou Michael F. , Schwartz Daniel
Published: December 2016

Protein kinase specificity is largely imparted through substrate binding pocket motifs. Missense mutations in these regions are frequently associated with human disease, and in some cases can alter substrate specificity. However, current efforts at decoding the influence of mutations on substrate specificity have been focused on disease-associated mutations. Here, we adapted the Proteomic Peptide Library (ProPeL) approach for determining kinase specificity to the task of exploring structure-function relationships in kinase specificity by interrogating the effects of synthetic mutation. We established a specificity model for the wild-type DYRK1A kinase with unprecedented resolution. Using existing crystallographic and sequence homology data, we rationally designed mutations that precisely reprogrammed the DYRK1A kinase at the P+1 position to mimic the substrate preferences of a related kinase, CK II. This study illustrates a new synthetic biological approach to reprogram kinase specificity by design, and a powerful new paradigm to investigate structure-function relationships underpinning kinase substrate specificity.
Water-mediated intermolecular interactions in 1,2-O-cyclohexylidene-myo-inositol: a quantitative analysis
Authors: Purushothaman Gayathri , Juvale Kapil , Kirubakaran Sivapriya , Vemula Praveen Kumar , Thiruvenkatam Vijay
Published: December 2016

The syntheses of newmyo-inositol derivatives have received much attention due to their important biological activities. 1,2-O-Cyclohexylidene-myo-inositol is an important intermediate formed during the syntheses of certainmyo-inositol derivatives. We report herein the crystal structure of 1,2-O-cyclohexylidene-myo-inositol dihydrate, C12H20O6·2H2O, which is an intermediate formed during the syntheses ofmyo-inositol phosphate derivatives, to demonstrate the participation of water molecules and hydroxy groups in the formation of several intermolecular O—H...O interactions, and to determine a low-energy conformation. The titlemyo-inositol derivative crystallizes with two water molecules in the asymmetric unit in the space groupC2/c, withZ= 8. The water molecules facilitate the formation of an extensive O—H...O hydrogen-bonding network that assists in the formation of a dense crystal packing. Furthermore, geometrical optimization and frequency analysis was carried out using density functional theory (DFT) calculations with B3LYP hybrid functionals and 6-31G(d), 6-31G(d,p) and 6-311G(d,p) basis sets. The theoretical and experimental structures were found to be very similar, with only slight deviations. The intermolecular interactions were quantitatively analysed using Hirshfeld surface analysis and 2D (two-dimensional) fingerplot plots, and the total lattice energy was calculated.
The gyrator for transforming nano memristor into meminductor
Authors: Wang Shao-Fu
Published: December 2016

Purpose

To solve the problem of meminductor in circuit design, this paper aims to describe a synthesis method and the mechanism in terms of constitutive relation of the gyrator for transforming nano memristor into meminductor.

Design/methodology/approach

The gyrator was designed to achieve memristor-meminductor transformation by using amplifiers and memristor.

Findings

The simulation results verify the flexibility of its operation.

Originality/value

This gyrator can be used in integrated circuit design such as filter, diplexer, and it has a simple and economical implementation.