bluuebunny/crossref_metadata_2025 huggingface dataset:
Masculinity, alexithymia, and fear of intimacy as predictors of UK men's attitudes towards seeking professional psychological help
Authors: Sullivan Luke , Camic Paul M. , Brown June S. L.
Published: January 2014

Objectives

Men's reluctance to access health care services has been under researched even though it has been identified as a potentially important predictor of poorer health outcomes amongst men. Male gender role socialization and male development may be important in accounting for men's underutilization of mental health services in the United Kingdom.

Method

A cross‐sectional online survey was used to administer standardized self‐report measures that were subject to regression analysis. Five hundred and eighty‐one men from the UK general population completed the survey, and 536 participants formed the final regression analysis.

Results

Men who score higher on measures of traditional masculine ideology, normative alexithymia, and fear of intimacy reported more negative attitudes towards seeking professional psychological help. Normative alexithymia fully mediated the effect of fear of intimacy on attitudes towards professional help seeking. In the final regression model, education significantly accounted for a proportion of unique variance in men's help‐seeking attitudes.

Conclusions

Hypothesized consequences of male emotional and interpersonal development and male gender role socialization were associated with men's attitudes towards seeking psychological help. These are important factors which could help to improve help seeking and mental health outcomes for men. Limitations of this study and implications for future research are discussed.

Statement of contribution

What is already known on this subject? Men are less likely to seek help for physical and psychological problems and have poorer health outcomes across nearly all major illness and injury. Men's reluctance to access health care services is believed to be a major contributory factor to poorer health outcomes for men.

What does the study add? The study is a large‐scale survey of UK men's attitudes towards professional psychological help seeking. Results provide evidence that hypothesized consequences of male gender role socialization and dominant masculine norms are associated with men's attitudes towards seeking professional psychological help.

Attitudes towards psychological help seeking were associated with masculinity, alexithymia, and intimacy.

Alexithymia fully mediated the effect of intimacy on men's attitudes towards psychological help seeking.

Promoting help seeking in men could improve men's emotional well‐being and interpersonal functioning.
Phylogeny of the symphytan grade of Hymenoptera: new pieces into the old jigsaw(fly) puzzle
Authors: Malm Tobias , Nyman Tommi
Published: January 2014

The Hymenoptera constitutes one of the largest, and ecologically and economically most important, insect orders. During the past decade, a number of hypotheses on the phylogenetic relationships among hymenopteran families and superfamilies have been presented, based on analyses of molecular and/or morphological data. Nevertheless, many questions still remain, particularly concerning relationships within the hyperdiverse suborder Apocrita, but also when it comes to the evolutionary history of the ancestrally herbivorous “sawfly” lineages that form the basal, paraphyletic grade Symphyta. Because a large part of the uncertainty appears to stem from limited molecular and taxonomic sampling, we set out to investigate the phylogeny of Hymenoptera using nine protein‐coding genes, of which five are new to analyses of the order. In addition, we more than tripled the taxon coverage across the symphytan grade, introducing representatives for many previously unsampled lineages. We recover a well supported phylogenetic structure for these early herbivorous hymenopteran clades, with new information regarding the monophyly of Xyelidae, the placement of the superfamily Pamphilioidea as sister to Tenthredinoidea + Unicalcarida, as well as the interrelationships among the tenthredinoid families Tenthredinidae, Cimbicidae, and Diprionidae. Based on the obtained phylogenies, and to prevent paraphyly of Tenthredinidae, we propose erection of the tribe Heptamelini to family status (Heptamelidae). In particular, our results give new insights into subfamilial relationships within the Tenthredinidae and other species‐rich sawfly families. The expanded gene set provides a useful toolbox for future detailed analyses of symphytan subgroups, especially within the diverse superfamily Tenthredinoidea.
A multicenter study of the attitude of secondary school teachers toward solid organ donation and transplantation in the southeast of Spain
Authors: Febrero Beatriz , Ríos Antonio , López‐Navas Ana , Martínez‐Alarcón Laura , Almela Javier , Sánchez Álvaro , Sánchez Jose , Parrilla Juan José , Ramírez Pablo , Parrilla Pascual
Published: January 2014

Background

Teachers play a fundamental role in providing information to adolescents and could influence their attitudes.

Objectives

To analyze the attitude of teachers toward organ donation and the concept of brain death (BD); the psychosocial variables related to attitude; and the information provided to pupils.

Methods

A multicenter study was carried out using a random sample of secondary school teaching staff from 10 schools (n = 327) in the southeast of Spain. Attitude toward organ donation was assessed using a validated questionnaire that was self‐administered and completed anonymously.

Results

The questionnaire completion rate was 88% (n = 288), with 75% (n = 215) in favor of organ donation, 23% had doubts, and 2% were not in favor. Regarding the knowledge of BD, 62% (n = 179) accepted that this meant a person's death. The variables associated with a more favorable attitude included conversations with family and friends (p < 0.05); a partner's favorable opinion (OR 3.194); knowledge of the concept of BD (p = 0.006); being a blood donor (OR 8.264); and a favorable attitude toward autopsy (OR 4.716). Teachers provided information about organ donation to pupils in 16% of cases (n = 47).

