bluuebunny/crossref_metadata_2025 huggingface dataset:
Accounting Conservatism: A Literature Review
Authors: Zhong Yuxiang , Li Wanli
Published: November 2016

Accounting conservatism is one of the most important properties of financial reporting. The goal of this article is to gain a better understanding of accounting conservatism. We explicate the evolution of conservatism over its long history. Accounting conservatism is indispensable because the main parties of a firm demand conservatism to mitigate agency costs. Various methods are used to measure accounting conservatism, which include balance sheet measures, income statement measures and earnings/stock return relation measures. Empirical research into accounting conservatism has flourished over the last two decades and we focus on the cross‐sectional and time‐series variations in conservatism. We conclude that accounting conservatism is important and cannot be excluded from accounting standards.
Sexualization reduces helping intentions towards female victims of intimate partner violence through mediation of moral patiency
Authors: Pacilli Maria Giuseppina , Pagliaro Stefano , Loughnan Steve , Gramazio Sarah , Spaccatini Federica , Baldry Anna Costanza
Published: November 2016

This paper examines the influence of female sexualization on people's willingness to provide help in cases of intimate partner violence (IPV). We examined how sexualization may make women seem lacking moral patiency and moral virtue both of which may lead to a reduced willingness to help. In the first study, participants read a fictitious newspaper article describing an IPV incident. They were then presented with a picture of the ostensible victim depicting the woman with either a sexualized or non‐sexualized appearance. Participants judged both the victim's moral patiency and morality, and then expressed their willingness to provide help to that victim. Although the sexualized victim was viewed as a lesser moral patient (Studies 1 and 2) and as less moral (Study 2), it was seeing the victim as unworthy of moral patiency rather than lacking moral virtue (immoral) that linked sexualization to reduced help. Controlling for participants’ sexism and women's admission of infidelity, Study 2 replicated that sexualization reduced helping intentions through a lack of moral patiency. Practical implications are discussed.
Oral cancer screening in private dental practices in a developing country: opportunities and challenges
Authors: Saleh Amyza , Kong Yink Heay , Haron Nabihah , Aripin Siti Fatimah , Vadiveloo Malliga , Hussaini Haizal , Zain Rosnah Binti , Cheong Sok Ching
Published: November 2016

Objectives

Private dental practitioners constitute approximately 40% of all registered dentists in Malaysia, and this group affords an avenue for prevention and early detection of oral cancer. However, such activities are still limited. This study investigated the feasibility of incorporating opportunistic screening of oral cancer in the private dental setting.

Methods

Dentists were recruited through two main dental associations in Malaysia and attended a 1‐day training session on recognizing abnormalities within the oral cavity. Following the training, the dentists conducted screening and provided risk habits cessation advice at their respective clinics for 6 months. The impact of the program was evaluated by determining the number of patients who were screened and/or provided with risk habits cessation advice.

Results

Twenty‐six dentists took part in the program and conducted opportunistic screening on a total of 2603 individuals. On average, they screened about 23.0% of their patients and 5.1% were given risk habits cessation advice. Notably, dentists who had lower patient load were more likely to conduct opportunistic screening.

Conclusions

While the participating private dentists state that they have a role in performing opportunistic screening and providing risk habits cessation advice, these activities are still not a priority area in the private clinics, strongly suggesting that strategies to motivate dentists in this setting are urgently needed.
Navigating Complex Decisions in Restoration Investment
Authors: Shoo Luke P. , Catterall Carla P. , Nicol Sam , Christian Rochelle , Rhodes Jonathan , Atkinson Penny , Butler Don , Zhu Roger , Wilson Kerrie A.
Published: November 2016

Ecosystem restoration requires choosing among potential interventions which differ in cost, and the time required to achieve outcomes of varying quality. Managers have different preferences for timeframes, certainty, and quality of outcomes, which can influence the choice of investment strategy. Here we develop a probabilistic approach to quantify expected restoration outcomes from alternative investment strategies, given operational constraints or alternative preferences. We apply the approach to a tropical forest restoration case study in which managers seek to allocate future resources between active planting and self‐organized regrowth. We find that the best strategy depends on the desired forest attributes and the time required for outcomes to be achieved. We quantify the trade‐off for three key forest attributes between restoring large areas of vegetation to low quality and restoring smaller areas to a higher quality. Explicit consideration of preferences and trade‐offs will enhance the likelihood that projects deliver desired outcomes.
Financial and Ecological Implications of Global Seafood Mislabeling
Authors: Stawitz Christine C. , Siple Margaret C. , Munsch Stuart H. , Lee Qi , Derby SAFS Research
Published: November 2016

Consumers and regulators influence conservation of marine finfish by controlling harvest demand and availability. Consumer power to choose sustainably‐harvested species is threatened by seafood mislabeling, which may be a product of fraud or human error. Here we examined the prevalence of mislabeling, and its financial and ecological implications, by compiling and analyzing an international dataset of DNA barcoding studies of marine finfish (n = 43). On average, DNA‐identified species sold were less expensive (−2.98% ex‐vessel price) and more sustainable (+3.88% IUCN status) than species listed on their label; thus, mislabeling had a net positive impact on the conservation status of sold species. However, ecological impacts of some frequently mislabeled taxa were potentially severe, suggesting eco‐conscious consumers may want to avoid certain genera. Mislabeling may be reduced by increasing traceability and identification of seafoods, particularly at points in the chain‐of‐custody beyond ports, where the majority of mislabeling occurred.
Innovativeness as an Unintended Outcome of Franchising: Insights from Restaurant Chains
Authors: Mallapragada Girish , Srinivasan Raji
Published: November 2016

