bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse Selection into and within the Individual Health Insurance Market in California in 2014
Authors: Fung Vicki , Peitzman Cassandra G. K. , Shi Julie , Liang Catherine Y. , Dow William H. , Zaslavsky Alan M. , Fireman Bruce H. , Derose Stephen F. , Chernew Michael E. , Newhouse Joseph P. , Hsu John
Published: May 2018

Objective

The Affordable Care Act (ACA) introduced reforms to mitigate adverse selection into and within the individual insurance market. We examined the traits and predicted medical spending of enrollees in California post‐ACA.

Data Sources

Survey of 2,103 enrollees in individual market plans, on‐ and off‐exchange, in 2014.

Study Design

We compared actual versus potential participants using data from the 2014 California Health Interview Survey on respondents who were individually insured or uninsured. We predicted annual medical spending for each group using age, sex, self‐rated health, body mass index, smoking status, and income.

Principal Findings

Average predicted spending was similar for actual ($3,377, 95 percent CI [$3,280‐$3,474]) and potential participants ($3,257 [$3,060‐$3,454]); however, some vulnerable subgroups were underrepresented. On‐ versus off‐exchange enrollees differed in sociodemographic and health traits with modest differences in spending ($3,448 [$3,330‐$3,565] vs. $3,175 [$3,012‐$3,338]).

Conclusions

We did not find evidence of selection into the overall insurance pool in 2014; however, differences by exchange status reflect the importance of including off‐exchange enrollees in analyses and the pool for risk adjustment. California's post‐ACA individual market has been a relative success, highlighting the importance of state policies and outreach efforts to encourage participation in the market.
Granulysin‐mediated apoptosis of trophoblasts in blighted ovum and missed abortion
Authors: Gulic Tamara , Laskarin Gordana , Dominovic Marin , Glavan Gacanin Lana , Babarović Emina , Rubesa Zeljka , Haller Herman , Rukavina Daniel
Published: May 2018

Problem

Granulysin (GNLY) is a cytotoxic molecule mostly present in decidual natural killer (NK) cells. Blighted ovum (BO) and missed abortion (MA) represent the early pathological pregnancies with hindered development of the embryoblast or a dead embryo. We investigated the GNLY‐mediated apoptotic mechanism potentially responsible for delayed termination of pregnancy.

Method of study

We performed immunohistological and immunofluorescence labeling of decidual tissues (GNLY, Apaf‐1, NF‐κB). NKG2A expression was analyzed by flow cytometry and GNLY mRNA by RT‐qPCR.

Results

The GNLY labeling intensity (H score) was lower in the nuclei of trophoblast cells in BO and MA. GNLY gene levels were inversely detected in BO and MA. A decreased decidual NK cell percentage was found in MA. NK cells from pathological pregnancies expressed lower NKG2A levels. The highest frequency of Apaf‐1 was found in trophoblast cells of MA. NF‐kB was highly expressed in decidual cells of BO.

Conclusion

The reduced activation of GNLY‐mediated killing might be implicated in the slower rejection of trophoblast cells in BO and MA. A decreased authentic decidual NK cell number could be responsible for low cytotoxicity against trophoblast cells in MA. In BO, trophoblast cells have a higher survival potential due to increased NF‐kB expression.
Effects of Plasma Proteins on the Transport and Surface Characteristics of Polysulfone/Polyethersulfone and Asymmetric Cellulose Triacetate High Flux Dialyzers
Authors: Kim Tae Ryung , Hadidi Mahsa , Motevalian Seyed Pouria , Sunohara Takashi , Zydney Andrew L.
Published: May 2018

Blood‐membrane interactions can have a large impact on the performance of hemodialysis membranes, particularly for high flux membranes in which the membrane itself provides very low resistance to solute transport. The objective of this study was to examine the effects of exposure to serum on the solute clearance and convective sieving characteristics of high flux polysulfone (Optiflux F250NR), polyethersulfone (ELISIO‐25H), and asymmetric cellulose triacetate (SOLACEA‐25H) hemodialyzers using both vitamin B12 and a range of polydisperse dextrans. Zeta potential measurements were used to obtain additional insights into the changes in membrane surface properties. Exposure to serum in a simulated dialysis session caused a significant reduction in both solute clearance and sieving coefficients for the polysulfone/polyethersulfone dialyzers, particularly for the larger molecular weight solutes. In contrast, the transport characteristics of the asymmetric cellulose triacetate dialyzers were almost unchanged after exposure to serum. The zeta potential of the cellulose triacetate membrane became slightly more negative after exposure to serum, consistent with an adsorbed protein layer composed largely of albumin. The net result is that the asymmetric cellulose triacetate dialyzer had dramatically higher clearance of the larger dextrans after exposure to serum, with the clearance and sieving coefficient for a 10 kDa molecular weight dextran being more than an order of magnitude greater than that of the polysulfone/polyethersulfone membranes. These results provide important insights into the expected clinical performance of these high flux dialyzers.
Patient‐reported outcomes of multiple myeloma patients treated with panobinostat after ≥2 lines of therapy based on the international phase 3, randomized, double‐blind, placebo‐controlled PANORAMA‐1 trial
Authors: Richardson Paul G. , Schlossman Robert L. , Roy Anuja N. , Panneerselvam Ashok , Acharyya Suddhasatta , Sopala Monika , Lonial Sagar
Published: May 2018