Conclusions

Seventy‐five percent of teachers are in favor of organ donation. Their attitude is affected by psychosocial factors.
Outcome of deceased donor renal transplantation in patients with an ileal conduit
Authors: McLoughlin Louise C. , Davis Niall F. , Dowling Catherine M. , Power Richard E. , Mohan Ponusamy , Hickey David P. , Smyth Gordon P. , Eng Molly M.P. , Little Dilly M.
Published: January 2014

Renal transplantation in recipients with an ileal conduit is uncommon and occasionally controversial as it has been associated with high morbidity and mortality rates. We report on 17 patients with an ileal conduit who received a deceased donor renal transplant at our institution between January 1986 and December 2012. We retrospectively reviewed their allograft and surgical outcome. There were four mortalities at five, five, 39, and 66 months post‐transplant. Sixteen of 17 grafts functioned immediately; one patient had primary non‐function secondary to vascular thrombosis. Thirteen of 17 (76.5%) grafts were functioning at a mean follow‐up period of 105 months. The mean serum creatinine at follow‐up was 111 μM (±38.62). Five patients had seven episodes of urosepsis requiring hospital admission, and five patients received treatment for renal stone disease. We conclude that given improvements in immunosuppression, surgical technique, infection treatment, and selection criteria, we believe that renal transplantation in the patient with an ileal conduit yields excellent graft survival, although there is a high morbidity rate in this cohort of patients in the long term.
Potentially Harmful International Cooperation on Global Public Good Provision
Authors: Buchholz Wolfgang , Cornes Richard , Rübbelke Dirk
Published: January 2014

Experience from climate policy suggests that full cooperation among all countries is not a likely outcome. In this paper we therefore consider the case where only members of a subgroup of countries cooperate by reciprocally matching their public good contributions. In a two‐stage game, matching rates are set at stage 1 then national contributions are chosen at stage 2. In the case of small coalitions, negative matching may result in the subgame‐perfect equilibrium that decreases global public good provision and outsiders' welfare. Moreover, a growing number of countries may paradoxically entail a reduction of equilibrium public good supply.
Restoration of endodontically treated teeth with major hard tissue loss – influence of post surface design on pull‐out bond strength of fiber‐reinforced composite posts
Authors: Koch Andreas Thomas Alfred , Binus Stefanie Martina , Holzschuh Barbara , Petschelt Anselm , Powers John M. , Berthold Christine
Published: January 2014

Aim

The aim was to evaluate the influence of post surface design and luting system on bond strength of quartz‐fiber‐reinforced composite posts (QFRCPs) luted to root canal dentin.

Materials and methods

Single‐rooted bovine teeth (n = 650) were randomly assigned (13 groups, n = 50), sectioned, endodontically treated, filled, and post space (length 8 mm) prepared. Custom‐made plain‐surfaced fiber posts (PSXRO) and (both RTD) macroretentive Macro‐Lock Post Illusion X‐RO (MLXRO) were inserted into the post spaces using six luting systems: Ketac Cem (KC), Fuji Plus (FP), RelyX Unicem, Multilink Primer_Multilink, Sealbond Ultima_CoreCem, and LuxaBond_LuxaCore Z. As control, a titanium post was cemented with KC. After water storage (24 h, 37°C), pull‐out test was performed, followed by failure mode assessment. Bond strength was calculated in MPa and analyzed using anova, Dunnett‐T3‐test, and Student's t‐test with Bonferroni correction.

Results

Post design and luting system significantly influenced the bond strength [MPa] (P < 0.05). Compared with the control 4.3 (1.5), all test groups exhibited higher bond strengths (P < 0.05), except for group PSXRO/KC 4.2 (1.0). The remaining bond strengths were PSXRO: FP 8.6 (1.5), RelyX Unicem 10.4 (3.4), Multilink Primer_Multilink 12.7 (3.0), SealBond Ultima_CoreCem 12.7 (3.0), LuxaBond_LuxaCore Z 15.7 (2.5), and MLXRO: KC 7.2 (2.2), FP 13.4 (2.5), RelyX Unicem 9.2 (2.9), Multilink Primer_Multilink 12.5 (4.5), SealBond Ultima_CoreCem 13.7 (4.6), LuxaBond_LuxaCore Z 20.6 (2.2). The bond strengths of MLXRO were higher than those of PSXRO when luted with KC, FP, and LuxaBond_LuxaCore Z (P < 0.05).

