bluuebunny/crossref_metadata_2025 huggingface dataset:
Mispricing of Sovereign Risk and Macroeconomic Stability in the Eurozone*
Authors: DE GRAUWE PAUL , JI YUEMEI
Published: October 2012

This article presents evidence that a significant part of the surge in the spreads of the PIIGS (Portugal, Ireland, Italy, Greece and Spain) countries in the eurozone during 2010–11 was disconnected from underlying increases in the debt‐to‐GDP (gross domestic product) ratios, and was the result of negative market sentiments that became very strong since the end of 2010. It is argued that the systematic mispricing of sovereign risk in the eurozone intensifies macroeconomic instability, leading to bubbles in good years and excessive austerity in bad years.
Translation, adaptation and data quality of a Danish version of the Burden Scale for Family Caregivers
Authors: Brogaard Trine , Neergaard Mette Asbjørn , Guldin Mai‐Britt , Sokolowski Ineta , Vedsted Peter
Published: October 2012

Background

The burden of caregiving can have various negative consequences. There is a need for health professionals to be able to measure the burden of caregiving among relatives of end‐stage cancer patients in a valid way. The Burden Scale for Family Caregivers (BSFC) has 28 items and was developed as a clinical tool for measuring the self‐reported burden among family caregivers caring for a relative at home.

Aim

To make a standardized translation of the English version of the BSFC into a Danish version and to report data quality in a group of Danish family caregivers caring for palliative care cancer patients.

Material and method

The BSFC was translated following WHO guidelines. Ninety family caregivers of end‐stage cancer patients were sent BSFC as part of a larger questionnaire. A total of 75 (83%) returned the questionnaire. Excluding responses with two or more missing items, 58 (64%) participants completed the BSFC.

Results

The words ‘care’, ‘caregiving’ and ‘caregiver’ were a challenge to the translators. The item response was moderate with missing answers from 4.0 to 18.7%. For the total sum‐score, mean perceived burden amongst participants was low (mean score 23.56 of max 84.00). Cronbach's alpha was 0.91 and average inter‐item correlation 0.26. Item‐rest correlations ranged from −0.02 to 0.72 and were below 0.40 for seven items. High scores on the BSFC was statistically significantly correlated with the feeling of social isolation (ρ = −0.332, p = 0.013) and with the dyspnoea subscale of the EORTC‐QLQ‐15‐PAL (ρ = 0.322, p = 0.012) but not with poor self‐reported health (ρ = −0.036, p = 0.805).

Conclusion

The BSFC was translated into Danish and showed problems with some data quality and validity measures. Hence, further psychometric testing on a larger population is needed before the scale can be recommended as a sum‐scale for scientific and clinical use.
Standing alone when life takes an unexpected turn: being a midlife next of kin of a relative who has suffered a myocardial infarction
Authors: Andersson Ewa Kazimiera , Borglin Gunilla , Sjöström‐Strand Annica , Willman Ania
Published: October 2012

Background

Suffering a myocardial infarction (MI) is a life‐threatening event that impacts not only on the individual concerned but also on the next of kin. However, there seems to be a paucity of naturalistic inquiries that focus specifically on midlife next of kin and their experience of being close to a relative who has suffered anMI. This study aims to elucidate the experience of being a midlife next of kin of a relative who has suffered a myocardial infarction.

Method

Nine women and four men in midlife participated in the focused interviews, which were conducted and analysed during 2010/2011 using Lindseths and Norbergs' description of the phenomenological hermeneutical method.

Findings

Four themes – Solely responsible, Lurking unease, Left out of the picture and Life on hold – formed the basis of the core themeStanding alone when life takes an unexpected turn. The core theme was interpreted as a central phenomenon encompassing the experience of being solely responsible for the well‐being of their relative and the family, thus putting their own life on hold. The core theme also reflected the next of kin's experience of being left out of the picture when it came to the relative's care before and after theMI.

Conclusion

The next of kin's negative feelings of standing alone were further intensified by their experience of being left out of the picture by the healthcare professionals concerning their relative's care. As a cardiac nurse, it would seem essential to have knowledge about the experiences of next of kin in connection with a relative'sMIevent. Such knowledge can facilitate the planning and organisation of nursing care and at the same time address the next of kin's role in the recovery and rehabilitation process.
Anxiety and depression among nursing home residents without cognitive impairment
Authors: Drageset Jorunn , Eide Geir Egil , Ranhoff Anette Hylen
Published: October 2012

Background

Anxiety and depression symptoms and their association with components of social support have been studied rarely among nursing home residents without cognitive impairment.

Aim

To investigate the prevalence of the diagnosis and symptoms of depression and anxiety and their combination, the use of antidepressant and anxiolytic drugs in nursing home residents without cognitive impairment and how attachment, nurturance, reassurance of worth and social integration are associated with anxiety and depression symptom scores.

Method

A cross‐sectional observation study of 227 residents 65–102 years old with ≥6 months'; residence in 30 nursing homes. All had a Clinical Dementia Rating ≤0.5 and could converse. The Hospital Anxiety and Depression Scale and Social Provision Scale were used in face‐to‐face interviews. Sociodemographic variables, medical diagnoses and drug information were obtained from medical records. Pearson's chi‐squared test and ordinal logistic regression were used to identify associations between anxiety and depression and the Social Provision Scale.

