bluuebunny/crossref_metadata_2025 huggingface dataset:
Intercultural education in situ
Authors: Hadjisoteriou Christina , Angelides Panayiotis
Published: May 2016

Purpose

The overarching purpose of this paper is to explore the transformation of intercultural education in Cyprus in the context of European integration. More specifically, it indicates the ways in which intercultural policy has been formed by complex and often counteractive influences. The analysis draws upon policy documents collected from the Ministry of Education and Culture (MEC) and interviews carried out with Cypriot policy-makers. Europe has come to play an important role in the development of Cypriot intercultural policy by becoming a mechanism of pressure for educational change. Through monitoring processes, Europe has indicated problems deriving from the culturally pluralistic character of the Cypriot society that should be addressed by national policies. In this context, Cyprus has initiated an educational reform, including a reform of the national curriculum towards a more intercultural orientation. Nonetheless, the findings of this research assert that there is a gap between policy rhetoric and practice.

Design/methodology/approach

This study reports on an analysis of the policy dynamics influencing intercultural education in the Greek–Cypriot context. The authors aim to examine the context and content of educational policies and directives which have been initiated and/or developed at the Greek–Cypriot level. To this end, the authors drew upon policy documentary and data derived from interviews conducted with Greek–Cypriot policy-makers and education officers.

Findings

It appears that intercultural education became an important part of the state’s rhetoric. Cyprus has initiated an educational reform, including a reform of the national curriculum towards a more intercultural orientation. Therefore, since 2008, the state and particularly the MEC have replaced the previously used term of multicultural education with the rhetoric of intercultural education and inclusion as the preferable educational responses to immigration.

Research limitations/implications

The findings of this study suggest that the development of intercultural education requires the re-conceptualisation and re-structuring of the Cypriot educational system and schooling. The state should adopt a balanced governance model between school autonomy and centralised management.

Practical implications

This paper can help schools and teachers to improve their intercultural education approach.

Social implications

The findings could be helpful for improving the intercultural education policy in Cyprus.

Originality/value

These research finding are the first that deal with intercultural education policy in Cyprus.
Leading to intrinsically reward professionals for sustained engagement
Authors: Stumpf Stephen A , Tymon, Jr. Walter G. , Ehr Robert J. , van Dam Nick H. M.
Published: May 2016

Purpose

– The purpose of this paper is to identify leader behaviors that foster intrinsic rewards (IRs) in technical professionals, sustain their felt and behavioral engagement, and relate the career outcomes of performance, satisfaction with the organization, and retention.

Design/methodology/approach

– Employing an action research approach, four studies were undertaken to: first, identify what intrinsically motivates professionals in a large R & D organization; second, create a survey of the leader behaviors that foster a sense of IR and engagement; and third, use the survey with two samples (Canada, Europe) to examine the relationships of engagement with three desired career outcomes.

Findings

– Leader behaviors can foster a sense of IRs which are related to performance, satisfaction with the organization, and retention. These relationships were partially mediated by felt and behavioral engagement, with felt engagement more strongly associated with satisfaction and retention, and behavioral engagement with performance.

Research limitations/implications

– Leaders play a significant role in fostering a sense of IR in technical professionals, which helps to sustain their engagement. Important distinctions among IRs, felt engagement, and behavioral engagement are made that contribute to a better understanding of how these constructs affect the careers of professionals.

Originality/value

– Professionals and other knowledge workers are often thought to be self-motivated, or motivated by the tasks they perform. Leaders can greatly enhance this motivation and important career outcomes of satisfaction, performance, and intent to stay.
How to increase organizational commitment through transactional leadership
Authors: Afshari Leila , Gibson Paul
Published: May 2016

Purpose

– The purpose of this paper is to explore the relationship between transactional leadership and willing organizational commitment in two significantly different organizations (one from the healthcare sector and one from manufacturing).

Design/methodology/approach

– Partial Least Squares was used to develop a mediation model explaining the underlying mechanism between contingent reward leadership and willing organizational commitment.

Findings

– The data indicates that, as expected, the relationship between transactional leadership and willing commitment in the manufacturing organization was mediated by both competence and relatedness; however, in the healthcare organization, to the surprise, this relationship was mediated by competence only.

Practical implications

– The authors develop a model that could help organizational managers and consultants improve the productivity and effectiveness of their work by taking the findings into account.

Originality/value

– Previous research has focused on the effectiveness of transformational research: this paper is one of the first to explore the relationship between transactional leadership and willing organizational commitment, taking into account the mediation effect of psychological need satisfaction.
Remarkable lives: Laura O’Brien in conversation with Jerome Carson
Authors: O'Brien Laura , Carson Jerome
Published: May 2016

Purpose

– The purpose of the paper is to provide a profile of Laura O’Brien.

Design/methodology/approach

– Laura provides a short biographical account of her life thus far. She is then interviewed by Jerome. She describes her abusive childhood and the effect this has had on her mental health.

Findings

– Despite enduring significant adversity, Laura has completed a Psychology degree, is finishing off a PGCE and hopes to go on to complete a PhD.

Research limitations/implications

– There has been increasing interest looking at the effects of childhood abuse on predisposing individuals to adult mental health problems. This case study provides evidence of this linkage.