Conclusion

The post surface design and luting system selection influenced the bond strength of conventionally and adhesively luted QFRCPs to bovine root canal dentin.
On Medawar's ‘Actively acquired tolerance of foreign cells’
Authors: Tolar Jakub , Tolarova Simona , McGrath John A.
Published: January 2014

The fields of dermatology and transplantation biology have recently come together in clinical trials of bone marrow transplantation for severe inherited blistering skin diseases. But the original link between these two disciplines goes back to an extraordinary publication in 1953 in Nature by Peter Medawar and colleagues that explored the immunological basis of successful skin transplantation between different strains of mice and how ‘foreign’ antigens could be perceived as ‘self’. This work led to the emergence of blood and bone marrow transplantation and thus transformed the practice of modern medicine.
TNF α‐induced leukocyte–endothelial cell interactions show marked interindividual differences independent of the clinical response to adalimumab
Authors: Lockmann Anike , Schön Michael P.
Published: January 2014

The responses of patients with psoriasis to TNFα‐antagonists show interindividual differences. Here, TNFα‐incubation induced endothelial adhesion molecules, a prerequisite for leucocyte recruitment to inflamed tissues. Using a standardized flow chamber system equipped with near‐confluent endothelial cells and a mobile phase containing human leucocytes, proportions of leucocytes interacting with endothelial cells were remarkably different between individual donors (up to 3.5‐fold), regardless of whether the leucocytes originated from patients with psoriasis (n = 10) or healthy donors (n = 10). Adalimumab abrogated adhesion molecule induction and interactions with leucocytes when present prior to or simultaneously with, but not after exposure of the cultures to TNFα. This pattern was seen similarly with leucocytes from healthy donors (n = 4), and patients whose psoriasis responded well to adalimumab (n = 5) and non‐responders (n = 5). Thus, although considerable interindividual differences of leucocyte–endothelial cell interactions were demonstrated ex vivo in a TNFα‐governed microenvironment, such differences are not associated with individual responses to treatment with adalimumab in vivo.
Critical role of Frizzled1 in age‐related alterations of Wnt/β‐catenin signal in myogenic cells during differentiation
Authors: Doi Ryosuke , Endo Mitsuharu , Yamakoshi Kimi , Yamanashi Yuji , Nishita Michiru , Fukada So‐ichiro , Minami Yasuhiro
Published: January 2014

Activation of Wnt/β‐catenin signal in muscle satellite cells (mSCs) of aged mice during myogenic differentiation has been appreciated as an important age‐related feature of the skeletal muscles, resulting in impairment of their regenerative ability following muscle injury. However, it remains elusive about molecules involved in this age‐related alteration of Wnt/β‐catenin signal in myogenic cells. To clarify this issue, we carried out expression analyses of Wnt receptor genes using real‐time RT‐PCR in mSCs isolated from the skeletal muscles of young and aged mice. Here, we show that expression of Frizzled1 (Fzd1) was detected at high levels in mSCs of aged mice. Higher expression levels of Fzd1 were also detected in mSC‐derived myogenic cells from aged mice and associated with activation of Wnt/β‐catenin signal during their myogenic differentiation in vitro. We also provide evidence that suppressed expression of Fzd1 in myogenic cells from aged mice results in a significant increase in myogenic differentiation, and its forced expression in those from young mice results in its drastic inhibition. These findings indicate the critical role of Fzd1 in altered myogenic differentiation associated with aging.
Sustainable Yield in Theory and Practice: Bridging Scientific and Mainstream Vernacular
Authors: Rudestam Kirsten , Langridge Ruth
Published: January 2014

Groundwater is a vital resource in California, and the concept of “sustainable yield” is an attempt to determine a metric that can ensure the long‐term resilience of groundwater systems. However, its meaning is ambiguous and quantification is challenging. To provide insight into developing a working definition that encompasses the inherent uncertainty and complexity of the term, this paper examines how sustainable yield in groundwater is interpreted by (1) scientists, (2) the courts in groundwater adjudications, (3) state agencies, and (4) local water practitioners. Through qualitative interviews, this paper identifies problems that local water agencies in the state encounter in engaging with sustainable yield as they incorporate the term in groundwater management practices. The authors recommend that any definitions make explicit the human dimensions of, and assumptions embedded in, the use of these terms in groundwater management practices, and they point to the value of participation in this process.
Effect of vacuum cooking treatment on physicochemical and structural characteristics of purple‐flesh potato
Authors: Iborra‐Bernad Consuelo , García‐Segovia Purificación , Martínez‐Monzó Javier
Published: January 2014

Cook‐vide (CV, vacuum boiling) and sous‐vide (SV, cooking in a vacuum‐sealed pouch) have been applied to cook purple‐flesh potatoes. Response surface methodology (RSM) sets up the work conditions of temperatures (78–92 °C) and times (16–44 min). Textural parameters, colour and anthocyanins have been measured in cooked samples, and microstructure of cooked tissues was observed with cryo‐SEM technique. CV and SV provided similar hardness (P > 0.05), while SV treatments provided samples more adhesive and cohesive than CV ones (P ≤ 0.05). Micrographs of cooked samples showed rounder cells in cook‐vide samples and higher swelling than in sous‐vide ones. SV treatment avoided the leaching into the water of anthocyanins (chromophore) retaining more of them in potatoes (P ≤ 0.05), as a consequence of which total colour difference was lower in SV samples compared with CV ones (P ≤ 0.05). Particularly, CV samples were lighter (higher values of L*) and less reddish (lower values of +a*) than SV ones (P ≤ 0.05).
Carpology of the species ofFerulasubgen.Merwia(Umbelliferae–Apioideae) and some taxonomic implications
Authors: Safina Lucia K. , Ostroumova Tatiana A. , Pimenov Michael G.
Published: January 2014

