bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the ways experienced nurses in Poland view their profession: a focus group study
Authors: Marcinowicz L. , Owlasiuk A. , Perkowska E.
Published: June 2016

Aims

To conduct an in‐depth analysis to understand how Polish nurses perceive their profession from the perspective of the jobs they perform and their experiences connected with the work.

Background

Although there are general educational standards in the nursing profession, nurses worldwide perform their jobs under different systems and cultural conditions. Exploring and describing how experienced nurses view their profession can contribute to recommendations on how to promote the image of the profession and can assist in recruiting new nurses.

Methods

A descriptive, explorative qualitative study was conducted. Focus groups (n = 6) were organized involving nurses (n = 60) who had between 8 and 33 years of work experience.

Findings

Data analysis revealed four main themes and ten sub‐themes: (i) the role of the nurse (idealistic view of a nurse's work before starting the job, realistic perception of the profession while doing the job); (ii) respect for a nurse (nurses’ attitudes towards one another, doctors’ attitudes towards nurses, patients’ and their families’ attitudes towards nurses); (iii) gender issues (stereotypes, favouritism towards male nurses); (iv) prestige of the profession (prestige of the nursing profession in society, remuneration, nurses’ choice of a future profession for their children).

Discussion

The study demonstrates that there is a huge discrepancy between the commonly held image of the nursing profession and the reality of the nurse's job. The idealistic view that it is a “clean” job in which the nurse only gives injections is not reflected in the actual duties.

Conclusion and implications for nursing and health policy

The findings revealed factors which influence the perception of the nursing profession in Poland, that is the system of education, professional experience and the current situation in which nurses perform their roles. Nurses’ current perception of the job may have negative consequences both for nurses themselves (e.g. burnout) and for the whole profession (e.g. negative selection). Nurses should aim to fulfil leadership roles and participate in the management of health policy so as to have greater influence on healthcare planning.
Role confusion as a barrier to effective carer involvement for people with intellectual disabilities in acute hospitals: findings from a mixed‐method study
Authors: Tuffrey‐Wijne Irene , Abraham Elisabeth , Goulding Lucy , Giatras Nikoletta , Edwards Christine , Gillard Steve , Hollins Sheila
Published: June 2016

Aims

To understand issues around carer roles that affect carer involvement for people with intellectual disabilities in acute hospitals.

Background

There is evidence that a lack of effective carer involvement can lead to poorer health outcomes for people with intellectual disabilities, but there is a lack of insight into the reasons for poor carer involvement in acute hospitals.

Design

Mixed methods in six acute hospital trusts in England (2011–2013).

Methods

Electronic hospital staff survey (n = 990), carer questionnaires (n = 88), semi‐structured interviews with hospital staff (n = 68) and carers (n = 37). Data were triangulated and analysed using a conceptual framework.

Results

There was strong support for carer involvement among hospital staff, and most carers indicated that they felt welcomed and supported. However, an investigation of negative experiences showed that there were discrepancies in the perspectives of hospital staff and carers on the scope of ‘carer involvement’. An important contributory factor to the effectiveness of carer involvement was the degree to which staff understood the importance of carer expertise (rather than simply carer work) and welcomed it. Carers’ contributions to basic nursing care tasks could be taken for granted by hospital staff, sometimes erroneously.

Conclusion

The roles and contributions of carers should be clarified on an individual basis by hospital staff. The authors propose a new model to support this clarification. Further research is needed to assess the suitability of the model for patients with intellectual disabilities and other vulnerable patient groups.
Performance indicators; the association between the quality of preventive care and the prevalence of hospital‐acquired skin lesions in adult hospital patients
Authors: van Dishoeck Anne‐Margreet , Looman Caspar W.N. , Steyerberg Ewout W. , Halfens Ruud J.G. , Mackenbach Johan P.
Published: June 2016

Aim

The aim of this study was to explore the relation between the occurrence of pressure ulcers or incontinence dermatitis and the quality of preventive care provided.

Background

Performance measurements using indicators has become standard practice in recent years. The prevalence of pressure ulcers with or without incontinence dermatitis is widely used as an indicator of the quality of nursing care.

Design

Matched case–control study.

Methods

We collected information on 132 patients selected from a prevalence study (April 2010). We matched 88 controls to 44 cases, controlling for duration of hospitalization and type of nursing unit. We wrote 132 patient reports, including patient factors and process criteria, using a chart review. Five expert teams assessed nine processes of care with guideline‐based review criteria. The expert teams assessed the reports blinded for outcome. The care process was assessed using a four‐point quality score ranging from optimal care to suboptimal care.

Results

In a multivariable analysis using conditional logistic regression, the pressure ulcer risk score and the quality score were associated with a poor outcome after adjustment for type of illness, age, care needs prior to hospitalization, intensive care stay during admission and the number of care problems.