Results

Twice as many residents had symptoms of depression (n = 72, 32%), anxiety (n = 33, 14%) and both (n = 22, 10%) as the respective diagnoses in their medical records (depression diagnosis, n = 40, 18%; anxiety, n = 20, 9%; both, n = 12, 5%). Nevertheless, more were treated with antidepressant and anxiolytic drugs than having the respective diagnosis. The social support subdimensions reassurance of worth and social integration were correlated with less depressive symptoms. Attachment was correlated with less anxiety.

Conclusion

Anxiety and depression symptoms were common and often not diagnosed. Attachment was associated with less anxiety and reassurance of worth and social integration with less depression. Nursing staff should give support to improve attachment, reassurance of worth and social integration and closely observe residents without cognitive impairment for symptoms of anxiety and depression.
An optimization model for the vehicle routing problem with practical three‐dimensional loading constraints
Authors: Junqueira Leonardo , Oliveira José F. , Carravilla Maria Antónia , Morabito Reinaldo
Published: October 2012

In this paper, we present an integer linear programming model for the vehicle routing problem that considers real‐world three‐dimensional (3D) loading constraints. In this problem, a set of customers make requests of goods that are wrapped up in boxes, and the objective is to find minimum cost delivery routes for a set of identical vehicles that, departing from a depot, visit all customers only once and return to the depot. Apart from the usual 3D container loading constraints that ensure the boxes are packed completely inside the vehicles and the boxes do not overlap each other in each vehicle, the problem also takes into account constraints related to the vertical stability of the cargo, multidrop situations, and load‐bearing strength of the boxes (including fragility). Computational tests with the proposed model were performed using an optimization solver embedded into a modeling language. The results validate the model and show that it is only able to handle problems of a moderate size. However, this model will be useful to motivate other researchers to explore approximate solution approaches to solve this problem, such as decomposition methods, relaxation methods, heuristics, among others, as well as to treat other variants of the problem, such as when time windows or a heterogeneous fleet are present, among others.
Elemental Analysis of Ochre Outcrops in Southern British Columbia, Canada
Authors: Macdonald B. L. , Hancock R. G. V. , Cannon A. , McNeill F. , Reimer R. , Pidruczny A.
Published: October 2012

Ochre is a red mineral pigment that was a key element of social and ceremonial practices among cultures of the Pacific Northwest Coast. It is recovered routinely from archaeological excavations, is visible as pigment for pictographs, and is described in the historical record as a trade item and component of ceremonial practices. Despite its ubiquity in the archaeological record, it is difficult to interpret its significance without first understanding the nature of its procurement and distribution. As a step towards identifying procurement practices, trade and resource use, it is necessary to thoroughly characterize ochre outcrops with regard to their intra‐source and regional variability. We analysed ochre from three outcrops using INAA to determine their elemental chemistry. The purpose of this study is threefold: to provide an example of the range of elemental variability within and between outcrops, to illustrate the effect of scale and geomorphological processes on elemental compositions and statistical interpretation, and to create a database of known deposits in southern British Columbia. The results demonstrate that ochre deposits may be differentiated on the basis of their chemistry, and that conservative statistical interpretation needs to be employed to assess true elemental variability within and between ochre deposits and regions.
Rationalising risk: grower strategies to manage plant disease in the UK wheat and potato sectors
Authors: Maye Damian , Ilbery Brian , Little Ruth
Published: October 2012

The threat that plant diseases and pests pose to food production and ecosystem services is neither well understood in the social sciences nor publicly debated, despite the fact that it is significant and growing. This paper presents findings from interviews with wheat and potato growers in two parts of the UK (Lincolnshire and Herefordshire). It uses conceptual work on risk and risk perception to understand how farmers encounter, comprehend and manage plant disease. Plant disease was perceived by growers as a significant but controllable risk mostly through the (generally) prophylactic use of spray chemicals. The introduction of revised European legislation governing – and potentially restricting – the use of ‘key’ agro‐chemicals may, in the future, reduce the perception and level of control growers feel they have over disease in their crops. Perceptions of plant disease risk and strategies to ameliorate their impact involve scientific deliberation and appear to be highly rational. However, such perceptions are not merely conceived in scientific terms. Decisionmaking is rational but encultured as a practical farm management priority rather than pure scientific risk.
Investing Today or Tomorrow? An Experimental Approach to Farmers’ Decision Behaviour
Authors: Maart‐Noelck Syster C. , Musshoff Oliver
Published: October 2012

An understanding of farmers’ decision‐making behaviour is important for adequate forecasts as well as policy recommendations regarding structural changes. We experimentally analyse the investment behaviour of real farmers. The observed investment decisions are contrasted with theoretical benchmarks from classical investment theory and the real options approach. Our results show that both theories cannot exactly explain investment behaviour. However, farmers learn from former investment decisions and do consider the value of waiting over time.
Cervical tumoral calcinosis with secondary hyperparathyroidism in a chronic hemodialysis patient
Authors: Sunder Sham , Verma Himanshu , Venkataramanan Krishnamoorthy
Published: October 2012