The genusFerulaL., with 180–185 species, is one of the largest genera of the Umbelliferae (Apiaceae). It is distributed in the ancient Mediterranean florogenetic area extending from Macaronesia, northeast Africa and the Iberian Peninsula to middle Asia, China and western Himalaya. One hundred and seventy‐five species occur in Asia; the biodiversity centers being in central Asia, Iran and Afghanistan. The presently adopted classification ofFerulaby E. P. Korovin is based on leaf, synflorescence, flower and fruit morphology, as well as some ecological considerations. Among fruit anatomical characters only the number of vittae (secretory ducts) was used to divideFerulainto six subgenera, one of which isMerwia. Fruit anatomy and morphology will be useful for a taxonomic revision ofFerula. In the present study, free‐hand and microtome sections of mericarps were studied with light microscopy, and fruit surfaces with SEM. Twenty‐two species, attributed to the subgenusMerwiaas well asFerula ghorana, were studied for the first time. The species differ from one another in the presence/absence of an indumentum, hair morphology and surface structure, position and number of vittae and vascular bundles, degree of development of marginal ribs, the presence or absence in the mesocarp of an outer collenchymatous layer and an inner mechanical layer. The studied species were divided into six carpological groups. The results suggest that the subgenus is not a natural monophyletic taxon. It is suggested that the nameMerwiashould be reserved for a small section which includesFerula litwinowianaand the closest desert species, while other species ofMerwiamay be classified in several oligotypic sections.Ferula decurrensandF. mogoltavicahave erroneously been regarded as having an affinity withF. litwinowiana.
Taxonomic notes on Macromitrium densum (Bryopsida) with a new synonym, M. brevissimum
Authors: Yu Jing , Yong Kien‐Thai , Guo Shui‐Liang
Published: January 2014

Macromitrium densum Mitt. (from Nepal) is well differentiated from other Asian congeners by its lingulate and strongly rugose leaves having cucullate, obtuse to retuse apices with a mucro, distinctly bulging upper and median leaf cells, and tuberculate lower and basal cells. Comparisons of the type and other specimens of M. brevissimum Dixon from Thailand with those of M. densum show that they belong to a single species, and hence, that the names are synonyms. By including M. brevissimum, the geographic range of M. densum is considerably expanded to cover Nepal, Thailand to north Peninsular Malaysia and Vietnam. The phenetic relationship between M. densum and other species of Macromitrium is also discussed.
The Experiences of Intimate Relationships by People with Intellectual Disabilities: A Qualitative Study
Authors: Rushbrooke Elizabeth , Murray Craig , Townsend Samantha
Published: January 2014

Background

People with intellectual disabilities face attitudinal and service barriers when attempting to form intimate relationships. To date, their experiences and views are under‐represented in the existing evidence base.

Method

The aim of this study was to carry out an interpretative phenomenological analysis exploring the experience of intimate relationships for nine adults with intellectual disabilities.

Results

Four main themes were identified: desiring relationships; expressing sexuality; having relationships; and who has control? Together these themes demonstrated that intimate relationships were desired and important to all participants, fulfilling a variety of their needs. In addition, participants faced a number of challenges related to intimate relationships.

Conclusion

The findings raise questions about how best to support people with intellectual disabilities with sexuality and intimate relationships. Implications for caregivers and services are discussed.
Detection and characterization of viruses of the genus Megalocytivirus in ornamental fish imported into an Australian border quarantine premises: an emerging risk to national biosecurity
Authors: Nolan D , Stephens F , Crockford M , Jones J B , Snow M
Published: January 2014

This report documents an emerging trend of identification of Megalocytivirus‐like inclusions in a range of ornamental fish species intercepted during quarantine detention at the Australian border. From September 2012 to February 2013, 5 species of fish that had suffered mortality levels in excess of 25% whilst in the post‐entry quarantine and had Megalocytivirus‐like inclusion bodies in histological sections were examined by PCR. The fish had been imported from Singapore, Malaysia and Sri Lanka. Ninety‐seven of 111 individual fish from affected tanks of fish tested were positive for the presence of Megalocytivirus by PCR. Sequence analysis of representative PCR products revealed an identical sequence of 621 bp in all cases which was identical to a previously characterized Megalocytivirus (Sabah/RAA1/2012 strain BMGIV48). Phylogenetic analysis of available Megalocytivirus major capsid protein (MCP) sequences confirmed the existence of 3 major clades of Megalocytivirus. The virus detected in this study was identified as a member of Genotype II. The broad host range and pathogenicity of megalocytiviruses, coupled to the documented spread of ornamental fish into the environment, render this a significant and emerging biosecurity threat to Australia.
Development and Validation of a National Data Registry for Midwife‐Led Births: The Midwives Alliance of North America Statistics Project 2.0 Dataset
Authors: Cheyney Melissa , Bovbjerg Marit , Everson Courtney , Gordon Wendy , Hannibal Darcy , Vedam Saraswathi
Published: January 2014

Introduction

In 2004, the Midwives Alliance of North America's (MANA's) Division of Research developed a Web‐based data collection system to gather information on the practices and outcomes associated with midwife‐led births in the United States. This system, called the MANA Statistics Project (MANA Stats), grew out of a widely acknowledged need for more reliable data on outcomes by intended place of birth. This article describes the history and development of the MANA Stats birth registry and provides an analysis of the 2.0 dataset's content, strengths, and limitations.

