bluuebunny/crossref_metadata_2025 huggingface dataset:
Articulating the unique competencies of admiral nurse practice
Authors: Carter Christine , Bray Jennifer , Read Kate , Harrison-Dening Karen , Thompson Rachel , Brooker Dawn
Published: September 2018

Purpose

The purpose of this paper is to describe the process of developing a contemporary competency framework for admiral nurses in dementia care.

Design/methodology/approach

Information and evidence was gathered from research and policy literature regarding competencies to deliver advanced practice within dementia care. An online survey completed by 75 admiral nurses with follow-up interviews clarified current practice across the range of service contexts in which they work. A focus group (FG) of people living with dementia and family carers, and a reference group of practitioners helped to develop a competency framework which was refined through FGs with admiral nurses working in different areas.

Findings

The literature review, survey and interviews provided a framework grounded in up-to-date evidence and contemporary practice. There was broad agreement in the literature and the practitioners’ priorities regarding the core competencies of advanced practice, with constructive suggestions for making the framework useable in practice. This resulted in a robust framework articulating the competencies of admiral nurses which could be used for continuous professional development.

Originality/value

Engaging the admiral nurses ensured the competencies were contemporary, succinct and applicable within practice, and also cultivated a sense of ownership. Developing the competency framework with the admiral nurses not for them provides an approach which may have value for professionals undertaking a similar process in their specialist area. It is anticipated the competency framework will provide further evidence of the benefits of specialist nurse support for families affected by dementia.
Improving the oral health of older people
Authors: Tinker A. , Gallagher J. , Awojobi T. , Ahilan A. , Dahwy A. Al , Faryabi-Araghi K. , Hassan V. , Hills R. , Khan P. , Kwaskowski T. , Li G.
Published: September 2018

Purpose

The purpose of this paper is to explore how adults may be supported in maintaining their oral health and to provide dental students with better knowledge of how the oral health of community living older people can be maintained and to make recommendations.

Design/methodology/approach

A pilot qualitative study involving eight dental students in three workshops in a Health Centre in South West London with 17 older adults whose ages ranged from 63 to 94 years with 82 percent female and 42 percent white.

Findings

For the older people, findings confirm previous research highlighting issues around prevention, delivery of care and access. However, other issues such as the use of fluoride and safety around tooth whitening were important. There was concern about the increasing privatisation of the dental service and problems in finding a dentist. For the dental students they valued time with older people and felt that they had a better understanding of them and research.

Research limitations/implications

The research was in one part of London and interviews were with only 17 older people. However, they were a mixed group in terms of age and ethnic origin.

Practical implications

These include the need to give older people more information and the value of simplicity e.g. through leaflets.

Social implications

Good oral health is important for physical and mental health and can help social participation and wellbeing.

Originality/value

Yes, this is original research.
The developmental environment modulates mating‐induced aggression and fighting success in adult female Drosophila
Authors: Bath Eleanor , Morimoto Juliano , Wigby Stuart
Published: September 2018

Competition over access to resources early in life can influence development, and, in turn, affect competitive phenotypes in reproductive adults. Theory predicts that competition between adult females should be especially context‐dependent, because of constraints imposed by high costs of reproduction. However, the potential impact of developmental environments on competition in adult females remains little understood.

In Drosophila melanogaster, the developmental environment can strongly influence adult condition, and prime adult competitive behaviour. In this species, female–female aggression is dependent on reproductive state and increases after mating due to the receipt of sperm and seminal fluid components. However, the effects of the developmental environment on adult female aggression, and any potential interactions with mating status, are unknown.

To address this problem, we first raised flies at low and high larval density, which altered competition over limited resources, produced large and small adult females, respectively, and potentially primed them for differing levels of adult competition. We then fought the resulting adult females, either as virgins, or after receiving aggression‐stimulating ejaculates at mating, to test for interacting effects.

We found, as expected, that mating elevated contest duration. However, this mating‐induced boost in aggression was strongly exacerbated for high density (small) females. Low density (large) females won more contests overall, but were not more successful in fights after mating. In contrast, mating increased the fighting success in females raised in high density environments.

Our results suggest that individuals who experience competitive, resource‐limited, rearing conditions are more sensitive to the aggression‐stimulating effects of the male ejaculate. This finding highlights the importance of the developmental environment in mediating adult social interactions and provides support for the theory that female–female aggression should be highly context‐dependent.

A plain language summary is available for this article.
Livestock grazing regulates ecosystem multifunctionality in semi‐arid grassland
Authors: Ren Haiyan , Eviner Valerie T. , Gui Weiyang , Wilson Gail W. T. , Cobb Adam B. , Yang Gaowen , Zhang Yingjun , Hu Shuijin , Bai Yongfei
Published: September 2018

Livestock grazing has been shown to alter the structure and functions of grassland ecosystems. It is well acknowledged that grazing pressure is one of the strongest drivers of ecosystem‐level effects of grazing, but few studies have assessed how grazing pressure impacts grassland biodiversity and ecosystem multifunctionality (EMF).

