bluuebunny/crossref_metadata_2025 huggingface dataset:
A very lucrative liquid: the emerging trade in human milk as a form of reproductive exploitation and violence against women
Authors: Steele Sarah Louise , Hernandez-Salazar Eduardo E.
Published: February 2020

Purpose

An emerging market in human milk exists for both nutritional and biomedical research purposes. This commercialisation of human milk, however, raises issues about the exploitation and violence against women.

Design/methodology/approach

This paper explores the framing of the issues as one of human rights, and whether the shifting of gender issues away from gender-specific spaces in legal and ethical debates, makes their ethical consideration and the tangible consequences from these considerations, into a potential further sources of exploitation and other forms of violence against women.

Findings

The authors find the commoditisation of human milk as a nutritional product deprives women from the centrality of their roles and, therefore, from the upholding of women rights and the adequate prevention of violence against women. They identify an emerging space where trafficking in women and girls can occur for their milk as part of a broader set of practices of reproductive exploitation. They also identify that existing legal, ethical and research discussions often frame labour or organ trafficking as the appropriate framework but find this inadequate to address the inherently gendered aspect of reproductive exploitation. The current response makes trafficking in women for their milk a potential practice while concealing the structural inequalities that underpin women’s experiences as the buyers and sellers of human milk.

Practical implications

The regulation of human milk sale should therefore move from a public health paradigm focused on safety to one of health and women’s rights, whereas human trafficking laws around the world should explicitly address reproductive exploitation.

Originality/value

Emerging forms of exploitation, such as human milk sale remain underdiscussed alongside other more prominent forms of reproductive exploitation, such as surrogacy. The authors call for explicit consideration of the emerging trade as its burdens fall exclusively on women and existing frameworks for addressing exploitation often overlook these emerging practices and the structural inequalities faced by women that drive these trades.
Violence in childhood-onset schizophrenia
Authors: Ross Randal G. , Maximon Julia , Kusumi Jonathan , Lurie Susan
Published: February 2020

Violence is elevated in older adolescents and adults with schizophrenia; however, little is known about younger children. This report focuses on rates of violence in younger children with schizophrenic-spectrum illnesses. A retrospective review of structured diagnostic interviews from a case series of 81 children, ages 4-15 years of age, with childhood onset of schizophrenic-spectrum illness is reported. Seventy-two percent of children had a history of violent behavior, including 25 children (31%) with a history of severe violence. Of those with a history of violence, 60% had a least one episode of violence that did not appear to be in response to an external stimulus (internally driven violence). There was no significant impact of age or gender. For many children, these internally driven violent episodes were rare and unpredictable, but severe. Similar to what is found in adolescents and adults, violence is common in children with schizophrenic-spectrum illnesses. General violence prevention strategies combined with early identification and treatment of childhood psychotic illnesses may decrease the morbidity associated with childhood psychotic violence.
Psychiatric worker and family members: pathways towards co-operation networks within psychiatric assistance services
Authors: Carbone Silvia
Published: February 2020

The family's role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric patients. This different mindset, which views the family as an alternative to institutionalization, leads to it being seen as an essential entity in the setting up of community service dynamics. We interviewed health professionals in order to understand obstacles of collaboration between family members and mental health care workers. The goal was to uncover actions that promote collaboration and help build alliances between families and psychiatric workers. Results showed that health professionals view the family as a therapeutic resource. Despite this view, family members were rarely included in patient treatment. The reasons is: the structures have a theoretical orientation of collaboration with the family but, for nurses not are organized a few meeting spaces with family members. Services should create moments, such as multi-family groups or groups of information, managed by nurses and not only by doctors. These occasions it might facilitate the knowledge between professionals and family members.
Post-vasectomy depression: a case report and literature review
Authors: Shaik Subahani , Rajkumar Ravi Philip
Published: February 2020

Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure – a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient's current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined.
Mandatory physical exercise for the prevention of mental illness in medical students
Authors: Bitonte Robert A. , DeSanto Donald Joseph
Published: February 2020

Medical students experience higher rates of mental illness than the general population. With competition rising for success in medical school, and residency, increasing incidence of distress are leading this population to experience higher rates of thoughts of dropping out of school, and even suicide. Since many stigmas deter medical students from receiving mental health counseling, such as the perceived inability to handle the stresses of medical school, and the potential lack of competitiveness for residencies if reported, prevention of mental illness may be a better course to take in reducing prevalence in this population. Regular exercise has demonstrated a positive effect on not only promoting physical health, but also mental health. Exercise encourages a healthy mood, positive self esteem, and better cognition, while decreasing the chances of depression, anxiety, and burnout. Implementing exercise time into medical school curriculums, just like the basic sciences, albeit for less time in the day, could provide a feasible way to ensure that all students are taking time to partake in this important activity for their well being. Though medical schools are rigid with attempts to make changes in their curriculum, thirty minutes a day, three to five times a week of exercise of the students' choice not only is more cost effective than counseling, but it also reduces the chances that they will experience burnout, which if left untreated could transcend into a compromised training experience.
Socio-cultural context and feelings of hatred and revenge in war veterans with post-traumatic stress disorder 15 years after war in Kosovo
Authors: Halimi Ramadan , Dragoti Emond , Halimi Hidajete , Sylejmani-Hulaj Nazife , Jashari-Ramadani Sevdie
Published: February 2020