Practical implications

– Patricia Deegan talks about mental health staff having to “hold the care” while the individual struggles with their personal recovery. Laura’s story shows how despite numerous overdoses and admissions, she has been able to battle through. Mental health staff should never give up. There are thousands of “Lauras” out there.

Social implications

– How much of Laura’s problems might have been avoided or minimised if there had been better interventions during her troubled childhood years?

Originality/value

– Given what she has endured, Laura’s recent career successes have been staggering.
Integrated staffing model for residential mental health rehabilitation
Authors: Parker Stephen , Dark Frances , Vilic Gabrielle , McCann Karen , O'Sullivan Ruth , Doyle Caroline , Lendich Bernice
Published: May 2016

Purpose

– A novel integrated staffing model for community-based residential rehabilitation services is described. The purpose of this paper is to achieve synergistic gains through meaningful integration of peer support and clinical workers within rehabilitation teams. Key features include the majority of roles within the team being held by persons with a lived experience of mental illness, the active collaboration between peer and clinical workers throughout all stages of a consumer’s rehabilitation journey, and an organizational structure that legitimizes and emphasizes the importance of peer work within public mental health service delivery. This staffing model is not anticipated to alter the core rehabilitation function and service models.

Design/methodology/approach

– The emergence of the integrated staffing model is described with reference to the policy and planning context, the evidence base for peer support, and the organizational setting. A conceptual and contextualized description of the staffing model in practice as compared to a traditional clinical staffing model is provided.

Findings

– There is a potential for synergistic benefits through the direct collaboration between horizontally integrated peer and clinical specialists within a unified team working toward a common goal. This staffing model is novel and untested, and will be subjected to ongoing evaluation.

Originality/value

– The integrated staffing model may provide a pathway to achieving valued and valuable roles for peer workers working alongside clinical staff in providing rehabilitation support to people affected by serious mental illness.
Evaluating the Prosper peer-led peer support network: a participatory, coproduced evaluation
Authors: Gillard Steve , Foster Rhiannon , Turner Kati
Published: May 2016

Purpose

– A range of one-to-one, group and online approaches to peer support are increasingly complementing formal mental health service delivery. Evidence is emerging of the potential benefits and challenges of peer support for individuals, communities and organisations. There is more limited evidence describing peer-led peer support networks. The paper aims to discuss these issues.

Design/methodology/approach

– In an evaluation of Prosper, a peer-led, peer support network and social movement, members of the network played a participatory role in the design, conduct and interpretative work of the evaluation. An online survey, one-to-one interviews and group discussions were used.

Findings

– The evaluation describes an evolving network with planning and development meetings constituting core activity for many members alongside a monthly training programme supporting people to set up their own activities. There were strong shared values, and consensus that Prosper could strengthen social networks, improve individual well-being and impact on the way people used mental health services. Challenges were identified around feelings of uncertainty and vulnerability in relation to involvement in the network.

Research limitations/implications

– The participatory nature of the evaluation adds value to the learning offered. This was a descriptive evaluation; potential is indicated for the more formal modelling and testing of peer-led network and social movement initiatives.

Practical implications

– Clarity is needed on the relationship of the network to statutory mental health services – specifically around taking on a “service provider” role – and on the advantages and challenges of a “hybrid” organisational model that combines traditional, hierarchical and new distributed forms of leadership and structure.

Social implications

– Prosper demonstrated potential to create a sense of common culture based on sharing lived experience and mutual peer support, providing an alternative to the traditional culture of mental health services.

Originality/value

– This paper offers wider learning derived from evaluation of a highly original initiative in peer leadership, network structure and interface with statutory mental health services.
Molecular typing using polymorphisms of the polyketide synthase gene (PKS1) of strains in Japan morphologically identified as Fonsecaea pedrosoi
Authors: Ushigami Tsuyoshi , Anzawa Kazushi , Mochizuki Takashi
Published: May 2016

Fonsecaea pedrosoi sensu lato is a major causative agent of dematiaceous fungal infection in Japan. Recent sequence analysis of the internal transcribed spacer (ITS) regions of the ribosomal RNA gene has shown that this species can be separated into three species: F. pedrosoi sensu stricto, F. monophora and F. nubica. The cell walls of dematiaceous fungi including the genus Fonsecaea contain melanin, which is important for their virulence. Polyketide synthase (PKS1) is an enzyme required for melanin synthesis. This study analyzed the phylogeny of strains of F. pedrosoi sensu lato isolated in Japan by sequencing the PKS1 gene and ITS regions and identifying molecular polymorphism. Sixty strains morphologically identified as F. pedrosoi isolated worldwide, including 37 strains isolated in Japan, were analyzed. ITS regions of the ribosomal RNA gene and part of the PKS1 gene region were amplified, yielding sequences of approximately 600 and 450 bp, respectively. Polymerase chain reaction products were sequenced, and cluster analysis was performed. The proposed phylogenetic tree based on PKS1 sequences closely matched that based on the ITS regions. Sequencing of both regions showed that the isolates from Japan belonged to the clade of F. monophora. Molecular variations of these Japanese strains were evaluated by assessing both ITS and PKS1 sequences. The 37 isolates could be divided into at least seven molecular subtypes. The combination of these two molecular markers provides a most robust method for intraspecies subtyping and further epidemiological study of F. monophora.
Habitat mapping of coastal wetlands using expert knowledge and Earth observation data
Authors: Adamo Maria , Tarantino Cristina , Tomaselli Valeria , Veronico Giuseppe , Nagendra Harini , Blonda Palma
Published: May 2016

Long‐term habitat mapping and change detection are essential for the management of coastal wetlands as well as for evaluating the impact of conservation policies. Earth observation (EO) data and techniques are a valuable resource for long‐term habitat mapping. Although the use of EO data is well developed for the automatic production of land cover (LC) maps, this is not the same for habitat maps, which are highly related to biodiversity.