The phase 3 PANORAMA‐1 trial led to regulatory approvals of panobinostat (PAN) in combination with bortezomib (BTZ) and dexamethasone (DEX) for the treatment of multiple myeloma after ≥2 prior regimens, including BTZ and an immunomodulatory drug. Patient‐reported outcomes (PROs) were assessed in PANORAMA‐1, with data available for 73 patients in the PAN + BTZ + DEX arm and 74 patients in the placebo (PBO) + BTZ + DEX arm. Per the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 (EORTC QLQ‐C30), global health status/quality of life (QoL) scores initially declined with PAN + BTZ + DEX during the first 24 weeks before approaching baseline scores and remaining steady during the next 24 weeks, with no difference between arms at Week 48. The EORTC QLQ‐Myeloma module (EORTC QLQ‐MY20) demonstrated initial improvements and subsequent stabilization of disease symptom scores in both arms and initial worsening and subsequent improvement of side effects of treatment scores, with the initial worsening more pronounced and recovery less pronounced with PAN + BTZ + DEX. Functional Assessment of Cancer Therapy/Gynecologic Oncology Group‐Neurotoxicity scores remained relatively stable and similar between the arms. Overall, these PRO findings support the addition of PAN to the BTZ+DEX regimen as an efficacious treatment option, with limited symptomatology and impact on patients’ QoL. The reported results are based on a descriptive analysis of the data. No formal statistical tests have been performed.
Emerging roles of long non‐coding RNA in cancer
Authors: Sanchez Calle Anna , Kawamura Yumi , Yamamoto Yusuke , Takeshita Fumitaka , Ochiya Takahiro
Published: May 2018

Since comprehensive analysis of the mammalian genome revealed that the majority of genomic products are transcribed in long non‐coding RNA (lncRNA), increasing attention has been paid to these transcripts. The applied next‐generation sequencing technologies have provided accumulating evidence of dysregulated lncRNA in cancer. The implication of this finding can be seen in many forms and at multiple levels. With impacts ranging from integrating chromatin remodeling complexes to regulating transcription and post‐transcriptional processes, aberrant expression of lncRNA may have repercussions in cell proliferation, tumor progression or metastasis. lncRNA may act as enhancers, scaffolds or decoys by physically interacting with other RNA species or proteins, resulting in a direct impact on cell signaling cascades. Even though their functional classification is well‐established in the context of cancer, clearer characterization in terms of their phenotypic outputs is needed to optimize and identify suitable candidates that enable the development of new therapeutic strategies and the design of novel diagnostic approaches. The present article aims to outline different cancer‐associated lncRNA according to their contribution to tumor suppression or tumor promotion based on their most current functional annotations.
Human Rights and the Pink Tide in Latin America: Which Rights Matter?
Authors: Grugel Jean , Fontana Lorenza B.
Published: May 2018

Latin America witnessed the election of ‘new Left’ governments in the early 21stcentury that, in different ways, sought to open a debate about alternatives to paradigms of neoliberal development. What has this meant for the way that human rights are understood and for patterns of human rights compliance? Using qualitative and quantitative evidence, this article discusses how human rights are imagined and the compliance records of new Left governments through the lens of the three ‘generations’ of human rights — political and civil, social and economic, and cultural and environmental rights. The authors draw in particular on evidence from Andean countries and the Southern Cone. While basic civil and individual liberties are still far from guaranteed, especially in the Andean region, new Left countries show better overall performances in relation to socio‐economic rights compared to the past and to other Latin American countries. All new Left governments also demonstrate an increasing interest in ‘third generation’ (cultural and environmental) rights, though this is especially marked in the Andean Left. The authors discuss the tensions around interpretations and categories of human rights, reflect on the stagnation of first generation rights and note the difficulties associated with translating second and third generation rights into policy.
Food‐web structure varies along environmental gradients in a high‐latitude marine ecosystem
Authors: Kortsch Susanne , Primicerio Raul , Aschan Michaela , Lind Sigrid , Dolgov Andrey V. , Planque Benjamin
Published: May 2018

Large‐scale patterns in species diversity and community composition are associated with environmental gradients, but the implications of these patterns for food‐web structure are still unclear. Here, we investigated how spatial patterns in food‐web structure are associated with environmental gradients in the Barents Sea, a highly productive shelf sea of the Arctic Ocean. We compared food webs from 25 subregions in the Barents Sea and examined spatial correlations among food‐web metrics, and between metrics and spatial variability in seawater temperature, bottom depth and number of days with ice cover. Several food‐web metrics were positively associated with seawater temperature: connectance, level of omnivory, clustering, cannibalism, and high variability in generalism, while other food‐web metrics such as modularity and vulnerability were positively associated with sea ice and negatively with temperature. Food‐web metrics positively associated with habitat heterogeneity were: number of species, link density, omnivory, path length, and trophic level. This finding suggests that habitat heterogeneity promotes food‐web complexity in terms of number of species and link density. Our analyses reveal that spatial variation in food‐web structure along the environmental gradients is partly related to species turnover. However, the higher interaction turnover compared to species turnover along these gradients indicates a consistent modification of food‐web structure, implying that interacting species may co‐vary in space. In conclusion, our study shows how environmental heterogeneity, via environmental filtering, influences not only turnover in species composition, but also the structure of food webs over large spatial scales.
Using food network unfolding to evaluate food–web complexity in terms of biodiversity: theory and applications
Authors: Kato Yoshikazu , Kondoh Michio , Ishikawa Naoto F. , Togashi Hiroyuki , Kohmatsu Yukihiro , Yoshimura Mayumi , Yoshimizu Chikage , Haraguchi Takashi F. , Osada Yutaka , Ohte Nobuhito , Tokuchi Naoko , Okuda Noboru , Miki Takeshi , Tayasu Ichiro
Published: May 2018