Conclusion

We found that the development of pressure ulcers or incontinence dermatitis was associated with the quality of the preventive care process, indicating that variation in their prevalence reflects variation in the quality of care.
Against the Political Exclusion of the Incapable
Authors: Munn Nicholas John
Published: June 2016

Political exclusion on grounds of incapacity is the primary remaining source of exclusion from the franchise. It is appealed to by states and theorists alike to justify excluding young people (under 18) and many people with cognitive disability from the franchise. Defenders of this exclusion claim that no wrong is done by this exclusion and that states gain some significant benefits from this restricting of the franchise. I have argued elsewhere that political exclusion as currently practiced in modern liberal democratic states in fact causes significant harms, as it excludes some people who have the relevant capacity for political participation. Here, I argue that the exclusion of incapable actors prevents no significant harms to democratic outcomes, and that it confers no significant democratic benefits on the states practising this exclusion. As such, I argue that we ought to heavily modify and perhaps even abandon the capacity standard for political inclusion.
An Exploration of Comfort and Discomfort Amongst Children and Young People with Intellectual Disabilities Who Depend on Postural Management Equipment
Authors: Lyons Elizabeth A. , Jones Diana E. , Swallow Veronica M. , Chandler Colin
Published: June 2016

Background

The natural response to the intrusive bodily sensation is positional change. This study explored how children and young people (CYP) with intellectual disabilities had their comfort needs met when using adaptive positioning equipment.

Methods

Thirteen qualitative case studies were undertaken. A parent, a teacher/key worker and a therapist for each CYP were interviewed, and daily routines were observed, with selective video recording. Single case and cross case analyses were undertaken.

Results

Attentive caregivers read the behavioural expressions of the CYP and responded reassuringly, safeguarding them from discomforting experiences. Threats to comfort include the restrictive nature of some equipment accessories, positioning errors and procedural stretching.

Conclusions

The same item of equipment can be both comfortable and uncomfortable. Given the social and interactional world in which the CYP live and learn, it is others who must accept responsibility for ensuring their optimal level of comfort.
Traditional livestock breeding practices of men and women Somali pastoralists: trait preferences and selection of breeding animals
Authors: Marshall K. , Mtimet N. , Wanyoike F. , Ndiwa N. , Ghebremariam H. , Mugunieri L. , Costagli R.
Published: June 2016

Somalia, one of the world's poorest countries, has livestock as the mainstay of the economy, with an estimated 65% of the population engaged in the livestock sector. This paper presents a gendered study on the traditional livestock breeding practices of Somali pastoralists for camels, cattle, sheep and goats, with a focus on documenting livestock traits of importance, the criteria used to select male breeding animals and the criteria used to cull female breeding animals. Data for the study were obtained by performing participatory rural appraisals (PRAs) with separate male and female pastoral groups from 20 settlements of the Tog‐Dheer region of Somaliland (in north‐western Somalia). In total, more than 500 pastoralists were involved. In terms of livestock ownership, goats were the most common species kept (97% of all households), followed by sheep (64%), camels (37%) and cattle (9%), with considerable herd size variation across households. Traits of key importance to the pastoralists varied by species and gender of the PRA group, but included adaptedness to harsh environmental conditions, high market value/high meat production and high milk production. The pastoralists practised sensible criteria for the selection of male breeding animals for all species, capturing aspects of productivity (milk yield, reproduction), adaptedness (good hardiness) and marketability (body size and conformation). Similarly, they practised sensible criteria for culling of female breeding animals, with females removed from the herd primarily for poor performance, but also to meet the livelihood needs of the family. Differences in the selection and culling criteria were noted by species, as well as gender of the pastoralists. On the whole, there was strong alignment between the livestock selection criteria used by the Somali pastoralists, their reasons for keeping livestock and the market requirements. This is not surprising given the intimate and long‐standing relationship between Somali pastoralists and their livestock.
Asymmetrical proliferative pattern loss linked to cyclin D1 overexpression during malignant transformation of the lip epithelium
Authors: Garcia N.G. , González‐Moles M.A. , Ruiz‐Ávila I. , Bravo M. , Ramos‐García P. , Minicucci E.M. , Domingues M.A.C. , Oliveira D.T.
Published: June 2016

Background

There is inadequate knowledge on the involvement of oncogenic mechanisms linked to the cyclin (CCND1) gene in lip squamous cell carcinoma (LSCC).

Objective

The aim of this study was to analyse the implication of cyclin D1 in the malignant transformation of lip lesions.

Methods

We immunohistochemically studied 45 actinic cheilitis cases (15 mild dysplasia, 15 moderate dysplasia, 15 severe dysplasia/carcinoma in situ), 30 LSCC cases with adjacent non‐tumour epithelium and 15 normal oral epithelium samples for detection of cyclin D1, β‐catenin and Ki‐67.

Results

Cyclin D1 and Ki‐67 expressions were significantly increased in the basal layer of premalignant epithelia and peripheral layers of tumour nests vs. controls. Premalignant epithelia had lost their asymmetrical proliferative pattern.

Conclusion

Lip carcinogenesis was associated with loss of the asymmetrical proliferative pattern, a preventive mechanism against lip oncogenesis, and with cyclin D1 overexpression.
New‐onset vitiligo and progression of pre‐existing vitiligo during treatment with biological agents in chronic inflammatory diseases
Authors: Méry‐Bossard L. , Bagny K. , Chaby G. , Khemis A. , Maccari F. , Marotte H. , Perrot J.L. , Reguiai Z. , Sigal M.L. , Avenel‐Audran M. , Boyé T. , Grasland A. , Gillard J. , Jullien D. , Toussirot E.
Published: June 2016

Background

The development of vitiligo during treatment with biological agents is an unusual event and only a few isolated cases have been reported.