A growing trend in improving innovation outcomes is to go outside the firm's boundaries. One mechanism by which firms extend organizational boundaries is through franchising their channels. Yet, the effects of franchising on innovation outcomes have been overlooked in the literature. We propose that a firm's emphasis on franchising will affect its organizational innovativeness, conceptualized as product and process innovativeness, independently and with other firm characteristics—franchising experience, firm size, financial leverage, and slack resources. We find support for our hypotheses using a nonlinear seemingly unrelated regression model estimated using panel data from 38 U.S. restaurant chains between 1992 and 2005. The positive effect of the emphasis on franchising on product innovativeness is stronger for firms with high financial leverage, but weaker for firms with high slack resources. For process innovativeness, the effect is stronger for firms with high financial leverage but weaker for large firms, and for firms with high franchising experience and high slack resources. The findings indicate that a firm's emphasis on franchising has contingent effects on product and process innovation outcomes. Thus, franchising emerges as a competing mechanism (to alliances and joint ventures) that extends organizational boundaries and affects organizational innovativeness.
Game Outcome Uncertainty and Television Audience Demand: New Evidence from German Football
Authors: Schreyer  , Torgler Benno , Schmidt Sascha L.
Published: November 2016

Despite its prominence in the economic literature, our knowledge regarding the role of game outcome uncertainty (GOU) in spectator decision-making is fairly limited. Even worse, studies testing the uncertainty of outcome hypothesis (UOH) by exploring TV demand for European football have further intensified the original ambiguity. In this paper, we revisit the role of GOU in spectator decision-making by testing the UOH with regard to two different sporting products: (1) domestic league and (2) knockout tournament games. Analyzing TV demand for almost 1,500 German football games, we find support for the UOH in league, though not in knockout tournament games.
Effects of end‐stage renal disease and dialysis modalities on blood ammonia level
Authors: Vaziri Nosratola D. , Khazaeli Mahyar , Nunes Ane C. F. , Harley Kevin T. , Said Hyder , Alipour Omeed , Lau Wei Ling , Pahl Madeleine V.
Published: November 2016

Introduction: Uremia results in a characteristic breath odor (uremic fetor) which is largely due to its high ammonia content. Earlier studies have shown a strong correlation between breath ammonia and blood urea levels and a 10‐fold reduction in breath ammonia after hemodialysis in patients with chronic kidney disease. Potential sources of breath ammonia include: (i) local ammonia production from hydrolysis of urea in the oropharyngeal and respiratory tracts by bacterial flora, and (ii) release of circulating blood ammonia by the lungs. While the effects of uremia and hemodialysis on breath ammonia are well known their effects on blood ammonia are unknown and were explored here.

Methods: Blood samples were obtained from 23 hemodialysis patients (immediately before and after dialysis), 14 peritoneal dialysis patients, and 10 healthy controls. Blood levels of ammonia, creatinine, urea, and electrolytes were measured.

Findings: No significant difference was found in baseline blood ammonia between hemodialysis, peritoneal dialysis and control groups. Hemodialysis procedure led to a significant reduction in urea concentration (P < 0.001) which was paradoxically accompanied by a modest but significant (P < 0.05) rise in blood ammonia level in 10 of the 23 patients studied. Change in blood ammonia pre‐ and post‐hemodialysis correlated with change in serum bicarbonate levels (r = 0.61, P < 0.01). On subgroup analysis of patients who had a rise in blood ammonia levels after dialysis, there was a strong correlation with drop in mean arterial pressure (r = 0.88, P < 0.01). The nadir intradialytic systolic blood pressure trended lower in the hemodialysis patients who had a rise in blood ammonia compared to the patients who manifested a fall in blood ammonia (124 ± 8 vs. 136 ± 6 mmHg respectively, P = 0.27).

Discussion: Fall in blood urea following hemodialysis in ESRD patients was paradoxically accompanied by a modest rise in blood ammonia levels in 43% of the patients studied, contrasting prior reported effects of hemodialysis on breath ammonia. In this subgroup of patients, changes in blood ammonia during hemodialysis correlated with rise in blood bicarbonate and fall in mean arterial blood pressure.
New eight‐layer twinned hexagonal perovskite microwave dielectric ceramic Ba8NiNb6O24
Authors: Tao Fengqiong , Wang Xiaoming , Gong Mielu , Lu Fengqi , Allix Mathieu , Kuang Xiaojun , Fang Liang
Published: November 2016

