bluuebunny/crossref_metadata_2025 huggingface dataset:
Youth Justice in England and Wales
Authors: Gelsthorpe Loraine , Lanskey Caroline
Published: December 2016

This chapter examines the youth justice system in England and Wales since its inception at the beginning of the twentieth century. It describes its institutional structures, and processes, and major policy trends. It also discusses tensions between welfarist and punitive responses to youth crime and the associated blurring of boundaries between childhood and adulthood, criminal and civil proceedings, social care and criminal justice. Beyond this, the chapter considers the net-widening and criminalizing tendencies of early twenty-first century managerialism, the increased severity of sentencing responses at the “heavier” end of the justice system, and the counter-narratives of restorative justice and diversion. Finally, the chapter reflects on reasons for the recent decline in the number of young people entering the system and being sentenced to custody and speculates on the future shape and character of youth justice in light of devolutionary pulls and political interests in cost-cutting and marketization of services.
Horticulture and the Roman Shaping of Nature
Authors: Pagán Victoria E.
Published: December 2016

In the Roman world, horticulture (the art and practice of garden cultivation and management) is one aspect of the larger enterprise of farming and agriculture. Hortus denotes a kitchen garden near the house for growing vegetables; horti are large-scale pleasure grounds or parks, privately owned but sometimes open to public use. The literary and material sources from the second century b.c.e. to the second century c.e. in the regions of Latium and Campania adhere to and diverge from generic conventions, distort and exaggerate their subject, and provide social commentary on the purposes and meanings of gardens. After surveying the sources, the second section of this article reviews scholarship on gardens: archaeological studies that ask what gardens are, and cultural studies that ask what gardens mean. The conclusion suggests two future directions: reception studies and environmental sustainability.
Positioning Theory and Social Justice
Authors: Warren Zachary , Moghaddam Fathali M.
Published: December 2016

This chapter demonstrates the dynamism and utility of positioning theory, in the domain of social justice. The illustrative examples are drawn from international intergroup situations, particularly in Afghanistan and Iraq. These situations involve interpretations of rights and duties by different groups, rights and duties being central to positioning theory. The chapter critically explores the questions of whether there are universals in rights and duties, and whether people apply moral principles consistently across contexts. Both the traditional empirical research literature and positioning theory reveal that context has an important influence on moral thinking, including on the interpretation of rights and duties.
Policy and Program Innovations in Prisons
Authors: Taxman Faye S. , Blasko Brandy
Published: December 2016

This chapter discusses current policy and program innovations in institutional corrections. Several jurisdictions have made considerable policy and program revisions in order to align correctional practices with evidence-based approaches. The authors present the advances in policies that emphasize the Risk-Need-Responsivity framework, reentry, and good-time credits in order to emphasize how these policies provide a foundation for the expansion of prison programming. Next, novel programming approaches, including efforts to build self-efficacy through strength-based approaches, build attachments and empathy to advance interpersonal skills, and address obstacles to reentry to the community, are reviewed. The link between prison programming and the legitimacy of a prison regime is discussed. Finally, a research agenda designed to advance policy and program innovations in prison settings is presented.
Brain Stimulation Treatments for Depression
Authors: George Mark S. , Short E. Baron , Kerns Suzanne E.
Published: December 2016

The use of brain stimulation for the treatment and investigation of mood disorders is rapidly expanding. Mood disorders are common, but so are treatment-refractory or intolerant patients, explaining increasing interest in alternatives to medications and talk therapy. Additionally, depressive episodes are periodic or temporary states and are thus amenable to pulsatile, non-systemic treatments. The oldest brain stimulation method, electroconvulsive therapy (ECT), remains the most effective acute antidepressant available. The newer brain stimulation methods, in particular repetitive transcranial magnetic stimulation (rTMS), also show that non-invasive stimulation of key brain regions not only effectively treats depression, but also causes quantifiable changes in brain biomarkers. More research is needed, though, to better understand how these treatments work, for whom they work, and how to optimize their use.
The current overuse and misuse of meta-analyses on sublingual immunotherapy: the case of grass pollen allergy
Authors: Ridolo Erminia , Incorvaia Cristoforo , Gritti Bruna Luciana , Passalacqua Giovanni
Published: December 2016

Purpose of review

Meta-analysis provides the highest level of evidence-based efficacy of a medical treatment or intervention. Allergen immunotherapy in its two forms of subcutaneous immunotherapy and sublingual immunotherapy (SLIT) is an effective treatment of respiratory allergy as shown by meta-analyses, but in recent years there has been an overflow of meta-analyses on SLIT, with contrasting results that may generate confusion among physicians.

Recent findings

It can be observed that flaws are often present in meta-analyses including: incorrect selection of trials, inappropriate use of evaluation parameters for the analysis, and unsuitable analyses. For instance, it is clear that a meta-analysis of several small studies does not predict the results of a single large study that remains the gold standard to assess the efficacy and safety of a treatment. To assess the interest of the matter, we calculated the number of citations of meta-analyses on SLIT efficacy in the 10 years after the first publication in 2005 and detected a continuous decrease in citations.