Objectives

To describe the clinical characteristics and evolution of patients developing new‐onset vitiligo following initiation of a biological agent for chronic inflammatory disease; and also to report the clinical course of pre‐existing vitiligo under biological therapy.

Methods

This nationwide multicentre, retrospective study, carried out between July 2013 and January 2015, describes the characteristics of a large series of 18 patients (psoriasis N = 8, inflammatory rheumatic diseases N = 8, ulcerative colitis N = 1, uveitis N = 1) who developed new‐onset vitiligo while receiving a biological agent.

Results

TNFα inhibitors were the most common biological agent involved (13/18) while anti‐IL‐12/23 and anti‐IL‐17 agents or abatacept were less common (4/18 and 1/18 respectively). Mean duration of biological agent exposure before vitiligo onset was 13.9 ± 16.5 months. Outcome was favourable for most patients (15/17) while maintaining the biological agent. Data were also collected for 18 patients (psoriasis N = 5, inflammatory rheumatic diseases N = 10, inflammatory bowel diseases N = 2, SAPHO N = 1) who had pre‐existing vitiligo when treatment with a biological agent started (TNFα inhibitors N = 15, ustekinumab N = 1, rituximab N = 1, tocilizumab N = 1). Vitiligo progressed in seven patients and was stable or improved in eight cases.

Conclusion

Vitiligo may thus emerge and/or progress during treatment with various biological agents, mainly TNFα inhibitors and could be a new paradoxical skin reaction. De novo vitiligo displays a favourable outcome when maintaining the biological agent, whereas the prognosis seems worse in cases of pre‐existing vitiligo.
Do daily ward interviews improve measurement of hospital quality and safety indicators? A prospective observational study
Authors: Sarkies Mitchell N. , Bowles Kelly‐Ann , Skinner Elizabeth H. , Haas Romi , Mitchell Deb , O'Brien Lisa , May Kerry , Ghaly Marcelle , Ho Melissa , Haines Terry P.
Published: June 2016

Rationale, aims and objectives

The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under‐reporting of hospital quality and safety indicators in incident reporting systems.

Methods

A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub‐acute and acute medical assessment unit.

Results

An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% (n = 72), pressure injuries by 21.7% (n = 48) and rapid response medical team calls by 12.7% (n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday (P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday (P = 0.01).

Conclusions

Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under‐reported in incident reporting systems, with variability in under‐reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety indicators.
Can we identify termination of resuscitation criteria in cardiac arrest due to drowning: results from the French national out‐of‐hospital cardiac arrest registry
Authors: Hubert Hervé , Escutnaire Joséphine , Michelet Pierre , Babykina Evgéniya , El Khoury Carlos , Tazarourte Karim , Vilhelm Christian , El Hiki Lahcen , Guinhouya Benjamin , Gueugniaud Pierre‐Yves ,   on behalf GR‐RéAC
Published: June 2016

Rationale, aims and objectives

The aim of this study was to describe the cohort of persons having experiences fatal and non‐fatal drowning events, registered in the French cardiac arrest registry and to identify termination of resuscitation criteria.

Methods

We performed a prospective multicenter study based on data from French cardiac arrest registry database. All patients with cardiac arrest after drowning (CAD) recorded between July 2011 and November 2014 were included. The population description was carried out by medians [interquartile ranges (IQR)] or frequencies. The characteristics were compared in terms of the primary endpoint (alive vs dead at hospital admission) using chi‐square or Fisher's exact and the Mann–Whitney U test. The predictive model was carried out using the multivariate logistic regression.

Results

The analysis included 234 CAD. The majority of patients were adults (83.6%) and males (64.5%). Most of the submersions occurred out of home (75.6%). We recorded 66.7% of incidents in fresh water. About a third of CAD was witnessed of which 33.8% had an immediate basic life support. Most of CAD patients received an advanced cardiac life support (87.2%). The median Mobile Medical Team response time was 22 [15–30] minutes. At hospital, 40.6% of patients were alive. Twenty one patients (9.0%) were discharged alive. Among them, 17 had a good neurological outcome. Faster interventions generally resulted in higher survival chances (Mobile Medical Team response time OR: 0.960[0.925; 0.996]; P = 0.0.031; no flow duration OR: 0.535[0.313; 0.913]; P = 0.022) if associated with ventilation (OR: 6.742[2.043; 22.250]; P = 0.002). Age (OR: 0.971[0.955; 0.988]; P = 0.001) and location outside (OR: 0.203[0.064; 0.625]; P = 0.007) are the other criteria of our model.