A new eight‐layer hexagonal perovskite Ba8NiNb6O24 was synthesized via the high‐temperature solid‐state reaction and its structure was characterized using selected area electron diffraction, high‐resolution transmission electron microscopy, and synchrotron X‐ray diffraction. Unlike the eight‐layer ordered shifted Ba8CoNb6O24 and Ba8ZnNb6O24, Ba8NiNb6O24 adopts a twinned structure with stacking sequence (ccch)2 for the BaO3 layers and displays more disordered cation and vacancies over the face‐sharing octahedral (FSO) sites than the twinned tantalates Ba8MTa6O24 (M=Zn, Ni, Co). The stabilization of twinned structure and cation/vacancy ordering in Ba8NiNb6O24 composition is correlated with the smaller size difference between Ni2+ and Nb5+ in comparison with those between (Zn/Co)2+ and Nb5+ in the shifted Ba8CoNb6O24 and Ba8ZnNb6O24. The Ba8NiNb6O24 pellet exhibits high dielectric permittivity εr ~ 40, modest Qf ~ 41 319 GHz, and large temperature coefficient of resonant frequency τf ~ 60 ppm/°C. The lower Qf value compared with the high‐Q Ba8MTa6O24 is ascribed to the reduced short‐range B‐cationic ordering inside the FSO dimers in Ba8NiNb6O24. These results contribute to understanding the interplay among chemical composition, structure, and dielectric properties of the eight‐layer twinned and shifted hexagonal perovskites.
Phase stability, electronic structures, and superconductivity properties of the BaPb1−xBixO3 and Ba1−xKxBiO3 perovskites
Authors: Liu Shi‐Yu , Meng Yang , Liu Shiyang , Li De‐Jun , Li Yaping , Liu Yingdi , Shen Yaogen , Wang Sanwu
Published: November 2016

Abstact

With extensive first‐principles calculations, we investigate the phase stability, electronic structures, and superconductivity properties of the BaPb1−xBixO3 (BPBO) and Ba1−xKxBiO3 (BKBO) perovskites with the cubic (C), tetragonal (T), and orthorhombic (O) phases. Our calculations show that the tetragonal superconducting phases of both perovskites are metastable. However, the orthorhombic phase of the BPBO perovskite in the superconductivity region is only slightly more stable than the tetragonal phase. The small energy difference between the T and O phases and the discontinuous T‐to‐O phase transition account for the experimentally observed coexistence of the T and O phases. On the other hand, the BKBO perovskite involves a large energy difference between the T and O phases, which induces a low equilibrium temperature of the discontinuous T‐to‐O phase transition, in agreement with the experimental observation that the tetragonal BKBO is maintained down to low temperatures. Moreover, the electronic structures of both BPBO and BKBO superconductors show a flat band near the Fermi level, which is favorable for superconductivity. Furthermore, we find that the longer the total length of the flat band segment is, the higher the critical temperature of the BPBO or BKBO perovskite is. This key finding could be generalized straightforwardly to other unconventional superconductors and can be used to design and find optimal composition with maximum Tc for new unconventional superconductors.
Electrical and hydrogen reduction enhances kinetics in doped zirconia and ceria: I. grain growth study
Authors: Dong Yanhao , Wang Haoren , Chen I‐Wei
Published: November 2016

The kinetics of mass transport is central to ceramic processing and device stability. In this work, the effect of electrical and hydrogen reduction on the grain growth behavior of doped zirconia and ceria has been investigated. Faster grain growth has been observed under reducing conditions in all cases. The results firmly establish that a depressed local oxygen potential can enhance cation kinetics in fluorite‐structured oxide ceramics. Meanwhile, a large electrical current can generate a sharp, spatially varied oxygen potential profile, creating a graded microstructure with a dramatic grain size transition across the length of the sample.
3D Dislocation structure evolution in strontium titanate: Spherical indentation experiments and MD simulations
Authors: Javaid Farhan , Stukowski Alexander , Durst Karsten
Published: November 2016

In the present work, the dislocation structure evolution around and underneath the spherical indentations in (001) oriented single crystalline strontium titanate (STO) was revealed by using an etch‐pit technique and molecular dynamics (MD) simulations. The 3D defect structure at various length scales and subsurface depths was resolved with the help of a sequential polishing, etching, and imaging technique. This analysis, combined with load‐displacement data, shows that the incipient plasticity (manifested as sudden indenter displacement bursts) is strongly influenced by preexisting dislocations. In the early stage of plastic deformation, the dislocation pile‐ups are all aligned in 〈100〉 directions, lying on {110}45 planes, inclined at 45° to the (001) surface. At higher mean contact pressure and larger indentation depth, however, dislocation pile‐ups along 〈110〉 directions appear, lying on {110}90 planes, perpendicular to the (100) surface. MD simulations confirm the glide plane nature and provide further insights into the dislocation formation mechanisms by tracing the evolution of the complete dislocation line network as function of indentation depth.
The variable nature of cognitive control in a university sample of young adult drinkers
Authors: Sharma Dinkar
Published: November 2016