Here, we assessed how different metrics of biodiversity (i.e., plants and soil microbes) and EMF responded to seven different grazing treatments based on an 11‐year field experiment in semi‐arid Inner Mongolian steppe.

We found that soil organic carbon, plant‐available nitrogen and plant functional diversity all decreased even at low grazing pressure, while above‐ground primary production and bacterial abundance decreased only at high levels of grazing pressure.

Structural equation models revealed that EMF was driven by direct effects of grazing, rather than the effects of grazing on plant or microbial community composition. Grazing effects on plant functional diversity and soil microbial abundance did have moderate effects on EMF, while plant richness did not.

Synthesis. Our results showed ecosystem functions differ in their sensitivity to grazing pressure, requiring a low grazing threshold to achieve multiple goals in the Eurasian steppe.

A plain language summary is available for this article.
Maintenance costs of male dominance and sexually antagonistic selection in the wild
Authors: Boratyński Zbyszek , Koskela Esa , Mappes Tapio , Mills Suzanne C. , Mokkonen Mikael
Published: September 2018

Variation in dominance status determines male mating and reproductive success, but natural selection for male dominance can be detrimental or antagonistic for female performance, and ultimately their fitness. Attaining and maintaining a high dominance status in a population of competing individuals is physiologically costly for males. But how male dominance status is mediated by maintenance energetics is currently not well understood, nor are the corresponding effects of male energetics on his sisters recognized.

We conducted laboratory and field experiments on rodent populations to test whether selective breeding for male dominance status (dominant vs. subordinate breeding lines) antagonistically affected basal metabolic rate (BMR) and fitness of females under wild conditions.

Our results showed elevated BMR in females, but not in males, from the dominant breeding line. However, phenotypically dominant males from the subordinate breeding line had the highest BMR.

Males from the dominant line with low BMR sired the most litters and offspring in the field. Similarly, females from the dominant selection line tended to have more offspring if they had lower BMR, while the opposite trend was found in females from the subordinate selection line. Females with high and low BMR reproduced most often, as indicated by a significant quadratic selection gradient.

The increased female BMR resulting from selection for male dominance suggests genetic incompatibility between sexes in metabolism inheritance. Elevated BMR in behaviourally dominant males, but not in males from the dominant breeding line, suggests physiological costs in males not genetically suited for dominance.

Fitness costs of elevated maintenance costs (measured as BMR) shown here support the energetic compensation hypothesis where high BMR is selected against as it would trade off energy required for other important life‐history attributes.

A plain language summary is available for this article.
Larger fragments have more late‐successional species of woody plants than smaller fragments after 50 years of secondary succession
Authors: Liu Jiajia , Coomes David A. , Hu Guang , Liu Jinliang , Yu Jingjing , Luo Yangqing , Yu Mingjian
Published: September 2018

Most fragmentation research focuses on the effects of carving up old‐growth forests, but less is known about influences of habitat fragmentation on secondary succession in patches of regenerating forests.

Working with forest dynamics on islands in a vast lake created by a hydroelectric dam in China (the Thousand Island Lake), we sampled 29 islands that were cleared of forest during dam construction in 1959 and then underwent succession. Measurements taken in 2009–2010 and 2014–2015 evaluated community assembly during succession, based on species diversity, functional traits and structural properties.

Forests on small islands remained at relatively early stages of compositional succession: species richness was low, and communities were dominated by early‐successional species, with few animal‐dispersed and shade‐tolerant plants. However, these islands had accumulated similar above‐ground biomass density to that on larger islands, mostly in the stems of a fast‐growing pine species. Island size was the key driver of secondary succession in regenerating forest fragments, while isolation had comparatively little effect. Edge effects were important for species composition and functional composition.

Synthesis. Habitat fragmentation resulting from the creation of an artificial lake affected community assembly, with fewer late‐successional species on smaller islands. Maintenance of large fragments is critical for the rapid succession of forests. Paradigms on habitat fragmentation effects drawn from old‐growth forest studies are unlikely to hold in regenerating forest fragments. Restoration activities should consider landscape patterns to accelerate secondary succession of regenerating forests.
Facilitation beyond species richness
Authors: Vega‐Álvarez Julia , García‐Rodríguez José Antonio , Cayuela Luis
Published: September 2018

Facilitation studies have previously focused on the effects of plant–plant interactions on species richness and, more recently, on functional traits or phylogenetic aspects. Little is known, however, about the simultaneous effects that facilitation have on overall biodiversity, jointly considering taxonomic, functional and phylogenetic diversity.

In this study, we investigated shrub facilitation on herb communities in a Mediterranean grassland over a 9‐year period (2007–2015), each year representing different water availability conditions. Taxonomic, functional and phylogenetic diversity indices were estimated using generalised Hill numbers within the integrated framework of attribute diversity. We used generalised linear mixed models to analyse the effect of shrub cover on the different diversity indices along a water availability gradient.