Today, the appropriateness of a meta-analysis should be carefully evaluated, taking into account that a meta-analysis uses a statistical approach to combine the results from multiple small studies to increase power, to improve estimates of the size of the effect, and/or to resolve uncertainty when reports disagree. Editors and reviewers of medical journals should consider that to judge a meta-analysis requires a high level of expertise that is obvious in reviewers belonging to the Cochrane organization.
Coexistence of Adult Onset Eruptive Syringoma and Bilateral Renal Cell Carcinoma: A Case Report
Authors: Incel Uysal Pinar , Yalcin Basak , Ozhamam Esra , Bozdogan Onder
Published: December 2016

Eruptive syringoma is an unusual variant of syringoma, which usually presents before or during puberty. It typically occurs in large numbers as multiple yellow-brown–colored papules, which may show spontaneous regression. Because some authors have proposed that it could present as a reactive process of eccrine ducts to an inflammatory reaction caused by an unknown trigger, the exact pathomechanism is still unclear. There are also reports in the literature on the association of eruptive syringoma in Down syndrome, diabetes, milium, sarcoidosis, and psychiatric disorders. Some reports in the literature highlighted the association of eruptive syringomas and neoplasms. We describe here a case of adult-onset eruptive syringoma in a 53-year-old man and discuss the possibility of its association with renal cell carcinoma as a paraneoplastic phenomenon.
Galectin-3 Expression in Benign and Malignant Skin Diseases With Epidermal Hyperplasia
Authors: Jiang Ze-xin , Tan Guo-zhen , Shi Zhen-rui , Zhang Yu-ping , Han Yan-fang , Wang Liangchun
Published: December 2016

Galectin-3 has been suggested relative to tumor genesis, progression, and metastasis in basal cell carcinoma and squamous cell carcinoma that are the most common skin cancers characterized by malignant epidermal proliferation. In this study, we evaluated galectin-3 expression in seborrheic keratosis, keratoacanthoma, and infectious diseases including verruca vulgaris, condyloma acuminatum, and chromoblastomycosis that are pathologically featured by benign epidermal proliferation. Galectin-3 expression was shown by immunohistochemical staining and quantified using the Image Pro Plus V6.0. We found that galectin-3 distributed evenly in normal skin around the body decreased significantly in all selected diseases compared with healthy controls, but it was comparable among each disease. These findings imply that galectin-3 do not differentiate between benign and malignant proliferation of keratinocytes.
Tic Symptoms Induced by Atomoxetine in Treatment of ADHD: A Case Report and Literature Review
Authors: Yang Rongwang , Li Rong , Gao Weijia , Zhao Zhengyan
Published: December 2016

Objective:

Patients with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for tic disorders. Atomoxetine (ATX) has been accepted as an alternative medication for patients with ADHD and a comorbid tic disorder. It is rarely reported that tic symptoms are induced by ATX.

Methods:

This present report described a boy with ADHD who developed tic symptoms during ATX initiation. We used an ABAB trial to confirm the tics were related to ATX administration. In addition, we reviewed the published literature of patients whose tic symptoms were confirmed or suspected of relating to ATX usage.

Results:

This present case with an ABAB design showed on-off control of tics with or without ATX, which allowed us to make a strong conclusion that the tics were related to ATX administration. Literature review also indicated that ATX might induce tic symptoms in children with ADHD, especially in those being boys and having a history of tics. The time from starting ATX to tics symptoms appearing was approximately 19 days. The most common tic symptoms were eye blinking, vocal tics, or throat clearing, and neck movements. These tics symptoms in most cases could be resolved after discontinuing ATX without further pharmacotherapy.

Conclusion:

Pediatricians and child psychiatrists should be well aware of this potential adverse effect in children with ADHD receiving ATX.
Drug-induced peripheral neuropathy
Authors: Green Sarah , Holton Andrew
Published: December 2016

Drug-induced peripheral neuropathy is an important clinical problem. It can cause irreversible symptoms such as pain and numbness that have an enormous impact on ability to function normally and perceived quality of life. This can lead to dose reductions or a requirement to cease treatment with a particular drug. The mechanisms of damage are not always fully understood, but particular drugs such as the cancer chemotherapy agents are well known as identified causes of peripheral neuropathy. Investigative methods are not always satisfactory and the diagnosis is frequently clinical. It is important for clinicians to be aware of the problem so that patients at risk are asked the relevant questions.
Meta-analysis of Comparison of the Newer P2Y12 Inhibitors (Oral Preparation or Intravenous) to Clopidogrel in Patients With Acute Coronary Syndrome
Authors: Zhang Lu , Lu Jun , Dong Weihua , Tian Huiping , Feng Weiyi , You Haisheng , He Hairong , Ma Jing , Dong Yalin
Published: December 2016

Aims:

New P2Y12 adenosine diphosphate receptor antagonists have been used in the treatment of acute coronary syndrome (ACS) with different results. This systematic review analyzed and compared the evidence from large, clinical trials regarding the efficacy of clopidogrel relative to that of cangrelor, prasugrel, and ticagrelor in reducing the incidence of cardiovascular events in patients with ACS.