The current study investigates the effect of task‐irrelevant alcohol distractors on cognitive control and its interaction with heavy/light drinking in a group of young adult drinkers. It was hypothesised that alcohol distractors would result in a reduction of proactive control (reduced conflict adaptation) especially in heavy drinkers. 60 participants took part in a face‐word version of the Stroop task preceded by an alcohol or neutral image. Light drinkers only showed a congruency effect which indicated a greater level of proactive control. Heavy drinkers showed a greater level of reactive control in which the conflict adaptation effect occurred with neutral images but not with alcohol images. Possible explanations are discussed.
Association between pulse pressure and body mass index in hypertensive and normotensive populations in the Korea National Health and Nutrition Examination Survey V, 2010–2012
Authors: Kang Min Gyu , Kim Kye‐Hwan , Koh Jin‐Sin , Park Jeong Rang , Hwang Seok‐Jae , Hwang Jin‐Yong , Ahn Jong Hwa , Jang Jeong Yoon , Jeong Young‐Hoon , Kwak Choong Hwan , Park Hyun Woong
Published: November 2016

The authors conducted a national cross‐sectional cohort study to evaluate the associations between pulse pressure (PP) and body mass index (BMI) and sex, according to blood pressure (BP) status. A total of 18 812 patients without a history of antihypertensive medication and cardiovascular disease were selected. There was good concordance between PP and the selected cardiovascular risk factors. PP increased with high BMI among patients with normal BP, but decreased with high BMI among patients with hypertension (HTN). BMI (ß, −0.260; SE, 0.039 [P<.001]) and male sex (ß, −4.727; SE, 1.100 [P<.001]) were negatively correlated with PP in a multivariate model adjusted for several risk factors in patients with HTN. In conclusion, PP was negatively correlated with BMI in patients with HTN, which may explain the higher cardiovascular risk in lean persons and women with HTN.
Partners in research: building academic‐practice partnerships to educate and mentor advanced practice nurses
Authors: Harbman Patricia , Bryant‐Lukosius Denise , Martin‐Misener Ruth , Carter Nancy , Covell Christine L. , Donald Faith , Gibbins Sharyn , Kilpatrick Kelley , McKinlay James , Rawson Krista , Sherifali Diana , Tranmer Joan , Valaitis Ruta
Published: November 2016

Rationale

Clinical practice is the primary focus of advanced practice nursing (APN) roles. However, with unprecedented needs for health care reform and quality improvement (QI), health care administrators are seeking new ways to utilize all dimensions of APN expertise, especially related to research and evidence‐based practice. International studies reveal research as the most underdeveloped and underutilized aspect of these roles.

Aims

To improve patient care by strengthening the capacity of advanced practice nurses to integrate research and evidence‐based practice activities into their day‐to‐day practice.

Methods

An academic‐practice partnership was created among hospital‐based advanced practice nurses, nurse administrators, and APN researchers to create an innovative approach to educate and mentor advanced practice nurses in conducting point‐of‐care research, QI, or evidence‐based practice projects to improve patient, provider, and/or system outcomes. A practice‐based research course was delivered to 2 cohorts of advanced practice nurses using a range of teaching strategies including 1‐to‐1 academic mentorship. All participants completed self‐report surveys before and after course delivery.

Results

Through participation in this initiative, advanced practice nurses enhanced their knowledge, skills, and confidence in the design, implementation, and/or evaluation of research, QI, and evidence‐based practice activities.

Conclusion

Evaluation of this initiative provides evidence of the acceptability and feasibility of academic‐practice partnerships to educate and mentor point‐of‐care providers on how to lead, implement, and integrate research, QI and evidence‐based activities into their practices.
Persistent threats to validity in single‐group interrupted time series analysis with a cross over design
Authors: Linden Ariel
Published: November 2016

Rationale, aims and objectives

The basic single‐group interrupted time series analysis (ITSA) design has been shown to be susceptible to the most common threat to validity—history—the possibility that some other event caused the observed effect in the time series. A single‐group ITSA with a crossover design (in which the intervention is introduced and withdrawn 1 or more times) should be more robust. In this paper, we describe and empirically assess the susceptibility of this design to bias from history.

Method

Time series data from 2 natural experiments (the effect of multiple repeals and reinstatements of Louisiana's motorcycle helmet law on motorcycle fatalities and the association between the implementation and withdrawal of Gorbachev's antialcohol campaign with Russia's mortality crisis) are used to illustrate that history remains a threat to ITSA validity, even in a crossover design.

Results

Both empirical examples reveal that the single‐group ITSA with a crossover design may be biased because of history. In the case of motorcycle fatalities, helmet laws appeared effective in reducing mortality (while repealing the law increased mortality), but when a control group was added, it was shown that this trend was similar in both groups. In the case of Gorbachev's antialcohol campaign, only when contrasting the results against those of a control group was the withdrawal of the campaign found to be the more likely culprit in explaining the Russian mortality crisis than the collapse of the Soviet Union.

