bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of scenarios for the integrated management of construction and demolition waste by life cycle assessment: A case study in Brazil
Authors: Penteado Carmenlucia Santos Giordano , Rosado Laís Peixoto
Published: July 2016

Brazil, as a result of economic development and strengthening of the construction industry in recent years, is generating an increasing amount of construction and demolition waste (CDW). Hence, environmental assessment of the management systems is vital. A life cycle assessment (LCA) is presented of CDW management in a medium-sized municipality located in the southeast region of Brazil, where the impacts of leaching were not considered due to absence of consistent data. Six different proposed scenarios for the current CDW management situation have been considered. These scenarios comprised the combined use of landfilling, sorting, and recycling, and the use of CDW as paving material for landfill roads, in different percentages. Considering 0.8 ton of waste as the functional unit, the life cycle inventory was performed using primary data obtained from field survey and secondary data from the database Ecoinvent version 3.1, and from the literature. The method CML 2 baseline 2001 was used for environmental impacts evaluation. The results highlight that recycling is beneficial when efficient CDW sorting takes place at construction sites, avoiding the transport of refuse to sorting and recycling facilities, and the distance between the generation source and the recycling unit is within 30 km. Thus, our results are helpful to ensure that the decision-making processes are based on environmental and technical aspects, and not only on economic and political factors, and also provide data and support for other LCA studies on CDW.
A spatial analysis of hierarchical waste transport structures under growing demand
Authors: Tanguy Audrey , Glaus Mathias , Laforest Valérie , Villot Jonathan , Hausler Robert
Published: July 2016

The design of waste management systems rarely accounts for the spatio-temporal evolution of the demand. However, recent studies suggest that this evolution affects the planning of waste management activities like the choice and location of treatment facilities. As a result, the transport structure could also be affected by these changes. The objective of this paper is to study the influence of the spatio-temporal evolution of the demand on the strategic planning of a waste transport structure. More particularly this study aims at evaluating the effect of varying spatial parameters on the economic performance of hierarchical structures (with one transfer station). To this end, three consecutive generations of three different spatial distributions were tested for hierarchical and non-hierarchical transport structures based on costs minimization. Results showed that a hierarchical structure is economically viable for large and clustered spatial distributions. The distance parameter was decisive but the loading ratio of trucks and the formation of clusters of sources also impacted the attractiveness of the transfer station. Thus the territories’ morphology should influence strategies as regards to the installation of transfer stations. The use of spatial-explicit tools such as the transport model presented in this work that take into account the territory’s evolution are needed to help waste managers in the strategic planning of waste transport structures.
Sustained Community Theater Participation as Civil Society Involvement
Authors: Forenza Brad
Published: July 2016

Community theaters proliferate in every state in the nation, yet they are rarely considered in civil society research. Participation in civil society is capable of producing individual (psychological empowerment) and community-level outcomes, yet less is known about how community theaters might be capable of producing the same. Guided by the empirically tested dimensions of intra-organizational empowerment, this qualitative study interrogates four internal processes of voluntary membership in a community theater (shared beliefs, opportunity role structure, social support, and leadership). Directed content analysis of 14 in-depth interviews support and extend our understanding of existing theory for this less examined population. Implications for policy, practice, and future research are discussed.
Religious Environments and the Distribution of Anti-Poverty Nonprofit Organizations
Authors: Polson Edward C.
Published: July 2016

Previous scholarship highlights the effect that religious environments have on community-level outcomes such as neighborhood stability, economic development, and crime. In the present study, I extend work on the contextual effects of religion by examining how the religious composition of U.S. counties is related to the distribution of anti-poverty nonprofit organizations. Anti-poverty nonprofits represent an important source of support for communities across the United States, and history suggests that religious people and groups have played a significant role in their development. Still, it is unclear whether some religious environments may be more nurturing of these organizations than others. Utilizing spatial regression models and county-level data, I seek to address this question. I find that the geographic concentration of some religious traditions is related to a more robust presence of anti-poverty nonprofit organizations than others.
Coupling stability-enhancing mechanism with compact self-recirculating injection in an axial flow compressor
Authors: Li Jichao , Du Juan , Nan Xi , Liu Le , Lin Feng
Published: July 2016

Compact self-recirculating injection that bleeds air from the casing downstream of a rotor blade row and injects the air as a wall jet upstream of the same rotor blade row is experimentally studied after the elaborated design of its structure. The bleed ports, injection ports, and recirculating channels are circumferentially discrete and occupy only 38% of the circumference. Separate tip air injection and outlet bleed air are simultaneously selected for comparison with the self-recirculating injection. Results show that the compact self-recirculating injection can improve the most stall margin by 6.12% among all the three cases on the premise of no efficiency penalty and can also enhance the efficiency (maximum of 1%) for only 0.47% of the total injected momentum ratio recirculated near stall. The details of the flow field are obtained using a multihole probe, a time-resolved Kiel probe, and pressure transducers. The detailed comparative analysis of the characteristic flow in terms of tip leakage flow, blade load, rotor wake feature, and blockage indicates that the self-recirculating injection can postpone the occurrence of stalling in the proposed compressor through a coupling influencing mechanism. One mechanism is to weaken the self-induced unsteadiness of tip leakage flow and to delay the forward movement of the interface between the tip leakage flow and the main flow. The other mechanism is to unload the blade tip and to recover the rotor wake. All these responses can lead to improved stall margin in the self-recirculating injection. This study may be helpful to guide the design of self-recirculating injection in actual application.
Behavioural Red Flags of Fraud— A Qualitative Assessment
Authors: Sandhu Namrata
Published: July 2016