We aimed to assess, in socio-cultural context, the level of hatred and revenge in war veterans with post-traumatic stress disorder (PTSD). The sampling frame consisted of 215 Kosova War veterans, randomly selected. The Harvard Trauma Questionnaire was used to assess the prevalence of PTSD and Manchester Short Assessment of Life was used to assess social satisfactions. The participants were asked to declare the strength of feelings of hatred and revenge in the four preceding weeks by using four items scale: not at all, a little bit/sometimes, a lot and extremely. Willingness for action of veterans was assessed using three item scale: yes, no or maybe. A probability level of 0.05 was adopted to be considered as statistically significant for differences among groups. DSM-IV-TR criteria for PTSD (very similar to DSM-V) were met by 52.6% of veterans; the data have confirmed existence of thoughts and fantasies of revenge against opposing forces by 42.8% veterans; at the same level 42.8% manifested feelings of hatred. Fantasies of taking revenge a lot was recorded by 19.5% and extremely by 1.4% of veterans, while hateful thoughts at level a lot were likely expressed by 22.3% and extreme by 2.8% of veterans. It is important to note that 84.7% were confident to act based on their beliefs. Social-economic and cultural factors have played major role in the understanding of psychological problems of traumatized individuals with a direct impact on their ability to function socially. This study has confirmed the urgent need for the establishment of psychological rehabilitation programs as well as programs for the social and economic rehabilitation of War Veterans.
Bipolar mood tendency and frontal activation using a multichannel near infrared spectroscopy
Authors: Uehara Toru , Ishige Yoko
Published: February 2020

This study aims to examine the association of frontal functioning with subclinical bipolar spectrum by a newly developed convenient method. We investigated subclinical bipolar tendency and frontal lobe activation during word productions using multi-channel near infrared spectroscopy. Participants: 44 healthy university students (mean ages 20.5 years old, and 29 female) gave their written informed consent, and we strictly protected privacy and anonymity was carefully preserved. A 13-items self-report questionnaire (Mood Disorders Questionnaire; MDQ) and a 16-channel near-infrared spectroscopy were used to compare frontal activations between two samples divided by median (4 points) of the total MDQ scores and to analyze correlations between relative changes of cerebral blood volume and bipolarity levels. There was no case suspected as bipolar disorders by MDQ screening (mean 3.4, max 10). Significant differences in lower activations were noted in the right and left pre-frontal cortex (PFC) with higher bipolarity scores using the specific software to analyze the NIRS waveform (P<0.05). Total MDQ were correlated significantly with frontal activation negatively in many channels; therefore, we conducted multiple linear regression to select significant frontal activations using the MDQ as a dependent variable. Stepwise method revealed that activation in left lateral PFC was negatively associated to bipolar tendency, and this regression model was significant (R2=0.10, F=4.5, P=0.04). Differences in frontal functioning suggest that subclinical bipolar tendencies might be related to left lateral PFC activations. It should be confirmed whether the identical pattern can be identified for clinical subjects with bipolar disorders.
The change of music preferences following the onset of a mental disorder
Authors: Gebhardt Stefan , von Georgi Richard
Published: February 2020

A psychiatric population (n=123) was examined on how music preferences had changed after the onset of a mental disorder. Most patients did not change their previous music preference; this group of patients considered music helpful for their mental state, showed more attractivity and enforcement as personality traits and used music more for emotion modulation. Patients who experienced a preference shift reported that music had impaired them during the time of illness; these patients showed less ego-strength, less confidence and less enforcement and used music less for arousal modulation. A third subgroup stopped listening to music completely after the onset of the mental disorder; these patients attribute less importance to music and also reported that music had impaired their mental state. They showed more ego-strength and used music less for emotion modulation. The results suggest that the use of music in everyday life can be helpful as an emotion modulation strategy. However, some patients might need instructions on how to use music in a functional way and not a dysfunctional one. Psychiatrists and psychotherapists as well as music therapists should be aware of emotion modulation strategies, subjective valence of music and personality traits of their patients. Due to the ubiquity of music, psychoeducative instructions on how to use music in everyday life plays an increasing role in the treatment of mental illness.
Psychopathology and urine toxicology in methadone patients
Authors: Sadek Gamal , Cernovsky Zack , Chiu Simon
Published: February 2020

