bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiological diagnosis of spinal arachnoid cysts: A pictorial essay
Authors: Ospina Moreno Carolina , Vela Marín Ana Carmen , Castán Senar Alba , Montejo Gañán Inmaculada , Cózar Bartos Magdalena , Marín Cárdenas Miguel Angel
Published: May 2016

Spinal arachnoid cysts (AC) are intraspinal extramedullary loculated cerebral spinal fluid collections. They are relatively uncommon lesions. Spinal AC often cause symptoms such as pain, weakness and radiculopathy. In this pictorial essay we demonstrate the main radiological features of spinal AC, as well as symptoms and complications associated with them. We also describe the main differential diagnoses.
Serotonin's Complex Role in Alcoholism: Implications for Treatment and Future Research
Authors: Marcinkiewcz Catherine A. , Lowery‐Gionta Emily G. , Kash Thomas L.
Published: May 2016

Current pharmacological treatments for alcohol dependence have focused on reducing alcohol consumption, but to date there are few treatments that also address the negative affective symptoms during acute and protracted alcohol withdrawal which are often exacerbated in people with comorbid anxiety and depression. Selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed to ameliorate these symptoms but can exacerbate anxiety and cravings in a select group of patients. In this critical review, we discuss recent literature describing an association between alcohol dependence, the SERT linked polymorphic region (5‐HTTLPR), and pharmacological response to SSRIs. Given the heterogeneity in responsiveness to serotonergic drugs across the spectrum of alcoholic subtypes, we assess the contribution of specific 5‐HT circuits to discrete endophenotypes of alcohol dependence. 5‐HT circuits play a distinctive role in reward, stress, and executive function which may account for the variation in response to serotonergic drugs. New optogenetic and chemogenetic methods for dissecting 5‐HT circuits in alcohol dependence may provide clues leading to more effective pharmacotherapies. Although our current understanding of the role of 5‐HT systems in alcohol dependence is incomplete, there is some evidence to suggest that 5‐HT3 receptor antagonists are effective in people with the L/L genotype of the 5‐HTTLPR polymorphism while SSRIs may be more beneficial to people with the S/L or S/S genotype. Studies that assess the impact of serotonin transporter polymorphisms on 5‐HT circuit function and the subsequent development of alcohol use disorders will be an important step forward in treating alcohol dependence.
Effects of livestock grazing on an Afromontane grassland bird community in the Bale Mountains of Ethiopia
Authors: Mamo Yosef , Asefa Addisu , Mengesha Girma
Published: May 2016

Livestock grazing has been considered to be one of the major causes for biodiversity degradation worldwide. In this study, we examined this effect on Afromontane grassland birds by comparing their diversity between ungrazed and grazed grassland sites in the northern Bale Mountains, Ethiopia. We counted birds and recorded vegetation height and cover along 28 (14 in each land‐use type) 1 km transects. We used six different diversity measures (richness, evenness, Shannon diversity, taxonomic diversity and taxonomic distinctness) to express bird diversity and explored which of these measures better reveal the diversity pattern. Vegetation structure differed significantly between the two sites; the first two principal components accounted for 78% of the variation. Discriminant function analysis (DFA) showed bird diversity to differ significantly between the two sites; taxonomic diversity (Delta) contributed the most to the difference between the two sites, while species richness contributed the least. The results of ANOVA indicated that all diversity measures, except species richness, were significantly higher in the protected site compared to the unprotected site. In general, this study showed that grazing had negatively affected bird diversity in the study area and the use of taxonomic diversity measures had enabled us to reveal the impact better.
Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: meta‐analysis by geographic region with a focus on European patients
Authors: Gómez‐Outes Antonio , Terleira‐Fernández Ana‐Isabel , Calvo‐Rojas Gonzalo , Suárez‐Gea M. Luisa , Vargas‐Castrillón Emilio
Published: May 2016

Aims

To analyse clinical outcomes with direct oral anticoagulants in patients with atrial fibrillation according to geographic region.

Methods

We systematically searched MEDLINE, CENTRAL, websites of regulatory agencies, clinical trials registers and conference proceedings for randomized controlled trials of direct oral anticoagulants (DOAC: dabigatran, rivaroxaban, apixaban or edoxaban) against warfarin for prophylaxis of stroke and systemic embolic events (SEE) in patients with atrial fibrillation (AF). Two investigators independently extracted data. Relative risks of stroke and SEE as well as major bleeding depending on geographic region were estimated using a random effect meta‐analysis.

Results

Five trials in 72 963 patients were analysed; 32 089 (44%) patients were recruited in Europe (Western Europe: 13 676; Eastern Europe: 18 413). We found significant subgroup differences for stroke/SEE depending on the geographic region (interaction P = 0.003; I2 88.5%), with a neutral effect of the DOAC vs. warfarin in Europe [relative risk (RR) 0.97, 95% confidence interval (CI) 0.85–1.11, I2 0%] and a significant reduction of stroke/SEE in other regions including North America, Latin America and Asia‐Pacific/other (RR 0.72, 95% CI 0.63–0.83, I2 33%). There was a similar reduction in risk of major bleeding in Europe (RR 0.82, 95% CI 0.73–0.92, I2 0%) and in other regions (RR 0.86, 95% CI 0.72–1.02, I2 78%).