Methods and Results:

This analysis compared newer P2Y12 inhibitors with clopidogrel of 13 clinical trials involved a total of 87,985 patients with ACS. The newer P2Y12 inhibitors include cangrelor, prasugrel, and ticagrelor. Newer P2Y12 inhibitors significantly decreased the risk of myocardial infarction and showed a trend toward reduction of cardiovascular death (odds ratio [OR] = 0.86, 95% confidence interval [CI], 0.77–0.96, and I
2 = 54%, P < 0.05); (OR = 0.85, 95% CI, 0.77–0.93, and I
2 = 42%, P < 0.001). The rates of stroke events and the incidence in patients with ACS did not differ statistically between the clopidogrel group and the group with newer P2Y12 inhibitors (OR = 0.95, 95% CI, 0.79–1.14, and I
2 = 0%, P = 0.57). However, newer P2Y12 inhibitors showed a significant increase in thrombosis in MI major or minor bleeding (OR = 1.21, 95% CI, 1.03–1.42, and I
2 = 56%, P = 0.02) compared with clopidogrel.

Conclusions:

Based on this meta-analysis, newer P2Y12 inhibitors were significantly more effective than clopidogrel in the events of myocardial infarction and cardiovascular death in patients with ACS, although the incidence of thrombosis in MI-defined bleeding was higher compared with clopidogrel.
The cross-sectional association between vasomotor symptoms and hemostatic parameter levels in postmenopausal women
Authors: Harrington Laura B. , Blondon Marc , Cushman Mary , Kaunitz Andrew M. , Rossouw Jacques E. , Allison Matthew A. , Martin Lisa W. , Johnson Karen C. , Rosing Jan , Woods Nancy F. , LaCroix Andrea Z. , Heckbert Susan R. , McKnight Barbara , Smith Nicholas L.
Published: December 2016

Objective:

Vasomotor symptoms (VMS) may be a marker of cardiovascular risk. We aimed to evaluate the cross-sectional association of VMS presence and severity with hemostatic parameter levels measured at baseline among Women's Health Initiative (WHI) Hormone Therapy trial postmenopausal participants.

Methods:

This cross-sectional analysis included 2,148 postmenopausal women with measures of VMS presence and severity reported in the 4 weeks before WHI baseline, who were not using warfarin or hormone therapy and for whom the following baseline hemostatic parameters were measured within the WHI Cardiovascular Disease Biomarker Case-Control Study: antithrombin, plasminogen activator inhibitor-1, protein C antigen, total and free protein S antigen, total and free tissue factor pathway inhibitor, D-dimer, normalized activated protein C sensitivity ratio, and thrombin generation. Using multiple linear regression, we estimated the adjusted average difference in each hemostatic parameter associated with VMS presence and severity. A multiple comparisons-corrected P value was computed using the P-min procedure to determine statistical significance of our smallest observed P value.

Results:

Women were 67 years of age on average and 33% reported VMS presence at baseline. There was some suggestion that VMS presence may be associated with a −0.34 adjusted difference in normalized activated protein C sensitivity ratio compared with no VMS (95% CI, −0.60 to −0.087; P = 0.009), but this association was not significant after correction for multiple comparisons (P = 0.073). VMS presence or severity was not significantly associated with the other hemostatic parameters.

Conclusions:

We found no convincing evidence that VMS presence or severity was associated with levels of hemostatic parameters among postmenopausal women.
Skeletal muscle mass is associated with higher dietary protein intake and lower body fat in postmenopausal women: a cross-sectional study
Authors: Silva Thaís R. , Spritzer Poli M.
Published: December 2016

Objective:

We investigated the association between skeletal muscle mass and dietary protein intake, habitual physical activity, body composition, and metabolic variables.

Methods:

One hundred three healthy postmenopausal women from southern Brazil (age 55.2 ± 4.9 y, body mass index 27.2 ± 4.6 kg/m2) were enrolled. Bone mineral density, %body fat, %trunk fat mass, and appendicular lean mass were assessed by dual-energy x-ray absorptiometry, resting metabolic rate by indirect calorimetry, and habitual physical activity by pedometer. Skeletal muscle mass index (SMI) was expressed as appendicular lean mass standardized to body mass index. The cutoff for low lean mass was <0.512. Protein intake was measured by a validated food frequency questionnaire and categorized into tertiles: ≤0.93 g/kg body weight (BW), 0.94 to 1.29 g/kg BW, and ≥1.3 g protein/kg BW.

Results:

The prevalence of low lean mass (SMI <0.512) was 7%. Waist circumference, %body fat, trunk fat mass, and diastolic blood pressure were higher, whereas SMI and mean daily steps were lower in women with protein intake ≤0.93 g/kg BW. SMI was positively correlated with physical activity (r = 0.205, P = 0.038) and protein intake (r = 0.334, P = 0.001), and negatively correlated with waist circumference (r = −0.505, P < 0.001) and %body fat (r = 0.808, P < 0.001). Linear regression analysis adjusted for age, time since menopause, previous smoking behavior, and energy intake showed an independent, positive contribution of protein intake (mean difference 0.007, 95% CI, 0.001-0.014, P = 0.044) and an independent, negative contribution of %body fat (mean difference −0.010, 95%CI, −0.011 to −0.008, P < 0.001) to SMI.