In a previous paper, we used the Food and Agricultural Organization (FAO) Land Cover Classification System (LCCS) environmental attributes (e.g. water quality, lithology, soil surface aspect) for LC‐to‐habitat class translation. However, these environmental attributes are often not openly available, not updated or are missing.

This paper offers an alternative, knowledge‐based solution to automatic habitat mapping. When only expert rules and EO data are used, the final overall map accuracy, which is obtained by comparing reference ground truth patches to the ones depicted in the output map, is lower (75·1%) than the accuracy obtained using environmental attributes alone (97·0%). Some ambiguities that still remain in habitat discrimination are resolved by integrating the use of LCCS environmental attributes (if available) and expert rules.

In this paper, we use very high‐resolution (VHR) satellite data and LIDAR data. LC classes are labelled according to the LCCS taxonomy, which offers a framework to integrate EO data with in situ and ancillary data. Output habitat classes are labelled according to the European Habitats Directive (92/43 EEC Directive) Annex I habitat types and Eunis habitat classification. Two Natura 2000 coastal wetland sites in southern Italy are considered.

Synthesis and applications. In this paper, we study the exploitation of ecological rules on vegetation pattern, plant phenology and habitat geometric properties for automatic translation of land cover (LC) maps to habitat maps in coastal wetlands. The methodology is useful for relatively inaccessible sites (e.g. wetlands) as it does not require in‐field campaigns (generally costly) but only the elicitation of ecological expert rules. This can support site (e.g. Natura 2000) managers in long‐term automatic habitat mapping. Habitat changes can be automatically detected by comparing map pairs, and trends can be quantified. This is particularly useful to satisfy the commitments of the European Habitats Directive (92/43/EEC), which requires Member States to take measures to maintain as, or restore to, favourable conservation status those natural habitat types and species of community interest that are listed in the Annexes to the Directive.
Cytoprotective effects of endothelin‐1 on mesenchymal stem cells: an in vitro study
Authors: Pourjafar Mona , Saidijam Massoud , Mansouri Kamran , Malih Sara , Ranjbar Nejad Tayebeh , Shabab Nooshin , Najafi Rezvan
Published: May 2016

Stem cell‐based therapies is a promising approach for regenerative therapy in various diseases. Some obstacles remain to be solved before clinical application of the cell therapy is realized, including increasing the survival of transplanted stem cells, reducing loss of transplanted cells, and maintaining adequate vascular supply. Recently, stem cell preconditioning with chemical and pharmacological agents has been shown to increase therapeutic efficacy. The present study investigated the effect of endothelin‐1 (ET‐1) on survival, angiogenesis, and migration of mesenchymal stem cells (MSCs), in vitro. MSCs were treated with various concentrations of ET‐1 and the expression of cyclooxygenase‐2 (COX‐2), hypoxia‐inducible factor‐1 (HIF‐1), C‐X‐C chemokine receptor type 4 (CXCR4), C‐C chemokine receptor type 2 (CCR2), vascular endothelial growth factor (VEGF), angiopoietin‐2 (Ang‐2), angiopoietin‐4 (Ang‐4) and matrix metalloproteinase‐2 (MMP‐2) were examined. Caspase 3 activity and prostaglandin E2 (PGE2) were determined by ELISA assay. MSCs migration and tube formation potential were assessed using scratch test and three dimensional vessel formation assay. ET‐1 enhanced the MSCs viability. In ET‐1‐ treated MSCs, expression of COX‐2, HIF‐1, CXCR4, CCR2, VEGF, Ang‐2, Ang‐4 and MMP‐2 were increased compared to control groups. Elevation of all these genes were reversed by celecoxib (50 μmol/L), a selective COX‐2 inhibitor. PGE2 generation, MSCs migration and tube formation were enhanced by ET‐1 conditioning, whereas caspase‐3 activity was reduced in these cells, compared to the control group. The results presented here reveal that preconditioning of MSCs with ET‐1 has strong cytoprotective effects through activation of survival signalling molecules and trophic factors.
Report of the Editor‐in‐Chief
Authors: Harvey David
Published: May 2016

Submissions to the Journal continue to increase steadily, with a strong international pattern, while our response times are also improving. The JAE's citation impact factor has recovered to 1.3 in 2014. Current indications are that 2015's score will be similar. Wiley‐Blackwell continue to provide a strong publishing platform with our full archive generating a continuing increase in the number of downloads.
Kyoto global consensus report on Helicobacter pylori gastritis and its impact on Chinese clinical practice
Authors: Chen Qi , Lu Hong
Published: May 2016