Fraud literature suggests that the presence or absence of fraudulent intentions can be assessed by a close scrutiny of human behaviour. This can help identify prospective fraud perpetrators. Given this consideration, the present study qualitatively explores the observations and views of people who have personally investigated or closely observed a fraud/fraudster. Twenty-six interviews help condense a checklist of behavioural red flags of fraud. The themes of strong ambition, social aloofness, extended working hours, dissatisfaction with current job, justifying unethical behaviour, personal problems and living standard disproportionate to current means are central to the articulations of the experiences of the respondents. Findings of the study have been integrated with the theory of the fraud triangle. This research displays the complementarity between a primary data based ex-post analysis of the behaviour of fraud perpetrators and existing literature on the subject. The results are likely to help improve professional standards related to frauds, both from an organizational and regulatory perspective.
Interventions for Reducing Hospital Readmission Rates: The Role of Hospice and Palliative Care
Authors: Cherlin Emily J. , Brewster Amanda L. , Curry Leslie A. , Canavan Maureen E. , Hurzeler Rosemary , Bradley Elizabeth H.
Published: July 2016

Background:

Despite evidence that enrollment with hospice services has the potential to reduce hospital readmission rates, previous research has not examined exactly how hospitals may promote the appropriate use of hospice and palliative care for their discharged patients. Therefore, we sought to explore the strategies used by hospitals to increase the use of hospice and palliative care for patients at risk of readmission.

Methods:

We conducted a secondary analysis of qualitative data from a study of hospitals that were participating in the State Action on Avoidable Readmissions (STAAR) initiative, a quality improvement collaborative. We used data attained from 46 in-depth interviews conducted during 10 hospital site visits using a standard discussion guide and protocol. We used a grounded theory approach using the constant comparative method to generate recurrent and unifying themes.

Results:

We found that a positive effect for hospitals participating in the STAAR initiative was enhanced engagement in efforts to promote greater use of hospice and palliative care as a possible method of reducing unplanned readmissions, the central goal of the STAAR initiative. Hospital staff described strategies to increase the use of hospice and palliative care that included (1) designing and implementing tracking systems to identify patients most at risk of being readmitted, (2) providing education about hospice and palliative care to family, internal and external clinical groups, and (3) establishing closer links to posthospital settings.

Conclusion:

National efforts to reduce rehospitalizations may result in improved integration of hospice and palliative care for patients who are at risk of readmission.
Students as Protégés
Authors: Bear Stephen , Jones Gwen
Published: July 2016

This study provides insight into the factors that influence satisfaction with an Internet-based practitioner–student mentoring relationship that is part of an undergraduate business school curriculum. Practitioner mentors are especially important because they can help student protégés learn the skills needed for their professional development, encourage the formation of professional networks, and enhance the protégés’ satisfaction with their education. In this study, we examine a number of factors that can potentially influence satisfaction with the mentoring relationship, including the protégé’s networking to find a mentor, protégé trust in the mentor, protégé self-disclosure, the level of protégé understanding of the mentoring program’s objectives, and how effectively the mentor serves as a role model. Hypotheses were tested through a structural equation model. The results showed that mentoring relationship satisfaction was positively associated with networking to find a mentor, trust in the mentor, protégé self-disclosure, protégé understanding of the objectives of the mentoring program, and the degree to which the protégé viewed the mentor as a role model. In addition, mentor trust was positively associated with the level of protégé self-disclosure. Implications for theory and practice are discussed, and recommendations on how to strengthen satisfaction with practitioner–student mentoring relationships are provided.
Lest Voting Also Become Theft
Authors: Walsh Sean Noah , Johnson Arielle Kay
Published: July 2016

Along with inequality in wealth, politics is increasingly divided between a very small percentage who can afford access and the vast majority who are effectively marginalized. In 2014, billionaire Tom Perkins essentially proposed eliminating that last trace of fairness by arguing that one ought to be able to purchase as many votes as he or she could afford. Ostensibly, one million dollars would buy one million votes. Given the current state of inequality, we concur that “one person, one vote” is no longer sensible. However, following from the political philosophy of Pierre Proudhon, we take the position that “property is theft.” Accordingly, the possession of wealth, far from being a source of increased rights, is exactly what disqualifies an individual from supernumerary votes. Instead, drawing upon Proudhon’s views, and those of other nineteenth-century anarchists, we argue that the poorest in society, those who have the least property and have therefore committed the least theft, ought to have a surplus of votes. Using anarchism as a framework for critique within the parameters of existing politics, we will argue that as wealth declines, individuals ought to be bestowed with additional votes as compensation.
Screening for Malignancy in Patients With Unprovoked Venous Thromboembolism: A Single-Center Retrospective Case Series
Authors: Barrett Aisling , Kevane Barry , Hall Patricia , Ní Áinle Fionnuala , Breslin Tomás
Published: July 2016