Conclusion

The DOAC did not provide additional benefit in reducing the risk of stroke/SEE compared with warfarin in European patients with AF, but were generally associated with a lower bleeding tendency than warfarin regardless of geographic region.
Bioethics and Climate Change: A Response to Macpherson and Valles
Authors: Resnik David B.
Published: May 2016

Two articles published in Bioethics recently have explored the ways that bioethics can contribute to the climate change debate. Cheryl Cox Macpherson argues that bioethicists can play an important role in the climate change debate by helping the public to better understand the values at stake and the trade‐offs that must be made in individual and social choices, and Sean Valles claims that bioethicists can contribute to the debate by framing the issues in terms of the public health impacts of climate change. While Macpherson and Valles make valid points concerning a potential role for bioethics in the climate change debate, it is important to recognize that much more than ethical analysis and reflection will be needed to significantly impact public attitudes and government policies.
Extracellular microvesicle microRNAs in children with sickle cell anaemia with divergent clinical phenotypes
Authors: Khalyfa Abdelnaby , Khalyfa Ahamed A. , Akbarpour Mahzad , Connes Phillippe , Romana Marc , Lapping‐Carr Gabrielle , Zhang Chunling , Andrade Jorge , Gozal David
Published: May 2016

Sickle cell anaemia (SCA) is the most frequent genetic haemoglobinopathy, which exhibits a highly variable clinical course characterized by hyper‐coagulable and pro‐inflammatory states, as well as endothelial dysfunction. Extracellular microvesicles are released into biological fluids and play a role in modifying the functional phenotype of target cells. We hypothesized that potential differences in plasma‐derived extracellular microvesicles (EV) function and cargo fromSCApatients may underlie divergent clinical trajectories. PlasmaEVfromSCApatients with mild, intermediate and severe clinical disease course were isolated, and primary endothelial cell cultures were exposed. Endothelial cell activation, monocyte adhesion, barrier disruption and exosome cargo (microRNAmicroarrays) were assessed.EVdisrupted the endothelial barrier and induced expression of adhesion molecules and monocyte adhesion in aSCAseverity‐dependent manner compared to healthy children. Microarray approaches identified a restricted signature of exosomal microRNAs that readily distinguished severe from mildSCA, as well as from healthy children. The microRNAcandidates were further validated using quantitative real time polymerase chain reaction assays, and revealed putative gene targets. Circulating exosomal microRNAs may play important roles in predicting the clinical course ofSCA, and in delineation of individually tailored, mechanistically‐based clinical treatment approaches ofSCApatients in the near future.
Papular acantholytic dyskeratosis of the anogenital and genitocrural area: case series and review of the literature
Authors: Al‐Muriesh Maher , Abdul‐fattah Bilal , Wang Xia , Zhao Mengjie , Chen Siyuan , Huang Changzheng
Published: May 2016

Background

Papular acantholytic dyskeratosis (PAD) of the anogenital/genitocrural area is described as a rare distinct clinicopathological entity known to dermatopathologists, although its characteristic histopathologic pattern resembles both Hailey–Hailey disease and Darier disease. The objective of this study is to describe the clinical characteristics, histopathologic features and response to treatment of PAD.

Methods

We report in detail six cases of PAD. A literature search of the keyword ‘papular acantholytic dyskeratosis’ was performed on Google scholar and PubMed, 21 cases of this entity were found. A total of 27 patients including our six cases are reviewed in this study.

Results

The mean age at diagnosis was 38.8 years with a male to female ratio of 0.8 : 1. Clinically, papular lesions (55.6%) are the typical manifestation of PAD, and the anogenital area (63%) is the most commonly involved site. Lesions were resistant to topical steroids, subcutaneous interferon and antibiotics while one case showed complete resolution of the lesions after retinoid therapy. Laser therapy showed good results in one case. None of the patients had spontaneous remission.

Conclusion

Awareness of the clinicopathological hallmarks herein may be important to avoid underdiagnosis of PAD and may contribute to understanding the pathogenesis of this rare disease.
A missense variant in GLP1R gene is associated with the glycaemic response to treatment with gliptins
Authors: Javorský M. , Gotthardová I. , Klimčáková L. , Kvapil M. , Židzik J. , Schroner Z. , Doubravová P. , Gala I. , Dravecká I. , Tkáč I.
Published: May 2016