Methods

Data collection and review procedures for the MANA Stats 2.0 dataset are described, along with methods for the assessment of data accuracy. We calculated descriptive statistics for client demographics and contributing midwife credentials, and assessed the quality of data by calculating point estimates, 95% confidence intervals, and kappa statistics for key outcomes on pre‐ and postreview samples of records.

Results

The MANA Stats 2.0 dataset (2004‐2009) contains 24,848 courses of care, 20,893 of which are for women who planned a home or birth center birth at the onset of labor. The majority of these records were planned home births (81%). Births were attended primarily by certified professional midwives (73%), and clients were largely white (92%), married (87%), and college‐educated (49%). Data quality analyses of 9932 records revealed no differences between pre‐ and postreviewed samples for 7 key benchmarking variables (kappa, 0.98‐1.00).

Discussion

The MANA Stats 2.0 data were accurately entered by participants; any errors in this dataset are likely random and not systematic. The primary limitation of the 2.0 dataset is that the sample was captured through voluntary participation; thus, it may not accurately reflect population‐based outcomes. The dataset's primary strength is that it will allow for the examination of research questions on normal physiologic birth and midwife‐led birth outcomes by intended place of birth.
Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009
Authors: Cheyney Melissa , Bovbjerg Marit , Everson Courtney , Gordon Wendy , Hannibal Darcy , Vedam Saraswathi
Published: January 2014

Introduction

Between 2004 and 2010, the number of home births in the United States rose by 41%, increasing the need for accurate assessment of the safety of planned home birth. This study examines outcomes of planned home births in the United States between 2004 and 2009.

Methods

We calculated descriptive statistics for maternal demographics, antenatal risk profiles, procedures, and outcomes of planned home births in the Midwives Alliance of North American Statistics Project (MANA Stats) 2.0 data registry. Data were analyzed according to intended and actual place of birth.

Results

Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively.

Discussion

For this large cohort of women who planned midwife‐led home births in the United States, outcomes are congruent with the best available data from population‐based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low‐risk women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.
Analgesics in postoperative care in hip fracture patients with dementia – reported by nurses
Authors: Rantala Maija , Hartikainen Sirpa , Kvist Tarja , Kankkunen Päivi
Published: January 2014

Aims and objectives

To describe the analgesic use in hip fracture patients with dementia during the first two postoperative days as reported by nurses.

Background

Nurses play a pivotal role in treating postoperative pain in patients with dementia and monitoring the effects of administered analgesics.

Design

Cross‐sectional descriptive questionnaire study in seven university hospitals and 10 central hospitals in Finland.

Methods

The study was conducted from March until May in 2011 in Finland. For this analysis, the focus was on the sample of nurses (n = 269) who were working in orthopaedic units. Analgesics were classified according to the Anatomical Therapeutic Chemical Classification System. Nonparametric tests were applied to find out the significant differences between analgesic use and different hospitals.

Results

Paracetamol and strong opioids administered orally or parenterally seemed to be the most typical of postoperatively used types of analgesics in patients with dementia. Nonsteroidal anti‐inflammatory analgesics and weak opioids were also commonly reported to be in use. There were no statistically significant differences between hospitals in typical daily doses. The majority of the nurses reported that the primary aim of postoperative pain management in hip fracture patients with dementia was ‘slight pain, which does not prevent normal functioning' (72%).

Conclusion

The pharmacological postoperative pain treatment in acute care was commonly based on the use of strong opioids and paracetamol in hip fracture patients with dementia. The reported use of transdermal opioids and codeine combination warrants further examination. Further studies are also needed to find out whether the pain is appropriately and adequately treated.

Relevance to clinical practice

Transdermal opioids and codeine combination may not be relevant analgesics for acute pain management in older adults. It is important to create a balance between sufficient pain relief and adverse effects of analgesics to allow early mobilisation and functional recovery.
The fulfilment of knowledge expectations during the perioperative period of patients undergoing knee arthroplasty – a Nordic perspective
Authors: Ingadottir Brynja , Johansson Stark Åsa , Leino‐Kilpi Helena , Sigurdardottir Arun K. , Valkeapää Kirsi , Unosson Mitra
Published: January 2014

Aims and objectives

To describe the possible differences between knowledge expectations and received knowledge of patients undergoing elective knee arthroplasty in Iceland, Sweden and Finland and also to determine the relationship between such a difference and both background factors and patient satisfaction with care.