The Kyoto global consensus report on Helicobacter pylori (H. pylori) gastritis has had a great effect on the field of H. pylori studies worldwide. For the first time H. pylori gastritis was defined entirely as an infectious disease and H. pylori‐associated dyspepsia as a new category of organic dyspepsia apart from functional dyspepsia, together with a proposed diagnostic algorithm. Accordingly, the report states that the eradication of H. pylori should be regarded as the first‐line treatment for dyspepsia. Moreover, H. pylori eradication before the development of pre‐neoplastic changes is recommended to reduce the risk of more serious complications of H. pylori gastritis. Despite the recommendations of this new global consensus, the task of transforming them into feasible and practical recommendations for individual countries will require them to become region‐specific, which requires further discussion.
Adjunctive targeted contrast‐enhanced ultrasonography for the work‐up of Breast Imaging Reporting and Data System category 3 and 4 lesions
Authors: Zhang Xiao‐Ling , Guan Jian , Li Mei‐Zhi , Liu Ming‐Juan , Guo Yan , Zheng Yan‐Ling , Yang Zheng , Yang Jian‐Yong
Published: May 2016

Introduction

The assessment and management of Breast Imaging Reporting and Data System category 3 and 4 lesions (BI‐RADS 3 and 4 lesions respectively) present numerous challenges for breast radiologists and physicians due to the ambiguity in the classification guidelines. Different imaging modalities have been investigated for their ability to provide additional aid in classification and management. The aim of this study was to evaluate the utility of targeted contrast‐enhanced ultrasonography (CEUS) as an adjunctive modality to mammography plus conventional ultrasound (MG + US) in the decision of whether further diagnostic work‐up is needed for BI‐RADS 3 and 4 lesions.

Methods

A total of 37 MG + US‐detected BI‐RADS 3 lesions and 60 MG + US‐detected BI‐RADS 4 lesions were analysed by targeted CEUS and biopsied. The effectiveness of CEUS in distinguishing benign from malignant entities among the breast lesions was evaluated by using the histological results of biopsied samples as the gold standard.

Results

Two BI‐RADS 3 and 14 BI‐RADS 4 lesions were diagnosed as true‐positive findings by targeted CEUS, with negative predictive values (NPVs) of 100% and 89.2% respectively.

Conclusions

Owing to the high NPV of targeted CEUS, a negative diagnosis of MG + US‐detected BI‐RADS 3 lesions by targeted CEUS can be helpful in avoiding unnecessary biopsies. However, targeted CEUS cannot be used to exclude patients with BI‐RADS 4 lesions from further diagnostic work‐up.
Systemic‐pulmonary artery shunt: A rare cause of false‐positive filling defect in the pulmonary arteries
Authors: Chawla Ashish , Bosco Jerome , Lim Tze Chwan , Gaikwad Vishal , Chung Raymond
Published: May 2016

Computed tomographic (CT) pulmonary angiography is widely used for evaluation of pulmonary embolism. Intraluminal filling defects in the contrast enhanced pulmonary arteries are considered diagnostic of pulmonary emboli. We report a false‐positive case where filling defects in the pulmonary artery were due to mixing of blood from a complex shunt or vascular malformation between the systemic arteries and pulmonary artery.
Importance of traditional protected areas for the collection of medicinal plants, Kongo‐Central (DRC)
Authors: Flavien Nzuki Bakwaye , Vanhove Wouter , Termote Céline , Van Damme Patrick
Published: May 2016

The Mbanza‐Ngungu region (Kongo‐Central province, DRC) currently faces continued forest deterioration. Many of these forests were traditionally protected areas of which to date, only traces are left. The aim of this study was to evaluate and compare the importance of forest remnants and other components of the landscape for the collection of medicinal plants in the Mbanza‐Ngungu Region, DRC. Between February 2009 and May 2012, semi‐structured interviews and participatory observations were conducted in this region with 51 traditional healers selected by means of the ‘snowball method’. Local importance of medicinal plants was determined by the medicinal Use Value parameter. Statistical analyses were carried out with SPSS 20.0 and based on chi‐square test, analysis of variance and post hoc comparison of means. Our results show that the forest remnants remain the main medicinal species provider: 68 species against 62 for agro‐ecosystems. However, the total number of citations for medicinal species uses is higher for agro‐ecosystems (293) than for forest remnants (233), and this difference is significant (P < 0·05). This could be explained, among others, by the fact that some forest remnants are respected or protected by the villagers for religious and ritual purposes (Sangi). This also points to the importance of agro‐ecosystems and secondary vegetation as provider of medicinal plants around rural villages, as seen elsewhere in the tropics.
New scoring system improves inter‐rater reliability of the Neonatal Oral‐Motor Assessment Scale
Authors: da Costa Saakje P. , Hübl Nicole , Kaufman Nicole , Bos Arend F.
Published: May 2016

Aim

The Neonatal Oral‐Motor Assessment Scale (NOMAS) is a standardised tool to assess sucking patterns in infants to 48 weeks of postmenstrual age (PMA). In the Netherlands, the interpretation of specific NOMAS items has evolved, leading to a new scoring system. Recent research using the NOMAS describes a way of clustering the most frequent items, and the aim of this study was to determine whether those changes improved the inter‐rater reliability.

Methods

The inter‐rater reliability was tested by two NOMAS‐certified therapists who scored 120 video recordings of 40 preterm infants, admitted to the University Hospital of Düsseldorf, Germany, at 34, 37 and 44 weeks PMA, for normal, disorganised and dysfunctional diagnosis. The NOMAS comprised 28 items and five clusters of items.