Conclusions:

In our healthy postmenopausal women, SMI was positively associated with protein intake and negatively associated with %body fat.
Telomere length is longer in women with late maternal age
Authors: Fagan Erin , Sun Fangui , Bae Harold , Elo Irma , Andersen Stacy L. , Lee Joseph , Christensen Kaare , Thyagarajan Bharat , Sebastiani Paola , Perls Thomas , Honig Lawrence S. , Schupf Nicole
Published: December 2016

Objective:

Maternal age at birth of last child has been associated with maternal longevity. The aim of this study was to determine whether older women with a history of late maternal age at last childbirth had a longer leukocyte telomere length than those with maternal age at last childbirth of 29 years or less.

Methods:

A nested case control study was conducted using data from the Long Life Family Study. Three hundred eighty-seven women who gave birth to at least one child and lived to the top fifth percentile of their birth cohort, or died before the top fifth percentile of their birth cohort died, but were at least 70 years old, were studied. Logistic regression models using generalized estimating equations were used to determine the association between tertiles of telomere length and maternal age at last childbirth, adjusting for covariates.

Results:

Age at birth of the last child was significantly associated with leukocyte telomere length. Compared with women who gave birth to their last child before the age of 29, women who were past the age of 33 when they had their last child were two to three times more likely to have leukocyte telomere length in the second and third tertiles than in the first tertile.

Conclusions:

These findings show an association between longer leukocyte telomere length and a later maternal age at birth of last child, suggesting that extended maternal age at last childbirth may be a marker for longevity.
Robotically Assisted Thoracic Surgery: Proposed Guidelines for Privileging and Credentialing
Authors: Bhora Faiz Y. , Al-Ayoubi Adnan M. , Rehmani Sadiq S. , Forleiter Craig M. , Raad Wissam N. , Belsley Scott G.
Published: December 2016

Objective

Increased use of robotically assisted thoracic surgery (RATS) necessitates effective credentialing guidelines to ensure safe outcomes. We provide a stepwise algorithm for granting privileges and credentials in RATS. This algorithm reflects graduated responsibility and complexity of the surgical procedures performed. Furthermore, it takes into account volume, outcomes, surgeon's competency, and appropriateness of robot usage.

Methods

We performed a literature review for available strategies to grant privileges and credentials for implementing robotic surgery. The following terms were queried: robot, robotic, surgery, and credentialing. We provide this algorithm on the basis of review of the literature, our institutional experience, and the experience of other medical centers around the United States.

Results

Currently, two pathways for robotic training exist: residency and nonresidency-trained. In the United Sates, Joint Commission: Accreditation, Health Care, Certification requires hospitals to credential and privilege physicians on their medical staff. In the proposed algorithm, a credentialing designee oversees and reviews all requests. Residency-trained surgeons must fulfill 20 cases with program directors’ attestation to obtain full privileges. Nonresidency-trained surgeons are required to fulfill simulation, didactics including online modules, wet laboratories (cadaver or animal), and observation of at least two cases before provisional privileges can be granted. A minimum number of cases (10 per year) are required to maintain privileges. All procedures are monitored via departmental QA/QI committee review. Investigational uses of the robot require institutional review board approval, and complex operations may require additional proctoring and QA/QI review.

Conclusions

Safety concerns with the introduction of novel and complex technologies such as RATS must be paramount. Our algorithm takes into consideration appropriate use and serves as a basic guideline for institutions that wish to implement a RATS program.
Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
Authors: Cremer Miriam , Maza Mauricio , Alfaro Karla , Morales Velado Mario , Felix Juan , Castle Philip E. , Kim Jane , Gage Julia C.
Published: December 2016

Objective

The Cervical Cancer Prevention in El Salvador is a demonstration project to introduce a lower-cost human papillomavirus (HPV)-DNA test into a public sector project. Started in October 2012, The Cervical Cancer Prevention in El Salvador consists of 3 phases and will ultimately screen 30,000 women. Results of phase 2 of the project are presented. The objective of this project was to compare colposcopy and noncolposcopy-based management for HPV-positive women.

Material and Methods

In phase 2, a total of 8,050 women, aged 30 to 49 years, were screened; 6,761 provided both self- and provider-collected specimens and 1,289 provided only provider-testing specimens. HPV results from self-collected specimens were not used in clinical management decisions. Women with provider-collected HPV-positive results were treated based on the strategy assigned to their community; the strategy was colposcopy management (CM) or screen-and-treat (ST) management if they were cryotherapy eligible or colposcopy if not eligible. Outcomes were assessed 6 months after screening.

Results

Overall, 489 (12.3%) of 3,963 women receiving CM and 465 (11.4%) of 4,087 women receiving ST tested HPV positive. In the CM cohort, 216 (44.2%) of 489 completed their intervention (203 treated, 11 diagnosed negative, 2 pregnant). In the ST cohort, 411 (88.4%) of 465 completed their intervention (407 treated, 2 diagnosed negative, 1 pregnant). Overall agreement between HPV test results from self-collected and provider-collected specimens was 93.7%, with a κ value of 0.70 (95% CI = 0.68–0.73).