Shrub cover had a positive effect on all attribute diversity indices, yet greater for abundant species. Shrubs also favoured survival of certain species (26.5% of total species), but above all they affected relative abundances of common species, filtering growth of dominant species (e.g.,Poa bulbosa)and promoting evenness. Diversity indices accounting only for abundant (i.e., high coverage) species showed the strongest facilitation effects that peaked at mid‐range water availability conditions.

Synthesis. Our results suggest that shrubs are key in the maintenance of all three dimensions of biodiversity in the Mediterranean grasslands, promoting more even communities, and to a lower extent, also species richness. We show that shrub facilitation on taxonomic, functional and phylogenetic diversity of herbaceous communities is maximum for abundant species at mid‐range values of water availability, in accordance with the humped‐back model. This study illustrates the need to evaluate different biodiversity dimensions from an integrated perspective, such as attribute diversity, to disentangle the role of facilitation in community assembly.
Inflammatory cytokines tumour necrosis factor‐α and interleukin‐8 enhance airway smooth muscle contraction by increasing L‐type Ca2+ channel expression
Authors: Ding Shengang , Zhang Jie , Yin Sheng , Lu Jingsen , Hu Min , Du Juan , Huang Junhao , Shen Bing
Published: September 2018

Inflammation elevates intracellular calcium concentrations ([Ca2+]i) in airway smooth muscle (ASM). The L‐type Ca2+ channel (L‐VDCC) plays an important role in regulating Ca2+ influx in ASM. However, the role of L‐VDCC in the inflammatory cytokine‐induced pathology of ASM remains unclear. In the present study, we used calcium imaging and isometric tension measurements to assess the role of L‐VDCC in agonist‐induced [Ca2+]i rise and the associated contractions in mouse ASM, and we used immunoblotting to identify L‐VDCC protein expression levels in mouse ASM after exposure to tumour necrosis factor alpha (TNF‐α) or interleukin‐8 (IL‐8). Our results showed that high‐K+‐ or carbachol‐induced contractions of mouse ASM were significantly greater after pretreatment with TNF‐α or IL‐8 for 24 hours. Both verapamil and nifedipine, L‐VDCC inhibitors, abolished this increased contraction induced by TNF‐α or IL‐8 pretreatment. Moreover, TNF‐α treatment enhanced carbachol‐induced Ca2+ influx in ASM cells, and this effect was abrogated by verapamil. Additionally, immunoblotting results showed that preincubation of mouse ASM with TNF‐α or IL‐8 also enhanced L‐VDCC protein expression. On the basis of these findings, we concluded that proinflammatory cytokines, such as TNF‐α and IL‐8, increase the expression level of L‐VDCC, which in turn contributes to augmented agonist‐induced ASM contractions. This effect of inflammation on L‐VDCC expression in ASM may be associated with airway hyper‐responsiveness and involved in the development of asthma.
Is South Korea as Leftist as It Gets? Labour Market Policy Reforms under the Moon Presidency
Authors: Kwon Soon‐Mee , Hong Ijin
Published: September 2018

Considering its conservative past, South Korea is undergoing an unprecedented turn to the left. Since priority was given to economic growth from the 1960s until the beginning of the 1990s, a close alliance between big business and government has characterised the country's labour market. Since the 1997 financial crisis, however, two decades of liberal and conservative governments have pushed a neoliberal agenda of labour market flexibilisation, which has resulted in growing inequality in a dualised labour market and left the trade unions in a marginal role. Following a rapid turn of events that led to the impeachment of conservative president Park Geun‐hye, left‐leaning President Moon Jae‐in seems determined to roll back this legacy of labour oppression with the strong support of trade unions and young voters. His administration is pushing for policy change with a series of expansionary active labour market policies aimed at promoting stability and full‐time employment. This article highlights the social‐democratic character of these reforms and the constraints in implementing them.
Systems Thinking as a Framework for Analyzing Commercial Determinants of Health
Authors: KNAI CÉCILE , PETTICREW MARK , MAYS NICHOLAS , CAPEWELL SIMON , CASSIDY REBECCA , CUMMINS STEVEN , EASTMURE ELIZABETH , FAFARD PATRICK , HAWKINS BENJAMIN , JENSEN JØRGEN DEJGÅRD , KATIKIREDDI SRINIVASA VITTAL , MWATSAMA MODI , ORFORD JIM , WEISHAAR HEIDE
Published: September 2018

Policy Points:

Worldwide, more than 70% of all deaths are attributable to noncommunicable diseases (NCDs), nearly half of which are premature and apply to individuals of working age. Although such deaths are largely preventable, effective solutions continue to elude the public health community.

One reason is the considerable influence of the “commercial determinants of health”: NCDs are the product of a system that includes powerful corporate actors, who are often involved in public health policymaking.

This article shows how a complex systems perspective may be used to analyze the commercial determinants of NCDs, and it explains how this can help with (1) conceptualizing the problem of NCDs and (2) developing effective policy interventions.