Food–web complexity often hinders disentangling functionally relevant aspects of food–web structure and its relationships to biodiversity. Here, we present a theoretical framework to evaluate food–web complexity in terms of biodiversity. Food network unfolding is a theoretical method to transform a complex food web into a linear food chain based on ecosystem processes. Based on this method, we can define three biodiversity indices, horizontal diversity (DH), vertical diversity (DV) and range diversity (DR), which are associated with the species diversity within each trophic level, diversity of trophic levels, and diversity in resource use, respectively. These indices are related to Shannon's diversity index (H′), whereH′ = DH + DV − DR. Application of the framework to three riverine macroinvertebrate communities revealed thatDindices, calculated from biomass and stable isotope features, captured well the anthropogenic, seasonal, or other within‐site changes in food–web structures that could not be captured withH′alone.
Dependence receptors – the dark side awakens
Authors: Negulescu Ana‐Maria , Mehlen Patrick
Published: May 2018

Transmembrane receptors are usually seen as on and off switches: when the specific ligand is bound, the receptor is on and transduces a downstream signal, whereas when the ligand is absent, the receptor is off. Over the last two decades several reports have argued for an alternative view where some receptors, depending on the context, will be active both in the presence and in the absence of ligand, being sort of onA and onB switch rather than on and off. These receptors have been named dependence receptors (DR) and they share the ability to actively trigger cell death when unbound by their respective ligands. DRs have been shown to be important guardians of tissue homeostasis. In pathological settings such as cancer, DRs are seen as tumour suppressors and a clinical trial is ongoing to assay whether these DRs can be used to provide clinical benefit by triggering cancer cell death. In this review we are reviewing this functional family of receptors and underlying their promising potential for targeted therapy against cancer.
Signals of large scale climate drivers, hatchery enhancement, and marine factors in Yukon River Chinook salmon survival revealed with a Bayesian life history model
Authors: Cunningham Curry J. , Westley Peter A. H. , Adkison Milo D.
Published: May 2018

Understanding how species might respond to climate change involves disentangling the influence of co‐occurring environmental factors on population dynamics, and is especially problematic for migratory species like Pacific salmon that move between ecosystems. To date, debate surrounding the causes of recent declines in Yukon River Chinook salmon (Oncorhynchus tshawytscha) abundance has centered on whether factors in freshwater or marine environments control variation in survival, and how these populations at the northern extremity of the species range will respond to climate change. To estimate the effect of factors in marine and freshwater environments on Chinook salmon survival, we constructed a stage‐structured assessment model that incorporates the best available data, estimates incidental marine bycatch mortality in trawl fisheries, and uses Bayesian model selection methods to quantify support for alternative hypotheses. Models fitted to two index populations of Yukon River Chinook salmon indicate that processes in the nearshore and marine environments are the most important determinants of survival. Specifically, survival declines when ice leaves the Yukon River later in the spring, increases with wintertime temperature in the Bering Sea, and declines with the abundance of globally enhanced salmon species consistent with competition at sea. In addition, we found support for density‐dependent survival limitations in freshwater but not marine portions of the life cycle, increasing average survival with ocean age, and age‐specific selectivity of bycatch mortality in the Bering Sea. This study underscores the utility of flexible estimation models capable of fitting multiple data types and evaluating mortality from both natural and anthropogenic sources in multiple habitats. Overall, these analyses suggest that mortality at sea is the primary driver of population dynamics, yet under warming climate Chinook salmon populations at the northern extent of the species’ range may be expected to fare better than southern populations, but are influenced by foreign salmon production.
Dermoscopic patterns of filiform papillae of the tongue in patients with and without connective tissue autoimmune diseases
Authors: Díaz‐González José Manuel , Vega‐Memije María E. , Mosqueda‐Taylor Adalberto , García‐Edgar Víctor Noé , Cuevas‐González Juan Carlos
Published: May 2018

Background

Connective tissue autoimmune diseases (CTADs) constitute a group of conditions, including rheumatoid arthritis; systemic lupus erythematosus; mixed connective tissue disease; calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome; scleroderma; dermatomyositis; and Sjögren syndrome. There are few studies on the alterations in filiform papillae in CTAD. Thus, the objective of this work was to determine whether there are changes in the macroscopic and dermoscopic patterns of filiform papillae.

Methods

This case–control study included patients who were diagnosed with CTAD. The dependent variable was the dermoscopic pattern of filiform papillae of the tongue, and the independent variables were age, gender, time of evolution, and current treatment. A photograph of the back of the tongue was taken, and subsequently, the same site was examined by dermatoscopy. The microscopic and dermoscopic patterns of filiform papillae were classified (Maeda).