Tumoral calcinosis is an uncommon and severe complication of chronic renal failure. It is generally associated with the presence of a high‐serum calcium‐and‐phosphorus product. We report here a case of a patient on maintenance hemodialysis who presented with progressively increasing, solitary, tumor‐like swelling over the nape of the neck. A 50‐year‐old female on thrice weekly maintenance hemodialysis for the last 3 years presented with a small swelling over the nape of the neck that had been progressively increasing over the last 1 year to cricket ball size. The patient was investigated and diagnosed as having tumoral calcinosis. The metastatic calcification occurring in the patient was most likely related to high calcium × phosphate product with coexistent secondary hyperparathyroidism possibly aggravated by vitamin D therapy. The patient was treated with withdrawal of vitamin D therapy, strict control of serum phosphate levels with noncalcemic phosphate binders, and subtotal parathyroidectomy. The neck swelling started decreasing in size after 2 months of parathyroidectomy and there was marked clinical improvement with drop in serum parathormone levels, over a period of 6 months. After 2 years of parathyroidectomy, the neck swelling again started increasing in size with increase in serum parathormone levels. The patient was treated with cinacalcet and the neck swelling gradually decreased in size along with control of serum parathormone and phosphate levels.
Childbirth in Santiago de Chile: Stratification, Intervention, and Child Centeredness
Authors: Murray Marjorie
Published: October 2012

On the basis of ethnographic work with women from different economic and educational backgrounds in Santiago, I describe the experiences of labor and birth from the point of view of women's priorities, socioeconomic constraints, and relationships with the medical system. I specifically focus on their desires expressed during the late prenatal period and their narratives of the actual birth. Class and the differences in opportunities resulting from educational and class inequalities melt down into near invisibility as vulnerability rises and women become increasingly subjected to medical decision making. The long‐standing Chilean focus on child centeredness, while shown to benefit bonding, can work to obliterate women's own desires and choices by encouraging them to “sacrifice their all” for the sake of the baby. This kind of sacrifice defines the meaning of the maternal body in Chile. I suggest further analysis of these factors is essential for an understanding of the hypermedicalized Chilean context.
PTSD and Key Somatic Complaints and Cultural Syndromes among Rural Cambodians: The Results of a Needs Assessment Survey
Authors: Hinton Devon E. , Hinton Alexander L. , Eng Kok‐Thay , Choung Sophearith
Published: October 2012

This article describes a culturally sensitive assessment tool for traumatized Cambodians, the Cambodian “Somatic Symptom and Syndrome Inventory” (SSI), and reports the outcome of a needs assessment conducted in rural Cambodia using the instrument. Villagers locally identified (N = 139) as still suffering the effects of the Pol Pot genocide were evaluated. All 139 had post‐traumatic stress disorder (PTSD) as assessed by the PTSD Checklist (PCL), and they had elevated SSI scores. The severity of the SSI items varied by level of PTSD severity, and several items—for example, dizziness, dizziness on standing, khyâl (a windlike substance) attacks, and “thinking a lot”—were extremely elevated in those participants with higher levels of PTSD. The SSI was more highly correlated to self‐perceived health (Short Form Health Survey–3) and past trauma events (Harvard Trauma Questionnaire) than was the PCL. The study shows the SSI items to be a core aspect of the Cambodian trauma ontology.
Promoting healthy ageing: Development of the Healthy Ageing Quiz
Authors: Cyarto Elizabeth V , Dow Briony , Vrantsidis Freda , Meyer Claudia
Published: October 2012

Aim:  The aim of this study was to develop the evidence‐based Healthy Ageing Quiz (HAQ).

Methods:  Phase 1 activities (focus groups with 33 older adults, literature review and discussion with an advisory panel) informed the development of a draft HAQ. Phase 2 involved assessing the quiz's psychometric properties and collecting respondent feedback.

Results:  Phase 1 provided broad topics for formulating quiz questions. In Phase 2, 297 and 122 respondents returned a quiz for validity and reliability testing respectively (over 70% response rate). The HAQ was found to be both valid (r =−0.7 to 0.6) and reliable (r = 0.8).

Conclusions:  The development of the HAQ was guided by the literature and input from older people and experts in healthy ageing. The quiz showed good psychometric properties and was acceptable to respondents. It allows older adults and people approaching old age to evaluate their current lifestyle in order to maximise their chances of ageing well.
Considering relocation to a retirement village: Predictors from a community sample
Authors: Crisp Dimity A , Windsor Tim D , Anstey Kaarin J , Butterworth Peter
Published: October 2012

Aim

To identify characteristics distinguishing older adults who have considered relocation to a retirement village in the future from those who have not.

Method

Community‐living residents (n = 517), aged 55 to 94, randomly selected from the Australian Capital Territory completed a postal survey.

Results

Consistent with prior research, the majority of respondents had not considered relocation to a retirement village. Retired persons, those aged 55–64 years, and persons reporting sufficient financial resources, poorer physical health and poorer current neighbourhood cohesion were most likely to have considered future relocation.