Conclusions

Human papillomavirus testing with ST management resulted in an approximately twice completion rate compared with CM management. Agreement between self- and provider-based sampling was good and might be used to extend screening to women in areas that are more difficult to reach.
Pump Speed Optimization in Stable Patients with a Left Ventricular Assist Device
Authors: Couperus Lotte E. , Delgado Victoria , Khidir Mand J. H. , Vester Marijke P. M. , Palmen Meindert , Fiocco Marta , Holman Eduard R. , Tops Laurens F. , Klautz Robert J. M. , Verwey Harriëtte F. , Schalij Martin J. , Beeres Saskia L. M. A.
Published: December 2016

Optimal left ventricular assist device (LVAD) functioning and preservation of right ventricular (RV) function are major survival determinants in destination therapy (DT)-LVAD recipients. Currently, the indication for routine pump speed optimization in stable patients and its effect on RV function at follow-up remain underexplored. Hemodynamically stable patients (N = 17, age 61 [interquartile range {IQR} 51–66] years; 13 [77%] male) underwent a routine speed ramp test. Echocardiographic images were obtained at incremental speed settings to determine optimal pump speed. In 8 patients (47%), LVAD speed could be optimized. In these patients, RV fractional area change (26% [IQR 23–31] to 35% [IQR 27–45], p = 0.04) and RV longitudinal peak systolic strain (−13% [IQR −16 to −9] to −17% [IQR −18 to −11], p = 0.02) at 3 months follow-up improved without RV dilatation. Furthermore, N-terminal pro-brain natriuretic peptide level decreased (3,162 [IQR 1,336–4,487] ng/L to 2,294 [IQR 1,157–3,810] ng/L, p = 0.02). No significant follow-up changes were found in patients without indication for speed adjustment. In conclusion, routine evaluation of optimal LVAD speed reveals the potential of speed optimization in a substantial proportion of stable LVAD-DT patients and can improve RV function.
Experience with Extracorporeal Life Support for Cardiogenic Shock in the Older Population more than 70 Years of Age
Authors: Pontailler Margaux , Demondion Pierre , Lebreton Guillaume , Golmard Jean-Louis , Leprince Pascal
Published: December 2016

The two main objectives of this single-center, retrospective study were to analyze the outcomes and to identify the independent predictors of 30 day and long-term mortality in case of cardiopulmonary resuscitation requiring extracorporeal life support (ECLS) in the elderly patients. From October 2004 to May 2014, 163 patients with a mean age of 75.5 years (range 70–91) required veno-arterial ECLS. The main indication was postcardiotomy cardiogenic shock (79.6%). Extracorporeal life support duration averaged 5.6 ± 4.3 days. Thirty-day mortality was 72% (n = 117) and follow-up survival rate was 14.1% with a median follow-up of 23.7 months (range 1.5–102.3). Lactatemia was identified as an independent risk factor of 30 day mortality. Previous stroke, lactatemia, bilirubinemia, and ECLS implantation under cardiac massage were identified as independent risk factors for long-term mortality. Extracorporeal life support after TAVI procedure and intra-aortic balloon pump support were identified as protective factors for both 30 day and long-term survival. The 23 patients, still alive at last follow up, have a good quality of life, doing well, and self-catering. Although mortality rate at 30 days is more than 70% in elderly patients requiring circulatory support with ECLS, survivors can pretend to an acceptable long-term survival with a good quality of life. Extracorporeal life support implantation in the elderly patients should remain scarce, but should still be considered as a therapeutic option in well-selected patients.
Infection, Oxidative Stress, and Changes in Circulating Regulatory T Cells of Heart Failure Patients Supported by Continuous-Flow Ventricular Assist Devices
Authors: Mondal Nandan K. , Sobieski Michael A. , Pham Si M. , Griffith Bartley P. , Koenig Steven C. , Slaughter Mark S. , Wu Zhongjun J.
Published: December 2016

The objective of this study was to investigate the changes in oxidative stress (OS) and circulating regulatory T cells (Tregs) of the immune system in patients supported by continuous-flow ventricular assist device (CF-VAD) with or without infection. We recruited 16 CF-VAD patients (5 with infection and 11 without infection) and 7 healthy volunteers. Generation of reactive oxygen species (ROS) from lymphocytes, superoxide dismutase (SOD) in erythrocyte, total antioxidant capacity (TAC), and oxidized low-density lipoprotein (oxLDL) in plasma were measured. Circulating Tregs were evaluated by flow cytometry. Heart failure (HF) patients had elevated OS than healthy volunteers as evident from higher lymphocyte ROS, elevated oxLDL, as well as depleted SOD and TAC levels. At baseline, HF patients had decreased percentage of Tregs (5.12 ± 1.5% vs. 8.14 ± 3.01%, p < 0.01) when compared with healthy volunteers. Postimplant patients with infection illustrated 35% and 44% rise in ROS and oxLDL, respectively, 31% decrease in TAC, and marked rise in percentage of Tregs (14.27 ± 3.17% vs. 9.38 ± 3.41%, p < 0.01) when compared with the patients without infection. Elevated OS and rise in Tregs were more prominent in CF-VAD patients with infection. In conclusion, OS and compromised immune system may be important indicators of systemic response of the body to CF-VAD among HF patients with infection.
Tolerability and Biological Effects of Long-Acting Octreotide in Patients With Continuous Flow Left Ventricular Assist Devices
Authors: Malhotra Rajiv , Shah Keyur B. , Chawla Raveen , Pedram Sammy , Smallfield Melissa C. , Priday Anna G. , DeWilde Christine T. , Brophy Donald F.
Published: December 2016