Results

We included 50 cases and 50 controls, 94% of whom were female. The mean age was 43.96 ± 14.65 years. Of the cases with CTAD, 25% presented with a normal macroscopic pattern, versus 36% (18) with pattern II, 12% (6) with pattern III, and 20% (10) with pattern IV. The dermoscopic pattern was type I in 23 cases (46%), type II in 16 (32%), type III in 10 (20%), and type IV in one patient (2%).

Conclusions

We have noted alterations in filiform papillae in CTADs, which emphasizes the importance of a detailed intraoral exploration and the macroscopic and dermoscopic evaluation of the dorsum of the tongue, specifically the filiform papillae.
Ecology and biogeography in 3D: The case of the Australian Proteaceae
Authors: Pausas Juli G. , Lamont Byron B.
Published: May 2018

The key biophysical pressures shaping the ecology and evolution of species can be broadly aggregated into three dimensions: environmental conditions, disturbance regimes and biotic interactions. The relative importance of each dimension varies over time and space, and in most cases multiple dimensions need to be addressed to adequately understand the habitat and functional traits of species at broad spatial and phylogenetic scales. However, it is currently common to consider only one or two selective pressures even when studying large clades. We illustrate the importance of the all‐inclusive multidimensional approach with reference to the large and iconic plant family, Proteaceae: we review life‐history traits related to these three dimensions for the 46 genera occurring in Australia and show that this family can be considered the product of a long history of harsh environments, recurrent fires and strong faunal interactions. Because most Proteaceae species occur in fire‐prone ecosystems and possess fire‐adaptive traits that are both ancient and essential for their survival, disturbance by fire is likely to explain much of this family's ecology, evolution and distribution. Approaches that only examine prevailing environmental variables may fail to identify the mechanisms that drive a taxon's biogeography; they need to consider the likely mechanisms of adaptation and accept or reject plausible alternative hypotheses as the evidence allows. As multidisciplinary teams that consider all aspects of a taxon's ecology are assembled, and databases and numerical tools become increasingly available, studies on the ecology, biogeography and diversity of organisms at broader spatial and phylogenetic scales will arrive at more realistic conclusions.
Do long‐distance migratory birds track their niche through seasons?
Authors: Zurell Damaris , Gallien Laure , Graham Catherine H. , Zimmermann Niklaus E.
Published: May 2018

Aim

Seasonal migration by animals is an extensively studied, global phenomenon. Yet, we still lack a general understanding whether migrants track their niche between summer and winter ranges (following fixed environmental conditions throughout the year) and which mechanisms influence this behaviour. Here, we assessed the degree of seasonal niche tracking in Holarctic long‐distance migratory birds (n = 717; excluding very rare species) and evaluate the influence of biogeographic (regional and range characteristics) and ecological (trophic) factors on tracking.

Location

Global.

Taxon

Birds.

Methods

We calculated seasonal niche overlap by means of ordination, and estimated the degree of niche tracking using similarity tests. Niche tracking was evaluated for two different environmental predictor sets: climate and vegetation productivity (reflecting resource selection) versus climate and land cover (reflecting habitat choice). Multivariate phylogenetic regression was used to evaluate effects of biogeographic and ecological traits on niche tracking.

Results

We found significant niche tracking in 65–95% of species with a higher proportion of species significantly tracking climate and land cover compared to climate and vegetation productivity. Traits explained 12–18% of the variance in niche tracking with strong regional differences, a negative effect of migration distance and positive effects of range size on niche tracking. The effects of niche breadth and trophic traits were less pronounced and varied between environmental predictor sets.

Main conclusions

Our results indicate that at coarse spatial resolution, long‐distance migratory species tend to track their niche and select largely similar environments through seasons. Stronger niche tracking of land cover could reflect conservatism in habitat selection across seasons, for example for foraging and roosting. This conservatism towards land cover should be considered when making predictions to future environments. A better understanding of the factors that constrain seasonal range limits will be critical for predicting how migration patterns could respond to future environmental changes.
Towards evaluation criteria in participatory flood risk management
Authors: Maskrey S.A. , Priest S. , Mount N.J.
Published: May 2018

Flood risk consists of complex and dynamic problems, whose management calls for innovative ways of engaging with a wide range of local stakeholders, many of whom lack the technical expertise to engage with traditional flood risk management practices. Participatory approaches offer potential for involving these stakeholders in decision‐making, yet limited advice is available to users in choosing which techniques to employ and what they might expect them to deliver. Assessing the effectiveness of participatory approaches in local flood risk management is a critical step towards better understanding how community resilience is built. This article presents a framework for evaluating participatory approaches to flood risk management that covers four evaluation elements (context, process, substantive, and social outcomes). Practical success criteria are provided for evaluation, with references indicating where further advice and guidance can be sought. Criteria are tailored to the requirements of flood risk management, and aim to be sufficiently flexible for the framework to be easily transferable.
End‐of‐life trajectory of coping and self‐care of patients with idiopathic pulmonary fibrosis: A meta‐synthesis using meta‐ethnography
Authors: Igai Yasuko
Published: May 2018

Aim

This study aimed to extract patient narratives regarding the end‐of‐life trajectory of their self‐care and coping experiences as patients with idiopathic pulmonary fibrosis and to use meta‐ethnography to discover common metaphors of their experience in order to inform the development of nursing interventions.