Several studies reported high rates of psychiatric commorbidity among methadone patients. We examined the relationships of measures of psychopathology to outcomes of screening urine tests for cocaine, opiates, and benzodiazepines in a sample of 56 methadone patients. They also completed the Symptom Check List-90-Revised (SCL-90-R). The highest scales in the SCL-90-R profile of our patients were those indicating somatic discomfort, anger, phobic anxiety, paranoid ideation, and also obsessive-compulsive disorder symptoms (scores above the 39th per centile). The only significant correlations between urine tests and SCL-90-R psychopathology were those involving benzodiazepines: patients with urine tests positive for benzodiazepines had lower social self-confidence (r=0.48), were more obsessive-compulsive (r=0.44), reported a higher level of anger (r=0.41), of phobic tendencies (r=40), of anxiety (r=0.39), and of paranoid tendencies (r=0.38), and also reported more frequent psychotic symptoms (r=0.43).
Psychological distress and emotional pain among adult attendees of a dental clinic: a case-control study
Authors: Erinfolami Adebayo Rasheed , Olagunju Andrew Toyin , Oshodi Yewande Olufunmilayo , Akinbode Abiola Adelphine , Fadipe Babatunde , Adeyemo Wasiu Lanre
Published: February 2020

We set out to carry out a case-control evaluation of psychological distress and emotional pain among adult attendees of a Nigerian dental clinic. A total of 201 subjects, made up of 101 dental patients (test group) matched with age and sex with 100 normal subjects (controls), was recruited into the study. All participants completed a designed socio-demographic questionnaire. General Health Question naire and Psyche ache Assessment Schedule were also administered to assess psychological distress based on cut-off scores ?3 and emotional pain based on cut-off scores ?28 respectively. The mean ages of study and control group were 33 (±12) and 36 (±13) years respectively, and both study and control groups were not significantly different in all the assessed socio-demographic parameters. Overall, 21.8% (n=22) of the subjects had psychological distress, while only 7% of the control group had psychological distress. This difference was statistically significant (P=0.003). Similarly, there was significant difference in the experience of psyche ache (unbearable psychological pain) as over a third of the dental patients (37.6%, n=38) had emotional pain, while only 13% of the controls experienced psych ache (P<0.001). In this study, the burden of psychological distress and emotional pain was many-fold in dental patients when compared with the controls.
A case of mania presenting with hypersexual behavior and gender dysphoria thatresolved with valproic acid
Authors: Heare Michelle R. , Barsky Maria , Faziola Lawrence R.
Published: February 2020

Hypersexuality and gender dysphoria have both been described in the literature as symptoms of mania. Hypersexuality is listed in the Diagnostic and Statistical Manual of Mental Disorders 5 as part of the diagnostic criteria for bipolar disorder. Gender dysphoria is less often described and its relation to mania remains unclear. This case report describes a young homosexual man presenting in a manic episode with co-morbid amphetamine abuse whose mania was marked by hypersexuality and the new onset desire to be a woman. Both of these symptoms resolved with the addition of valproic acid to antipsychotics. This case report presents the existing literature on hypersexuality and gender dysphoria in mania and describes a treatment option that has not been previously reported.
Lady with erotic preference for diapers
Authors: Cernovsky Zack , Bureau Yves
Published: February 2020

A patient in her 20s was referred to us for psychological assessment due to her depression and suicide attempts. She mentioned being anorgasmic except when diapered and emphasized her erotic preference for diapers. Her childhood included maternal deprivation in an impecunious family headed by an irritable physically disabled father on social assistance. Given the maternal deprivation in childhood, her erotic fixation on diapers parallels the emotional attachment to diapers observed by Harlow in mother deprived infant monkeys. Etiological hypotheses should also include the paradigm of avoidance learning from theories of behavior therapy. Our patient does not wish to change her sexual preference: in such cases, fetishism is not considered as an illness by DSM5. However, she needs to be treated for pathological levels of depression with suicidal ideation and low self-esteem.
Delirium, caused by suspending treatment of hypothyroidism
Authors: Hernández-Sandí Alejandro , Quirós-Baltodano David , Oconitrillo-Chaves Michelle
Published: February 2020