Background

Knee arthroplasty is a fast‐growing and a successful treatment for patients with osteoarthritis. Patient education can improve surgery outcomes, but it remains unknown what knowledge patients expect to receive and actually acquire during the perioperative period and what factors are related to that experience.

Design

Descriptive, prospective survey.

Methods

In total, 290 patients answered questionnaires about their expectations (Knowledge Expectations of hospital patients ‐ scale) before surgery and about received knowledge (Received Knowledge of hospital patients ‐ scale) and satisfaction with hospital care (Patient Satisfaction Scale) at discharge. Sociodemographics, clinical information, accessibility to knowledge from healthcare providers (Access to Knowledge Scale), and preferences for information and behavioural control (Krantz Health Opinion Survey) were collected as background data.

Results

Patients' knowledge expectations were higher (mean 3·6,SD0·4) than their perception of received knowledge (mean 3·0,SD0·7). Multiple linear regression analysis showed that access to knowledge, information preferences and work experience within health‐ or social care explained 33% (R²) of the variation in the difference between received and expected knowledge. Patients reported high satisfaction with their care except regarding how their family was involved.

Conclusion

Patients undergoing knee arthroplasty receive less knowledge than they expect, and individual factors and communication with healthcare providers during hospitalisation are related to their experience. The content of patient education and family involvement should be considered in future care.

Relevance to clinical practice

The results strengthen the knowledge base on the educational needs of knee arthroplasty patients and can be used to develop and test new interventions.
The impact of virtual admission on self‐efficacy in patients with chronic obstructive pulmonary disease – a randomised clinical trial
Authors: Emme Christina , Mortensen Erik L , Rydahl‐Hansen Susan , Østergaard Birte , Svarre Jakobsen Anna , Schou Lone , Phanareth Klaus
Published: January 2014

Aims and objectives

To investigate how virtual admission during acute exacerbation influences self‐efficacy in patients with chronic obstructive pulmonary disease, compared with conventional hospital admission.

Background

Telemedicine solutions have been highlighted as a possible way to increase self‐efficacy in patients with chronic diseases, such as chronic obstructive pulmonary disease. However, little is known about how telemedicine‐based virtual admission as a replacement of hospital admission during acute exacerbation affects chronic obstructive pulmonary disease patients' self‐efficacy.

Design

This study was a nonblinded, randomised clinical multicentre trial. The study was a substudy to The Virtual Hospital, investigating the feasibility and safety of telemedicine‐based treatment at home for patients with acute exacerbation of chronic obstructive pulmonary disease.

Methods

Participants were consecutively randomised to virtual admission or conventional hospital admission. Data from 50 patients were analysed. Self‐efficacy was assessed at baseline, three days after discharge, and also six weeks and three months after discharge, using the Danish version of ‘The chronic obstructive pulmonary disease self‐efficacy scale'.

Results

Intergroup comparison showed no significant differences between the two groups at baseline, three days after discharge, six weeks after discharge or three months after discharge. Furthermore, intragroup comparison did not reveal significant differences in the chronic obstructive pulmonary disease self‐efficacy scale mean sum score within the two groups.

Conclusions

The results of the study suggest that there is no difference between self‐efficacy in chronic obstructive pulmonary disease patients undergoing virtual admission, compared with conventional hospital admission. However, the anticipated sample size could not be reached, which prompts caution regarding interpretation of the findings.

Relevance to clinical practice

This study provides new insight into how virtual admission affects chronic obstructive pulmonary disease patients' self‐efficacy. Clinicians should consider the timing, duration and the content in the design of telemedical interventions directed at improving chronic obstructive pulmonary disease patients' self‐efficacy, as telemedicine solutions alone may not be sufficient to enhance self‐efficacy.
Coping strategies among patients with newly diagnosed amyotrophic lateral sclerosis
Authors: Jakobsson Larsson Birgitta , Nordin Karin , Askmark Håkan , Nygren Ingela
Published: January 2014

Aims and objectives

To prospectively identify different coping strategies among newly diagnosed amyotrophic lateral sclerosis patients and whether they change over time and to determine whether physical function, psychological well‐being, age and gender correlated with the use of different coping strategies.

Background

Amyotrophic lateral sclerosis is a fatal disease with impact on both physical function and psychological well‐being. Different coping strategies are used to manage symptoms and disease progression, but knowledge about coping in newly diagnosed amyotrophic lateral sclerosis patients is scarce.

Design

This was a prospective study with a longitudinal and descriptive design.

Methods

A total of 33 patients were included and evaluation was made at two time points, one to three months and six months after diagnosis. Patients were asked to complete the Motor Neuron Disease Coping Scale and the Hospital Anxiety and Depression Scale. Physical function was estimated using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale.

Results

The most commonly used strategies were support and independence. Avoidance/venting and information seeking were seldom used at both time points. The use of information seeking decreased between the two time points. Men did not differ from women, but patients ≤64 years used positive action more often than older patients. Amyotrophic Lateral Sclerosis Functional Rating Scale was positively correlated with positive action at time point 1, but not at time point 2. Patients' psychological well‐being was correlated with the use of different coping strategies.