Context

The high burden of noncommunicable diseases (NCDs) is politically salient and eminently preventable. However, effective solutions largely continue to elude the public health community. Two pressing issues heighten this challenge: the first is the public health community's narrow approach to addressing NCDs, and the second is the involvement of corporate actors in policymaking. While NCDs are often conceptualized in terms of individual‐level risk factors, we argue that they should be reframed as products of a complex system. This article explores the value of a systems approach to understanding NCDs as an emergent property of a complex system, with a focus on commercial actors.

Methods

Drawing on Donella Meadows's systems thinking framework, this article examines how a systems perspective may be used to analyze the commercial determinants of NCDs and, specifically, how unhealthy commodity industries influence public health policy.

Findings

Unhealthy commodity industries actively design and shape the NCD policy system, intervene at different levels of the system to gain agency over policy and politics, and legitimize their presence in public health policy decisions.

Conclusions

It should be possible to apply the principles of systems thinking to other complex public health issues, not just NCDs. Such an approach should be tested and refined for other complex public health challenges.
The Impact of Parental and Medical Leave Policies on Socioeconomic and Health Outcomes in OECD Countries: A Systematic Review of the Empirical Literature
Authors: NANDI ARIJIT , JAHAGIRDAR DEEPA , DIMITRIS MICHELLE C. , LABRECQUE JEREMY A. , STRUMPF ERIN C. , KAUFMAN JAY S. , VINCENT ILONA , ATABAY EFE , HARPER SAM , EARLE ALISON , HEYMANN S. JODY
Published: September 2018

Policy Points:

Historically, reforms that have increased the duration of job‐protected paid parental leave have improved women's economic outcomes.

By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism.

The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well‐being.

Context

Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co‐operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes.

Methods

We conducted a systematic review of the peer‐reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta‐analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs.

Findings

We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave‐taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied.

Conclusions

There is substantial quasi‐experimental evidence to support expansions in the duration of job‐protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job‐protected paid leave or lack a national paid leave entitlement altogether.
Beneficial effects of tolvaptan on atrial remodeling induced by chronic intermittent hypoxia in rats
Authors: Zhang Kai , Ma Zuowang , Wang Weiding , Liu Ruimeng , Zhang Yue , Yuan Meng , Li Guangping
Published: September 2018

Introduction

Atrial remodeling in the form of fibrosis is considered as the substrate for the development of atrial fibrillation (AF). The aim of this study was to investigate the effects of tolvaptan on chronic intermittent hypoxia (CIH) induced atrial remodeling and the mechanisms underlying such changes.

Methods

A total of 45 Sprague‐Dawley rats were randomized into three groups: Control group, CIH group, CIH with tolvaptan treatment (CIH‐T) group (n = 15). CIH rats were subjected to CIH 6 hour/d for 30 days, and CIH‐T rats were administrated tolvaptan while they received CIH. After the echocardiography examination, rats were sacrificed in the 31 days. In each group, 5 rats were randomly selected for isolated heart electrophysiology testing, for other 10 rats, the tissues of atria were sampled for histological and molecular biological experiments, Masson's trichrome staining was used to evaluate the extent of atrial fibrosis, expression levels of microRNA‐21 (miR‐21), Sprouty‐1 (Spry1), phosphatase, and tensin homolog (PTEN), extracellular regulated protein kinase (ERK), phospho‐extracellular regulated protein kinase (p‐ERK), matrix metalloprotein 9 (MMP‐9), phosphoinositide 3‐kinase (PI3K), protein kinase B (AKT), phospho‐protein kinase B (p‐AKT), nuclear factor‐k‐gene binding (NF‐κB), phosphor‐nuclear factor‐k‐gene binding (p‐NF‐κB) were measured.

Results

Compared to the Control rats, CIH rats showed higher atrial interstitial collagen deposition and AF inducibility, mRNA levels of miR‐21, MMP‐9, PI3K, AKT, and protein levels of ERK, p‐ERK, MMP‐9, NF‐κB, p‐NF‐κB were significantly increased, whereas mRNA levels of Spry1, ERK, and protein levels of Spry1, PTEN, PI3K, AKT, p‐AKT were significantly decreased. Treatment with tolvaptan attenuated CIH‐induced atrial fibrosis, reduced AF inducibility, expression levels of miR‐21 and its downstream factors were also improved.

Conclusions

CIH‐induced significant atrial remodeling in our rat model, which was attenuated by tolvaptan. These changes may be explained due to alterations in miR‐21/Spry1/ERK/MMP‐9, miR‐21/PTEN/PI3K/AKT, and NF‐κB pathways by tolvaptan.
Policy‐Based Evidence Making in Local Government: The New South Wales’ Municipal Merger Program, 2011 to 2017
Authors: Dollery Brian
Published: September 2018

Contemporary public policymaking relies heavily on commercial consultants for specialised advice. In this paper, we examine the problematic nature of this phenomenon by considering the controversial forced amalgamation programme in New South Wales (NSW) local government over the period 2011 to 2017. By way of a critical examination of two key consultant reports underlying theNSWmunicipal mergers, we show that the failure of this programme to achieve its intended aims is due in large measure to the nature of the externalised advice on which it was based and the manner in which that advice was solicited from commercial consultants.
Bias and sample size in intensive care unit trials: Protocol for a meta‐epidemiological study
Authors: Anthon Carl Thomas , Granholm Anders , Perner Anders , Laake Jon Henrik , Møller Morten Hylander
Published: September 2018

Background

Systematic errors (bias) and random errors result in inflated and imprecise intervention effect estimates in randomised clinical trials (RCT) and meta‐analyses. We aim to assess time trends in the Cochrane risk of bias domains and sample size in RCTs of intensive care unit (ICU) interventions.