Patients with implanted continuous, nonpulsatile, left ventricular assist devices (LVADs) have increased the occurrence of gastrointestinal bleeding (GIB). Although the pathophysiology is multifactorial, there are few treatments beyond supportive care. Octreotide acetate is a somatostatin analog that reduces GIB in various patient populations. However, there are sparse case series that suggest octreotide acetate may reduce GIB in LVAD patients. This 10 patient, 28 week phase I study evaluated the safety and tolerability of octreotide acetate long-acting release (LAR) 20 mg depot injection every 4 weeks until week 16 after LVAD placement. Secondary aims were occurrence of GIB and measurement of vascular endothelial growth factor, fibrinogen, von Willebrand factor, and platelet aggregation across the study period. Ten patients were enrolled, and eight completed the study. The two study dropouts were not related to octreotide. None of the patients experienced side effects or safety concerns related to octreotide nor did GIB occur in the study population. Vascular endothelial growth factor levels were maintained in the reference range throughout the duration of the study. There did appear to be laboratory evidence of acquired von Willebrand syndrome, with mildly low platelet aggregation studies. In conclusion, octreotide acetate LAR 20 mg depot injection was safe and effective in this population.
Adherence to Oral Administration of Endocrine Treatment in Patients With Breast Cancer
Authors: Iacorossi Laura , Gambalunga Francesca , Fabi Alessandra , Giannarelli Diana , Marchetti Anna , Piredda Michela , De Marinis Maria Grazia
Published: December 2016

Background:

Breast cancer is the most common cancer in women in the world, and it is also the leading cause of cancer deaths among women. Nevertheless, breast cancer survival has increased as a result of improvements in early diagnosis and therapy, for example, oral endocrine therapy. Despite the importance of adherence to endocrine therapy, its trend appears complex and multidimensional and therefore has many loopholes and missing information.

Objective:

The study aims to explore the experiences of adherence to endocrine therapy in women with breast cancer and their perceptions of the challenges they face in adhering to their medication prescribed.

Methods:

The study used a qualitative exploratory design, with face-to-face semistructured interviews. Data were analyzed using framework analysis in accordance with Ritchie and Spencer’s approach.

Results:

The sample included 27 women. Seven themes were identified: the different faces of adherence, fear of the drug, adherence stimulates the balance of the experience of illness, adherence influences the future of disease, adherence requires attention to the person, knowledge seeking, and “forgetfulness” activates the search for functional strategies.

Conclusions:

This study shows that adherence assumes different connotations that are mainly influenced by the type of relationship established with health professionals the attention paid to the person, the information received, and the influence that the drug has on the disease.

Implications for Practice:

It appears that fear has a strong influence on the behaviors involved in taking the therapy. The only way to overcome irrational fear is to improve the patient’s knowledge.
Lifestyle Behaviors, Perceived Stress, and Inflammation of Individuals With Chronic Graft-Versus-Host Disease
Authors: Lynch Kelly Debra , Lyon Debra E. , Periera Deidre , Garvan Cynthia , Wingard John
Published: December 2016

Background:

Stress is a potent immunomodulator contributing to chronic conditions. Chronic graft-versus-host disease (cGVHD) is a life-threatening late effect of allogeneic hematopoietic cell transplantation associated with stress and exaggerated immune response that may be associated to lifestyle behaviors.

Objective:

The aim of this study is to explore associations among lifestyle behaviors, perceived stress, and inflammation of individuals with cGVHD.

Methods:

A secondary analysis from a prospective observational study of 24 adults (≥18 years) with cGVHD was conducted. Demographic, clinical, and symptom data were assessed using medical records and validated self-report measures; inflammatory markers were assessed using multiplex and enzyme-linked-immunosorbent assays from plasma.

Results:

Spiritual growth and total perceived stress were correlated (P < .001). Nutrition and C-reactive protein were negatively correlated (P = .02). Physical activity and cytokines (interleukin [IL]-2, IL-4, IL-5, IL-7, IL-10, IL-12, IL-13, IL-17, and granulocyte colony-stimulating factor) were associated (P < .05). Perceived stress and inflammatory markers were not associated. Individuals did not routinely engage in assessed health-promoting lifestyle behaviors.

Conclusion:

Associations in this sample were noted among lifestyle behaviors, perceived stress, and inflammation. Given these promising findings, further research with a larger sample size is needed to test these associations. Activity, nutrition, stress management, and social support interventions may reduce stress and inflammation. Particularly, connecting with one’s higher-self may reduce levels of perceived stress. Finding ways to engage survivors in healthy lifestyle behaviors should be explored.