Conclusions

Support and independence were the most used coping strategies, and the use of different strategies changed over time. Psychological well‐being was correlated with different coping strategies in newly diagnosed amyotrophic lateral sclerosis patients.

Relevance to clinical practice

The knowledge about coping strategies in early stage of the disease may help the nurses to improve and develop the care and support for these patients.
Differences in the chemical composition of organic‐walled dinoflagellate resting cysts from phototrophic and heterotrophic dinoflagellates
Authors: Bogus Kara , Mertens Kenneth Neil , Lauwaert Johan , Harding Ian C. , Vrielinck Henk , Zonneveld Karin A. F. , Versteegh Gerard J. M.
Published: January 2014

Dinoflagellates constitute a large proportion of the planktonic biomass from marine to freshwater environments. Some species produce a preservable organic‐walled resting cyst (dinocyst) during the sexual phase of their life cycle that is an important link between the organisms, the environment in which their parent motile theca grew, and the sedimentary record. Despite their abundance and widespread usage as proxy indicators for environmental conditions, there is a lack of knowledge regarding the dinocyst wall chemical composition. It is likely that numerous factors, including phylogeny and life strategy, determine the cyst wall chemistry. However, the extent to which this composition varies based on inherent (phylogenetic) or variable (ecological) factors has not been studied. To address this, we used micro‐Fourier transform infrared spectroscopy to analyze nine cyst species produced by either phototrophic or heterotrophic dinoflagellates from the extant orders Gonyaulacales, Gymnodiniales, and Peridiniales. Based on the presence of characteristic functional groups, two significantly different cyst wall compositions are observed that correspond to the dinoflagellate's nutritional strategy. The dinocyst wall compositions analyzed appeared carbohydrate‐based, but the cyst wall produced by phototrophic dinoflagellates suggested a cellulose‐like glucan, while heterotrophic forms produced a nitrogen‐rich glycan. This constitutes the first empirical evidence nutritional strategy is related to different dinocyst wall chemistries. Our results indicated phylogeny was less important for predicting composition than the nutritional strategy of the dinoflagellate, suggesting potential for cyst wall chemistry to infer past nutritional strategies of extinct taxa preserved in the sedimentary record.
Invasibility of boreal wetland plant communities
Authors: Ström Lotta , Jansson Roland , Nilsson Christer
Published: January 2014

Question

How does germination and establishment of non‐resident plant species differ among major types of wetland ecosystems in boreal forest landscapes?

Location

A 250‐km2 large boreal forest landscape in northern Sweden.

Methods

We performed a germination and establishment experiment to test for differences between three major wetland types: riparian zones, open wetlands and forested wetlands. These wetland types differ ecologically, hydrologically and in their distribution in the landscape. Six species of vascular plant native to the region but absent or rare in one or more of the three wetland types were sown separately in plots with two different levels of disturbance (complete vegetation removal and control) and were monitored for 3 yr. For two species, seed‐sowing density was varied to test for effects of propagule pressure.

Results

All six species were able to germinate and survive in all habitats and disturbance levels, suggesting that all three wetland types are invasible. There were positive correlations between germination or survival and species richness in resident vegetation for four out of six species, i.e. species‐rich sites were more invasible. The germination frequency did not vary with seed‐sowing density, indicating that density‐dependent effects were small. All species had higher survival in their resident habitat, while the effect of disturbance was small.

Conclusions

The results suggest that the low levels of plant invasion observed in boreal wetlands are better explained by low propagule pressure than high resistance to invasion. However, the habitat dependency of survival implies that population establishment is only expected in habitats to which the species are adapted. Nevertheless, levels of invasion might increase in the future, given that more species are being introduced as a result of increases in transport and trade.
Evaluating the effectiveness of domestic abuse prevention education: Are certain children more or less receptive to the messages conveyed?
Authors: Fox Claire L. , Corr Mary‐Louise , Gadd David , Sim Julius
Published: January 2014

Purpose

A number of school‐based domestic abuse prevention programmes have been developed in the United Kingdom, but evidence as to the effectiveness of such programmes is limited. The aim of the research was to evaluate the effectiveness of one such programme and to see whether the outcomes differ by gender and experiences of domestic abuse.

Method

Pupils aged 13–14 years, across seven schools, receiving a 6‐week education programme completed a questionnaire to measure their attitudes towards domestic violence at pre‐, post‐test, and 3‐month follow‐up, and also responded to questions about experiences of abuse (as victims, perpetrators, and witnesses) and help seeking. Children in another six schools not yet receiving the intervention responded to the same questions at pre‐ and post‐test. In total, 1,203 children took part in the research.

Results

Boys and girls who had received the intervention became less accepting of domestic violence and more likely to seek help from pre‐ to post‐test compared with those in the control group; outcomes did not vary by experiences of abuse. There was evidence that the change in attitudes for those in the intervention group was maintained at 3‐month follow‐up.