Delirium, or acute confusional syndrome, is a set of symptoms whose care involves not only psychiatry, but also many other medical specialties. Being as how the syndrome is caused by multiple factors, it is important to recognize each risk factor affecting the patient in order to anticipate and prevent it. In case of diagnosis, identifying and treating the root cause that triggered is important, given that it has a high rate of comorbidity and an elevated cost of medical care. We describe a case where a patient with hypothyroidism began suffering from delirium due to an abrupt discontinuation of levothyroxine treatment. Previously, the patient was seemingly healthy. After the medical treatment was interrupted, sensory processing and behavior were altered, and symptoms fluctuated, for a short period of time, showing disorientation and memory and language impairment.
Reliability, validity and psychometric properties of the Greek translation of the posttraumatic stress disorder scale
Authors: Kontoangelos Konstantinos , Tsiori Sofia , Poulakou Garyfalia , Protopapas Konstantinos , Katsarolis Ioannis , Sakka Vissaria , Kavatha Dimitra , Papadopoulos Antonios , Antoniadou Anastasia , Papageorgiou Charalambos C.
Published: February 2020

The Greek version of the Davidson Trauma Scale (DTS) was developed to respond to the need of Greek-speaking individuals. The translated questionnaire was administered to 128 HIV outpatients (aged 37.1±9.1) and 166 control patients (aged 32.4±13.4). In addition to the DTS Greek scale, subjects were assessed with two other scales useful for assessing validity. For each factor analyses two components were extracted, based on Cattell's scree test. The two components solution accounted for 55.34% of the total variation in case of frequency variables and 61.45% in case of severity variables. The Cronbach's alpha coefficient and Guttman split-half coefficient of the DTS scale were 0.93 and 0.88 respectively. The test-retest reliability of the Greek version of DTS scale proved to be satisfactory. Individual items had good intra-class correlation coefficients higher than 0.5, which means that all questions have high levels of external validity. The psychometric strength of interview for post-traumatic stress disorder-Greek version it's reliable for its future use, particularly for screening subjects with possible diagnosis of posttraumatic stress disorder.
Psychometric testing of immigrants and natives in an acute psychiatry facility
Authors: Berg John E.
Published: February 2020

The diagnostic process after referral to an acute psychiatric treatment facility consists of more than the clinical investigation and laboratory tests. Psychometric tests in a broad range of languages may be such an augmentation of our diagnostic armamentarium. Whether such tests are in use, and how they are distributed among different patient categories was the aim of the study. All referrals in one calendar year (N=1168), as they are depicted in the hospital computerized medical records, were investigated. Fifty-six (6.1%) out of 926 ethnic Norwegians and six (3.0%) out of 198 non-Western immigrants were tested, whereas none of the 44 Western immigrants. The difference between ethnic Norwegians and the immigrants was significant (Z=-3.05 and P=0.002). Psychometric tests were thus almost not in use, and even lesser so in immigrants. Mean number of resident days was higher among those tested, 11.7 (SD=11.2) versus those not tested, 7.4 (SD=10.4) days, t=2.97 and P=0.004. Length of stay for ethnic Norwegians did not differ from that for non-Western immigrants 11.4 versus 11.7, respectively. The patients tested were older than those not tested. Mean age was 43.0 (SD=14.4) versus 38.8 (SD=12.1), with a t=2.65 and P=0.03. The difference in resident days between all immigrants and ethnic Norwegians was significant with a Z=−2.232 and P=0.026. Level of testing was higher in ethnic Norwegians, and the tested patients stayed longer, maybe indicating more room for testing. Whether this low test-activity influences treatment quality is an unsettled question.
Electroconvulsive therapy hasn't negative effects on short-term memory function, as assessed using a bedside hand-held device
Authors: Müller Helge H.O. , Reike Mareen , Grosse-Holz Simon , Röther Mareike , Lücke Caroline , Philipsen Alexandra , Kornhuber Johannes , Grömer Teja W.
Published: February 2020

Electroconvulsive therapy (ECT) is effective in the treatment of treatment-resistant major depression. The fear of cognitive impairment after ECT often deters patients from choosing this treatment option. There is little reliable information regarding the effects of ECT on overall cognitive performance, while short-term memory deficits are well known but not easy to measure within clinical routines. In this pilot study, we examined ECT recipients' pre- and post-treatment performances on a digital ascending number tapping test. We found that cognitive performance measures exhibited good reproducibility in individual patients and that ECT did not significantly alter cognitive performance up to 2 hours after this therapy was applied. Our results can help patients and physicians make decisions regarding the administration of ECT. Digital measurements are recommended, especially when screening for the most common side effects on cognitive performance and short-term memory.
Treatment of 22q11.2 deletion syndrome-associated schizophrenia with comorbid anxiety and panic disorder
Authors: Borders Candace B. , Suzuki Amanda , Safani David
Published: February 2020