Gliptins act by increasing endogenous incretin levels. Glucagon‐like peptide‐1 receptor (GLP1R) and glucose‐dependent insulinotropic peptide receptor (GIPR) are their indirect drug targets. Variants of GLP1R and GIPR have previously been associated with the incretin effect. The aim of the present pilot study was to examine associations of the GLP1R and GIPR gene variants with the glycaemic response to gliptins. A total of 140 consecutive patients with type 2 diabetes were followed‐up 6 months after initiation of gliptin treatment. GLP1R rs6923761 (Gly168Ser) and GIPR rs10423928 genotyping was performed using real‐time PCR, with subsequent high‐resolution melting analysis. The main study outcome was reduction in glycated haemoglobin (HbA1c) after treatment. GLP1R Gly168Ser variant was significantly associated with reduction in HbA1c in an additive model (β = −0.33, p = 0.011). The mean reduction in HbA1c in Ser/Ser homozygotes was significantly lower compared with Gly‐allele carriers [0.12 ± 0.23% vs. 0.80 ± 0.09% (1.3 ± 2.5 mmol/mol vs. 8.7 ± 1.0 mmol/mol); p = 0.008]. In conclusion, GLP1R missense variant was associated with a reduced response to gliptin treatment. The genotype‐related effect size of ∼0.7% (8 mmol/mol) is equal to an average effect of gliptin treatment and makes this variant a candidate for use in precision medicine.
Treatment intensification for patients with type 2 diabetes and poor glycaemic control
Authors: Fu A. Z. , Sheehan J. J.
Published: May 2016

Aims

To identify the time to and patient characteristics associated with treatment intensification in patients with type 2 diabetes (T2D) and poor glycaemic control.

Methods

Using a large US insurance claims database, we conducted a retrospective cohort study among adult patients with T2D and glycated haemoglobin (HbA1c) ≥8% (index date) after ≥3 months of therapy including metformin. Patients were required to have continuous enrolment for at least 12 months before (baseline) and after index date, and no injectable antidiabetes medications. We defined treatment intensification as prescription fill for injectable or additional oral antidiabetic drugs (OADs). Cox modelling was performed to identify factors associated with time to treatment intensification.

Results

For the 11 525 patients meeting the inclusion criteria, the mean age at index date was 57 years, 40% were female and the mean index HbA1c was 9.1%. Overall, 37% of patients had their treatment intensified <6 months after, 11% had their treatment intensified 6–12 months after, and 52% did not have their treatment intensified <12 months after the index date. A higher index HbA1c was associated with early intensification [hazard ratio (HR) 1.18 for HbA1c ≥9 to <10% and HR 1.41 for HbA1c ≥10% compared with HbA1c ≥8 to <9%; p < 0.0001), and later line of therapy was associated with late intensification (HR 0.78 for metformin with one OAD and HR 0.68 for metformin with ≥2 OADs compared with metformin monotherapy; p < 0.0001).

Conclusions

Fewer than half of patients with T2D and treatment failure received intensification within 12 months in a real‐world US population. Factors associated with treatment inertia can be used to target clinical care for these patients.
The life and death of barn beetles: faunas from manure and stored hay inside farm buildings in northern Iceland
Authors: FORBES VÉRONIQUE , DUGMORE ANDREW J. , ÓLAFSSON ERLING
Published: May 2016

1. Subfossil beetle remains from archaeological sites have proven invaluable for examining past living conditions, human activities, and their impacts on landscapes and ecosystems.

2. In Iceland, specific economic practices (e.g. land management and natural resource exploitation) and major historical events (i.e. colonisation, economic intensification and commercialisation, and urbanisation) have affected local environments and left recognisable traces in the beetle subfossil record.

3. Understanding the ecology of synanthropic beetles is crucial if they are to be employed in high‐resolution reconstructions of past lifeways and their ecological impacts, yet, because buildings' interiors are rarely the object of systematic entomological research, the ecological requirements of many such species are poorly understood.

4. A survey was conducted of live and dead beetle faunas from habitats that have so far been largely neglected by entomological research: stable manure and stored hay inside farm buildings, two key facets of a northern European pastoral economy.

5. The present results clarify the ecological requirements of some under‐studied synanthropic beetles and the processes by which their exoskeletons may become incorporated into the archaeological record while also producing new records of exotic species recently introduced to Iceland.

6. This paper provides crucial guidance for the interpretation of archaeological beetle assemblages and highlights the potential of further investigations of indoor insect faunas for clarifying the causes, processes, and ecological impacts of recent bio‐invasions.
Physicians’ opinions regarding the criteria for resuming oral intake after aspiration pneumonia: A questionnaire survey and cluster analysis of hospitals across Japan
Authors: Kenzaka Tsuneaki , Kumabe Ayako , Kosami Koki , Matsuoka Yasufumi , Minami Kensuke , Ninomiya Daisuke , Noda Ayako , Okayama Masanobu
Published: May 2016

Aim

To investigate the items that are considered by physicians when making decisions regarding the resumption of oral intake among patients with aspiration pneumonia who have undergone short‐term fasting.

Methods

We surveyed 2490 Japanese hospitals that had internal medicine and respiratory medicine departments. We mailed questionnaires that contained 24 items related to oral intake resumption after aspiration pneumonia to the head of the department at each hospital. Cronbach statistics, principal component analysis and cluster analysis were used to analyze the results.

Results

We received responses from 350 hospitals; 89.7% of the respondents answered that they “Strongly agree” that “level of consciousness” is a useful criterion for resuming oral intake. Furthermore, 66%, 66%, 63.4%, 58.5% and 51% of the respondents answered that they “strongly agree” regarding the use of SpO2, the discretion of the attending physician, body temperature, swallowing function test results, mental state and respiratory rate, respectively. In the cluster analysis, level of consciousness, body temperature, SpO2, respiratory rate, mental state and the discretion of the attending physician belonged to the first cluster. The second cluster consisted of the patient's request, the family's request, the opinions of the medical staff and non‐physician healthcare providers, and performance status.