Results

The therapists agreed on the level of diagnoses for 116 of 120 recordings (Cohen's Κ 0.90), on an item level for 107 of 120 recordings (Cohen's Κ 0.78) and on a cluster level for 108 of 120 recordings (Cohen's K 0.90).

Conclusion

The new scoring system improved the inter‐rater reliability of the NOMAS on all levels, highlighting the importance of NOMAS user having a clear understanding on how to interpret and score each item.
Supportive care utilization and treatment toxicity in children with Down syndrome and acute lymphoid leukaemia at free‐standing paediatric hospitals in the United States
Authors: Salazar Elizabeth G. , Li Yimei , Fisher Brian T. , Rheingold Susan R. , Fitzgerald Julie , Seif Alix E. , Huang Yuan‐Shung , Bagatell Rochelle , Aplenc Richard
Published: May 2016

Although inferior outcomes of children with Down syndrome (DS) and acute lymphoid leukaemia (ALL) are established, national supportive care patterns for these patients are unknown. A validated retrospective cohort of paediatric patients diagnosed with ALL from 1999 to 2011 was assembled from the US Pediatric Health Information System (PHIS) database to examine organ toxicity, sepsis, and resource utilization in children with and without DS. Among 10699 ALL patients, 298 had DS‐ALL (2·8%). In a multivariate model, DS was associated with increased risk of cardiovascular (odds ratio [OR] 2·0, 95% confidence interval [CI] 1·6–2·7), respiratory (OR 2·1, 95% CI: 1·6–2·9), neurologic (OR 3·4, 95% CI 1·9–6·2), and hepatic (OR 1·4, 95% CI 1·0–1·9) dysfunction and sepsis (OR 1·8, 95% CI: 1·4–2·4). Children with DS‐ALL used significantly more respiratory support, insulin, and anti‐infectives, including broad‐spectrum Gram‐positive agents, quinolones, and azoles. They used significantly fewer analgesics and antiemetics compared to non‐DS‐ALL children. Ultimately, this study confirms the increased risk of infectious and end‐organ toxicity in children with DS‐ALL and quantifies important differences in resource utilization between children with DS and non‐DS ALL. These findings highlight the importance of investigating the impact of these care variations and developing specific supportive care guidelines for this population.
The Combination of Scopolamine and Psychostimulants for the Prevention of Severe Motion Sickness
Authors: Zhang Li‐Li , Liu Hong‐Qi , Yu Xu‐Hong , Zhang Ying , Tian Jia‐Sheng , Song Xu‐Rui , Han Bing , Liu Ai‐Jun
Published: May 2016

Background and aims

Severe motion sickness is a huge obstacle for people conducting precise aviation, marine or emergency service tasks. The combination of scopolamine and d‐amphetamine is most effective in preventing severe motion sickness. However, this combination is not included in any present pharmacopoeia due to the abuse liability of d‐amphetamine. We wanted to find a combination to replace it for the treatment of severe motion sickness.

Methods and results

We compared the efficacy of scopolamine, diphenhydramine, and granisetron (representing three classes of drugs) with different doses, and found that scopolamine was the most effective one. We also found scopolamine inhibited central nervous system at therapeutic doses and caused anxiety. Then, we combined it with different doses of psychostimulants (d‐amphetamine, modafinil, caffeine) to find the best combination for motion sickness. The efficacy of scopolamine with modafinil (1 + 10 mg/kg) was equivalent to that of scopolamine with d‐amphetamine (1 + 1 mg/kg); This combination also excited central nervous system and abolished the anxiety caused by scopolamine.

Conclusions

The optimal dose ratio of scopolamine and modafinil is 1:10. This combination is beneficial for motion sickness and can abolish the side effects of scopolamine. So, it might be a good replacement of scopolamine and d‐amphetamine for severe motion sickness.
Advancing Conservation by Understanding and Influencing Human Behavior
Authors: Reddy Sheila M.W. , Montambault Jensen , Masuda Yuta J. , Keenan Elizabeth , Butler William , Fisher Jonathan R.B. , Asah Stanley T. , Gneezy Ayelet
Published: May 2016

Behavioral sciences can advance conservation by systematically identifying behavioral barriers to conservation and how to best overcome them. Behavioral sciences have informed policy in many other realms (e.g., health, savings), but they are a largely untapped resource for conservation. We propose a set of guiding questions for applying behavioral insights to conservation policy. These questions help define the conservation problem as a behavior change problem, understand behavioral mechanisms and identify appropriate approaches for behavior change (awareness, incentives, nudges), and evaluate and adapt approaches based on new behavioral insights. We provide a foundation for the questions by synthesizing a wide range of behavior change models and evidence related to littering, water and energy conservation, and land management. We also discuss the methodology and data needed to answer these questions. We illustrate how these questions have been answered in practice to inform efforts to promote conservation for climate risk reduction. Although more comprehensive research programs to answer these questions are needed, some insights are emerging. Integrating two or more behavior change approaches that target multiple, context‐dependent factors may be most successful; however, caution must be taken to avoid approaches that could undermine one another (e.g., economic incentives crowding out intrinsic incentives).
Factors related to tracheostomy timing and ventilator weaning: findings from a population in Northern Taiwan
Authors: Chen Hui‐Chin , Song Lixin , Chang Hsin‐Chieh , Hsu Min‐Tao
Published: May 2016

Introduction

Determining the optimal time for performing a tracheostomy and weaning a patient off a ventilator is typically challenging for physicians, respiratory therapists, patients and patients' families.