Methods

A comprehensive search of qualitative research using electronic databases, in English and Japanese, regarding patients with IPF, identified four articles. The meta‐ethnography approach followed seven steps, which provided a synthesis of the phenomena from both comparative and cumulative analyses of the qualitative data.

Results

Seven key concepts and metaphors were synthesized: (i) an extended period before obtaining a diagnosis (“Waiting for the other shoe to drop”); (ii) suffering as the pathway of illness (“Gloom and doom”); (iii) the burden of the symptoms and loss of independence (“Staggering under the load”); (iv) acceptance and living with the restrictions of home oxygen therapy (“A double‐edged sword”); (v) changes in the family role (“All in the same boat”); (vi) existential suffering (“Dead‐end streets and rays of hope”); and (vii) challenges to maintain independent living (“Making the best of it”). Reciprocal, refutational, and line‐of‐argument modes of synthesis revealed the relationships of the metaphors. Meta‐ethnography provided a mechanism for a cumulative knowledge base for necessary nursing interventions.

Conclusions

The critical nursing interventions were: the relief of symptoms, particularly dyspnea and cough; coordinating lifestyle changes; providing psychological support for living with an illness beginning from the time of diagnosis; and carefully starting the end‐of‐life discussions with patients and families.
NonScarring Diffuse Hair Loss in Women: a Clinico‐Etiological Study from tertiary care center in North‐West India
Authors: Poonia Kavita , Thami Gurvinder Pal , Bhalla Mala , Jaiswal Shivani , Sandhu Jasleen
Published: May 2018

Background

Diffuse hair loss (DHL) is a common problem in adult women and has a major impact on quality of life. Ascertaining the etiological diagnosis is a challenging task in such patients. Satisfactory treatment can only be instituted after ascertaining the cause of hair loss.

Objective

To study the clinico‐epidemiological profile of nonscarring DHL in females and to ascertain its underlying etiological factors.

Study design

Of a total of 110 females, who presented with nonscarring DHL to the outpatient dermatology department, 100 qualified for inclusion in the study. A detailed history, clinical examination, and laboratory investigations were performed in all the patients. Statistical analysis was performed on the data collected.

Results

Of 100 cases of DHL which were included in the study, commonest was chronic telogen effluvium (CTE) (62%), followed by female pattern hair loss (FPHL) (22%) and acute telogen effluvium (ATE) (16%). Incidence of hair loss was highest in 21‐40 years age group. Psychological stress was seen to be a precipitating factor in 18 patients and found most commonly in women belong to CTE group (n‐16, 25.8%). Hemoglobin levels ranged from 80 to 142 gm/L (mean: 119 ± 110). Low hemoglobin level (<120 gm/L) was observed in 57% patients. Total serum ferritin <10 ng/mL was seen in 20 patients, vitamin B12 < 211 pg/mL in 76 cases, vitamin D3 < 30 ng/mL in 81 cases. Subclinical hypothyroidism was present in 11% cases.

Conclusions

Nonscarring DHL is a multifactorial condition with highest incidence in 21‐ to 40‐year age group. Serum ferritin, serum vitamin B12, and D3 levels seem to have a contributing role in the pathogenesis of hair loss, and their supplementation may be needed for a faster regrowth of hair in all cases of hair loss irrespective of the pattern.
The importance of reflecting on practice: How personal professional development activities affect perceived teamwork and performance
Authors: Welp Annalena , Johnson Anya , Nguyen Helena , Perry Lin
Published: May 2018

Aims and objectives

To examine the relationships between participation in personal professional development activities (e.g., coaching, mentoring), teamwork and performance; to investigate the mediating and moderating effects of reflective thinking and perceived usefulness of development activities.

Background

Professional development is associated with better performance and attitudes towards one's work. This study adds to this research by focusing on understanding this effect and the conditions under which this occurs.

Design

Cross‐sectional survey study.

Methods

Participants were 244 nurses working in a large, metropolitan acute public hospital. They completed a questionnaire consisting of validated measures and provided information on frequency of participation and perceived usefulness of personal professional development activities. We analysed data using regression‐based moderated mediation analyses.

Results

The relationship between frequency of participation in personal professional development activities and both perceived teamwork and performance was mediated by reflective thinking. Perceived usefulness of development activities moderated the relationship between frequency of participation in personal professional development activities and reflective thinking.

Conclusion

Our results highlight the importance of professional development activities that go beyond knowledge‐ or skill‐based training. Activities that cater to nurses’ personal professional development needs are also associated with more positively perceived teamwork and performance. Results provide insights into the mediating mechanisms: Participation in personal professional development activities encouraged reflective thinking, which was associated with better perceived teamwork and performance. This association between personal professional development activities and reflective thinking was even stronger where nurses perceived the activities as useful.