Conclusions

Physicians consider several criteria during decision‐making regarding oral intake resumption, which can be assigned to two clusters. Future studies are required to develop generalizable and objective criteria. Geriatr Gerontol Int 2017; 17: 810–818.
Bone quality assessed using quantitative ultrasound at the distal radius does not differ in antiretroviral therapy‐naïve HIV‐positive and HIV‐negative Rwandan women
Authors: Mutimura E , Shi Q , Hoover DR , Anastos K , Rudakemwa E , Dusingize JC , Sinabye JD , Yin MT
Published: May 2016

Objectives

The incidence of fractures appears to be increased in HIV‐infected individuals.

Methods

We assessed bone quality using quantitative ultrasound (QUS) in HIV‐infected and uninfected Rwandan women. A Sunlight Omnisense 7000 QUS was used to measure the speed of ultrasound (SOS) at the distal radius in 646 antiretroviral therapy (ART)‐naïve HIV‐infected women and 211 HIV‐uninfected women. The Z‐scores for SOS were based on data for women of the same age from the manufacturer's reference material.

Results

The mean CD4 cell count was 285 (± 166) cells/μL in the HIV‐positive women. SOS Z‐scores adjusted and unadjusted for body mass index did not differ between the groups. SOS did not differ by CD4 count (< 200 vs. ≥ 200 cells/μL: 4016 (± 117) vs. 4028 (± 107) m/s, respectively; p=0.19.

Conclusions

In HIV‐positive ART‐naïve Rwandan women with advanced HIV disease, bone quality at the distal radius was similar to that in HIV‐negative controls.
The mutual control of iron and erythropoiesis
Authors: Camaschella C. , Pagani A. , Nai A. , Silvestri L.
Published: May 2016

Background

Iron is essential for hemoglobin synthesis during terminal erythropoiesis. To supply adequate iron the carrier transferrin is required together with transferrin receptor endosomal cycle and normal mitochondrial iron utilization. Iron and iron protein deficiencies result in different types of anemia. Iron‐deficiency anemia is the commonest anemia worldwide due to increased requirements, malnutrition, chronic blood losses and malabsorption. Mutations of transferrin, transferrin receptor cycle proteins, enzymes of the first step of heme synthesis and iron sulfur cluster biogenesis lead to rare anemias, usually accompanied by iron overload. Hepcidin plays an indirect role in erythropoiesis by controlling plasma iron. Inappropriately high hepcidin levels characterize the rare genetic iron‐refractory iron‐deficiency anemia (IRIDA) and the common anemia of chronic disease. Iron modulates both effective and ineffective erythropoiesis: iron restriction reduces heme and alpha‐globin synthesis that may be of benefit in thalassemia.

Material and Methods

This review relies on the analysis of the most recent literature and personal data.

Results

Erythropoiesis controls iron homeostasis, by releasing erythroferrone that inhibits hepcidin transcription to increase iron acquisition in iron deficiency, hypoxia and EPO treatment. Erythroferrone, produced by EPO‐stimulated erythropoiesis, inhibits hepcidin only when the activity of BMP/SMAD pathway is low, suggesting that EPO somehow modulates the latter signaling. Erythroblasts sense circulating iron through the second transferrin receptor (TFR2) that, in animal models, modulates the sensitivity of the erythroid cells to EPO.

Discussion

The advanced knowledge of the regulation of systemic iron homeostasis and erythropoiesis‐mediated hepcidin regulation is leading to the development of targeted therapies for anemias and iron disorders.
Pro‐ and anticoagulant properties of factor V in pathogenesis of thrombosis and bleeding disorders
Authors: Dahlbäck Björn
Published: May 2016

Factor V (FV) serves an important role in the regulation of blood coagulation, having both pro‐ and anticoagulant properties. The circulating high molecular weight single‐chain FV molecule undergoes a series of proteolytic cleavages during both activation of coagulation and during anticoagulant regulation of coagulation by activated protein C (APC). It is noteworthy that mutations in the factor V gene (F5) either cause thrombosis or bleeding. New insights into the importance and complexity of FV functions have been generated from elucidation of the pathogenic mechanisms of two familial mutations in the F5 gene. The first mutation was identified as a result of the discovery of APC resistance as the most common risk factor for venous thrombosis. The mutation (FV Leiden) predicts the Arg506Gln replacement, which impairs the normal regulation of FVa by APC, as the Arg506 site is an important APC cleavage site. In addition, elucidation of APC resistance resulted in the discovery of the anticoagulant APC cofactor activity of FV. The second FV mutation (FVA2440G), identified in a family with an autosomal dominant bleeding disorder, has led to the discovery of an alternative splicing generating a previously unidentified FV isoform (FV‐Short), which inhibits coagulation via an unexpected and intriguing mechanism involving the coagulation inhibitor TFPI‐α. These are naturally occurring mutations in the F5 gene that have generated new knowledge on the role of FV in regulation of coagulation and the importance of genetic risk factors for thrombosis and bleeding.
Myeloproliferative neoplasms (BCR‐ABL1 negative) and myelodysplastic/myeloproliferative neoplasms: current diagnostic principles and upcoming updates
Authors: Geyer J. T. , Orazi A.
Published: May 2016