Purpose

This study examined the factors influencing tracheostomy timing and ventilator weaning and described the transition‐care placement of patients who experience unsuccessful ventilator weaning.

Methods

A retrospective design was employed, and 2 years of data were collected through a medical chart review performed at a hospital in Northern Taiwan. Sixty patients who received tracheostomies in the intensive care unit (ICU) or respiratory care center were enrolled. The data included each patient's demographic information, disease diagnosis, and Glasgow Coma Scale score and Acute Physiology and Chronic Health Evaluation II scores.

Results

For patients on a ventilator in an ICU, the tracheostomy rate was 2.7%. Early (within 21 days) and late (>21 days) tracheostomies accounted for 36.7% and 63.3%, respectively. Of the patients who had received tracheostomies, 36.7% experienced ventilator weaning. The factors related to tracheostomy timing were disease diagnosis (P = 0.036) and days of ventilator use (P = 0.003). The factors related to ventilator weaning included disease diagnosis (P = 0.010) and tracheostomy timing (P = 0.001). Early tracheostomies were 10.9 times more likely than late tracheostomies to result in ventilator weaning (95%CI =2.5–47.7, P = 0.002).

Conclusions

Tracheostomy timing was strongly correlated with ventilator weaning. Early tracheostomy was higher successful ventilator weaning rates. The surgical patients were more likely to receive an early tracheostomy. However, the number of patients in Taiwan who received tracheostomies was lower than that in other countries. Further study maybe need to understand cultural variations in the acceptance of tracheostomies by patients.
Long‐term follow‐up of five yr shows superior renal function with everolimus plus early calcineurin inhibitor withdrawal in the PROTECT randomized liver transplantation study
Authors: Sterneck Martina , Kaiser Gernot M. , Heyne Nils , Richter Nicolas , Rauchfuss Falk , Pascher Andreas , Schemmer Peter , Fischer Lutz , Klein Christian G. , Nadalin Silvio , Lehner Frank , Settmacher Utz , Gotthardt Daniel , Loss Martin , Ladenburger Stephan , Wimmer Peter , Dworak Markus , Schlitt Hans J.
Published: May 2016

Background

The 12‐month (M) PROTECT study showed that de novo liver transplant recipients (LTxR) who switched from a calcineurin inhibitor (CNI)‐based immunosuppression to a CNI‐free everolimus (EVR)‐based regimen showed numerically better renal function. Here, we present the five‐yr follow‐up data.

Methods

PROTECT was a randomized controlled study in which LTxR received basiliximab and CNI‐based immunosuppression ± corticosteroids. Patients were randomized 1:1 to receive EVR or continue CNI. Patients completing the core study could enter the extension study on their randomized treatment.

Results

A total of 81 patients entered the extension study (41, EVR; 40, CNI). At M59 post‐randomization, the adjusted mean eGFR was significantly higher in the EVR group, with a benefit of 12.4 mL/min using Cockcroft–Gault (95% CI: 1.2; 23.6; p = 0.0301). Also, there was a significant benefit for adjusted and unadjusted eGFR using the four‐variable Modification of Diet in Renal Disease (MDRD4) or Nankivell formula. During the extension period, treatment failure rates were similar. SAEs occurred in 26 (63.4%) and 28 (70.0%) of the patients in EVR and CNI groups, respectively.

Conclusion

Compared with the CNI‐based treatment, EVR‐based CNI‐free immunosuppression resulted in significantly better renal function and comparable patient and graft outcomes after five‐yr follow‐up.
Similar efficacy and safety of once‐weekly dulaglutide in patients with type 2 diabetes aged ≥65 and <65 years
Authors: Boustani M. A. , Pittman I. , Yu M. , Thieu V. T. , Varnado O. J. , Juneja R.
Published: May 2016

Aims

To evaluate the efficacy and safety of dulaglutide 1.5 and 0.75 mg in elderly patients (aged ≥65 years) with type 2 diabetes (T2D) in six phase III clinical trials.

Methods

Patients were grouped into two age groups: ≥65 and <65 years. Pooled analysis for glycated haemoglobin (HbA1c) change from baseline, percentage of patients achieving HbA1c targets, and gastrointestinal tolerability were evaluated at 26 weeks for each dulaglutide dose. Change in weight from baseline and rates of hypoglycaemia were evaluated for each individual study.

Results

A total of 958 of 5171 (18.5%) patients were aged ≥65 years. The reductions in HbA1c were similar between age groups for dulaglutide 1.5 mg‐treated patients {least squares [LS] mean for patients aged ≥65 years: −1.24 [95% confidence interval (CI) −1.36, −1.12] and for patients aged <65 years: −1.29 [95% CI −1.38, −1.20]} and for dulaglutide 0.75 mg‐treated patients [LS mean for patients aged ≥65 years: −1.16 (95% CI −1.29, −1.03) and for patients aged <65 years: −1.10 (95% CI −1.19, −1.01)] at 26 weeks. The percentages of patients who achieved HbA1c targets of <7, <8 or <9% were also similar in the two groups with both dulaglutide doses. Patients aged ≥65 years had similar weight change to patients aged <65 years. Severe hypoglycaemic events were infrequent. A similar incidence of gastrointestinal adverse events was observed in each age group with both dulaglutide doses.