Conclusions

The model is helpful to highlight explanative variables concerning CAD patients' outcome. The next step is the validation of these five factors by a larger study. Prevention and public training to lifesaving behaviours must be considered as priorities in French public health programmes.
Unexpected female preference for smaller males in the marbled goby Pomatoschistus marmoratus
Authors: Locatello L. , Mazzoldi C. , Santon M. , Sparaciari S. , Rasotto M. B.
Published: June 2016

The study tested the role of body size and of nest size in female mate choice in the marbled goby, Pomatoschistus marmoratus. The results show a female preference for smaller males, supporting the idea that smaller males may be preferred to larger ones in the absence of male–male competition. No effect of nest size was detected, suggesting that other nest characteristics, beyond nest size, may be implicated.
Anticholinergic Medication Use and Risk of Fracture in Elderly Adults with Depression
Authors: Chatterjee Satabdi , Bali Vishal , Carnahan Ryan M. , Chen Hua , Johnson Michael L. , Aparasu Rajender R.
Published: June 2016

Limited research exists regarding the effect of anticholinergics on falls and fractures in elderly nursing home residents in the United States. This study examined the risk of fractures associated with anticholinergic medication use in elderly nursing home residents with depression. A nested case‐control design involving a cohort of elderly adults with depression from the 2007 to 2010 Minimum Data Set (MDS)–linked Medicare data was used to evaluate the risk of fractures. The study sample included Medicare beneficiaries aged 65 and older diagnosed with depression having at least one nursing home stay during 2007 to 2010 and no history of falls or fractures in 2007 (base period). Cases were individuals with incident fractures after the baseline period. For each case, four age‐ and sex‐matched controls were selected using incidence density sampling. Anticholinergic exposure was defined using the Anticholinergic Drug Scale (ADS). Prescription of Level 2 or 3 anticholinergic medications within 30 days before the event date was the primary exposure. The primary outcome was an inpatient or outpatient claim for a fracture between January 1, 2008, and December 31, 2010. A conditional logistic regression model stratified on matched case‐control sets was used to evaluate association between anticholinergic use and fractures, controlling for other risk factors of the outcome. The study sample consisted of 40,452 individuals with fractures and 161,808 matched controls. After adjusting for other risk factors, high‐level anticholinergic use was associated with 14% greater fracture risk than nonuse (odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.11–1.17). The high risk of fractures remained consistent across levels of anticholinergic potency (Level 2, OR = 1.15, 95% CI = 1.11–1.19; Level 3, OR = 1.10, 95% CI = 1.07–1.15). The study findings remained consistent in multiple sensitivity analyses. Overall, use of high‐level anticholinergic medications was associated with greater risk of fracture than no use in elderly adults with depression. Given safety concerns, there is a need to optimize anticholinergic use in elderly adults.
Association Between Mortality and Heritability of the Scale of Aging Vigor in Epidemiology
Authors: Sanders Jason L. , Singh Jatinder , Minster Ryan L. , Walston Jeremy D. , Matteini Amy M. , Christensen Kaare , Mayeux Richard , Borecki Ingrid B. , Perls Thomas , Newman Anne B. ,   The Long Life Family Study Research Group
Published: June 2016

Objectives

To investigate the association between mortality and heritability of a rescaled Fried frailty index, the Scale of Aging Vigor in Epidemiology (SAVE), to determine its value for genetic analyses.

Design

Longitudinal, community‐based cohort study.

Setting

The Long Life Family Study (LLFS) in the United States and Denmark.

Participants

Long‐lived individuals (N = 4,875, including 4,075 genetically related individuals) and their families (N = 551).

Measurements

The SAVE was administered to 3,599 participants and included weight change, weakness (grip strength), fatigue (questionnaire), physical activity (days walked in prior 2 weeks), and slowness (gait speed); each component was scored 0, 1, or 2 using approximate tertiles, and summed (range 0 (vigorous) to 10 (frail)). Heritability was determined using a variance component–based family analysis using a polygenic model. Association with mortality in the proband generation (N = 1,421) was calculated using Cox proportional hazards mixed‐effect models.

Results

Heritability of the SAVE was 0.23 (P < .001) overall (n = 3,599), 0.31 (P < .001) in probands (n = 1,479), and 0.26 (P < .001) in offspring (n = 2,120). In adjusted models, higher SAVE scores were associated with higher mortality (score 5–6: hazard ratio (HR) = 2.83, 95% confidence interval (CI) = 1.46–5.51; score 7–10: HR = 3.40, 95% CI = 1.72–6.71) than lower scores (0–2).

Conclusion

The SAVE was associated with mortality and was moderately heritable in the LLFS, suggesting a genetic component to age‐related vigor and frailty and supporting its use for further genetic analyses.
Effect of Statin Therapy on Mortality in Older Adults Hospitalized with Coronary Artery Disease: A Propensity‐Adjusted Analysis
Authors: Rothschild Daniel P. , Novak Eric , Rich Michael W.
Published: June 2016

Objectives

To examine the effect of statins on long‐term mortality in older adults hospitalized with coronary artery disease (CAD).

Design

Retrospective analysis.

Setting

University teaching hospital.

Participants

Individuals aged 80 and older (mean aged 85.2, 56% female) hospitalized from January 2006 to December 2010 with acute myocardial infarction (AMI), unstable angina pectoris, or chronic CAD and discharged alive (N = 1,262). Participants were divided into those who did (n = 913) and did not (n = 349) receive a discharge prescription for a statin.

Measurements

All‐cause mortality over a median follow‐up of 3.1 years.

Results

Participants treated with statins were more likely to be male, to have a primary diagnosis of AMI, to have traditional cardiovascular risk factors, and to receive other standard cardiovascular medications in addition to statins. In unadjusted analysis, statin therapy was associated with lower mortality (hazard ratio (HR) = 0.83, 95% confidence interval (CI) = 0.71–0.96). After adjustment for baseline differences between groups and propensity for receiving statin therapy, the effect of statins on mortality was no longer significant (HR = 0.88, 95% CI = 0.74–1.05). The association between statins and mortality was similar in participants aged 80 to 84 and those aged 85 and older.