Relevance to clinical practice

Personal professional development activities enhance reflection in and on practice as these activities were linked with higher perceived quality of care and teamworking. It is important to ensure that the positive effects of personal professional development activities should target nurses’ professional development needs and need to be perceived as useful by those who undertake them.
Educational intervention on delirium assessment using confusion assessment method‐ICU (CAM‐ICU) in a general intensive care unit
Authors: Ramoo Vimala , Abu Harlinna , Rai Vineya , Surat Singh Surindar Kaur , Baharudin Ayuni Asma’ , Danaee Mahmoud , Thinagaran Raveena Rajalachimi R
Published: May 2018

Aims and Objectives

To assess intensive care unit nurses’ knowledge of intensive care unit delirium and delirium assessment before and after an educational intervention. In addition, nurses’ perception on the usefulness of a delirium assessment tool and barriers against delirium assessment were assessed as secondary objectives.

Background

Early identification of delirium in intensive care units is crucial for patient care. Hence, nurses require adequate knowledge to enable appropriate evaluation of delirium using standardised practice and assessment tools.

Design

This study, performed in Malaysia, used a single‐group pretest–posttest study design to assess the effect of educational interventions and hands‐on practices on nurses’ knowledge of intensive care unit delirium and delirium assessment.

Methods

Sixty‐one nurses participated in educational intervention sessions, including classroom learning, demonstrations and hands‐on practices on the Confusion Assessment Method‐Intensive Care Unit. Data were collected using self‐administered questionnaires for the pre‐ and postintervention assessments. Analysis to determine the effect of the educational intervention consisted of the repeated‐measures analysis of covariance.

Results

There were significant differences in the knowledge scores pre‐ and postintervention, after controlling for demographic characteristics. The two most common perceived barriers to the adoption of the intensive care unit delirium assessment tool were “physicians did not use nurses’ delirium assessment in decision‐making” and “difficult to interpret delirium in intubated patients”.

Conclusions

Educational intervention and hands‐on practices increased nurses’ knowledge of delirium assessment. Teaching and interprofessional involvements are essential for a successful implementation of intensive care unit delirium assessment practice.

Relevance to Clinical Practice

This study supports existing evidences, indicating that education and training could increase nurses’ knowledge of delirium and delirium assessment. Improving nurses’ knowledge could potentially lead to better delirium management practice and improve ICU patient care. Thus, continuous efforts to improve and sustain nurses’ knowledge become relevant in ICU settings.
Examining the relationship between traumatic growth and psychological resilience in young adult children of parents with and without a mental disorder
Authors: Ergün Gül , Gümüş Funda , Dikeç Gül
Published: May 2018

Aim and objectives

To investigate the relationship between traumatic growth and psychological resilience in young adult children of parents with a mental disorder and to compare them with young adult children of parents without mental disorders.

Background

Negative life experiences that lead to trauma can affect young adults' psychological resilience, either positively or negatively. This study investigates levels of traumatic growth, the characteristics of psychological resilience and the relationship between the former and latter in young adults between the ages of 18–23 who have parents with a mental disorder and who have parents without a mental disorder.

Design

This study was designed as a cross‐sectional, descriptive study and was conducted between June 1 and October 31, 2017.

Methods

The sample of the study consisted of young adult children of outpatients with mental disorders who applied to the Psychiatric Polyclinics of Burdur State Hospital (334) and young adult children of parents without mental disorders who applied to different polyclinics (332). A total of 666 individuals participated in the study.

Results

Comparative analyses showed a significant difference between the participants who had parents with a mental disorder and participants who had parents without mental disorders in terms of the mean scale scores and all subscale scores on the Post‐Traumatic Growth Inventory and Resilience Scale for Adults.

Conclusion

It was found that individuals who had parents without a mental disorder were negatively affected after traumatic events and that their psychological resilience was high.

Relevance to clinical practice

This study provides data on the characteristics of traumatic growth and psychological resilience levels of not only young adults whose parents have mental disorders but also young adults whose parents do not have mental disorders. In the light of this study's findings, psychiatric nurses may benefit from conducting early screening and intervention programmes to help increase the psychological resilience of young adults whose parents have mental disorders.
Development and psychometric evaluation of the Swedish propensity to achieve healthy lifestyle scale in patients with hypertension
Authors: Broström Anders , Pakpour Amir H , Ulander Martin , Nilsen Per
Published: May 2018

Purpose

To develop and validate a Swedish questionnaire to measure propensity for behaviour change regarding food habits, physical activity and weight reduction in patients with hypertension.

Design

Cross‐sectional design.

Methods

A total of 270 consecutive patients with hypertension diagnosed at four primary care centres in Sweden were included. The 6‐item Swedish version of the Propensity to Achieve Healthy Lifestyle Scale (PAHLS) was developed to measure propensity for behaviour change regarding food habits, physical activity and weight reduction. The PAHLS (i.e., including three items for preparedness and three items for capacity) was developed by three multiprofessional researchers inspired by the transtheoretical model of behaviour change in collaboration with clinically active nurses. Data were collected by questionnaires on food habits (i.e., the Food Frequency Questionnaire), physical activity (the International Physical Activity Questionnaire), propensity for a healthy lifestyle (the PHLQ), as well as during a clinical examination. Exploratory (EFA) and confirmatory factor analyses (CFA), as well as Rasch analysis, were used.