Since the publication of the latest World Health Organization (WHO) classification in 2008, there has been a significant effort for clarification of unresolved questions, especially with the help of the rapidly developing field of molecular genetic studies, next‐generation sequencing in particular. Numerous entities within the WHO categories of myeloproliferative neoplasms (MPNs) and myelodysplastic (MDS)/MPNs have been extensively studied, with large published series attempting to characterize and better define their morphologic and molecular genetic features. This emerging genetic landscape maintains a robust correlation with the various disease entities recognized by the WHO classification scheme based on a careful integration of detailed clinical information, bone marrow and peripheral blood morphology, immunohistology, and genomics. This brief review summarizes the current guidelines as they apply to diagnosing both the classical BCR‐ABL1 negative MPN (polycythemia vera, essential thrombocythemia, and primary myelofibrosis) and the more common subtypes of MDS/MPN overlap syndromes. The more important recent molecular updates as well as the upcoming changes to the current WHO classification, expected to be published in late 2016, will also be briefly reviewed.
Morphology, Ontogeny, and Molecular Phylogeny of Two Freshwater Species of Deviata (Ciliophora, Hypotrichia) from Southern China
Authors: Luo Xiaotian , Fan Yangbo , Hu Xiaozhong , Miao Miao , Al‐Farraj Saleh A. , Song Weibo
Published: May 2016

The morphology and partial morphogenesis of two freshwater hypotrichous ciliates, Deviata brasiliensis Siqueira‐Castro et al., 2009 and Deviata rositae Küppers et al., 2007, isolated from southern China, were investigated using live observation and protargol staining. Our populations resemble the original ones in terms of their live characters and ciliary patterns. The main determinable morphogenetic features of D. brasiliensis basically correspond with those of the type population. However, the origin of anlage V for either proter or opisthe is ambiguous: whether anlage V for the proter originates from parental frontoventral row 2 (the same as in the original population) or parental frontoventral row 3 (the same as in Deviata abbrevescens) or even de novo is not clear; the anlage V for the opisthe is possibly derived from frontoventral row 3 and further migrates to frontoventral row 2, like that in D. abbrevescens. In addition, the SSU rRNA gene was first sequenced for both species. Molecular phylogenetic analyses suggest that the genus Deviata is non‐monophyletic and has a close relationship with Perisincirra paucicirrata.
Length of Stay in the Emergency Department and Occurrence of Delirium in Older Medical Patients
Authors: Bo Mario , Bonetto Martina , Bottignole Giuliana , Porrino Paola , Coppo Eleonora , Tibaldi Michela , Ceci Giacomo , Raspo Silvio , Cappa Giorgetta , Bellelli Giuseppe
Published: May 2016

Objectives

To determine whether emergency department (ED) length of stay before ward admission is associated with incident delirium in older adults.

Design

Prospective cohort study.

Setting

Hospital.

Participants

Individuals aged 75 and older without delirium at ED entry, coma, aphasia, stroke, language barrier, psychiatric disorder, or alcohol abuse (N = 330).

Measurements

On ED admission, individuals underwent standardized evaluation of comorbidity (Cumulative Illness Rating Scale), cognitive impairment (Short Portable Mental Status Questionnaire), functional independence (activities of daily living, instrumental activities of daily living), pain (Numeric Rating Scale), and acute clinical conditions (Acute Physiology and Chronic Health Evaluation II). During the first 3 days after ward admission, the presence of delirium (defined as ≥1 delirium episodes within 72 hours) was assessed daily using a rapid assessment for delirium (4AT scale). ED length of stay was calculated as the time (hours) between ED registration and when the person left the ED.

Results

ED length of stay longer than 10 hours (odds ratio (OR) = 2.23, 95% confidence interval (CI) = 1.13–4.41), moderate to severe cognitive impairment (OR = 5.47, 95% CI = 2.76–10.85), and older age (OR = 1.07, 95% CI = 1.01–1.13) were associated with delirium onset.

Conclusion

ED length of stay longer than 10 hours was associated with greater risk of delirium in hospitalized older adults, after adjusting for age and cognitive impairment.
Risk of vicarious trauma in nursing research: a focused mapping review and synthesis
Authors: Taylor Julie , Bradbury‐Jones Caroline , Breckenridge Jenna P , Jones Christine , Herber Oliver Rudolf
Published: May 2016

Aims and objectives

To provide a snapshot of how vicarious trauma is considered within the published nursing research literature.

Background

Vicarious trauma (secondary traumatic stress) has been the focus of attention in nursing practice for many years. The most pertinent areas to invoke vicarious trauma in research have been suggested as abuse/violence and death/dying. What is not known is how researchers account for the risks of vicarious trauma in research.