Methods and design

We will conduct a meta‐epidemiologic study of RCTs included in Cochrane systematic reviews assessing any intervention used in adult patients admitted to the ICU. We will search the Cochrane Database of Systematic Reviews and include reviews published from March 2011 corresponding to the latest update in the Cochrane risk of bias tool. We will extract data on risk of bias judgments in the seven Cochrane bias domains and trial sample sizes and evaluate time trends using run charts. The primary outcome will be time trends in the annual proportion of trials with overall low risk of bias (low risk of bias in all bias domains). The secondary outcomes include time trends in the annual median trial sample size, and the annual proportion of trials with low‐, unclear‐ and high risk of bias in each of the seven Cochrane bias domains.

Discussion

The outlined meta‐epidemiologic study will assess time trends in risk of bias and sample sizes in RCTs assessing ICU interventions. This will inform researchers, healthcare personnel and policymakers on the general reliability of findings from RCTs of ICU interventions over time, and inform future RCT design and reporting.
Glutamate Transmission to Ventral Tegmental Area GABA Neurons Is Altered by Acute and Chronic Ethanol
Authors: Williams Stephanie B. , Yorgason Jordan T. , Nelson Ashley C. , Lewis Natalie , Nufer Teresa M. , Edwards Jeff G. , Steffensen Scott C.
Published: September 2018

Background

Ventral tegmental area (VTA) GABA neurons have been heavily implicated in alcohol reinforcement and reward. In animals that self‐administer alcohol, VTA GABA neurons exhibit increased excitability that may contribute to alcohol's rewarding effects. The present study investigated the effects of acute and chronic ethanol exposure on glutamate (GLU) synaptic transmission to VTA GABA neurons.

Methods

Whole‐cell recordings of evoked, spontaneous, and miniature excitatory postsynaptic currents (eEPSCs, sEPSCs, and mEPSCs, respectively) were performed on identified GABA neurons in the VTA of GAD67‐GFP+ transgenic mice. Three ethanol exposure paradigms were used: acute ethanol superfusion; a single ethanol injection; and chronic vapor exposure.

Results

Acute ethanol superfusion increased the frequency of EPSCs but inhibited mEPSC frequency and amplitude. During withdrawal from a single injection of ethanol, the frequency of sEPSCs was lower than saline controls. There was no difference in α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA)/N‐methyl‐d‐aspartate (NMDA) ratio between neurons following withdrawal from a single exposure to ethanol. However, following withdrawal from chronic ethanol, sEPSCs and mEPSCs had a greater frequency than air controls. There was no difference in AMPA/NMDA ratio following chronic ethanol.

Conclusions

These results suggest that presynaptic mechanisms involving local circuit GLU neurons, and not GLU receptors, contribute to adaptations in VTA GABA neuron excitability that accrue to ethanol exposure, which may contribute to the rewarding properties of alcohol via their regulation of mesolimbic dopamine transmission.
Early‐onset group B streptococcal disease in a risk factor‐based prevention setting: A 15‐year population‐based study
Authors: Chen Julie C. , Jenkins‐Marsh Sue , Flenady Vicki , Ireland Susan , May Meryta , Grimwood Keith , Liley Helen G.
Published: September 2018

Background

Intrapartum chemoprophylaxis reduces early‐onset group B streptococcal disease (EOGBSD) in newborns. Some guidelines advise that intrapartum antibiotics should be offered following universal antenatal screening for GBS carriage and others recommend intrapartum antibiotics based on clinical risk factors alone. Since 1999, Queensland guidelines have recommended a risk factor‐based approach. We examined trends in EOGBSD rates over time in Queensland in the setting of these guidelines and whether management of cases reflected the recommendations.

Methods

A state‐wide retrospective search of pathology databases, allowing near‐complete, population‐based case identification, was conducted to detect live‐born infants from January 2000 to December 2014 with GBS cultured from blood or cerebrospinal fluid within seven days of age. A nested audit of EOGBSD cases comparing two epochs, 2000–2010 and 2011–2014, was performed to determine patient characteristics and guideline adherence for each case.

Results

Mean incidence of EOGBSD in Queensland from 2000 to 2014 was 0.33 per 1000 live births (SD± 0.08) with no changing trend over time. The case‐mortality rate in the 2011–2014 epoch was 1.2% compared to 11.9% in 2000–2004 (odds ratio (OR) 0.09, 95% confidence interval (CI) 0.002–0.67). The proportion of EOGBSD cases who were preterm infants decreased from 29.8% to 13.3% (OR 0.36, 95% CI 0.14–0.84). Of cases with risk factors in the 2011–2014 epoch, 46% received intrapartum antibiotics compared to 25% in 2000–2004 (OR 2.49, 95% CI 0.86–7.58, P = 0.09).