Conclusions

Even with a robust crossover design, single‐group ITSA models remain susceptible to bias from history. Therefore, a comparable control group design should be included, whenever possible.
Otolith morphology varies between populations, sexes and male alternative reproductive tactics in a vocal toadfish Porichthys notatus
Authors: Bose A. P. H. , Adragna J. B. , Balshine S.
Published: November 2016

In this study, the morphology of sagittal otoliths of the plainfin midshipman fish Porichthys notatus was compared between populations, sexes and male alternative reproductive phenotypes (known as ‘type I males or guarders’ and ‘type II males or sneakers’). Sagitta size increased with P. notatus size and changes in shape were also detected with increasing body size. Porichthys notatus sagittae begin as simple rounded structures, but then elongate as they grow and take on a more triangular and complex shape with several prominent notches and indentations along the dorsal and caudal edges. Moreover, the sagittae of the two geographically and genetically distinct populations of P. notatus (northern and southern) differed in shape. Porichthys notatus from the north possessed taller sagittae with deeper caudal indentations compared to P. notatus from the south. Sagitta shape also differed between females and males of the conventional guarder tactic. Furthermore, guarder males had smaller sagittae for their body size than did sneaker males or females. These differences in sagittal otolith morphology are discussed in relation to ecological and life history differences between the sexes and male tactics of this species. This is the first study to investigate teleost otolith morphology from the perspective of alternative reproductive tactics.
Effect of zein coating enriched by addition of functional constituents on the lipid oxidation of roasted hazelnuts
Authors: Yıldırım Esra , Barutçu Mazı Işıl
Published: November 2016

This study investigates the effects of hazelnut skin extract powder (HEP) and α‐tocopherol addition to zein coating on lipid oxidation, texture, and moisture content of roasted hazelnuts. Total phenolic content of hazelnut skin extracted with three different solvents (acetone, ethanol, methanol) under hot (50°C) and cold (29°C) conditions were determined. The highest phenolic content (652.6 mg GAE/g) was achieved by using methanol as solvent at 50°C. Uncoated and coated hazelnuts were subjected to accelerated shelf‐life testing at 40°C for 5 months. Peroxide value, free acidity, K232, and K270 values of oil fraction of hazelnuts were measured at each month as indicators of oxidative rancidity. All coatings significantly reduced the investigated parameters indicating that they are all effective in prevention of oxidation. α‐Tocopherol incorporated coating provided the lowest PV (1.21 meqO2/kg) and K232 (3.03) values at the end of storage period and also it has the smoothest outer surface appearance. Hardness values and moisture contents of coated and uncoated hazelnuts remained unchanged during storage.

Practical applications

Application of zein coating reduced the oxidative rancidity of roasted hazelnuts without producing significant changes in its color, texture, or moisture content at ambient storage conditions. Incorporation of α‐tocopherol improved the coating performance while incorporation of HEP did not at the level of 0.5% (w/v). This study shows that the shelf‐life of roasted hazelnuts may be enhanced by coating with zein solution containing natural antioxidant.
Quality changes of air‐packaged chicken meat stored under different temperature conditions and mathematical modelling for predicting the microbial growth and shelf life
Authors: Ghollasi‐Mood Farahnaz , Mohsenzadeh Mohammad , Hoseindokht Mohammad‐Reza , Varidi Mehdi
Published: November 2016

The purpose of the present study was to investigate the changes in bacterial flora including the number of Pseudomonas spp., total viable count, lactic acid bacteria and Enterobacteriaceae and to predict the shelf life of air‐packaged chicken meat stored at different storage temperatures (0 °C, 4 °C, 10 °C, and 15 °C). The correlation coefficient between Pseudomonas spp. count, total viable count, total volatile basic nitrogen, sensory evaluation scores, and pH showed that Pseudomonas spp. is a specific spoilage organism (Nychas, Skandamis et al.) (R2> .940, p < .01). The Gompertz model was fitted well to the experimental data (p < .001, R2> .989) and the MSE values were relatively small. The specific growth rate of Pseudomonas spp. in the chicken meat was 0.096, 0.122, 0.287, and 0.528/hr at 0 °C, 4 °C, 10 °C, and 15 °C, respectively. The lag phase was 74.3 hr, 25.2 hr, 14.8 hr, and 2.7 hr at 0 °C, 4 °C, 10 °C, and 15 °C, respectively. The Arrhenius equation was used as a secondary model to describe the effect of temperature on the maximum growth rate of Pseudomonas spp. in the poultry. The activation energy for growth of Pseudomonas spp. in the chicken meat was 74.0 kJ/mol. Finally, an exponential equation was used for shelf life prediction of poultry meat. The Gompertz model satisfactorily predicted the growth of Pseudomonas spp. as the specific spoilage organism in the air‐packaged chicken meat stored under different temperature conditions.

Practical applications

There is no significant difference between experimental and predicted data by the model for air‐packed poultry meat, so the data tested in laboratory media could be easily used in real food after the mathematical process using the Gompertz model and it can be used to control the potential hazard in food and quality control.
Improving Pain Relief in Elder Patients (I‐PREP): An Emergency Department Education and Quality Intervention
Authors: Hogan Teresita M. , Howell Michael D. , Cursio John F. , Wong Alexandra , Dale William
Published: November 2016

Objectives

To assess the effectiveness of a novel combined education and quality improvement (QI) program for management of pain in older adults in the emergency department (ED).

Design

Controlled pre/postintervention examination.

Setting

An academic urban ED seeing 60,000 adult visits annually.

Participants

Individuals aged 65 and older experiencing moderate to severe pain.