Conclusion

In this cohort of older adults hospitalized with CAD, statin therapy had no significant effect on long‐term survival after adjustment for between‐group differences. These findings, although preliminary, call into question the benefit of statin therapy for secondary prevention in a real‐world population of adults aged 80 and older and underscore the need for shared decision‐making when prescribing statins in this age group.
Mortality in Individuals Aged 80 and Older with Type 2 Diabetes Mellitus in Relation to Glycosylated Hemoglobin, Blood Pressure, and Total Cholesterol
Authors: Hamada Shota , Gulliford Martin C.
Published: June 2016

Objectives

To evaluate whether low glycosylated hemoglobin (HbA1c), blood pressure (BP), and total cholesterol (TC) are associated with lower risk of all‐cause mortality in very old individuals with type 2 diabetes mellitus.

Design

Population‐based cohort study.

Setting

Primary care database in the United Kingdom.

Participants

Individuals aged 80 and older with type 2 diabetes mellitus (N = 25,966).

Measurements

Associations between baseline HbA1c, BP, and TC and all‐cause mortality were evaluated in Cox proportional hazards models. Analyses were adjusted for sex, age, duration of diabetes mellitus, lifestyle variables, HbA1c, BP, TC, comorbidities, prescribing of antidiabetic and cardiovascular drugs, and participants’ general practice.

Results

There were 4,490 deaths during follow‐up (median 2.0 years; mortality 104.7 per 1,000 person‐years). Mortality in participants with low (<6.0% (<42 mmol/mol)) or high (≥8.5% (≥69 mmol/mol)) HbA1c was similar to that in those with the reference HbA1c (8.0–8.4% (64–68 mmol/mol)). Mortality was lowest in individuals with HbA1c of 7.0–7.4% (53–57 mmol/mol) (80.9 per 1,000 person‐years, adjusted hazard ratio (aHR) = 0.80, 95% confidence interval (CI) = 0.70–0.91, P = .001). Mortality was higher in individuals with lower BP (e.g., <130/70 mmHg, 151.7 per 1,000 person‐years, aHR = 1.52, 95% CI = 1.34–1.72, P < .001 vs reference BP <150/90 mmHg) and in the lowest TC category (<3.0 mmol/L, 138.7 per 1,000 person‐years, aHR = 1.42, 95% CI = 1.24–1.64, P < .001 vs reference TC 4.5–4.9 mmol/L). The relationship between TC and mortality varied according to sex and prescription of lipid‐lowering drugs.

Conclusion

Low HbA1c, BP, and TC may be associated with higher mortality in very old adults with type 2 diabetes mellitus. Further research is required to understand these associations and to identify optimal treatment targets in this population.
Warfarin Treatment and All‐Cause Mortality in Community‐Dwelling Older Adults with Atrial Fibrillation: A Retrospective Observational Study
Authors: Pilotto Alberto , Gallina Pietro , Copetti Massimiliano , Pilotto Andrea , Marcato Francesco , Mello Anna M. , Simonato Matteo , Logroscino Giancarlo , Padovani Alessandro , Ferrucci Luigi , Panza Francesco ,   the Multidimensional Prognostic Index_Age Project Investigators
Published: June 2016

Objectives

To investigate the relationship between warfarin treatment and different strata of all‐cause mortality risk assessed using the Multidimensional Prognostic Index (MPI) based on information collected using the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA) in community‐dwelling older adults with atrial fibrillation (AF).

Design

Retrospective observational study.

Setting

Older community‐dwelling adults who underwent a SVaMA evaluation establishing accessibility to homecare services and nursing home admission from 2005 to 2013 in the Padova Health District, Italy.

Participants

Community‐dwelling individuals with AF aged 65 and older (N = 1,827).

Measurements

Participants were classified as being at mild (MPI‐SVaMA‐1), moderate (MPI‐SVaMA‐2), or severe (MPI‐SVaMA‐3) risk of mortality using the MPI‐SVaMA, a validated prognostic tool based on age, sex, comorbidity, cognitive status, mobility and functional disability, pressure sore risk, and social support. The association between warfarin treatment and mortality was tested using multivariate‐ and propensity score–adjusted Cox regression models, controlling for age, sex, all SVaMA domains, concomitant diseases, and drug treatments.

Results

Higher MPI‐SVaMA scores were associated with lower rates of warfarin treatment and higher 3‐year mortality. After adjustment for propensity score quintiles, warfarin treatment was significantly associated with lower 2‐year mortality in individuals with MPI‐SVaMA‐1 (hazard ratio (HR) = 0.64, 95% confidence interval (CI) = 0.50–0.82), MPI‐SVaMA‐2 (HR = 0.68, 95% CI = 0.55–0.85), and MPI‐SVaMA‐3 (HR = 0.55, 95% CI = 0.44–0.67). Heterogeneity analyses confirmed that the effect of warfarin treatment was not different between MPI‐SVaMA groups (P for heterogeneity = .48).