Conclusions

EOGBSD incidence rate in Queensland remained low during 2000–2014. However, both the 2011–2014 case‐mortality rate and the proportion of preterm cases significantly decreased. Missed opportunities for intrapartum chemoprophylaxis remain.
Rainbows in the society: A measure of hope for society
Authors: Jin Borae , Kim Yong‐Chan
Published: September 2018

The aim of this study was to develop and validate a measure of social hope. Previous studies have extensively reported on personal hope and its outcomes. Although a few studies have suggested the concept of collective or social hope, there is no instrument to assess the construct. In this study, we created a 5‐item scale, drawing on Snyder's hope theory, and collected two sets of survey data online. Analysis of these data sets revealed that the new scale was structurally unidimensional and internally consistent. In association with Snyder's State Hope Scale, the Social Hope Scale showed convergent and discriminant validity. The social hope construct also exhibited theoretically meaningful relationships with political efficacy and self‐construal (concurrent validity). Finally, social hope was higher for those who had participated in certain types of social activism than it was for those who had not (predictive validity). These results suggest that the Social Hope Scale is a reliable and valid self‐report measure of hopeful thinking for society.
A Novel Bayesian Multiple Testing Approach to Deregulated miRNA Discovery Harnessing Positional Clustering
Authors: Chandra Noirrit Kiran , Singh Richa , Bhattacharya Sourabh
Published: September 2018

MicroRNAs (miRNAs) are small non-coding RNAs that function as regulators of gene expression. In recent years, there has been a tremendous interest among researchers to investigate the role of miRNAs in normal as well as in disease processes. To investigate the role of miRNAs in oral cancer, we analyse expression levels of miRNAs to identify miRNAs with statistically significant differential expression in cancer tissues. In this article, we propose a novel Bayesian hierarchical model of miRNA expression data. Compelling evidence has demonstrated that the transcription process of miRNAs in the human genome is a latent process instrumental for the observed expression levels. We take into account positional clustering of the miRNAs in the analysis and model the latent transcription phenomenon nonparametrically by an appropriate Gaussian process. For the purpose of testing, we employ a novel Bayesian multiple testing method where we mainly focus on utilizing the dependence structure between the hypotheses for better results, while also ensuring optimality in many respects. Indeed, our non-marginal method yielded results in accordance with the underlying scientific knowledge which are found to be missed by the very popular Benjamini–Hochberg method.
Humanoid robots supporting children’s learning in an early childhood setting
Authors: Crompton Helen , Gregory Kristen , Burke Diane
Published: September 2018

This qualitative study explored the affordances provided by the integration of the NAO humanoid robot in three preschool classrooms. Using the Head Start Early Learning Outcomes Framework as a lens, the researchers qualitatively analyzed data from focus groups, observations, field notes and student artifacts, using grounded coding to uncover language and communication, physical, cognitive and social–emotional learning experiences for children. The researchers also examined interactions between the robot, children and teachers to identify successes and challenges experienced during the integration. Findings indicate the robot provided opportunities for student development in all learning domains. Students were intellectually curious about the robot; data showed their eagerness to “talk with,” generate questions about, make eye contact with and learn more about the robot. Students viewed these interactions as two‐way. The presence of the robot created much enthusiasm and excitement, resulting in the opportunity for students to practice waiting their turn and cooperation. Challenges uncovered show that teachers lacked experience and knowledge in the integration and operation of the robot. Despite these challenges, findings show that teachers welcomed the robot as a tool in the classroom to align with curriculum requirements and meet the developmental needs of children.
Towards sustainable technology‐enhanced innovation in higher education: Advancing learning design by understanding and supporting teacher design practice
Authors: Bennett Sue , Lockyer Lori , Agostinho Shirley
Published: September 2018

Improving teacher design promises to be a scalable, sustainable approach to building capacity amongst a workforce faced with complex and evolving drivers of change in higher education worldwide. While design has long been recognised as a routine part of teaching, there has been renewed interest in supporting and understanding the design work that teachers do to foster innovation, particularly in technology‐enhanced learning, at institutional scale by influencing teachers’ practices. Re‐framing teaching as design usefully emphasises the creative problem‐solving needed to balance pedagogical, logistical and technical considerations within specific educational contexts, tailored to learners’ needs. There is potential for this re‐framing to build on and advance work in “learning design” and “design for learning” that has generated a wide range of practical supports and tools. In this article, we explore, problematise and conceptualise the notion of “teacher as designer” within the complexity of contemporary higher education through a critical review of existing empirical and conceptual work internationally. We offer insights into the current state of knowledge about teacher design in higher education, highlight gaps and possibilities, offer a new conceptualisation drawing on practice theory and set out propositions to provoke further debate about teacher design as a vehicle for sustainable innovation in higher education.
SLC2A5 overexpression in childhood philadelphia chromosome‐positive acute lymphoblastic leukaemia
Authors: Zhao Pan , Huang Jingcao , Zhang Dan , Zhang Danfeng , Wang Fangfang , Qu Ying , Guo Tingting , Qin Yu , Wei Jin , Niu Ting , Zheng Yuhuan
Published: September 2018