Intervention

Linked standardized education and continuous QI for multidisciplinary staff in an urban, academic ED from January 2012 to January 2014.

Measurements

Pain intensity, percentage receiving and time to pain assessment and reassessment, percentage receiving and time to delivery of analgesic.

Results

The percentage of participants with final pain score of 4 or less (out of 10) increased 47.5% (95% confidence interval (CI) = 41.8–53.2%). Median decrease in pain intensity improved significantly, from 0.0 to 5.0 points (P < .001). Median final pain score decreased from 7.0 to 4.0 points (P < .001). The percentage of participants with any pain improvement increased 43.7% (95% CI = 37.1–50.3%, P < .001). Pain reassessments increased significantly (from 51.9% to 82.5%, P < .001). The percentage receiving analgesics increased significantly (from 64.1% to 84.8%, P < .001). After the intervention, participants had 3.1 (95% CI = 2.1–4.4, P < .001) greater odds of receiving analgesics and 4.7 (95% CI = 3.5–6.5, P < .001) greater odds of documented pain reassessment.

Conclusion

The I‐PREP intervention substantially improved pain management in older adults in the ED with moderate to severe musculoskeletal or abdominal pain. Significant reductions in pain intensity were achieved, the timing of pain assessments and reassessments was improved, and analgesics were delivered faster. Tightly linking education to targeted QI improved pain management of older adults in the ED.
Effect of the Interplay Between Genetic and Behavioral Risks on Survival After Age 75
Authors: Rizzuto Debora , Keller Lina , Orsini Nicola , Graff Caroline , Bäckman Lars , Bellocco Rino , Wang Hui‐Xin , Fratiglioni Laura
Published: November 2016

Objectives

To explore the association between genes that may be related to human mortality, taking into account the possible contribution of morbidity, and investigate whether lifestyle behaviors may attenuate genetic risk.

Design

Twenty‐five‐year population‐based cohort study.

Setting

Kungsholmen cohort, Stockholm, Sweden.

Participants

Individuals aged 75 and older (N = 1,229).

Measurements

The associations between single‐nucleotide variations in 14 genes (previously associated with mortality or to diseases linked to mortality), relevant lifestyle risk behaviors (smoking; mental, physical, or social inactivity; moderate or poor social network), and mortality were estimated using Cox regression.

Results

People with allelic variation in four genes related to cardiovascular diseases and metabolism were more likely to die: apolipoprotein (APO)C1 GG and AG carriers, APOE ɛ4 carriers, insulin‐degrading enzyme (IDE) TC carriers, and phosphatidylinositol 3‐kinase (PI3KCB) GG carriers. Individuals with multiple adverse alleles had 62% higher mortality rate than those with none. In contrast, people with no risk behaviors (low‐risk profile) had 65% lower mortality rate than people with all examined risk behaviors (high‐risk profile). Combining the genetic and environmental factors, it was found that, independent of genetic profile, individuals with a low‐risk profile had up to 64% lower mortality rate than those with a moderate high– or high‐risk profile and at least one genetic risk factor.

Conclusion

This study supports and expands evidence that genetic variations in APOE, IDE, and PI3KCB are associated with lower mortality rate, although lifestyle behaviors can modulate their effects.
Willingness to Pay for a Maternity Waiting Home Stay in Zambia
Authors: Vian Taryn , White Emily E. , Biemba Godfrey , Mataka Kaluba , Scott Nancy
Published: November 2016

Introduction

Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource‐poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes‐residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability.

Methods

We conducted a mixed‐methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context.

Results

The maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use.

Discussion

While Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households.
Improving Utilization of the Family History in the Electronic Health Record
Authors: Hickey Kathleen T. , Katapodi Maria C. , Coleman Bernice , Reuter‐Rice Karin , Starkweather Angela R.
Published: November 2016

Purpose

The purpose of this article is to provide an overview of Family History in the Electronic Health Record and to identify opportunities to advance the contributions of nurses in obtaining, updating and assessing family history in order to improve the health of all individuals and populations.

Organizing Construct

The article presents an overview of the obstacles to charting Family History within the Electronic Health Record and recommendations for using specific Family History tools and core Family History data sets.

Methods

Opportunities to advance nursing contributions in obtaining, updating, and assessing family history in order to improve the health of all individuals were identified. These opportunities are focused within the area of promoting the importance of communication within families and between healthcare providers to obtain, document, and update family histories.

Findings

Nurses can increase awareness of existing resources that can guide collection of a comprehensive and accurate family history and facilitate family discussions. In this paper, opportunities to advance nursing contributions in obtaining, updating, and assessing family history in order to improve the health of all individuals were identified.

Conclusions

Aligned with the clinical preparation of nurses, family health should be used routinely by nurses for risk assessment and to help inform patient and family members on screening, health promotion, and disease prevention. The quality of family health information is critical in order to leverage the use of genomic healthcare information and derive new knowledge about disease biology, treatment efficacy, and drug safety. These actionable steps need to be performed in the context of promoting evidence‐based applications of family history that will be essential for implementing personalized genomic healthcare approaches and disease prevention efforts.