22q11.2 deletion syndrome (22q11DS) is a risk factor for psychiatric illnesses, including schizophrenia and anxiety. Small studies have shown that several neuroleptic medications are effective in treating psychosis in this population, but are also associated with an increased risk of adverse effects - particularly, seizures. In this case, we discuss a 34-year-old patient presenting with late onset schizophrenia, which ultimately led to her diagnosis of 22q11DS. Subsequent management of the patient's psychosis with asenapine was complicated by concurrent anxiety and panic disorder; thus, we examine the role of anxiolytic therapy in conjunction with antipsychotics in this patient population.
Ankle edema after administration of selective serotonin reuptake inhibitors
Authors: Kontoangelos Konstantinos , Ecomomou Marina , Papageorgiou Charalambos
Published: February 2020

Clinical manifestations of drug-induced skin reactions include a wide range of symptoms, from mild drug-induced exanthemas to dangerous and life-threatening generalized systematic reactions. Drug-induced skin reactions to psychotropic medication are usually associated with antiepileptic drugs. However, a significant role can be assigned to selective serotonin reuptake inhibitors. We report a case of a female patient, who after approximately one month therapy with escitalopram developed a bilateral ankle edema, which resolved completely within the first week following its discontinuation. Although serious complications are rare, clinicians should be aware of severe skin complications in patients treated with antidepressants, which necessitate careful clinical monitoring and management. Individualization of pharmacotherapy is crucial, together with regular evaluation of safety and tolerance of the treatment.
Addiction and religiosity in facing suicide: a qualitative study on meaning of life and death among homeless people
Authors: Testoni Ines , Russotto Salvatore , Zamperini Adriano , Leo Diego De
Published: February 2020

This qualitative research explores the relationship between religiosity, suicide thoughts and drug abuse among 55 homeless people, interviewed with interpretative phenomenological analysis. Analyzing the thematic structure of the participants' narrations, important main themes appeared in order to avoid suicide, among which family, the certainty of finding a solution and the will to live. However, the suicide ideation inheres in about 30% of participants, almost all believers, addicted and/or alcoholics. Results suggest that religiosity and meaning of death neither prevent from substances abuse and alcoholism, nor is a protective factor against suicide ideation. Meanings of life are the most important reasons for living, and when they are definitively considered unworkable, alcohol and drug help to endure life in the street. A specific model is discussed.
Fully-integrated medical home for people with severe and persistent mental illness: A description and outcome analysis of a Medicare Advantage Chronic Special Needs Program
Authors: Myers Robert
Published: February 2020

People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Traditional case management approaches are not always able to provide the intense and direct interventions required to adequately address the psychiatric, medical and social needs of this unique population. This article describes a Medicare Advantage Chronic Special Needs Program that provides a Medical Home, Active Community Treatment, and Integrated Care. A comparison of utilization and patient outcome measures of this program with fee for service Medicare found significant reduction in utilization and costs, as well as increased adherence to the management of chronic medical conditions and preventative services.
Scale for retrospective assessment of immediate concussion symptoms
Authors: Cernovsky Zack Zdenek , Istasy Paul Victor Fayez , Bureau Yves , Chiu Simon
Published: February 2020

The retrospective diagnosis of concussion is often missed by clinicians. We present a brief scale for retrospective assessment of the immediate concussion symptoms (ICS) to facilitate the diagnosis of patients without visible head injury or full loss of consciousness. We administered the scale to 90 survivors of car accidents (mean age 42.0, SD=13.6; 33 males, 57 females) at 2 to 33 months after their accident. Our scale consists of 6 items and these were endorsed by the following % of our respondents: feeling dazed (64.4% of our 90 respondents), stunned (73.3%), confused (70.0%), disoriented (62.2%), dizzy (57.8%), and loss of consciousness (22.2%). The statistical properties of the scale are satisfactory (Cronbach alpha = 0.74). The scale correlates with post-accident insomnia (r=0.28), depression (r=0.29), and also with Rivermead measure of the chronic post-concussion syndrome (r=0.34). The ICS scale could be used as a starting point in longitudinal research with brain imaging procedures to evaluate the stages of recovery from the initial concussion. Attached are the English, Spanish, French, German, Italian, Russian, and Czech versions of our scale.
Repetitive transcranial magnetic stimulation (rTMS) using different TMS instruments for major depressive disorder at a suburban tertiary clinic
Authors: Davila Maria Cristina , Ely Brianna , Manzardo Ann M.
Published: February 2020

Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulatory technique used to modulate orbital frontal corticostriatal (OFC) activity and clinical symptomatology for psychiatric disorders involving OFC dysfunction. We examined the effectiveness of rTMS in the treatment of major depressive disorder in an applied clinical setting (Awakening KC CNI) to assess efficacy and optimize rTMS parameters within clinical practice. A retrospective review of medical records was carried out on patients with major depressive disorder undergoing rTMS therapy at Awakenings KC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) total score, clinical remission rate and week achieved were evaluated over 6 weeks of treatment to assess clinical response referencing two different rTMS instruments (MagVenture; NeuroStar). Our survey included 247 participants from males (N=98) and females (N=149) with average baseline PHQ-9 scores of 21.7±4, classified as severe depression. Clinically rated remission rates of 72% were achieved in 3.1±1.0 weeks and associated with prior history of psychiatric hospitalization, suicide attempts and substance use disorder. Average baseline PHQ-9 scores decreased significantly over time with proportionately greater remission rates achieved for patients treated using the MagVenture over NeuroStar instrument. rTMS in applied clinical practice is efficacious over a wide range of settings and patients. Clinical response was related to severity of depression symptoms (e.g., prior hospitalization; suicide attempts) validating efficacy in critically ill groups. Clinical response may be impacted by rTMS instrument, magnetic field parameters or individual factors.
Comparison of performances of flexible sensors on foil and paper for efficient bacterial concentration measurement
Authors: Kojic Tijana , Radovanovic Milan , Stojanovic Goran M. , Pivas Bojana , Medic Deana , Al-Salami Hani
Published: February 2020

Purpose

The purpose of this study was to develop flexible sensors for detection of different concentrations of bacteria, such as Pseudomonas aeruginosa and Staphylococcus aureus, in saline.

Design/methodology/approach

The sensors were fabricated using ink-jet printing technology and they consist of a pair of silver interdigitated electrodes printed on mechanically flexible substrates – foil and paper. In house measurement setup for testing and characterization of sensors has been developed. Structural, electrical and mechanical properties of flexible sensors have been determined and compared.

Findings

The characteristics of sensor – the resonant frequency as a function of different concentrations of each bacteria – are presented. The obtained results demonstrate different resonant frequencies for each dilution of Pseudomonas aeruginosa and Staphylococcus aureus in physiological saline.

Research limitations/implications

Both sensors showed accurate measurements of bacterial count, which can be achieved with detection of resonant frequency, and this is reflective of the number of bacterial cells within a sample.

Practical implications

The findings suggest that the newly developed method based on measuring resonant frequency corresponds well with bacterial cell count, thus establishing a new proof-of-concept that such method can have significant applications in bacterial cell counting that are economic and easily maintained.

Social implications

Fast, cost-effective, accurate and non-invasive method for detection of different bacteria from saline was developed.

Originality/value

For the first time, comparison between performances of flexible sensors on foil and paper for bacteria detection is demonstrated. Almost linear dependence between shift of resonant frequency of developed sensors and concentration of bacteria has been obtained.
Senior tourism – a scientometric review (1998-2017)
Authors: Pestana Maria Helena , Wang Wan-Chen , Parreira Artur
Published: February 2020

Purpose

This study aims to identify intellectual structures, emerging trends and future research opportunities via a bibliometric analysis of senior tourism research from 1998 until 2017.

Design/methodology/approach

A detailed search of 700 core articles and 7,221 citations collated from Web-of-Science and Scopus was implemented and analyzed through CiteSpace.

Findings

The results reveal a slow increase in the amount of research, with six main areas of research. The most cited articles are mainly older. The USA has a solid leadership in publications, followed by Australia and China. The network of journals and institutions show a core peripheral structure where Tourism Management and University of Queensland are ranked first. The identification of structural holes, critical articles and the development of new emerging tendencies highlights the priorities in the senior tourism domain, pointing to new opportunities for research.

Originality/value

The originality of this paper consists in a temporal and dynamic analysis of the past two decades, using CiteSpace for a co-citation and co-occurrence network analysis.
The role of sensory ecology and cognition in social decisions: Costs of acquiring information matter
Authors: Schneeberger Karin , Taborsky Michael
Published: February 2020

We generally assume that animals should maximize information acquisition about their environment to make prudent decisions. But this is a naïve assumption, as gaining information typically involves costs.

This is especially so in the social context, where interests between interacting partners usually diverge. The arms race involved in mutual assessment is characterized by the attempt to obtain revealing information from a partner while providing only as much information by oneself as is conducive to one's own intentions.

If obtaining information occasions costs in terms of time, energy and risk, animals should be selected to base their decisions on a cost–benefit ratio that takes account of the trade‐off between the risk of making wrong choices and the costs involved in information acquisition, processing and use.

In addition, there may be physiological and/or environmental constraints limiting the ability to obtaining, processing and utilizing reliable information.