To study glycolysis/glycogenesis‐related genes expression in childhood B‐cell acute lymphoblastic leukaemia (B‐ALL), we performed a microarray‐based analysis using published gene expression profiles. We found that SLC2A5, which encodes solute carrier family 2 member 5 (SLC2A5, previously termed GLUT5) that facilitates cell fructose uptake, was up‐regulated in Philadelphia chromosome‐positive ALL (Ph+ALL). Microarray‐based analyses also suggested that SLC2A5 expression was significantly down‐regulated in childhood B‐ALL with t(1;19) or 11q23 mutation. High SLC2A5 expression was found in patients who had disease recurrence within 3 years, early relapse, shortened complete remission duration and positive minimal residue disease (MRD) status after treatment. SLC2A5 overexpression at both the mRNA and protein level in Ph+ALL was confirmed in a validation cohort of childhood B‐ALL. We also validated the correlation of SLC2A5 expression and MRD status. A mechanistic study using a human Ph+ALL cell line showed that BCR‐ABL1 kinase might regulate SLC2A5 expression via MYC. The tyrosine kinase inhibitors (TKIs) imatinib and dasatinib repressed SLC2A5 expression and the cell uptake of fructose. Fructose protected the tumour cells from nutrition deficiency and drug‐induced cell death. Overall, our findings showed that SLC2A5 was up‐regulated in childhood Ph+ALL. SLC2A5 expression correlated with childhood B‐ALL clinical factors, such as MRD status. Given that TKIs could inhibit SLC2A5 expression, repression of fructose utility after TKI treatment contributes to TKI‐induced Ph+ALL cytotoxicity. Targeting SLC2A5 might be promising in B‐ALL treatment, especially for Ph+ALL patients with high SLC2A5 expression.
The Efficacy of Preschool Developmental Indicators as a Screen for Early Primary School‐Based Literacy Interventions
Authors: Schluter Philip J. , Audas Richard , Kokaua Jesse , McNeill Brigid , Taylor Barry , Milne Barry , Gillon Gail
Published: September 2018

Literacy success lays the foundation for children's later educational, health, and well‐being outcomes. Thus, early identification of literacy need is vital. Using data from New Zealand's national preschool health screening program for fiscal years 2010/2011–2014/2015, demographic and health variables from 255,090 children aged 4 years were related to whether they received a literacy intervention in early primary school. Overall, 20,652 (8.1%) children received an intervention. Time‐to‐event analysis revealed that all considered variables were significantly related to literacy intervention (all p < .01), but the full model lacked reasonable predictive power for population screening purposes (Harrell's c‐statistic = .624; 95% CI [.618, .629]). Including more direct literacy measures in the national screening program is likely needed for improvement.
Clinical and demographic characteristics of fatal anaphylaxis in Spain (1998‐2011): A comparison between a series from the hospital system and a national forensic series
Authors: Tejedor‐Alonso Miguel A. , Martínez‐Fernandez Pilar , Vallejo‐de‐Torres Gloria , Navarro‐Escayola Esperanza , Moro‐Moro Mar , Alberti‐Masgrau Nuria
Published: September 2018

Background

Reports of fatal anaphylaxis remain scarce because of the rarity of the condition and the fact that information is limited to a few countries.

Objective

Our objective was to investigate clinical and demographic characteristics and the causes of fatal anaphylaxis in Spain using two databases of cases of fatal anaphylaxis.

Methods

We analysed fatal anaphylaxis in a series from the Spanish hospital system and a series from the National Institute of Toxicology and Forensic Sciences (Instituto Nacional de Toxicología y Ciencias Forenses [INTCF]), which predominantly comprise extrahospital deaths. Deaths from the Spanish hospital system were retrieved from among all deaths occurring during 1998‐2011 using codes related to anaphylaxis. Deaths due to anaphylaxis in the INTCF database during the same period were retrieved by 2 allergists, who identified cases in which anaphylaxis was a possible cause of death. A logistic regression model was constructed to predict the characteristics of fatal anaphylaxis in each database.

Results

The incidence of death by anaphylaxis in Spain using both databases was 0.25 (95% CI, 0.24‐0.26) deaths per million person‐years. The most frequent causes of death in the hospital system were drugs (46.1%), unknown causes (40.0%), and foods (10.4%); in the INTCF, the most common causes of death were drugs (47.2%), insect stings (30.6%), and foods (11.1%). The logistic regression model showed that fatal anaphylaxis due to unknown causes (OR 15.2, 95% CI 1.8‐129.8) was more likely in the hospital database, whereas insect stings (OR 100, 95% CI 10‐833.3) and previous atopic comorbidity (OR 15.2, 95% CI 6.3‐33.3) were more likely in the INTCF database.