Conclusion

Community‐dwelling older adults with AF benefitted from anticoagulation in terms of lower all‐cause mortality over a mean follow‐up of 2 years, regardless of poor health and functional condition. Although this benefit can be ascribed to the treatment, it may also reflect better overall care.
Indigenous Names, Revitalization Politics, and Regimes of Recognition in the Northwest Amazon
Authors: Shulist Sarah
Published: June 2016

Este artigo analisa como as práticas do estado e os movimentos de valorização cultural estão contribuindo para a mudança da identidade indígena e das práticas culturais dos povos tukano e baré no Noroeste da Amazônia. Considerou‐se como as políticas de reconhecimento e autenticidade usada pelo estado em relação aos nomes indígenas, interagem com o esforço de valorizar e revitalizar as línguas e culturas minoritárias. Demonstrou‐se que, para cada um desses diferentes grupos indígenas, tanto nas ideias quanto nas práticas culturais em relação aos nomes indígenas e as identidades apresentadas podem ser vistas grandes mudanças devido aos novos sentidos políticos aos quais são ligados.
Neonatal hydrocephalus is a result of a block in folate handling and metabolism involving 10‐formyltetrahydrofolate dehydrogenase
Authors: Naz Naila , Jimenez Alicia Requena , Sanjuan‐Vilaplana Anna , Gurney Megan , Miyan Jaleel
Published: June 2016

Folate is vital in a range of biological processes and folate deficiency is associated with neurodevelopmental disorders such as neural tube defects and hydrocephalus (HC). 10‐formyl‐tetrahydrofolate‐dehydrogenase (FDH) is a key regulator for folate availability and metabolic interconversion for the supply of 1‐carbon groups. In previous studies, we found a deficiency of FDH in CSF associated with the developmental deficit in congenital and neonatal HC. In this study, we therefore aimed to investigate the role of FDH in folate transport and metabolism during the brain development of the congenital hydrocephalic Texas (H‐Tx) rat and normal (Sprague–Dawley) rats. We show that at embryonic (E) stage E18 and E20, FDH‐positive cells and/or vesicles derived from the cortex can bind methyl‐folate similarly to folate receptor alpha, the main folate transporter. Hydrocephalic rats expressed diminished nuclear FDH in both liver and brain at all postnatal (P) ages tested (P5, P15, and P20) together with a parallel increase in hepatic nuclear methyl‐folate at P5 and cerebral methylfolate at P15 and P20. A similar relationship was found between FDH and 5‐methyl cytosine, the main marker for DNA methylation. The data indicated that FDH binds and transports methylfolate in the brain and that decreased liver and brain nuclear expression of FDH is linked with decreased DNA methylation which could be a key factor in the developmental deficits associated with congenital and neonatal HC.

image

Folate deficiency is associated with neurodevelopmental disorders such as neural tube defects and hydrocephalus. 10‐formyl‐tetrahydrofolate‐dehydrogenase (FDH) is a key regulator for folate availability and metabolic interconversion. We show that FDH binds and transports methylfolate in the brain. Moreover, we found that a deficiency of FDH in the nucleus of brain and liver is linked with decreased DNA methylation which could be a key factor in the developmental deficits associated with congenital and neonatal hydrocephalus cells.
Externalizing Problem Behavior in Adolescence: Parenting Interacting With DAT1 and DRD4 Genes
Authors: Janssens Annelies , Van Den Noortgate Wim , Goossens Luc , Colpin Hilde , Verschueren Karine , Claes Stephan , Van Leeuwen Karla
Published: June 2016

This study extends previous gene‐by‐environment (G × E) research through design and methodological advances and examines alternative hypotheses of diathesis stress, vantage sensitivity, and differential susceptibility. In a sample of 984 adolescents and their parents, we examined whether effects of parental support, proactive, punitive, harsh punitive, and psychological control on externalizing problem behavior are moderated by adolescents' genotype for the dopamine transporter (DAT1) or receptor D4 (DRD4) gene. Results provided evidence for main effects of parenting behavior and DRD4, and multiple interaction effects of which one survived Bonferroni correction. Adolescents carrying a long DRD4 variant were more susceptible to the effects of parental proactive control on aggression, for better and for worse. Critical considerations were made regarding the complexity of G × E research.
Antihyperalgesic effects of dexketoprofen and tramadol in a model of postoperative pain in mice – effects on glial cell activation
Authors: Romero-Alejo Elizabeth , Puig Margarita M , Romero Asunción
Published: June 2016

Objectives

To define likely targets (i.e. glia) and protocols (analgesic combinations) to improve postoperative pain outcomes and reduce chronic pain after surgery. Specifically, to assess the antihyperalgesic effects of the dexketoprofen : tramadol (DEX : TRM) combination, exploring the implication of glial activation.

Methods

In a mouse model of postincisional pain, we evaluated mechanical nociceptive thresholds (Von Frey) for 21 days postoperatively. We assessed DEX and TRM alone and combined (1 : 1 ratio) on postoperative hyperalgesia (POH, day 1) and delayed latent pain sensitisation (substantiated by a naloxone challenge; PS, day 21). The interactions were analysed using isobolograms, and concomitant changes in spinal glial cell activation were measured.

Key findings

On day 1, DEX completely blocked POH, whereas TRM induced 32% inhibition. TRM, but not DEX, partially (47%) protected against PS, at 21 days. Co-administration of DEX : TRM (1 : 1 ratio) showed additivity for antihyperalgesia. Both drugs and their combination totally inhibited surgery-induced microglia activation on day 1, but had no effect on surgery-induced astrocyte activation (1 day) or re-activation after naloxone (21 days).