Clinical Relevance

Family health history is one of the most important tools for identifying the risk of developing rare and chronic conditions, including cardiovascular disease, cancer, and diabetes, and represents an integration of disease risk from genetic, environmental, and behavioral/lifestyle factors. In fact, family history has long been recognized as a strong independent risk factor for disease and is the current best practice used in clinical practice to guide risk assessment.
Rethinking the Use of Neutral Faces as a Baseline in fMRI Neuroimaging Studies of Axis‐I Psychiatric Disorders
Authors: Filkowski Megan M. , Haas Brian W.
Published: November 2016

Major Axis‐I disorders including major depressive disorder (MDD), bipolar disorder (BD), anxiety disorder, and schizophrenia are associated with a host of aberrations in the way social stimuli are processed. Face perception tasks are often used in neuroimaging research of emotion processing in both healthy and patient populations, and to date, there exists a mounting body of evidence, both behavioral and within the brain, indicating that emotional faces compared to neutral faces are processed abnormally by those with Axis‐I disorders relative to healthy control (HC) groups. The use of neutral faces as a “baseline control condition” is predicated on the assumption that neutral faces are processed in the same way HCs and individuals with major Axis‐I disorders. In this paper, existing fMRI studies examining the way neutral faces are processed in groups with Axis‐I disorders involving socioaffective perception are reviewed. In reviewing available studies, a consistent pattern of results demonstrated that these disorders are associated with abnormal frontolimbic activity in response to neutral faces and in particular within the amygdala and prefrontal regions such as the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) compared to HC groups. Specifically, increased amygdala activation was consistently reported in response to neutral faces in anxiety disorders and schizophrenia. Abnormal medial PFC activity was reported in patients with MDD, and patients with BD exhibit decreased activity in the DLPFC and ACC relative to HCs. In addition, specific suggestions to overcome these obstacles with new research and additional analyses are discussed.
Root hemiparasitic plants are associated with high diversity in temperate grasslands
Authors: Fibich Pavel , Lepš Jan , Chytrý Milan , Těšitel Jakub
Published: November 2016

Questions

Is the incidence of root hemiparasitic plants in non‐forest vegetation associated with high diversity? Are root hemiparasites more associated with species‐rich vegetation than other species?

Location

Czech Republic.

Methods

Plot size‐corrected species richness, Shannon diversity and Pielou's evenness were computed for a representative set of 18 101 vegetation plots representing all main types of terrestrial open (non‐forest) habitats of the country. Null models of species richness assuming occurrence of a random species with given occurrence frequency, reflecting higher incidence probability in species‐rich plots, were constructed for 16 common root hemiparasitic species. The null model distribution of species richness was subsequently compared with the actual mean species richness of plots containing the respective root hemiparasites. Median values of plot Shannon diversity and evenness were computed for each species in the database. Values obtained for plots containing individual root hemiparasites were compared with distribution of values for other species in the database.

Results

The occurrence of 11 of 16 root hemiparasites studied was associated with high species richness significantly more than under random expectations; three species were negatively associated. Three root hemiparasites were among the top 5% of all species associated with high species richness and Shannon diversity, and eight were among the top 25%. Almost 50% of the top 1% most species‐rich plots contained at least one root hemiparasitic species.

Conclusions

We demonstrated a positive association between the incidence of most root hemiparasites and diversity of non‐forest terrestrial plant communities at a broad landscape scale. This finding scales up the results of experimental studies that showed some root hemiparasites act as ecosystem engineers, increasing vegetation diversity. Root hemiparasites should be regarded as important biodiversity indicators and potential drivers of biodiversity. As such, conserving their wild populations or promoting their establishment should become a goal of nature conservation and ecological restoration.
Replacement of Soybean Meal with Fermented Jatropha curcas Kernel Meal in the Diet of Labeo rohita Fingerlings: Effect on Hemato‐biochemical and Histopathological Parameters
Authors: Phulia Vikas , Sardar Parimal , Sahu Narottam Prasad , Shamna N. , Fawole Femi John , Gupta Subodh , Gadhave P. D.
Published: November 2016

Jatropha kernel meal was detoxified through the process of solid‐state fermentation using Aspergillus niger fungus. A 60‐d feeding trial was conducted to evaluate the effects of replacing soybean meal (SBM) with fermented Jatropha kernel meal (FJKM) on the hemato‐biochemical and histopathological parameters in Labeo rohita fingerlings (average weight 6.05 ± 0.04 g). A total of 180 fish were randomly distributed in 12 experimental tanks in four dietary groups, namely control (SBM‐based diet), T1 (10% FJKM replacing 33.3% SBM), T2 (20% FJKM replacing 66.7% SBM), and T3 (30% FJKM replacing 100% SBM). There was no significant difference in the red blood cell, white blood cell, hemoglobin, total protein, albumin, globulin, and respiratory burst activity among the various groups, but significantly higher hematocrit value and albumin/globulin ratio were observed in the T2‐fed group compared with the control. No statistical difference was found in serum glucose level of the control and FJKM‐fed groups. Histopathological examination of the intestine and liver indicated no adverse effects in the control and FJKM‐fed groups. Our findings revealed that FJKM can replace 100% SBM protein in the diets of L. rohita fingerlings, without any adverse effects on fish health.
Neutral or non‐neutral communities: temporal dynamics provide the answer
Authors: Engen Steinar , Solbu Erik Blystad , Sæther Bernt‐Erik
Published: November 2016