Conclusions

The identification of factors characterising older adults seeking retirement village housing in the future is important in developing an understanding of the needs and expectations of the older population, and may allow aged care providers to better target the development of services to population needs (e.g. health‐care supports). Further investigation into the specific expectations of the 55–64 year cohort is required.
Non‐contraceptive uses and benefits of combined oral contraception
Authors: Carey Molly S , Allen Rebecca H
Published: October 2012

Key content

Dysmenorrhoea can be treated successfully with combined oral contraceptives.

Combined oral contraceptives have been shown to reduce and regulate menstrual bleeding.

Combined oral contraceptives can treat acne in women also desiring contraception.

Severe premenstrual syndrome may respond to drospirenone‐containing combined oral contraceptives.

Use of combined oral contraceptives decreases the risk of endometrial and ovarian cancer.

Learning objectives

To explain the role of combined oral contraceptives in reducing the risk of cancer.

To identify the uses of combined oral contraceptives in treating gynaecological problems such as dysmenorrhoea, abnormal uterine bleeding, premenstrual syndrome, acne, hirsutism and polycystic ovary syndrome.

Ethical issues

Compared with preventing pregnancy, the risk/benefit profile of combined oral contraceptives for non‐contraceptive indications may be different and women should be counseled according to their individual circumstance.
Who should perform the ultrasound examinations in gynaecology?
Authors: Roberts Mark , Hughes Tracey
Published: October 2012

Key content

This review debates the merits of who should perform the ultrasound examinations in gynaecology. In favour of clinicians (gynaecologists):

Gynaecologists, with a captive population, have a vested interest in learning ultrasound examination of the pelvis.

Basic ultrasound has been embedded in the core RCOG curriculum and the new RCOG training module in gynaecology has been launched.

With the ideals of ‘point‐of‐care’ investigation and ‘one stop’ assessment, future service delivery in gynaecological ultrasound could rely largely on gynaecologists.

In favour of radiology staff (radiologists and sonographers):

Gynaecological ultrasound is more than an adjunct to bimanual examination.

There is a concern that relocation of ultrasound into gynaecology clinics and wards may lead to the loss of the systematic approach seen in radiology departments, which covers patient safety, maintenance of equipment, reporting and archiving.

If radiologists are disenfranchised then the risk is loss of specialist radiology support when a vaginal scan does not give all the answers.

Learning objectives

To be aware of training programmes in gynaecological ultrasound.

To be familiar with appropriate methods of record keeping in ultrasound examination.

To understand quality assurance in delivery of an ultrasound service.

To understand the complementary nature of both a vaginal and a transabdominal pelvic ultrasound scan.

Ethical issues

Operators in gynaecological ultrasound should be appropriately trained, adequately resourced and should work within their level of competence.
Prevention and treatment of postmenopausal osteoporosis
Authors: Kwun Sunna , Laufgraben Marc J , Gopalakrishnan Geetha
Published: October 2012

Key content

Osteoporotic fractures are associated with increased morbidity and mortality.

Clinical history and bone densitometry can identify individuals at risk for osteoporotic fractures.

Treatment is available to prevent and treat osteoporosis.

Learning objectives

Identify populations at risk for osteoporotic fractures.

Make the diagnosis of osteoporosis.

Decide appropriate treatment for the prevention or treatment of osteoporosis.

Ethical issues

Maximising health benefit while minimising financial implications.
Service Supply Management Structure in Offshore Outsourcing
Authors: Tate Wendy L. , Ellram Lisa M.
Published: October 2012

This research examines the relationship between strategy and structure in the highly complex services offshore outsourcing environment. The analysis uses data from the in‐depth case studies of six organizations that purchase services (primarily call center services) to assess how the strategy of offshore outsourcing of services affects organizational structure and to develop a better understanding of the offshore outsourcing of services phenomenon. While organizations often have local buying offices and very formal structures for buying materials globally, the same is not true for purchased services. The issue of proper organizational structure for effectively managing offshore outsourced services has not been assessed. This research also aims to add to the growing body of literature related to Service‐Dominant Logic, which recognizes that services cannot be effectively studied through the lens of manufacturing. This research applies case study findings to assess how the elements of structure, namely centralization, formalization and complexity, are affected by offshore outsourcing of services. All of the organizations studied here indicate that their processes evolved and that pursuing an offshore services purchasing strategy lead to structural adaptations in terms of more centralized, team‐based structures, more formalized processes and more complex structures. However, most of the cases tried to retain some level of flexibility to allow for continued adaptation and improvement.
Clinical value of whole‐body F‐18 fluorodeoxyglucose positron emission tomography/computed tomography in patients with carcinoma of unknown primary
Authors: Wang Guohui , Wu Yaopan , Zhang Weidong , Li Jiayao , Wu Peihong , Xie Chuanmiao
Published: October 2012

Introduction

The purpose of the study is to investigate the clinical value of F‐18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting the primary sites in patients with carcinoma of unknown primary (CUP).

Methods

The reports of FDG PET/CT scans of 164 patients with CUP syndrome in consecutive 2589 patients referred to our department from January 2006 to June 2010 were retrospectively reviewed. The final results were obtained from the pathologic reports, other imaging modalities diagnoses and clinical follow‐up data.