Conclusions

The DEX : TRM combination could have clinical advantages: a complete prevention of POH after surgery, together with a substantial (48%) inhibition of the development of PS by TRM. Microglia, but not astrocyte activation, could play a relevant role in the development of postoperative pain hypersensitivity.
Sleep restriction can attenuate prioritization benefits on declarative memory consolidation
Authors: Lo June C. , Bennion Kelly A. , Chee Michael W. L.
Published: June 2016

As chronic sleep restriction is a widespread problem among adolescents, the present study investigated the effects of a 1‐week sleep restriction (SR) versus control period on the consolidation of long‐term memory for prose passages. We also determined whether the benefit of prioritization on memory is modulated by adequate sleep occurring during consolidation. Fifty‐six healthy adolescents (25 male, aged 15–19 years) were instructed to remember a prose passage in which half of the content was highlighted (prioritized), and were told that they would receive an additional bonus for remembering highlighted content. Following an initial free recall test, participants underwent a 7‐night period in which they received either a 5‐h (SR) or 9‐h (control) nightly sleep opportunity, monitored by polysomnography on selected nights. Free recall of the passage was tested at the end of the sleep manipulation period (1 week after encoding), and again 6 weeks after encoding. Recall of highlighted content was superior to that of non‐highlighted content at all three time‐points (initial, 1 week, 6 weeks). This beneficial effect of prioritization on memory was stronger 1 week relative to a few minutes after encoding for the control, but not the SR group. N3 duration was similar in the control and SR groups. Overall, the present study shows that the benefits of prioritization on memory are enhanced over time, requiring time and sleep to unfold fully. Partial sleep deprivation (i.e. 5‐h nocturnal sleep opportunity) may attenuate such benefits, but this may be offset by preservation of N3 sleep duration.
The effects of long‐term experimental warming on the structure of three High Arctic plant communities
Authors: Edwards Marc , Henry Gregory H.R.
Published: June 2016

Questions

Are warming trends in High Arctic tundra consistent across plant communities within a given site, or is there evidence for fine‐scale heterogeneity in the response of plant community structure to experimental warming? How has the composition, cover and canopy height of three High Arctic plant communities responded to 18 yr of experimental warming? To what extent can hand‐held remote sensing methods serve as a proxy for community structure in tundra ecosystems?

Location

Alexandra Fiord lowland, Ellesmere Island, Canada.

Methods

We experimentally warmed patches of tundra using the International Tundra Experiment (ITEX) open‐top chambers to simulate climate change. We measured differences in community structure after 18 yr of experimental warming in three distinct plant communities: a wet sedge meadow, a mesic evergreen shrub‐dominated community and a dry deciduous shrub‐dominated community. We measured plant cover, height and growth form composition using a point‐intercept method and investigated the use of hand‐held NDVI at the plot scale as a proxy for plant community structure.

Results

All three plant communities showed unique differences after long‐term experimental warming. Both the meadow and evergreen shrub communities had significant differences in community composition between control and warmed plots, but none of the communities showed differences in plant cover or height. Deciduous shrubs and bryophytes were more abundant in warmed over control plots at both the evergreen shrub and meadow communities. Warmed plots in the meadow community had fewer graminoids and lower height values. Lichen was consistently less abundant in warmed plots across all communities where it occurred. NDVI values were driven by deciduous shrubs, and graminoids and showed community‐specific correlations with plant cover.

Conclusions

Our results suggest community‐level resistance to warming in terms of plant cover and height, but compositional differences support the hypothesis that climate change responses will be community‐specific. Plot‐scale studies such as this one can reveal important details that contribute to the understanding and validation of coarser‐scale measurements from satellite data.
Effects of Dietary Savory and Myrtle Essential Oils on Growth, Survival, Nutritional Indices, Serum Biochemistry, and Hematology of Farmed Rainbow Trout, Oncorhynchus mykiss, Fry
Authors: Mohamadi Saei Mohsen , Beiranvand Kiarash , Khalesi Mohammad K. , Mehrabi Farzaneh
Published: June 2016

The effects of diets containing different levels of essential oils from savory Satureja khuzestanica Jamzad and myrtle Myrtus communis L and an immunity complement were investigated on growth, survival, nutritional indices, serum biochemistry, and hematology of farmed rainbow trout, Oncorhynchus mykiss, fry (n = 4500; 5 ± 2 g). The essential oils were dosed as 300 and 500 mg/kg diet. After 60 d, the fish fed 300 mg/kg of the essential oils showed the highest counts of white blood cells (P < 0.05). The same treatment revealed the greatest levels of hematocrit, total protein, and albumin, but glucose and cholesterol values significantly decreased compared with the control (P < 0.05). Feeding fish with 300 mg/kg of the essential oils led to highest records of specific growth rate and survival rate but the lowest feed conversion ratio (FCR), and those fed with immunity complement attained the lowest values of growth parameters. The fry fed with immunity complement and 300 mg/kg of myrtle essential oil achieved the highest and lowest FCR values, respectively. The results indicate that dietary supplementation of 300 mg/kg of the above essential oils exert positive impacts on the growth performance, feeding efficiency, and hematological factors in O. mykiss.
Identification and functional analysis of two toxin–antitoxin systems in Campylobacter jejuni
Authors: Shen Zhangqi , Patil Rocky D. , Sahin Orhan , Wu Zuowei , Pu Xiao‐Ying , Dai Lei , Plummer Paul J. , Yaeger Michael J. , Zhang Qijing
Published: June 2016