Here, we discuss recent empirical evidence for the proposition that social decisions are to an important extent based on the costs that result from acquiring, processing, evaluating and storing information. Using examples from different taxa and ecological contexts, we aim at drawing attention to the often neglected costs of information recipience, with emphasis on the potential role of sensory ecology and cognition in social decisions.
The geography of grassland plant chemistry and productivity accounts for ant sodium and sugar usage
Authors: Clay Natalie A.
Published: February 2020

In Focus: Kaspari, M., Welti, E. A. R., & de Beurs, K. M. (2020). The nutritional geography of ants: Gradients of sodium and sugar limitation across North American grasslands. Journal of Animal Ecology, 89, 276‐284. Biologically essential elements and macromolecules impact individuals to ecosystems and vary across space. Predictive frameworks for understanding community patterns across nutritional gradients are increasingly important as the nutritional landscape is continually altered by global change. Grasslands vary in the quantity and quality of essential nutrients that can impact plant consumer abundance, biomass and activity, but causes for variation, particularly across large spatial scales are poorly understood. In 53 North American grasslands spanning 16° latitude, Kaspari et al. (2020) tested three hypotheses for explaining sources of sodium (Na) limitation and five hypotheses for explaining sources of sugar limitation of ants, which are common and ecologically important omnivores that consume both plant‐ and animal‐derived material. For both Na and sugar, over half of the variation in ant bait usage was accounted for by their predictions. Specifically, after accounting for ant activity (ant usage of sugar baits), ant Na‐limitation was next best predicted by plant Na content and lastly, insect biomass, while sugar limitation after accounting for activity (ant usage of Na baits) was best predicted by growing season, then ecosystem productivity, plant potassium (K) and phosphorous (P), respectively. Kaspari et al. (2020) demonstrate the importance of plant physiology and chemistry towards a predictive framework for understanding sugar‐ and Na‐limitation and highlights the importance of tackling ecological questions from a geographical perspective. This framework can provide a useful foundation for predicting future patterns in grassland organism nutritional ecology as plant species and physiology are altered with global change.
Preservation of the mesureter to reduce urinary complications: analysis of data from the observational Leipzig School MMR study
Authors: Wolf B , Espig O , Stolzenburg J‐U , Horn L‐C , Aktas B , Höckel M
Published: February 2020

Objective

To evaluate the feasibility and effect of mesureteral preservation on urinary complications in the context of total mesometrial resection (TMMR), a surgical treatment for cervical cancer.

Design

Retrospective cohort study with historic control.

Setting

Single tertiary academic centre.

Population

Women older than 18 with primary cervical cancer staged FIGO IB1–IIB enrolled in the prospective Leipzig School MMR study and underwent total mesometrial resection (TMMR) without adjuvant radiation.

Method

We retrospectively analysed 100 consecutive TMMR procedures which were performed for cancer of the uterine cervix and in which the mesureter was preserved (intervention group, 01/2014–06/2017). We compared this group with the previous 100 consecutive TMMRs, which were performed before the introduction of mesureteral preservation (control group, 09/2010–01/2014).

Main outcome measures

The occurrence of urological and specifically ureteral complications.

Results

Mesureteral preservation was feasible and was associated with a significant decrease in ureteral complications (11% without mesureteral preservation versus 3% with mesureteral preservation, P = 0.049). Furthermore, we found a significant decrease in the number of postoperative percutaneous nephrostomies and re‐operations (7% versus none, P = 0.014). There was also a trend towards a decrease in other urinary complications such as postoperative bladder atony and uretero‐vaginal fistulas.

Conclusion

The mesureter constitutes a convenient dissection plane enabling the preservation of lateral ureteral blood supply during TMMR. In our study, maintenance of mesureteral integrity was associated with a significant reduction in ureteral complications. Mesureteral preservation might also be useful in other types of pelvic surgeries that carry a high risk of ureteral damage.

Tweetable abstract

Surgical preservation of the mesureter in cervical cancer patients was associated with a reduction in urinary complications.
Developmental Validation of the ANDE 6C System for Rapid DNA Analysis of Forensic Casework and DVI Samples
Authors: Turingan Rosemary S. , Tan Eugene , Jiang Hua , Brown Jessi , Estari Yeshwanthi , Krautz‐Peterson Greice , Selden Richard F
Published: February 2020

A developmental validation was performed to demonstrate reliability, reproducibility, and robustness of the ANDE Rapid DNA Identification System for processing of crime scene and disaster victim identification (DVI) samples. A total of 1705 samples were evaluated, including blood, oral epithelial samples from drinking containers, samples on FTA and untreated paper, semen, bone, and soft tissues. This study was conducted to address the FBI’s Quality Assurance Standards on developmental validation and to accumulate data from a sufficient number of unique donors and sample types to meet NDIS submission requirements for acceptance of the ANDE Expert System for casework use. To date, no Expert System has been approved for such samples, but the results of this study demonstrated that the automated Expert System performs similarly to conventional laboratory data analysis. Furthermore, Rapid DNA analysis demonstrated accuracy, precision, resolution, concordance, and reproducibility that were comparable to conventional processing along with appropriate species specificity, limit of detection, performance in the presence of inhibitors. No lane‐to‐lane or run‐to‐run contamination was observed, and the system correctly identified the presence of mixtures. Taken together, the ANDE instrument, I‐Chip consumable, FlexPlex chemistry (a 27‐locus STR assay compatible with all widely used global loci, including the CODIS core 20 loci), and automated Expert System successfully processed and interpreted more than 1200 unique samples with over 99.99% concordant CODIS alleles. This extensive developmental validation data provides support for broad use of the system by agencies and accredited forensic laboratories in single‐source suspect‐evidence comparisons, local database searches, and DVI.
‘A Reward for so Meritorious an Action’ ? Lord Hervey's Summons to the House of Lords and Walpole's Management of the Upper Chamber (1727–42)
Authors: Eagles Robin
Published: February 2020