Design

Focused mapping review and synthesis. Empirical studies meeting criteria for abuse/violence or death/dying in relevant Scopus ranked top nursing journals (n = 6) January 2009 to December 2014.

Methods

Relevant papers were scrutinised for the extent to which researchers discussed the risk of vicarious trauma. Aspects of the studies were mapped systematically to a pre‐defined template, allowing patterns and gaps in authors' reporting to be determined. These were synthesised into a coherent profile of current reporting practices and from this, a new conceptualisation seeking to anticipate and address the risk of vicarious trauma was developed.

Results

Two thousand five hundred and three papers were published during the review period, of which 104 met the inclusion criteria. Studies were distributed evenly by method (52 qualitative; 51 quantitative; one mixed methods) and by focus (54 abuse/violence; 50 death/dying). The majority of studies (98) were carried out in adult populations. Only two papers reported on vicarious trauma.

Conclusion

The conceptualisation of vicarious trauma takes account of both sensitivity of the substantive data collected, and closeness of those involved with the research. This might assist researchers in designing ethical and protective research and foreground the importance of managing risks of vicarious trauma.

Relevance to clinical practice

Vicarious trauma is not well considered in research into clinically important topics. Our proposed framework allows for consideration of these so that precautionary measures can be put in place to minimise harm to staff.
Association of frail index and quality of life among community‐dwelling older adults
Authors: Chang Shu‐Fang , Wen Gi‐Mi
Published: May 2016

Aims and objectives

To examine the independent effect of frailty on quality of life.

Background

The World Health Organisation has proposed that frailty be used to indicate a lack of successful ageing. However, studies investigating the relationship between frail phenotypes and quality of life are lacking.

Design

This research employed a cross‐sectional design.

Methods

The Study of Osteoporotic Fractures index was used based on the following three criteria: unexpected weight loss, inability to rise from a chair without using the armrests five times, and feeling a lack of energy. Participants who fulfilled more than two, one or zero criteria were considered as frail, prefrail or robust respectively. Moreover, this study used the Taiwanese version of the World Health Organisation Quality of Life‐BREF to assess the quality of life of older people. A multiple linear regression was performed to investigate the independent effect of frail status on each quality of life subscale.

Results

A total of 239 older people [average age = 74·77 years; standard deviation = 7·02 years; 104 males (43·5%) and 135 females (56·5%)] participated in this study. The multiple linear regression analysis showed that the older people who were more advanced in age and had been diagnosed with a greater number of chronic diseases had a lower comprehensive quality of life. The Study of Osteoporotic Fractures index was associated only with the environmental domain of the World Health Organisation Quality of Life‐BREF.

Conclusions

Compared with robust and prefrail older people, frail older people have worse biomarkers, health statuses, and quality of life. The Study of Osteoporotic Fractures index was correlated only with the quality of life environmental domain.

Relevance to clinical practice

Professional nurses must understand the differences among frail, prefrail and robust older people with regard to their biomarkers, health status, and quality of life. In addition, a comprehensive nursing intervention programme must be developed to improve the quality of life of older people.
The relationship between attachment styles and childhood trauma: a transgenerational perspective – a controlled study of patients with psychiatric disorders
Authors: Özcan Neslihan K , Boyacioğlu Nur E , Enginkaya Semra , Bilgin Hülya , Tomruk Nesrin B
Published: May 2016

Aims and objectives

This study had two aims. The first aim was to compare attachment styles and traumatic childhood experiences of women with psychiatric disorders and their children to a control group. The second aim was to determine the relationship between attachment styles and traumatic childhood experiences both in mothers and their children.

Background

According to attachment theories, trauma in an early relationship initiates a developmental cascade in which insecure attachments may occur.

Design

A cross‐sectional, descriptive study which, employed a case–control design, was performed between May 2013–March 2014.

Methods

This study was conducted in 63 women with psychiatric disorders and their children. The control group consisted of 63 women without any psychiatric disorders and their children. Data were collected using questionnaire forms, including the Adult Attachment Style Scale and the Childhood Trauma Questionnaire for both mothers and children. Descriptive statistics, a Pearson correlation and comparative statistics were used to analyse data.

Results

The childhood trauma scores of both the women with psychiatric disorders and their children were higher than the control group scores. Compared to the control group, the mothers with psychiatric disorders and their children were found to have less secure attachment styles. It was determined that the mothers and children with insecure attachment were more likely to have been abused.

Conclusion

These results point to a relationship between trauma in childhood and attachment style. They also suggest that this relationship may undergo intergenerational transfer.