Toxin–antitoxin (TA) systems are widely distributed in bacteria and play an important role in maintaining plasmid stability. The leading foodborne pathogen, Campylobacter jejuni, can carry multiple plasmids associated with antibiotic resistance or virulence. Previously a virulence plasmid named pVir was identified in C. jejuni 81‐176 and IA3902, but determining the role of pVir in pathogenesis has been hampered because the plasmid cannot be cured. In this study, we report the identification of two TA systems that are located on the pVir plasmid in 81‐176 and IA3902, respectively. The virA (proteic antitoxin)/virT (proteic toxin) pair in IA3902 belongs to a Type II TA system, while the cjrA (RNA antitoxin)/cjpT (proteic toxin) pair in 81‐176 belongs to a Type I TA system. Notably, cjrA (antitoxin) represents the first noncoding small RNA demonstrated to play a functional role in Campylobacter physiology to date. By inactivating the TA systems, pVir was readily cured from Campylobacter, indicating their functionality in Campylobacter. Using pVir‐cured IA3902, we demonstrated that pVir is not required for abortion induction in the guinea pig model. These findings establish the key role of the TA systems in maintaining plasmid stability and provide a means to evaluate the function of pVir in Campylobacter pathobiology.
GhERF‐IIb3 regulates the accumulation of jasmonate and leads to enhanced cotton resistance to blight disease
Authors: Cacas Jean‐Luc , Pré Martial , Pizot Maxime , Cissoko Maimouna , Diedhiou Issa , Jalloul Aida , Doumas Patrick , Nicole Michel , Champion Antony
Published: June 2016

The phytohormone jasmonic acid (JA) and its derivatives, collectively referred to as jasmonates, regulate many developmental processes, but are also involved in the response to numerous abiotic/biotic stresses. Thus far, powerful reverse genetic strategies employing perception, signalling or biosynthesis mutants have broadly contributed to our understanding of the role of JA in the plant stress response and development, as has the chemical gain‐of‐function approach based on exogenous application of the hormone. However, there is currently no method that allows for tightly controlled JA production in planta. By investigating the control of the JA synthesis pathway in bacteria‐infected cotton (Gossypium hirsutum L.) plants, we identified a transcription factor (TF), named GhERF‐IIb3, which acts as a positive regulator of the JA pathway. Expression of this well‐conserved TF in cotton leaves was sufficient to produce in situ JA accumulation at physiological concentrations associated with an enhanced cotton defence response to bacterial infection.
Stress response in medically important Mucorales
Authors: Singh Pankaj , Paul Saikat , Shivaprakash M. Rudramurthy , Chakrabarti Arunaloke , Ghosh Anup K.
Published: June 2016

Mucorales are saprobes, ubiquitously distributed and able to infect a heterogeneous population of human hosts. The fungi require robust stress responses to survive in human host. We tested the growth of Mucorales in the presence of different abiotic stress. Eight pathogenic species of Mucorales, including Rhizopus arrhizus, Rhizopus microsporus, Rhizomucor pusillus, Apophysomyces elegans, Licthemia corymbifera, Cunninghamella bertholletiae, Syncephalastrum racemosum and Mucor racemosus, were exposed to different stress inducers: osmotic (sodium chloride and d‐sorbitol), oxidative (hydrogen peroxide and menadione), pH, cell wall and metal ions (Cu, Zn, Fe and Mg). Wide variation in stress responses was noted: R. arrhizus showed maximum resistance to both osmotic and oxidative stresses, whereas R. pusillus and M. indicus were relatively sensitive. Rhizopus arrhizus and R. microsporus showed maximum resistance to alkaline pH, whereas C. bertholletiae, L. corymbifera, M. racemosus and A. elegans were resistant to acidic pH. Maximum tolerance was noted in R. microsporus to Cu, R. microsporus and R. arrhizus to Fe and C. bertholletiae to Zn. In contrast, L. corymbifera, A. elegans and M. indicus were sensitive to Cu, Zn and Fe respectively. In conclusion, R. arrhizus showed high stress tolerance in comparison to other species of Mucorales, and this could be the possible reason for high pathogenic potential of this fungi.
Identification and typing of the emerging pathogen Candida auris by matrix‐assisted laser desorption ionisation time of flight mass spectrometry
Authors: Girard Victoria , Mailler Sandrine , Chetry Marion , Vidal Céline , Durand Géraldine , van Belkum Alex , Colombo Arnaldo L. , Hagen Ferry , Meis Jacques F. , Chowdhary Anuradha
Published: June 2016

Candida auris is an emerging antifungal resistant yeast species causing nosocomial and invasive infections, emphasising the need of improved diagnostics and epidemiological typing methods. We show that MALDI‐TOF VITEK‐MS followed by amplified length polymorphisms allows for accurate species identification and subsequent epidemiological characterisation of strains encountered during potential outbreaks.