Implications for Practice:

Information from this study allows nurses to be informed about the role of lifestyle behaviors on inflammation and stress to provide anticipatory guidance to HCT survivors regarding lifestyle choices that may mitigate inflammation and stress to promote positive health outcomes.
Acculturation and Postpartum Depressive Symptoms among Hispanic Women in the United States
Authors: Alhasanat Dalia , Giurgescu Carmen
Published: December 2016

Purpose:

The purpose of this review was to evaluate studies that examined the relationship between acculturation and postpartum depression (PPD) among immigrant and/or refugee women in the United States.

Methods:

A systematic, computer-assisted search of quantitative, English-language, peer-reviewed, published research articles was conducted in the Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Maternity and Infant Care databases using the keyword terms of “postpartum depression” and “perinatal depression” in combination with “acculturation.” Studies were included if they were conducted in the United States.

Results:

Seven studies met inclusion criteria. Three studies used longitudinal designs and four used cross-sectional designs. All were conducted with Hispanic women. Only one study used a diagnostic tool to measure PPD; the remaining studies used screening tools to measure postpartum depressive symptoms. Most studies used country of birth, country of residence, and language preferences to measure acculturation. Five studies reported acculturation was positively related to risk of postpartum depressive symptoms, and two studies reported no relationship.

Clinical Implications:

Higher levels of acculturation were related to higher risk of postpartum depressive symptoms in Hispanic women living in the United States. Nurses should have an understanding of stressors of immigrant women to guide their assessment and screening for postpartum depressive symptoms and make appropriate referrals. More research is needed to confirm the relationship between acculturation and PPD among immigrant women from different cultural backgrounds.
Treat Me Like Everyone Else
Authors: Neal-Boylan Leslie , Miller Michelle
Published: December 2016

The Americans With Disabilities Act requires that nursing programs not discriminate against students with disabilities. This article describes a qualitative study of RNs who had disabilities while in nursing school. As students, participants tried to hide their disabilities, experienced fear and anger from faculty, were frequently told they could never be nurses, wanted to be treated like everyone else, had to work harder than others to prove themselves worthy, and learned to advocate for themselves.
Project Shikamana: Baseline Findings From a Community Empowerment–Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania
Authors: Kerrigan Deanna , Mbwambo Jessie , Likindikoki Samuel , Beckham Sarah , Mwampashi Ard , Shembilu Catherine , Mantsios Andrea , Leddy Anna , Davis Wendy , Galai Noya
Published: December 2016

Background:

Community empowerment approaches have been found to be effective in responding to HIV among female sex workers (FSWs) in South Asia and Latin America. To date, limited rigorous evaluations of these approaches have been conducted in sub-Saharan Africa.

Methods:

A phase II community randomized controlled trial is being conducted in Iringa, Tanzania, to evaluate the effectiveness of a community empowerment–based combination HIV prevention model (Project Shikamana) among a stratified sample of HIV-infected and HIV-uninfected FSWs. Cohort members were recruited from entertainment venues across 2 communities in the region using time-location sampling. All study participants gave consent, and were surveyed and screened for HIV at baseline. Primary biological study outcomes are viral suppression among the HIV-infected and remaining free of HIV among HIV-uninfected women.

Results:

A cohort of 496 FSWs was established and is currently under follow-up. Baseline HIV prevalence was 40.9% (203/496). Among HIV-infected FSWs, 30.5% (62/203) were previously aware of their HIV status; among those who were aware, 69.4% were on antiretroviral therapy (43/62); and for those on antiretroviral therapy, 69.8% (30/43) were virally suppressed. Factors associated with both HIV infection and viral suppression at baseline included community, age, number of clients, and substance use. Amount of money charged per client and having tested for sexually transmitted infection in the past 6 months were protective for HIV infection. Social cohesion among FSWs was protective for viral suppression.

Conclusions:

Significant gaps exist in HIV service coverage and progress toward reaching the 90-90-90 goals among FSWs in Iringa, Tanzania. Community empowerment approaches hold promise given the high HIV prevalence, limited services and stigma, discrimination, and violence.
The Analgesic Effect of Ropivacaine Combined With Dexmedetomidine for Incision Infiltration After Laparoscopic Cholecystectomy
Authors: Yu Jun-Ma , Sun Hao , Wu Chao , Dong Chun-Shan , Lu Yao , Zhang Ye
Published: December 2016

Background:

Local anesthetics infiltration is one consensus efficient strategy for pain relief after laparoscopic cholecystectomy (LC). The aim of this study was to investigate analgesia efficacy of incisional infiltration with ropivacaine plus dexmedetomidine.

Methods:

Patients scheduled for LC were assigned to 4 groups by different medications for trocar wound infiltration. The incidence of adverse events and the analgesic effect of ropivacaine combined with dexmedetomidine for incision infiltration were recorded.

Results:

Incisional infiltration of ropivacaine combining with dexmedetomidine could significantly reduce postoperative pain and the amount of pethidine requirement. Furthermore, it could also reduce time to walk without assistance, improve the efficacy of analgesia and sleep quality during the first night after LC, but did not increase the incidence of surgical adverse events.