Relevance to clinical practice

This study contributes to the existing literature on the relationship between childhood traumas and attachment. Psychiatric nurses should focus not only on psychiatric disorders but also on the difficulties a patient faces regarding being a parent.
Maternal pre‐pregnancy obesity and gestational weight gain influence neonatal neurobehaviour
Authors: Aubuchon‐Endsley Nicki , Morales Monique , Giudice Christina , Bublitz Margaret H. , Lester Barry M. , Salisbury Amy L. , Stroud Laura R.
Published: May 2016

Maternal weight before and during pregnancy is associated with offspring neurobehaviour in childhood. We investigated maternal weight prior to and during pregnancy in relation to neonatal neurobehaviour. We hypothesized that maternal obesity and excessive gestational weight gain would be associated with poor neonatal attention and affective functioning. Participants (n = 261) were recruited, weighed and interviewed during their third trimester of pregnancy. Pre‐pregnancy weight was self‐reported and validated for 210 participants, with robust agreement with medical chart review (r = 0.99). Neurobehaviour was measured with the NICU Network Neurobehavioural Scale (NNNS) administered on Days 2 and 32 postpartum. Maternal exclusion criteria included severe or persistent physical or mental health conditions (e.g. chronic disease or diagnoses of Bipolar Disorder or Psychotic Spectrum Disorders), excessive substance use, and social service/foster care involvement or difficulty understanding English. Infants were from singleton, full‐term (37–42 weeks gestation) births with no major medical concerns. Outcome variables were summary scores on the NNNS (n = 75–86). For women obese prior to pregnancy, those gaining in excess of Institute of Medicine guidelines had infants with poorer regulation, lower arousal and higher lethargy. There were no main effects of maternal pre‐pregnancy body mass index on neurobehaviour. Women gaining above Institute of Medicine recommendations had neonates with better quality of movement. Additional studies to replicate and extend results past the neonatal period are needed. Results could support underlying mechanisms explaining associations between maternal perinatal weight and offspring outcomes. These mechanisms may inform future prevention/intervention strategies. © 2016 Blackwell Publishing Ltd
Scaling up breastfeeding programmes in a complex adaptive world
Authors: Pérez‐Escamilla Rafael , Hall Moran Victoria
Published: May 2016

The 2016 Breastfeeding Lancet Series continues to provide unequivocal evidence regarding the numerous benefits that optimal breastfeeding practices offer to children and women worldwide and the major savings that improving these practices can have as a result of their major public health benefits. Unfortunately, this knowledge remains underutilized as there has been little progress scaling up effective breastfeeding programmes globally. Improving the uptake and scaling up of effective national breastfeeding programmes that are potent enough to improve exclusive breastfeeding duration should be a top priority for all countries. Complex analysis systems longitudinal research is needed to understand how best to empower decision makers to achieve this goal through well‐validated participatory decision‐making tools to help their countries assess baseline needs, including costs, as well as progress with their scaling‐up efforts. Sound systems thinking frameworks and scaling‐up models are now available to guide and research prospectively future scaling‐up efforts that can be replicated, with proper adaptations, across countries.
Fluid intake and recommendations in older adults: More data are needed
Authors: Scherer R. , Maroto‐Sánchez B. , Palacios G. , González‐Gross M.
Published: May 2016

Older people are vulnerable to hypohydration due to physiological and cognitive changes that occur with age. Inadequate fluid intake is the main contributor to hypohydration in this age group, but very little is known about their drinking habits and specific fluid intake recommendations are lacking. Therefore, the aim of this short review was to summarise published data on fluid consumption in adults aged 65 years and older. The PubMed database was searched for all relevant studies published between 1995 and 2014 globally. The search identified 12 suitable papers for review. Results indicated that reported fluid intake in older adults varied considerably between studies. Lack of standardisation for reporting ‘fluid intake’ is a problem in this literature. In conclusion, data about fluid intake in older adults are scarce and inconclusive. Consensus on a definition for ‘fluid intake’ is necessary if an international age‐specific reference range for the elderly is to be set.
Constructing Causal Diagrams for Common Perinatal Outcomes: Benefits, Limitations and Motivating Examples with Maternal Antidepressant Use in Pregnancy
Authors: Bandoli Gretchen , Palmsten Kristin , Flores Katrina F. , Chambers Christina D.
Published: May 2016

Background

Covariate selection to reduce bias in observational data analysis has primarily relied upon statistical criteria to guide researchers. This approach may lead researchers to condition on variables that ultimately increase bias in the effect estimates. The use of directed acyclic graphs (DAGs) aids researchers in constructing thoughtful models based on hypothesised biologic mechanisms to produce the least biased effect estimates possible.

Methods

After providing an overview of different relations in DAGs and the prevailing mechanisms by which conditioning on variables increases or reduces bias in a model, we illustrate examples of DAGs for maternal antidepressants in pregnancy and four separate perinatal outcomes.

Results

By comparing and contrasting the diagrams for maternal antidepressant use in pregnancy and spontaneous abortion, major malformations, preterm birth, and postnatal growth, we illustrate the different conditioning sets required for each model. Moreover, we illustrate why it is not appropriate to condition on the same set of covariates for the same exposure and different perinatal outcomes. We further discuss potential selection biases, overadjustment of mediators on the causal path, and sufficient sets of conditioning variables.