Results

There were 142 cases in the results analysis, as 19 patients were lost to follow‐up and three patients were excluded. FDG PET/CT successfully detected primary tumours in 67 (47.2%) out of 142 patients. Among this group, 53 were pathologically proved and 17 patients were confirmed by clinical follow‐up. The primary sites of 38 (56.7%) were in lung, eight (11.9%) in nasopharynx and 13 (19.4%) in digestive system. Six patients were misdiagnosed by FDG PET/CT scan. FDG PET/CT could not detect the primary lesion in 66 patients, and three primary tumours were identified by conventional work‐up after negative FDG PET/CT scan. The accuracy, sensitivity and specificity of FDG PET/CT scan in detecting the primary site in this study were 93.7%, 95.7% and 91.7%, respectively. FDG PET/CT scan changed the medical management of about 33.8% of 142 CUP patients.

Conclusion

FDG PET/CT whole‐body imaging is a valuable tool in detecting the primary tumour of patients with CUP site.
Concordance between thoracic multidisciplinary meeting recommendations for radiation therapy and actual treatment for lung cancer
Authors: Loh Jasmin , Stevens Graham , Stevens Wendy , Kolbe John
Published: October 2012

Introduction

There is limited evidence whether decisions of Thoracic Multidisciplinary Meetings (TMDMs) are reflected in the treatment lung cancer patients actually receive. Aims were to determine concordance between TMDM recommendations for radiotherapy (RT) and actual RT administered and to compare cases that received RT that were referred or not referred from TMDMs.

Method

A retrospective review of demographic and clinical data for all lung cancer cases within the Auckland‐Northland region referred for RT from TMDMs (January–June 2009) and all cases that received RT but were not referred from TMDMs (January–August 2009).

Results

Of 110 cases referred for RT from TMDMs, 86 (78%) were offered RT (76 with the same treatment intent) and 78 (71%) received RT. Ten (9%) cases were deemed unsuitable for RT; 7 (6%) deteriorated; 4 (4%) declined or did not attend; 3% other. Fifty‐one other cases received RT without TMDM presentation. Cases with remote domicile or recurrent disease were significantly less likely to have been presented at TMDMs. TMDM presentation did not significantly increase transit time to RT. The proportion of RT cases referred from TMDMs had increased substantially since 2004.

Conclusion

The concordance between TMDM recommendations for RT and both the RT administered and the intent of treatment suggests a useful role for TMDMs. Concordance could be increased by improving RT timeliness and improved education of other disciplines and patients regarding the role of RT. Strategies to increase presentation at TMDM include attention to geographically isolated groups.
Roepke Lecture in Economic Geography—Who Needs the Nation‐State?
Authors: Rodrik Dani
Published: October 2012

abstract

The nation‐state has long been under attack from liberal economists and cosmopolitan ethicists alike. But it has proved remarkably resilient and remains the principal locus of governance as well as the primary determinant of personal attachments and identity. The global financial crisis has further underscored its centrality. Against the background of the globalization revolution, the tendency is to view the nation‐state as a hindrance to the achievement of desirable economic and social outcomes. Yet it remains indispensable to the achievement of those goals.
Correlation Between Photoluminescence and Structural Defects in Ca1+xCu3−xTi4O12 Systems
Authors: Oliveira Larissa H. , Paris Elaine C. , Avansi Waldir , Ramirez Miguel A. , Mastelaro Valmor R. , Longo Elson , Varela José A.
Published: October 2012

Ca1+xCu3−xTi4O12 powders were synthesized by a conventional solid‐state reaction. X‐ray diffraction (XRD) was performed to verify the formation of cubic CaCu3Ti4O12 (CCTO) and orthorhombic CaTiO3 (CTO) phases at long range. Rietveld refinements indicate that excess Ca atoms added to the Ca1−xCu3−xTi4O12 (x = 1.0) composition segregated in a CaTiO3 secondary phase suggesting that solubility limit of Ca atoms in the CaCu3Ti4O12 lattice was reached for this system. The FE‐SEM images show that the Ca1+xCu3−xTi4O12 (0 < x < 3) powders are composed of several agglomerated particles with irregular morphology. X‐ray absorption near‐edge structure spectroscopy (XANES) spectra indicated [TiO5Voz]‐[TiO6] complex clusters in the CaCu3Ti4O12 structure which can be associated with oxygen vacancies (Voz = Vox, Vo•, and Vo••) whereas in the CaTiO3 powder, this analysis indicated [TiO6]–[TiO6] complex clusters in the structure. Ultraviolet‐visible (UV–vis) spectra and photoluminescence (PL) measurements for the analyzed systems revealed structural defects such as oxygen vacancies, distortions, and/or strains in CaCu3Ti4O12 and CaTiO3 lattices, respectively.
The extended arm of health professionals? Relatives' experiences of patient's recovery in a fast‐track programme
Authors: Norlyk Annelise , Martinsen Bente
Published: October 2012

Aim

To report a study of the lived experience of being a close relative to a patient with colon cancer participating in a fast‐track programme.