Conclusion

Both dulaglutide doses were well tolerated, with similar efficacy in patients with T2D aged ≥65 years to those aged <65 years. Dulaglutide can be considered a safe and effective treatment option for use in older adults.
Characterization of Cylindrocarpon‐like species associated with litter in the old‐growth beech forests of Central Europe
Authors: Jankowiak R. , Stępniewska H. , Szwagrzyk J. , Bilański P. , Gratzer G.
Published: May 2016

Cylindrocarpon‐like fungi are globally distributed plant pathogens and have a wide range of host species. However, very little is known about the species that live in the topsoil of forests and their potential role in reducing the natural regeneration of tree species, particularly of forest trees that produce abundant fruit only once every few years. To enhance our understanding of the species that inhabit the topsoil, we studied the diversity and pathogenicity of Cylindrocarpon‐like fungi inhabiting the litter in old‐growth mixed‐beech forests in the Carpathians (Poland) and in the Alps (Austria), and in a managed beech stand in the Krakowsko‐Częstochowska Highland (Poland). The fungi inhabiting the beech litter were investigated using beechnuts and pine seedlings as bait. Isolates were identified based on morphology and DNA sequencing. The pathogenicity of the most common species was investigated by inoculating beech germinants. A wide range of Cylindrocarpon‐like fungi were associated with the beech litter: 718 cultures representing 12 species were isolated. Five taxa were identified down to species level: namely Ilyonectria crassa, I. pseudodestructans, I. rufa, Neonectria candida and N. obtusispora, and seven species were identified to genus level (Neonectria or Ilyonectria species). Ilyonectria destructans, which is considered to be the sexual morph of ‘Cylindrocarpon destructans’, was not found. There were qualitative and quantitative differences between the different forest sites in terms of Neonectria and Ilyonectria species composition in beech litter. The isolation frequency and species richness of Cylindrocarpon‐like fungi were greatest in beech litter taken from old‐growth mixed‐beech forests. Neonectria and Ilyonectria species were capable of killing beech germinants, suggesting that they may play a negative role in natural beech regeneration.
Occurrence of powdery mildew caused by Podosphaera pannosa on lemon eucalyptus
Authors: Cho S. E. , Park J. H. , Lee S. H. , Lee C. K. , Shin H. D.
Published: May 2016

In 2014, powdery mildew was observed on pot‐grown lemon eucalyptus (Corymbia citriodora, Myrtaceae) in Korea. Based on morphological data and phylogenetic analysis of anamorph isolates, this fungus was identified as Podosphaera pannosa. This is the first report of powdery mildew caused by P. pannosa on lemon eucalyptus. Our results, which include a detailed morphological description and molecular data analysis, support previous records of P. pannosa on Eucalyptus spp. and thus on taxa outside the Rosaceae.
Characterization of microsatellites in Fusicladium effusum, cause of pecan scab
Authors: Bock C. H. , Chen C. , Yu F. , Stevenson K. L. , Arias R. S. , Wood B. W.
Published: May 2016

Pecan scab, caused by the plant pathogenic fungus Fusicladium effusum, is the most destructive disease of pecan. Little is known of the population genetic diversity of this pathogen. In this study, microsatellites were mined from the F. effusum genome, and flanking primers were subsequently designed. A total of 275 microsatellites were screened, and 33 selected primers produced reliable, polymorphic markers against 46 isolates of F. effusum from 11 diverse locations in the southeastern USA. The number of alleles per microsatellite locus ranged from two to 17, and the polymorphic information content (PIC) from 0.475 to 0.911. A unique pattern informative combination (UPIC) analysis of three groups of 12 isolates each and 33 primers consistently showed a minimum number of markers required for the maximum discrimination of isolates equal to 3. The characteristics of the unique patterns (UP) and informative contents (IC) were very similar. However, the primers that were selected by UPIC were not necessarily the same for each of the three groups. Using all 46 isolates showed each locus was polymorphic, with a single‐population level Shannon's information index of 1.516, indicating substantial diversity. These markers show a range in polymorphic content and power of discrimination that will be valuable tools for studies of genetic diversity in F. effusum.
Factors influencing the dispersion ofArceuthobium oxycedriinCentralSpain: evaluation with a new null model for marked point patterns
Authors: Ramón P. , De la Cruz M. , Zavala I. , Zavala M. A.
Published: May 2016