Conclusion

In our efforts to construct parsimonious models that minimise confounding and selection biases, we must rely upon our scientific knowledge of the causal mechanism. By structuring data collection and analysis around hypothesised DAGs, we ultimately aim to validly estimate the causal effect of interest.
Parenthood and Worrying About Climate Change: The Limitations of Previous Approaches
Authors: Ekholm Sara , Olofsson Anna
Published: May 2016

The present study considers the correlation between parenthood and worry about the consequences of climate change. Two approaches to gauging people's perceptions of the risks of climate change are compared: the classic approach, which measures risk perception, and the emotion‐based approach, which measures feelings toward a risk object. The empirical material is based on a questionnaire‐based survey of 3,529 people in Sweden, of whom 1,376 answered, giving a response rate of 39%. The results show that the correlation of parenthood and climate risk is significant when the emotional aspect is raised, but not when respondents were asked to do cognitive estimates of risk. Parenthood proves significant in all three questions that measure feelings, demonstrating that it is a determinant that serves to increase worry about climate change.
Validity and reliability of the Danish version of the 9‐item European Heart Failure Self‐care Behavior Scale
Authors: Østergaard Birte , Mahrer‐Imhof Romy , Lauridsen Jørgen , Wagner Lis
Published: May 2016

Objective

To assess the self‐care of patients with heart failure (HF), reliable and validated instruments are needed. The aim of this study was to test the validity and reliability of the Danish version of the European Heart Failure Self‐care Behavior Scale (EHFScBS‐9) based on previous studies reporting 1, 2 and 3 factors, respectively.

Methods

A convenience sample of 147 patients with HF completed the EHFScBS‐9. Psychometric properties of the Danish version of the EHFScBS‐9 were tested with factor loadings, factor correlations and goodness‐of‐fit indices for four different measurement models based on confirmatory factor analysis.

Results

All of the items, except item 9 about regular exercise, demonstrated satisfactory item‐total correlation ≥0.30. Regarding the fit of the models on the sample data, the most superior fit was observed for the two‐factor solution in terms of root‐mean‐square error of approximation (RMSEA), goodness‐of‐fit index (GFI), adjusted GFI (AGFI) and comparative fit index (CFI), which all reached the predefined threshold value, except for the normed fit index (NFI) at 0.90. Factor score determinacy (FSD) for the four models tested was 0.88 for the one‐factor solution, 0.54 and 0.87 for the two‐factor model, 0.83–0.55 for the first three‐factor model and 0.87–0.38 for the second three‐factor model.

Conclusions

The EHFScBS‐9 questionnaire is a valid and reliable instrument to assess heart failure‐specific self‐care behaviours in a Danish population.
Securitization as a Source of Insecurity: A Ground‐Level Look at the Functioning of Europe's External Border in Lampedusa
Authors: Orsini Giacomo
Published: May 2016

Immigration to Europe increasingly emerges as a core security concern. In response to these growing anxieties the external border of Schengen space of free movement of people was established to limit uncontrolled immigration to the European Union. Yet, looking closely at how this border works in Lampedusa and its surrounding seawaters, one realizes the functioning of the European external border works to undermine the legitimacy of institutions on the island, de facto challenging law enforcement both on the island as well as at sea. Based on the data collected during the six‐months‐long fieldwork that I conducted on the island, this paper disentangles the complex machinery of the border as it structures in Lampedusa, and presents how such complex governing technology works through authorities’ strategic use of local land and seawaters and their simultaneous neglect for the concerns of the population inhabiting them – representing a major source of insecurity for islanders.
The Rainbow Is Burning: Analysing Public Contemporary Art as Site of the Polish Symbolic Conflict Over LGBT Rights, the Nation and Europe
Authors: Dunin‐Wąsowicz Roch
Published: May 2016

This paper examines the meanings and the social function of the Rainbow artwork mounted on one of Warsaw's central squares. It analyses how its public presence became site of the Polish symbolic conflict over LGBT rights, nationhood, and Europe. On the one hand, the Rainbow illuminates existing social cleavages – the way in which Polish national subjectivity is currently reconstructed in relation to undergoing social and civilisational changes after EU accession. On the other hand, the Rainbow not only represents existing differences in society, but itself catalyses polarisation of public attitudes. It does so mainly because of its perceived LGBT symbolism. It is shown that while the symbolic conflict may be intensifying and political fringe polarisation is indeed occurring, popular sentiments are actually liberalising, public visibility of the LGBT minority is historically unparalleled, and a European civilisational aspiration is overwhelmingly embraced in Polish society. This paper shows that though homophobic right‐wing radicalisation does occur, it is mainly a result of political ideology supply, and that overwhelming popular support for the artwork and its ‘gay’ meaning reflects actual social liberalisation and a pluralisation of the public sphere in contemporary Poland.
Technological Innovation and Nationalistic Discourse in Late Nineteenth‐Century Japan: The Incandescent Lamp and Perceived Challenges to Ethnic‐National Identity
Authors: Wachutka Michael
Published: May 2016

The ambivalence between Westernization and nationalism is a major theme in modern Japanese history, the Meiji period (1868–1912) ranks as one of its most exhilarating epochs. For the government's major policies at the beginning of this new era, ‘revival’ and ‘progress’ were two sides of the same coin – the first was a principle for the country's new internal organization based on the spirit of ancient mysticism involving the reverential evocation of imperial ancestors of an ‘unbroken’ line reaching all the way to the Japanese kami or deities, whereas the other was a policy for adopting external culture in the spirit of modern pragmatism. In every respect, the early Meiji years were a time of rapid and major transformations.