Results

Of the 270 patients (50% women), 27% scored low levels of physical activity on the International Physical Activity Questionnaire, and 34% of the patients were obese (body mass index ≥30 kg/m2). The EFA (explaining 54% of the variance) showed unidimensionality for the PAHLS that was supported by both CFA and Rasch analyses. No floor and 1.9% ceiling effects were found. Multiple group CFA (an extension of structural equation modelling) showed that the PAHLS operated equivalently across both male and female patients. Internal consistency (Cronbach's alpha 0.83) and composite reliability (0.89) were good.

Conclusion

The initial testing of PAHLS provided good validity and reliability scores to measure propensity for behaviour change in patients with hypertension.

Relevance to Clinical Practice

The PAHLS can be used by nurses as a tool to simplify shared decision‐making in relation to behavioural changes.
Serial Cohabitation in Young Adulthood: Baby Boomers to Millennials
Authors: Eickmeyer Kasey J. , Manning Wendy D.
Published: May 2018

Age at first marriage in the United States has consistently increased while age at cohabitation has stalled. These trends present an opportunity for serial cohabitation (multiple cohabiting unions). The authors argue that serial cohabitation must be measured among those at risk, who have ended their first cohabiting union. Drawing on data from the National Survey of Family Growth Cycle 6 (2002) and continuous (2006–2013) interview cycles, the authors find that serial cohabitation is increasing among women at risk. Millennials, born 1980 to 1984, had 50% higher rates of cohabiting twice or more after dissolving their first cohabitation. This increase is not driven by the composition of Millennials at risk for serial cohabitation. This work demonstrates the importance of clearly defining who is at risk for serial cohabitation when reporting estimates as well as continuing to examine how the associations between sociodemographic characteristics and serial cohabitation may shift over time.
First reports of a mass mortality event across multiple life stages in a mesopelagic jellyfish in high latitude coastal waters
Authors: Bozman Andrea , Aksnes Dag L. , Eiane Ketil
Published: May 2018

Mass mortality events can occur naturally and may have important ecological impacts on local populations. The abundance and stage structure of the coronate scyphozoan Periphylla periphylla in a Northern Norwegian fjord were studied between October 2010 and August 2011. Developmental stage composition varied for the duration of the study, with early developmental stages only present in the autumn and winter. Records of large number of dead P. periphylla across multiple life stages revealed that a mass mortality event occurred towards the end of the study period. The abundance of live medusa increased from 27 to 39 individuals (ind.)·1,000 m–3 from October 2010 to February 2011, then fell to <10 ind.·1,000 m–3 in August 2011. The estimated abundance of dead jellyfish increased from slightly >1 ind.·1,000 m–3 in October 2010 to >34 ind.·1,000 m–3 in August 2011, corresponding to an estimated population mortality of >80% on the last sampling date. Mortality increased as the length of high solar irradiance periods increased. Based on previous published evidence that strong light is harmful to P. periphylla, we speculate whether the light climate of this high latitude location may have contributed to the mass mortality of P. periphylla.
Pediatric marginal donor hearts: Trends in US national use, 2005‐2014
Authors: Morrison Adam K. , Gowda Charitha , Tumin Dmitry , Phelps Christina M. , Hayes Don , Tobias Joseph , Gajarski Robert J. , Nandi Deipanjan
Published: May 2018

Pediatric patients awaiting heart transplant face high mortality rates due to donor organ shortages, including non‐use of marginal donor hearts. We examined national trends in pediatric marginal donor heart use over time. UNOS data were queried for heart donors <18 years from 2005 to 2014. The proportion of donor hearts considered marginal was determined using previously cited marginal characteristics: left ventricular ejection fraction (LVEF) <50%, use of ≥2 inotropes, cerebrovascular death, CDC high‐risk status, and eGFR < 30 mL/min/1.73 m2. Disposition of donor hearts was determined and stratified by marginal donor status. Of 6778 pediatric hearts offered from 2005 to 2014, 2373 (35.0%) were considered marginal. Non‐use of marginal donor hearts was significantly higher than that of donor hearts without any marginal characteristics (59.5% vs 20.3%, P < .001). In particular, LVEF < 50% and donor inotropes were associated with high rates of organ non‐use among pediatric donors. Yet, non‐use of marginal donor organs decreased from 67% to 48% from 2005 to 2014 (P < .001). Although the proportion of pediatric donor hearts used for pediatric patients has increased, more than half of donor hearts are declined for use in pediatric recipients due, in part, to perceived marginal status.
Review of Humanitarian Refuge in the United Kingdom: Sanctuary, Asylum, and the Refugee Crisis
Authors: Ibrahim Yasmin , Howarth Anita
Published: May 2018

This article traces the U.K.'s tepid response to the recent refugee crisis confronting Europe today and reviews Britain's approach to provide sanctuary from its ideological/historical origins to its policy enactments over time (1905‐2016). That approach resonates with the deep tensions the issue of immigration raises within the nation state and the intense uncoupling of refuge and sanctuary from its humanitarian initiatives. We juxtapose the U.K. government's engagement with the refugee crisis against its “tradition of humanitarianism” in which Britain has idealized itself as sanctuary to those who have fled from persecution, torture, or conflict. This historic ideal of refuge has been challenged with numerous immigration and asylum‐related policies as well as increased securitization of border controls in response to the changing political context since 1905. We argue that “sanctuary” is a diminished and contentious component of its present‐day humanitarianism involving increased securitization and asylum policies with stringent immigration controls. We trace the U.K.'s harsh and restrictive stance toward the refugee and the asylum seeker through a series of policies from the Aliens Act in 1905 to the Dubs Amendment of 2016 which seek to delegitimize refugees, enact tighter barriers to entry, and cast them as economic “migrants” and as suspect figures in a post‐9/11 world.