Conclusions

These findings suggest that such a programme shows great promise, with both boys and girls benefiting from the intervention, and those who have experienced abuse and those who have not (yet) experienced abuse showing a similar degree of attitude change.
Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology
Authors: Price L. H. , Li Y. , Patel A. , Gyawali C. P.
Published: January 2014

Background

Multiple rapid swallows (MRS) during esophageal high resolution manometry (HRM) assess esophageal neuromuscular integrity by evaluating postdeglutitive inhibition and rebound contraction, but most reports performed only a single MRS sequence. We assessed patterns of MRS reproducibility during clinical HRM in comparison to a normal cohort.

Methods

Consecutive clinical HRM studies were included if two separate MRS sequences (four to six rapid swallows ≤4 s apart) were successfully performed. Chicago Classification diagnoses were identified; contraction wave abnormalities were additionally recorded. MRS‐induced inhibition (contraction ≤3 cm during inhibition phase) and rebound contraction was assessed, and findings compared to 18 controls (28.0 ± 0.7 year, 50.0% female). Reproducibility consisted of similar inhibition and contraction responses with both sequences; discordance was segregated into inhibition and contraction phases.

Key Results

Multiple rapid swallows were successfully performed in 89.3% patients and all controls; 225 subjects (56.2 ± 0.9 year, 62.7% female) met study inclusion criteria. Multiple rapid swallows were reproducible in 76.9% patients and 94.4% controls (inhibition phase: 88.0% vs 94.4%, contraction phase 86.7% vs 100%, respectively, p = ns). A gradient of reproducibility was noted, highest in well‐developed motor disorders (achalasia spectrum, hypermotility disorders, and aperistalsis, 91.7–100%, p = ns compared to controls); and lower in lesser motor disorders (contraction wave abnormalities, esophageal body hypomotility) or normal studies (62.2–70.8%, p < 0.0001 compared to well‐developed motor disorders). Inhibition phase was most discordant in contraction wave abnormalities, while contraction phase was most discordant when studies were designated normal.

Conclusions & Inferences

Multiple rapid swallows are highly reproducible, especially in well‐developed motor disorders, and complement the standard wet swallow manometry protocol.
Transplastomic Nicotiana benthamiana plants expressing multiple defence genes encoding protease inhibitors and chitinase display broad‐spectrum resistance against insects, pathogens and abiotic stresses
Authors: Chen Peng‐Jen , Senthilkumar Rajendran , Jane Wann‐Neng , He Yong , Tian Zhihong , Yeh Kai‐Wun
Published: January 2014

Plastid engineering provides several advantages for the next generation of transgenic technology, including the convenient use of transgene stacking and the generation of high expression levels of foreign proteins. With the goal of generating transplastomic plants with multiresistance against both phytopathogens and insects, a construct containing a monocistronic patterned gene stack was transformed into Nicotiana benthamiana plastids harbouring sweet potato sporamin, taro cystatin and chitinase from Paecilomyces javanicus. Transplastomic lines were screened and characterized by Southern/Northern/Western blot analysis for the confirmation of transgene integration and respective expression level. Immunogold localization analyses confirmed the high level of accumulation proteins that were specifically expressed in leaf and root plastids. Subsequent functional bioassays confirmed that the gene stacks conferred a high level of resistance against both insects and phytopathogens. Specifically, larva of Spodoptera litura and Spodoptera exigua either died or exhibited growth retardation after ingesting transplastomic plant leaves. In addition, the inhibitory effects on both leaf spot diseases caused by Alternaria alternata and soft rot disease caused by Pectobacterium carotovorum subsp. carotovorum were markedly observed. Moreover, tolerance to abiotic stresses such as salt/osmotic stress was highly enhanced. The results confirmed that the simultaneous expression of sporamin, cystatin and chitinase conferred a broad spectrum of resistance. Conversely, the expression of single transgenes was not capable of conferring such resistance. To the best of our knowledge, this is the first study to demonstrate an efficacious stacked combination of plastid‐expressed defence genes which resulted in an engineered tolerance to various abiotic and biotic stresses.
Epistemic Entitlement and Luck
Authors: Goldberg Sandy
Published: January 2014

The aim of this paper is to defend a novel characterization of epistemic luck. Helping myself to the notions of epistemic entitlement and adequate explanation, I propose that a true belief suffers from epistemic luck iff an adequate explanation of the fact that the belief acquired is true must appeal to propositions to which the subject herself is not epistemically entitled (in a sense to be made clear below). The burden of the argument is to show that there is a plausible construal of the notions of epistemic entitlement and adequate explanation on which the resulting characterization of epistemic luck, though admittedly programmatic, has several important virtues. It avoids difficulties which plague modal accounts of epistemic luck; it can explain the conflicting temptations one can feel in certain alleged cases of epistemic luck; it offers a novel account of the value of knowledge, without committing itself to any particular analysis of knowledge; and it illuminates the significance for epistemology of the phenomenon of epistemic luck itself.