In 1733 Lord Hervey was summoned to the house of lords early. The move has traditionally been seen as part of an effort by Walpole to increase his ministry's strength in the upper chamber in spite of objections voiced by allies such as the duke of Newcastle. This essay seeks to reconsider the circumstances of the move and question more broadly the management of the Lords during the ‘Robinocracy’.
Radiological ‘SATs’ monitor: The use of ‘study ascribable times’ to assess the impact of clinical workload on resident training in a resource‐limited setting
Authors: Le Roux Camilla Engela , Le Roux Nelmarie , Pitcher Richard Denys
Published: February 2020

Introduction

Globally, increasing clinical demands threaten postgraduate radiology training programmes. Time‐based assessment of clinical workload is optimal in the academic environment, where an estimated 30% of consultant time should ideally be devoted to non‐reporting activities. There has been limited analysis of the academic radiologist workload in low‐ and middle‐income countries.

Methods

Departmental staffing and clinical statistics were reviewed for 2008 and 2017. The Royal Australian and New Zealand College of Radiologists ‘study ascribable times’ (RANZCR‐SATs) for primary consultant reporting were used with the Royal College of Radiologists (RCR) 2012 guidelines for secondary review of resident reports, to estimate the total consultant‐hours required for each year’s clinical workload. Analyses were stratified by type of investigation (plain‐film vs. special) and expressed as a proportion of the total annual available consultant working hours.

Results

Reporting all investigations required 90% and 100%, while reporting special investigations alone, demanded 53% and 69% of annual consultant working hours in 2008 and 2017, respectively. Between 2008 and 2017, the proportion of consultant time available for plain‐film reporting decreased from 17% to 1%, while preserving 30% for non‐reporting activities.

Conclusion

A time‐based analysis of the academic radiologist’s clinical workload, utilizing the RANZCR‐SATs and RCR 2012 guidelines for primary and secondary reporting, respectively, provides a reasonably accurate reflection of the service pressures in resource‐constrained environments and has potential international applicability.
Does Medicare‐eligible high‐risk breast cancer screening MRI target the right women?
Authors: Lo Glen , McLaughlin Aden , Jacques Angela , Dhillon Ravinder , Porter Gareth , Jayaratne Thilina , Bose Sharmistha , Bourke Anita
Published: February 2020

Introduction

MRI is the most sensitive modality to screen for breast cancer, but it is expensive with somewhat limited access. Audit of screening performance should reflect appropriate population targeting.

Methods

An observational study on consecutively screened high‐risk women, assessment of the contralateral breast staging a new cancer, or surveillance in women with prior breast cancer or high‐risk lesion in Perth, Western Australia. All breast MRI studies from 1 January 2015 to 7 September 2018 were included. Studies were 3T comprising T2, DWI, ADC and T1‐weighted +/‐ fat saturation +/‐ IV gadolinium, +/‐ subtraction. DCE was read on the dynamics or DynaCAD (Invivo, Gainesville, FL, USA). Fellowship‐trained breast radiologists blindly double‐read by consensus; additional reader/s arbitrated. The reference standard was the histopathology result or cancer registry notification for cancer diagnoses and benign biopsies, benign follow‐up imaging or subsequent screening MRI.

Results

Of 993 MRI studies in 554 women, 870 eligible MRI were performed in 471 women, and 706 had a reference standard. Median age was 44 years (range 18–80). The majority of studies (65% 457/706) were screening Medicare rebate‐eligible high familial risk; 26% for surveillance after a breast cancer or contralateral staging; 6% screened BRCA carriers. Eleven cancers were diagnosed, eight were MRI‐detected. Only two of these were at high‐risk screening MRI. Five were detected at staging contralateral ILC, after negative 2D mammography and ultrasound. Cancer prevalence was highest for staging contralateral ILC, at 600/10,000 MRI, for high‐risk screening 77/10,000 MRI and surveillance 116/10,000 MRI.

Conclusions

Cancers were predominantly detected in women undergoing preoperative staging of new invasive lobular carcinoma in the contralateral breast, rather than the Medicare rebate‐eligible high‐risk screening group.