Background

Studies have documented that postoperative recovery can be accelerated and that hospitalization can be reduced through fast‐track programmes. Due to the early discharge and the increasing demands on patients for self‐care, patients' relatives seem to play a pivotal role in fast‐track programmes. However, research is limited into how patients' close relatives are affected by and involved in the postoperative recovery process.

Design

A descriptive phenomenological approach using Reflective Lifeworld Research.

Methods

The study was carried out within the descriptive phenomenological framework of Reflective Lifeworld Research. Data were collected in 2008 from in‐depth interviews with twelve relatives.

Findings

Relatives experienced a huge responsibility for both the patient's well‐being and for the patient's compliance with the daily regimen. Relatives were caught in a conflicting double role. They were the extended arm of the health professionals but also the caring, supporting partner. A tension arose between relatives' desire to help the patient by taking an active part in the recovery process and the feelings of not always having the resources needed.

Conclusion

Relatives seem to suffer in silence as they bear the burden of the patient's diagnosis, the disruption of life, and the taken‐for‐granted responsibility for the patient's recovery process. From an existential perspective, this caring responsibility can be understood as ethical pain. Relatives should be seen as a distinct group with special caring needs of their own.
Longitudinal Correlated Changes in Conscientiousness, Preventative Health‐Related Behaviors, and Self‐Perceived Physical Health
Authors: Takahashi Yusuke , Edmonds Grant W. , Jackson Joshua J. , Roberts Brent W.
Published: October 2012

Objective

Previous research has found that conscientiousness has positive associations with preventative health‐related behaviors and self‐perceived health, but little is known about the links between changes in these variables over time. In the present study, we examined how levels and changes in conscientiousness were linked to levels and changes in both preventative health‐related behaviors and self‐perceived physical health.

Method

Personality and health questionnaires were administered to participants in two waves, with an interval of approximately three years. Participants ranged in age from 19 to 94. To elucidate the tripartite relations between conscientiousness, preventative health‐related behaviors, and self‐perceived physical health, we used latent change models to estimate levels and changes of these latent constructs over time.

Results

Changes in conscientiousness were significantly and positively correlated with changes in preventative health behaviors and changes in self‐perceived physical health. Changes in preventative health behaviors partially mediated the relation between changes in conscientiousness and changes in self‐perceived physical health.

Conclusions

This longitudinal study extends previous research on conscientiousness and health by exploring the relations between latent variables over a 3‐year period. It provides evidence that increases in conscientiousness and preventative health‐related behaviors are associated with improvements in self‐perceived health over the same time period.
You're Inferior and Not Worth Our Concern: The Interface Between Empathy and Social Dominance Orientation
Authors: Sidanius Jim , Kteily Nour , Sheehy‐Skeffington Jennifer , Ho Arnold K. , Sibley Chris , Duriez Bart
Published: October 2012

Objective

This project was directed at examination of the potential reciprocal relationship between empathy and social dominance orientation (SDO), with the purpose of testing the predictions from Duckitt's highly influential dual process model of prejudice, and further examining the validity of the mere effect view of social dominance orientation.

Method

To examine this relationship, the authors employed cross‐lagged structural equation modeling with manifest variables across two studies using large samples from different parts of the world. Study 1 consisted of data from two waves of 389 (83% female) Belgian university students, with each wave separated by 6 months. Study 2 consisted of two waves of data from a national probability sample of 4,466 New Zealand adults (63% female), with each wave separated by a 1‐year interval.

Results

Results supported our expectation of a reciprocal longitudinal relationship between empathy and SDO. Moreover, the results also revealed that SDO's effect on empathy over time tended to be stronger than empathy's effect on SDO over time, countering the predictions derived from the dual process model.

Conclusions

These results represent the first time the possible reciprocal effects of empathy and SDO on one another have been examined using panel data rather than less appropriate cross‐sectional analysis. They suggest the need to reexamine some key assumptions of the dual process model and further question the mere effect view of SDO.
Does Ego Development Increase During Midlife? The Effects of Openness and Accommodative Processing of Difficult Events
Authors: Lilgendahl Jennifer Pals , Helson Ravenna , John Oliver P.
Published: October 2012

Objective

Although Loevinger's model of ego development is a theory of personality growth, there are few studies that have examined age‐related change in ego level over developmentally significant periods of adulthood. To address this gap in the literature, we examined mean‐level change and individual differences in change in ego level over 18 years of midlife.

Method

In this longitudinal study, participants were 79 predominantly White, college‐educated women who completed the Washington University Sentence Completion Test in early (age 43) and late (age 61) midlife as well as measures of the trait of Openness (ages 21, 43, 52, and 61) and accommodative processing (assessed from narratives of difficult life events at age 52).

Results

As hypothesized, the sample overall showed a mean‐level increase in ego level from age 43 to age 61. Additionally, a regression analysis showed that both the trait of Openness at age 21 and accommodative processing of difficult events that occurred during (as opposed to prior to) midlife were each predictive of increasing ego level from age 43 to age 61.