Conclusions & Clinical Relevance

The estimated frequency of fatal anaphylaxis in Spain was among the lowest reported. Future studies of fatal anaphylaxis should use databases from different origins in order to show the considerable heterogeneity in this type of death.
Rheumatoid‐nodule‐like cutaneous granuloma associated with recombinase activating gene 1‐deficient severe combined immunodeficiency: A rare case
Authors: Van Horn Sandra A. , Johnson Kathryn M. , Childs John M.
Published: September 2018

Cutaneous granulomas without detectable infectious etiology rarely occur in children and adults with primary immunodeficiency disorders. These cutaneous granulomas are primarily seen in combined variable immunodeficiency, ataxia‐telangiectasia, and severe combined immunodeficiency (SCID) and can emulate the reaction patterns seen in sarcoidosis and granuloma annulare. To date, the literature has described only six cases of non‐infectious cutaneous granulomas in SCID. We report an unusual case of cutaneous granuloma, mimicking a sarcoma, in a 40‐year old male with recombinase activating gene 1‐deficient SCID, who presented with a slow‐growing globus mass over the lateral aspect of the right elbow. There was heterogeneous enhancement on MRI, which was concerning for neoplasm but no malignancy was found on frozen or permanent sections. GMS, PAS with diastase, and AFB stains, as well as microbiology cultures, were negative. An AE1/AE3 stain was negative and a CD163 stain highlighted histiocytes. No infectious etiology was identified and histopathology revealed palisaded granulomatous dermatitis, most closely resembling a rheumatoid nodule. Although cutaneous manifestations have been reported in nearly half of primary immunodeficiency disorder cases, non‐infectious cutaneous granulomas are exceedingly rare in SCID. To our knowledge, this is the first case report of cutaneous palisaded granulomatous dermatitis mimicking a rheumatoid nodule in a major joint.
Upper‐limb contracture development in children with cerebral palsy: a population‐based study
Authors: Hedberg‐Graff Jenny , Granström Fredrik , Arner Marianne , Krumlinde‐Sundholm Lena
Published: September 2018

Aim

The aim of this study was to investigate the longitudinal development of passive range of motion (ROM) in the upper limbs in a population‐based sample of children with cerebral palsy (CP), and to investigate which children are more likely to develop contractures related to functional level, CP subtype, and age.

Method

Registry data of annual passive ROM measurements of the upper limbs from 771 children with CP (417 males, 354 females; mean age 11y 8mo, [SD 5mo] range 1–18y) were analysed. Mixed models were used to investigate at what age decreased passive ROM occurs. Odds ratios were calculated to compare risks and logistic regression analysis was used to predict contracture development.

Results

Thirty‐four per cent of the children had developed contractures. Among these children, decreased passive ROM was significant at a mean age of 4 years for wrist extension and 7 years for shoulder flexion, elbow extension, and supination. Children at Manual Ability Classification System (MACS) level V had a 17‐times greater risk of contractures than children at MACS level I.

Interpretation

One‐third of the children in the total population developed upper‐limb contractures while passive ROM decreased with age. MACS level was the strongest predictor of contracture development.

What this paper adds

In a population‐based sample of 771 children with cerebral palsy, 34% developed an upper‐limb contracture.

Contracture development started at preschool age.

The first affected movements were wrist extension and supination.

Passive range of motion decreased with age.

High Manual Ability Classification System level was the most important predictor of contractures.
Selective motor control and gross motor function in bilateral spastic cerebral palsy
Authors: Noble Jonathan J , Gough Martin , Shortland Adam P
Published: September 2018

Aim

To investigate the relationship between selective motor control (SMC), muscle volume, and spasticity with gross motor function in adolescents and young adults with bilateral spastic cerebral palsy (CP).

Method

Eleven male participants with CP (mean age 15y 7mo, standard deviation 3y 6mo, range 12y 1mo–23y 1mo) in Gross Motor Function Classification System (GMFCS) levels I to IV took part in this cross‐sectional study. Magnetic resonance imaging (MRI) of both lower limbs of all participants were acquired, from which 18 muscles were manually segmented and muscle volume calculated by a single assessor. Muscle volumes were normalized to body mass and averaged between limbs for each individual. SMC was assessed using Selective Control Assessment of the Lower Extremity (SCALE). Spasticity was assessed using the Modified Ashworth Scale (MAS), and gross motor functional ability was assessed using the Gross Motor Function Measure (GMFM‐66).

Results

GMFM‐66 was strongly positively correlated to SCALE (r=0.901, p≤0.001) and lower limb muscle volume normalized to body mass (r=0.750, p=0.008). MAS was significantly correlated with GMFM‐66 (r=−0.691, p=0.018).

Interpretation

SMC is a major factor influencing gross motor function in individuals with CP. Lower limb muscle volume and spasticity also influence gross motor function.

What this paper adds

Selective motor control is a major factor of gross motor function in adolescents and young adults with bilateral cerebral palsy (CP).

Gross motor function is related to muscle size and level of spasticity in adolescents and young adults with bilateral CP.