Neutral models for community dynamics are based on the assumption that temporal variation is only influenced by demographic stochasticity, ignoring the influence of fluctuations in the environment. Demographic and environmental stochasticity are known to have very different effects on the population dynamics of single species. Communities, however, are usually analyzed with emphasis on the shape of the species abundance distribution rather than on their dynamical characteristics. Accordingly, examination of the validity of the neutral model has typically been based on statistical analyses of the shape of the species abundance distribution or form of the species–area relationships. Here we illustrate that both demographic and environmental noise must be included to obtain realistic description of community dynamics. We do this by a simple approach comparing two different dynamic models both leading to Fisher's log series species abundance distribution: the neutral model with only demographic noise, and a limiting form of an approximate gamma model most strongly affected by environmental noise. While keeping Fisher's diversity parameter α constant, the turnover rates for observable species become much greater and average life‐times of species much smaller in the gamma model than in the neutral model. In practice, the neutral model tends to produce unrealistically small turnover rates for large populations. This illustrates that realistic assumptions about the stochastic components of the underlying population dynamics of single species are important for correctly characterizing dynamical changes in species composition of communities. This approach can provide a powerful tool for identifying the principal factors affecting the structure of communities.
Polymyxin‐B immobilized column–direct hemoperfusion for adolescent toxic shock syndrome
Authors: Nanishi Etsuro , Hirata Yuichirou , Lee Sooyoung , Kaku Noriyuki , Momii Kenta , Kubota Kensuke , Nishio Hisanori , Maehara Yoshihiko , Hara Toshiro
Published: November 2016

Toxic shock syndrome (TSS) is a critical illness associated with toxin from Staphylococcus aureus. Despite recent advances in critical care, mortality remains high and additional effective therapy is required. We report an adolescent case of TSS successfully treated with direct hemoperfusion using polymyxin‐B immobilized fiber (PMX‐DHP). The patient with spina bifida also had ischial pressure ulcer, and developed TSS associated with methicillin‐resistant S. aureus. Despite conventional treatment, the patient developed refractory shock, which was immediately improved with PMX‐DHP. PMX‐DHP has been widely used for the treatment of sepsis to remove circulating endotoxins produced by Gram‐negative bacteria, but beneficial effects have also been reported for Gram‐positive bacterial infection. To our knowledge, this is the first report on PMX‐DHP for TSS in an adolescent patient, and we propose that PMX‐DHP could be a new treatment strategy for severe TSS in children as well.
Accuracy and safety of ward based pleural ultrasound in the Australian healthcare system
Authors: Hammerschlag Gary , Denton Matthew , Wallbridge Peter , Irving Louis , Hew Mark , Steinfort Daniel
Published: November 2016

ABSTRACT

Background and objective

Ultrasound has been shown to improve the accuracy and safety of pleural procedures. Studies to date have been performed in large, specialized units, where pleural procedures are performed by a small number of highly specialized physicians. There are no studies examining the safety and accuracy of ultrasound in the Australian healthcare system where procedures are performed by junior doctors with a high staff turnover.

Methods

We performed a retrospective review of the ultrasound database in the Respiratory Department at the Royal Melbourne Hospital to determine accuracy and complications associated pleural procedures.

Results

A total of 357 ultrasounds were performed between October 2010 and June 2013. Accuracy of pleural procedures was 350 of 356 (98.3%). Aspiration of pleural fluid was successful in 121 of 126 (96%) of patients. Two (0.9%) patients required chest tube insertion for management of pneumothorax. There were no recorded pleural infections, haemorrhage or viscera puncture.

Conclusion

Ward‐based ultrasound for pleural procedures is safe and accurate when performed by appropriately trained and supported junior medical officers. Our findings support this model of pleural service care in the Australian healthcare system.
The feasibility of office‐based propofol sedation for dental care in patients with intellectual disability by sedation practitioners
Authors: Vaessen Hermanus H. B. , Schouten Antonius N. J. , van der Hoeve Henriette , Knape Johannes T. A.
Published: November 2016

Background

The quality of oral health care for intellectually disabled patients is a significant challenge due to behavioral issues. Intravenous propofol sedation may be useful to relieve the anxiety and fear, and make dental procedures more acceptable. The aim of this study was to evaluate the safety and effectiveness of propofol sedation, by trained nonmedical sedation practitioners, during dental treatments in an office‐based setting.

Methods

Intellectually disabled patients (124) were subjected to restorative dental procedures and moderately sedated using intravenous propofol. Vital signs, cooperation of the patient, and sedation depth were continuously assessed.

Results

Propofol sedation was effective for dental treatment. All procedures resulted in a sufficient level of sedation without moderate or severe complications.

Conclusion

Propofol sedation can be safely and effectively performed in an office‐based setting by sedation practitioners, who have experience in propofol sedation and are trained in the care of patients with disabilities.