Conclusions

These findings counter prior claims that ego level remains stable during adulthood and contribute to our understanding of the underlying processes involved in personality growth in midlife.
Heterogeneous Patterns of Stress Over the Four Years of College: Associations With Anxious Attachment and Ego‐Resiliency
Authors: Galatzer‐Levy Isaac R. , Bonanno George A.
Published: October 2012

Objective

A growing body of literature suggests that college students display alarming rates of psychological distress. However, studies of responses to significant life stressors in other contexts have found that people respond in heterogeneous ways and that attachment style and ego‐resiliency mitigate the effects of stressors on mental health.

Method

Individual differences in distress among a cohort of students (N = 157; Mean age = 18.8 years, 62.6% female) across the four years of college were analyzed using latent class growth analysis. Trajectories were then regressed on levels of anxious and avoidant attachment and ego‐resiliency.

Results

Four discrete patterns emerged characterized by healthy and maladaptive patterns of stress response, indicating that students respond to college in heterogeneous ways. Several patterns showed significant variability in distress by semester. Low levels of anxious but not avoidant attachment predicted membership in the stable‐low distress or resilient class while ego‐resiliency predicted membership in both the resilient and moderate distress classes.

Conclusions

Findings indicate that low levels of anxious attachment and the ability to flexibly cope with adversity may be associated with better mental health throughout college. Implications from stress response and developmental perspectives are discussed.
Cognitive‐Affective Processing System Analysis of Intra‐Individual Dynamics in Collaborative Therapeutic Assessment: Translating Basic Theory and Research Into Clinical Applications
Authors: Shoda Yuichi , Wilson Nicole L. , Chen Jessica , Gilmore Amanda K. , Smith Ronald E.
Published: October 2012

According to the cognitive‐affective processing system (CAPS) model, behavior is a function of how the distinctive cognitive‐affective system of the individual responds to one's subjective experience of the situation encountered. Thus an individual's maladaptive coping processes may be understood by identifying the nature of the situations that a client experiences as highly stressful and the psychological reactions they trigger. An initial study established the feasibility and utility of an Internet‐based CAPS daily diary program; it was then used to facilitate a clinical stress‐management intervention. The daily diary enabled researchers and clinicians to gather Highly‐Repeated Within‐Persons (HRWP) data on the situational features, cognitions, affect, and coping behaviors associated with daily life stress, which were then analyzed separately for each participant to identify each individual's unique and distinctive pattern of intra‐individual dynamics. Results suggested that individuals differed reliably in the features of psychological situations that triggered stress and maladaptive coping behaviors. HRWP analysis of daily diary data enhanced the efficacy of clinical intervention, and clients' self‐regulatory capabilities and life satisfaction were shown to increase over the course of the intervention. We discuss how our program of research fits into the larger goals of translational science and current NIMH clinical research priorities.
(In)Congruence of Implicit and Explicit Communal Motives Predicts the Quality and Stability of Couple Relationships
Authors: Hagemeyer Birk , Neberich Wiebke , Asendorpf Jens B. , Neyer Franz J.
Published: October 2012

Objective

Previous research has shown that motive congruence, as observed in convergingly high or low scores on implicit and explicit motive measures, promotes well‐being and health. Extending this individual perspective to the realm of couple relationships, the present investigation examined intra‐ and interpersonal effects of communal motive (in)congruence on relationship satisfaction and stability.

Method

The implicit partner‐related need for communion, the explicit desire for closeness, and relationship satisfaction were assessed in a sample of 547 heterosexual couples aged 18 to 73 years. In a one‐year follow‐up study, information on relationship stability was obtained, and relationship satisfaction was reassessed. The researchers tested cross‐sectional and longitudinal effects of motive (in)congruence by dyadic moderation analyses.

Results

Individuals scoring congruently high on both motives reported the highest relationship satisfaction in concurrence with motive assessment and 1 year later. In addition, motive incongruence predicted an increased risk of relationship breakup over 1 year.

Conclusions

The results highlight the significance of both implicit and explicit motives for couple relationships. Motive incongruence was confirmed as a dispositional risk factor that so far has not been considered in couple research. Future research directions addressing potential mediators of the observed effects and potential moderators of motive (in)congruence are discussed.
Combined paediatric NAFLD fibrosis index and transient elastography to predict clinically significant fibrosis in children with fatty liver disease
Authors: Alkhouri Naim , Sedki Emad , Alisi Anna , Lopez Rocio , Pinzani Massimo , Feldstein Ariel E. , Nobili Valerio
Published: October 2012

Background

Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of disease from simple steatosis to steatohepatitis, to fibrosis and cirrhosis. The paediatric NAFLD fibrosis index (PNFI) and transient elastography (TE) are potential noninvasive markers for fibrosis.

To prospectively evaluate the performance of PNFI and TE in assessing clinically significant fibrosis in children with biopsy‐proven NAFLD.

Methods

Our cohort consisted of 67 consecutive children with biopsy‐proven NAFLD. The stage of fibrosis was scored according to the Nonalcoholic Steatohepatitis Clinical Research Network. Fibrosis ≥ 2 was considered clinically significant. PNFI was calculated using age, waist circumference and triglycerides. TE was performed using the Fibroscan apparatus.