Related Articles

Duman, Yoav H. 2014. “.” Politics & Policy 42 (): 187‐220. http://onlinelibrary.wiley.com/doi/10.1111/polp.12065/abstract

McKay, Fiona H.,
Lucy Hall, and
Kehla Lippi. 2017. “.” Politics & Policy 45 (): 169‐193. http://onlinelibrary.wiley.com/doi/10.1111/polp.12198/abstract

Silverman, Stephanie J. 2012. “‘.” Politics & Policy 40 (): 1131‐1157. http://onlinelibrary.wiley.com/doi/10.1111/j.1747-1346.2012.00393.x/abstract

Related Media

Gentleman, Amelia. 2015. “‘What Crime Have I Committed to be Held Like This?’: Yarl's Wood.” The Guardian. March 3. https://www.theguardian.com/uk-news/2015/mar/03/inside-yarls-wood-detention-centre-asylum-seekers-abuse-suicide

Polachowska, Maria. 2012. “Kindertransport: A Journey to Life.” BBC Newsnight. https://www.youtube.com/watch?v=XqP0uVSj3bQ

. 2017. “Global Trends: Forced Displacement in 2016.” http://www.unhcr.org/uk/statistics/unhcrstats/5943e8a34/global-trends-forced-displacement-2016.html
A Utility-Based Bayesian Phase I–II Design for Immunotherapy Trials with Progression-Free Survival End Point
Authors: Guo Beibei , Park Yeonhee , Liu Suyu
Published: May 2018

Immunotherapy has been hailed as the biggest breakthrough for treating cancer since the first development of chemotherapy. The new features of immunotherapy make the traditional clinical trial paradigm increasingly inefficient and dysfunctional. We propose a Bayesian phase I–II design for immunotherapy trials called BDFIT to find the optimal biological dose (OBD). We jointly model the toxicity outcome, progression-free survival (PFS) and immune response. PFS and toxicity are used as the primary end points to determine the OBD, whereas the immune response is used as an ancillary end point to screen out futile doses quickly and to predict the PFS when needed. A utility function is formulated to account for the risk–benefit trade-off and to quantify the desirability of the dose. During the trial, based on accumulating data, the estimates of the model and dose desirability are continuously updated and used to guide the dose assignment and to select the OBD. The simulation study shows that the BDFIT design has desirable operating characteristics.
Darboux Transformations and Global Explicit Solutions for Nonlocal Davey–Stewartson I Equation
Authors: Zhou Zi‐Xiang
Published: May 2018

For the nonlocal Davey–Stewartson I equation, the Darboux transformation is considered and explicit expressions of the solutions are obtained. Like other nonlocal equations, many solutions of this equation may have singularities. However, by suitable choice of parameters in the solutions of the Lax pair, it is proved that the solutions obtained from seed solutions which are zero and an exponential function of t, respectively, by a Darboux transformation of degree n are global solutions of the nonlocal Davey–Stewartson I equation. The derived solutions are soliton solutions when the seed solution is zero, in the sense that they are bounded and have n peaks, and “dark cross soliton” solutions when the seed solution is an exponential function of t, in the sense that they are bounded and their norms change fast along some crossing straight lines.
Endosperm sugar accumulation caused by mutation of PHS8/ISA1 leads to pre‐harvest sprouting in rice
Authors: Du Lin , Xu Fan , Fang Jun , Gao Shaopei , Tang Jiuyou , Fang Shuang , Wang Hongru , Tong Hongning , Zhang Fengxia , Chu Jinfang , Wang Guodong , Chu Chengcai
Published: May 2018

Pre‐harvest sprouting (PHS) is an unfavorable trait in cereal crops that could seriously decrease grain yield and quality. Although some PHS‐associated quantitative trait loci or genes in cereals have been reported, the molecular mechanism underlying PHS remains largely elusive. Here, we characterized a rice mutant, phs8, which exhibits PHS phenotype accompanied by sugary endosperm. Map‐based cloning revealed that PHS8 encodes a starch debranching enzyme named isoamylase1. Mutation in PHS8 resulted in the phytoglycogen breakdown and sugar accumulation in the endosperm. Intriguingly, with increase of sugar contents, decreased expression of OsABI3 and OsABI5 as well as reduced sensitivity to abscisic acid (ABA) were found in the phs8 mutant. Using rice suspension cell system, we confirmed that exogenous sugar is sufficient to suppress the expression of both OsABI3 and OsABI5. Furthermore, overexpression of OsABI3 or OsABI5 could partially rescue the PHS phenotype of phs8. Therefore, our study presents important evidence supporting that endosperm sugar not only acts as an essential energy source for seed germination but also determines seed dormancy and germination by affecting ABA signaling.