Conclusions:

The use of ropivacaine and dexmedetomidine may be considered as an alternative treatment for postoperative pain in patients undergoing LC.
Effect of Pectoral Electrostimulation on Reduction of Mammary Ptosis After Bariatric Surgery
Authors: Ruiz-Tovar Jaime , Llavero Carolina
Published: December 2016

Background:

Over 90% of women report to be very dissatisfied with the aspect of their breast after bariatric surgery. Breast reconstructive surgeries are often not funded by the National Health Service or private health insurances in many countries and the patient must pay a high economic amount to undergo it.

Patients and Methods:

A prospective randomized clinical trial of patients undergoing bariatric surgery was performed. Patients were randomly assigned into 3 groups: patients undergoing percutaneous electrostimulation of the pectoral muscle combined with specific training (group 1), patients doing the specific training alone (group 2), and patients without any specific treatment (group 3). The assigned treatment began 15 days after surgery and was maintained during 12 weeks.

Results:

Twenty-five women were included in each group. In the posttreatment anthropometric measures significant differences between groups could be observed in Regnault classification (P=0.014), ptosis (P=0.017), and projection (P=0.025). Multiple comparisons revealed that there were no significant differences in all these variables between group 2 and group 3, whereas a significant difference could be observed between groups 1 and 2 and 1 and 3. Median satisfaction score with the prescribed treatment was significantly better in group 1 than in the other groups.

Conclusions:

Percutaneous electrostimulation of the pectoral muscle combined with specific training achieves a reduction in the breast ptosis and an increased projection, resulting in greater satisfaction of the patients, when compared with only specific training or without any specific activity.
Effects of exercise interventions and physical activity behavior on cancer-related cognitive impairments: an update
Authors: Schaffrath Nils , Oberste Max , Zimmer Philipp
Published: December 2016

Purpose of review

The purpose of this review is to give an update on studies investigating the influence of physical activity behavior and exercise interventions on cancer-related cognitive impairments.

Recent findings

Cross-sectional and observational studies underline previous findings, revealing an association of cancer patients’ fitness and their cognitive functions. Results from interventional studies are sparse. Only one study investigated self-perceived cognitive function in breast cancer patients as a secondary outcome, indicating no effects.

Recent research on physical activity and exercise interventions is still restricted by methodological limitations, including the wide variation in assessments and the lack of adequate control groups.
Human influences on evolution, and the ecological and societal consequences
Authors: Hendry Andrew P. , Gotanda Kiyoko M. , Svensson Erik I.
Published: December 2016

Humans have dramatic, diverse and far-reaching influences on the evolution of other organisms. Numerous examples of this human-induced contemporary evolution have been reported in a number of ‘contexts’, including hunting, harvesting, fishing, agriculture, medicine, climate change, pollution, eutrophication, urbanization, habitat fragmentation, biological invasions and emerging/disappearing diseases. Although numerous papers, journal special issues and books have addressed each of these contexts individually, the time has come to consider them together and thereby seek important similarities and differences. The goal of this special issue, and this introductory paper, is to promote and expand this nascent integration. We first develop predictions as to which human contexts might cause the strongest and most consistent directional selection, the greatest changes in evolutionary potential, the greatest genetic (as opposed to plastic) changes and the greatest effects on evolutionary
diversification
. We then develop predictions as to the contexts where human-induced evolutionary changes might have the strongest effects on the population dynamics of the focal evolving species, the structure of their communities, the functions of their ecosystems and the benefits and costs for human societies. These qualitative predictions are intended as a rallying point for broader and more detailed future discussions of how human influences shape evolution, and how that evolution then influences species traits, biodiversity, ecosystems and humans.

This article is part of the themed issue ‘Human influences on evolution, and the ecological and societal consequences’.
Urban driven phenotypic changes: empirical observations and theoretical implications for eco-evolutionary feedback
Authors: Alberti Marina , Marzluff John , Hunt Victoria M.
Published: December 2016

Emerging evidence that cities drive micro-evolution raises the question of whether rapid urbanization of Earth might impact ecosystems by causing systemic changes in functional traits that regulate urban ecosystems' productivity and stability. Intraspecific trait variation—variation in organisms' morphological, physiological or behavioural characteristics stemming from genetic variability and phenotypic plasticity—has significant implications for ecological functions such as nutrient cycling and primary productivity. While it is well established that changes in ecological conditions can drive evolutionary change in species' traits that, in turn, can alter ecosystem function, an understanding of the reciprocal and simultaneous processes associated with such interactions is only beginning to emerge. In urban settings, the potential for rapid trait change may be exacerbated by multiple selection pressures operating simultaneously. This paper reviews evidence on mechanisms linking urban development patterns to rapid phenotypic changes, and differentiates phenotypic changes for which there is evidence of micro-evolution versus phenotypic changes which may represent plasticity. Studying how humans mediate phenotypic trait changes through urbanization could shed light on fundamental concepts in ecological and evolutionary theory. It can also contribute to our understanding of eco-evolutionary feedback and provide insights for maintaining ecosystem function over the long term.

This article is part of the themed issue ‘Human influences on evolution, and the ecological and societal consequences’.