Results

Ten patients had fibrosis stage 2–3 and 57 patients had stage 0–1. Both PNFI and TE values were significantly higher in patients with significant fibrosis (P < 0.05). The area under the receiver operating characteristic (ROC) curve for predicting significant fibrosis of PNFI and TE were 0.747 and 1.00 respectively (P = 0.005). The combined use of PNFI and TE could predict the presence or absence of clinically significant fibrosis in 98% of children with NAFLD.

Conclusions

In children with NAFLD, the combination of PNFI and TE can be used to accurately assess the presence of clinically significant liver fibrosis. This will help to identify patients who should undergo liver biopsy because the confirmation of advanced fibrosis would lead to closer follow‐up and screening for cirrhosis‐related complications.
Pathogen pollution and the emergence of a deadly amphibian pathogen
Authors: McKenzie Valerie J. , Peterson Anna C.
Published: October 2012

Imagine a single pathogen that is responsible for mass mortality of over a third of an entire vertebrate class. For example, if a single pathogen were causing the death, decline and extinction of 30% of mammal species (including humans), the entire world would be paying attention. This is what has been happening to the world's amphibians – the frogs, toads and salamanders that are affected by the chytrid fungal pathogen, Batrachochytrium dendrobatidis (referred to as Bd), which are consequently declining at an alarming rate. It has aptly been described as the worst pathogen in history in terms of its effects on biodiversity (Kilpatrick et al. 2010). The pathogen was only formally described about 13 years ago (Longcore et al. 1999), and scientists are still in the process of determining where it came from and investigating the question: why now? Healthy debate has ensued as to whether Bd is a globally endemic organism that only recently started causing high mortality due to shifting host responses and/or environmental change (e.g. Pounds et al. 2006) or whether a virulent strain of the pathogen has rapidly disseminated around the world in recent decades, affecting new regions with a vengeance (e.g. Morehouse et al. 2003; Weldon et al. 2004; Lips et al. 2008). We are finally beginning to shed more light on this question, due to significant discoveries that have emerged as a result of intensive DNA‐sequencing methods comparing Bd isolates from different amphibian species across the globe. Evidence is mounting that there is indeed a global panzootic lineage of Bd (BdGPL) in addition to what appear to be more localized endemic strains (Fisher et al. 2009; James et al. 2009; Farrer et al. 2011). Additionally, BdGPL appears to be a hypervirulent strain that has resulted from the hybridization of different Bd strains that came into contact in recent decades, and is now potentially replacing the less‐virulent endemic strains of the pathogen (Farrer et al. 2011). In a new study published in this issue of Molecular Ecology, Schloegel et al. (2012) identify an additional unique Bd lineage that is endemic to the Atlantic Brazilian rainforests (Bd‐Brazil) and provide striking evidence that the Bd‐Brazil lineage has sexually recombined with the BdGPL lineage in an area where the two lineages likely came into contact as a result of classic anthropogenically mediated ‘pathogen pollution’(see below). Fungal pathogens, including Bd, have the propensity to form recombinant lineages when allopatric populations that have not yet formed genetic reproductive barriers are provided with opportunities to intermingle, and virulent strains may be selected for because they tend to be highly transmissible (Fisher et al. 2012). As Schloegel et al. (2012) point out, the demonstrated ability for Bd to undergo meiosis may also mean that it has the capacity to form a resistant spore stage (as yet undiscovered), based on extrapolation from other sexually reproducing chytrids that all have spore stages.
AvianPlasmodiumlineages found in spot surveys of mosquitoes from 2007 to 2010 at Sakata wetland, Japan: do dominant lineages persist for multiple years?
Authors: Kim K. S. , Tsuda Y.
Published: October 2012

The ecology and geographical distribution of disease vectors are major determinants of spatial and temporal variations in the transmission dynamics of vector‐borne pathogens. However, there are limited studies on the ecology of vectors that contribute to the natural transmission of most vector‐borne pathogens. AvianPlasmodiumparasites are multihost mosquito‐borne pathogens transmitted by multiple mosquito species, which might regulate the diversity and persistence of these parasites. From 2007 to 2010, we conducted entomological surveys at Sakata wetland in central Japan, to investigate temporal variation in mosquito occurrence and prevalence of avianPlasmodiumlineages in the mosquito populations. A polymerase chain reaction (PCR)‐based method was used to detectPlasmodiumparasites and identify the blood sources of mosquitoes.Culex inatomiiandC. pipiens pallensrepresented 60.0% and 34.8% of 11 mosquito species collected, respectively. Our results showed that the two dominant mosquito species most likely serve as principal vectors of avianPlasmodiumparasites during June, which coincides with the breeding season of bird species nesting in the wetland reed beds. Fourteen animal species were identified as blood sources of mosquitoes, with the oriental reed warbler (Acrocephalus orientalis) being the commonest blood source. Although there was significant temporal variation in the occurrence of mosquitoes and prevalence ofPlasmodiumlineages in the mosquitoes, the dominantPlasmodiumlineages shared by the two dominant mosquito species were consistently found at the same time during transmission seasons. Because vector competence cannot be confirmed solely byPCRapproaches, experimental demonstration is required to provide definitive evidence of transmission suggested in this study.