The dwarf mistletoe,Arceuthobium oxycedri, is found on populations ofJuniperus oxycedrus, in central Spain. This species can have negative effects on the physiology of its host, including mortality. Understanding the mechanisms that control its distribution and dispersal is critical to assessing its potential for spread. We assessed dwarf mistletoe distribution within a population ofJ. oxycedrus, including infected and uninfected host individuals. A new null model of parasitic dispersion was built using two dispersal kernel forms that were simulated with lower and upper envelopes for second‐order functions to summarize a point pattern, such as Ripley'sK, nearest‐neighbour distribution and pair correlation functions. Nine dispersal scenarios were constructed with half‐bandwidth kernels (10, 20, 30 m) and initial population of infected trees (P0 = 05, 10 and 20). These scenarios were compared with the observed pattern and evaluated using the goodness‐of‐fit test. Significant differences at short distance (r < 10 m) were found between the observed pattern and simulated patterns, corresponding to the range of seed dispersal of the dwarf mistletoe. Interactions between infected and uninfected hosts patterns at all scales were identified, suggesting thatA. oxycedriuses other mechanisms in addition to ballistic seed shooting as secondary dispersal agents to spread to distances greater than 20 m. Given that the seed characteristics facilitate dispersal by adhesion, we infer that spread between host individuals is amplified by seed transport by birds or small mammals.
Night‐time sleep in Parkinson's disease – the potential use of Parkinson's KinetiGraph: a prospective comparative study
Authors: Klingelhoefer L. , Rizos A. , Sauerbier A. , McGregor S. , Martinez‐Martin P. , Reichmann H. , Horne M. , Chaudhuri K. R.
Published: May 2016

Background and purpose

Night‐time sleep disturbances are important non‐motor symptoms and key determinants of health‐related quality of life (HRQoL) in patients with Parkinson's disease (PD). The Parkinson's KinetiGraph (PKG) can be used as an objective measure of different motor states and periods of immobility may reflect episodes of sleep. Our aim was to evaluate whether PKG can be used as an objective marker of disturbed night‐time sleep in PD.

Methods

In this prospective comparative study, data from PKG recordings over six consecutive 24 h periods are compared with Hauser diaries and scales focusing on motor state, sleep and HRQoL in PD patients. Thirty‐three ‘non‐sleepy’ PD patients (PD‐NS) were compared with 30 PD patients presenting with excessive daytime sleepiness (PD‐EDS). The groups were matched for age, gender and Hoehn and Yahr state.

Results

In the PD‐EDS group subjective sleep reports correlated with the PKG's parameters for quantity and quality night‐time sleep, but not in the PD‐NS group. There were no significant correlations of the night‐time sleep quantity parameters of the Hauser diary with subjective sleep perception, neither in the PD‐EDS nor in the PD‐NS group.

Conclusions

This first PKG based study of night‐time sleep in PD suggests that PKG could be used to provide an easy to use and rough evaluation of aspects of night‐time sleep and one that could flag patients where polysomnography may be required. In sleepy PD patients for instance, quantity and quality PKG parameters correlate with different aspects of sleep such as insomnia, parasomnia and restless legs syndrome.
Association between body composition and hip fractures in older women with physical frailty
Authors: Zaslavsky Oleg , Li Wenjun , Going Scott , Datta Mridul , Snetselaar Linda , Zelber‐Sagi Shira
Published: May 2016

Aim

We sought to determine the extent to which higher lean and fat mass as measured by dual X‐ray absorptiometry in older adults with frailty are related to total hip bone mass density (BMD) index and the rate of hip fractures.

Methods

The data are from the Women's Health Initiative Observational Study. We identified 872 participants aged ≥65 years with body composition measures and positive frailty. Frailty was determined using modified Fried's criteria. Linear and Cox regressions were used to model study outcomes.

Results

During the follow‐up period, 5.6% patients (n = 49) had sustained a hip fracture. Body composition indexes were associated with total hip BMD (P < 0.001 for all). In models adjusted for age, ethnicity, smoking, history of fractures, recurrent falls, number of frailty criteria and corresponding lean mass, the hazard ratio for hip fracture per 1 kg/m2 increase in fat mass was 0.73 (95% confidence interval 0.60–0.88) for appendicular compartment, 0.76 (95% confidence interval 0.65–0.89) for trunk and 0.84 (95% confidence interval 0.77–0.93) for whole‐body fat mass. The hazard ratio for hip fracture per 1 kg/m2 increase in appendicular lean mass was 0.63 (95% confidence interval 0.46–0.88). However, after final adjustment for total hip BMD, the only index that remained statistically significant was whole‐body fat mass (P for trend = 0.04).

Conclusions

We showed that in frail older women, higher fat and lean mass was associated with reduced hip‐fracture rates. Higher whole‐body adiposity, however, was also associated with lower hip‐fracture rate independent of total hip BMD. The present results confirm the importance of weight maintenance in frail populations. Geriatr Gerontol Int 2017; 17: 898–904.
Surviving Information Overload: How Elite Politicians Select Information
Authors: Walgrave Stefaan , Dejaeghere Yves
Published: May 2016

Information in politics is overabundant. Especially elite politicians are bombarded with information. Politicians must be selective to stay on top of the information torrent. Aggregate‐level work within the bounded rationality framework showed that information selection is at the core of decision making. Yet, an answer to the question as to how individual elite politicians go about selecting information is lacking. We know that they unavoidably do, but how exactly they perform this selection task remains largely unknown. The article draws on interviews with 14 party leaders and ministers in Belgium about their information processing. We present a typology, and a funnel, of consecutive information selection mechanisms and attitudes. Politicians partially outsource their information selection to procedures and/or staffers, they personally apply rigorous rules of thumb about what to attend to and what not, and they compensate the pressure and constant risk of messing up with a large dose of self‐confidence.