In this prospective review of cancer screening in unselected patients with unprovoked venous thromboembolism (VTE) presenting to a large teaching hospital in the Republic of Ireland, we aimed to determine the effects of the implementation of the National Institute for Health and Care Excellence screening policy in a “real-world” population. Within our institution, 64 individuals presented with unprovoked VTE during the study period, of whom 47 underwent a screening computed tomography (CT) scan. Two cases of previously undiagnosed cancer were identified. However, in both cases, the clinical history provided by the affected individuals would have prompted a CT scan regardless of the recommendations of the screening policy. The screening CT scans identified 18 incidental lesions within the cohort, which required further diagnostic studies. None of the additional investigations completed to date have detected any lesion of clinical significance. These findings support the view that cancer screening with CT imaging in unselected individuals with unprovoked VTE is not justified or cost-effective.
Strategic Visibility and the Production of Day-Labor Spaces: A Case Study from the San Diego Metropolitan Area
Authors: Crotty Sean M.
Published: July 2016

In cities across the United States, groups of mostly men congregate in public and semipublic spaces in hopes of being hired for short-term work. The particular spaces where laborers congregate each day are crucial to their economic and social fortunes, yet to date, there is limited research examining the spatial organization of these sites. In this article, I draw on relational perspectives on the production of space and governmentality practices to examine day-labor hiring spaces in the San Diego Metropolitan Area. Drawing on more than seven years of mixed-methods research, I argue that laborers collectively employ strategic visibility: a set of spatial practices that reduces the potential for conflict and ensures laborers’ continued access to the particular spaces on which their survival depends. This analysis suggests that laborers’ site-selection and spatial practices are driven by pragmatic, economic concerns, rather than fear of interactions with policing agencies and/or anti-immigrant residents.
Noninvasive Brain Stimulation Techniques Can Modulate Cognitive Processing
Authors: Veniero Domenica , Strüber Daniel , Thut Gregor , Herrmann Christoph S.
Published: July 2016

Recent methods that allow a noninvasive modulation of brain activity are able to modulate human cognitive behavior. Among these methods are transcranial electric stimulation and transcranial magnetic stimulation that both come in multiple variants. A property of both types of brain stimulation is that they modulate brain activity and in turn modulate cognitive behavior. Here, we describe the methods with their assumed neural mechanisms for readers from the economic and social sciences and little prior knowledge of these techniques. Our emphasis is on available protocols and experimental parameters to choose from when designing a study. We also review a selection of recent studies that have successfully applied them in the respective field. We provide short pointers to limitations that need to be considered and refer to the relevant papers where appropriate.
Extra Virgin Olive Oil Improves Oxidative Stress, Functional Capacity, and Health-Related Psychological Status in Patients With Fibromyalgia
Authors: Rus Alma , Molina Francisco , Ramos Manuel Miguel , Martínez-Ramírez María Josefa , del Moral María Luisa
Published: July 2016

Objectives:

Fibromyalgia (FM) is a chronic disease that imposes physical, psychological, and social limitations. We have reported that oxidative stress may play a role in the pathophysiology of FM. Olive oil has been shown to be effective treatment against the oxidative stress associated with several diseases. The aim of this study was to investigate the effect of olive oil on oxidative stress and health-related parameters in FM.

Methods:

This preliminary study was performed on blood samples of 23 women diagnosed with FM who consumed 50 ml of organic olive oil daily for 3 weeks. Subjects were randomized into two groups: one ingested extra virgin olive oil (EVOO) and the other refined olive oil (ROO), which have different antioxidant content. The patients’ oxidative (lipid, protein, and DNA oxidation) and antioxidative (antioxidant enzyme activities and compounds) profiles were examined before and after the treatment period. Functional capacity and physical and mental health status were assessed using the Fibromyalgia Impact Questionnaire (FIQ) and the Physical Component (PCS-12) and Mental Component Summaries (MCS-12) of the Short Form-12 Health Survey, respectively.

Results:

Significant differences were found in pre–post change between the EVOO and ROO groups for protein carbonyls, lipid peroxidation, and FIQ and MCS-12 scores. Differences between groups approached statistical significance for oxidative DNA damage and levels of the antioxidant compound zinc.

Conclusions:

EVOO may protect women with FM against oxidative stress in addition to improving functional capacity and health-related psychological status. Findings suggest that olive oil may be a valuable therapeutic support in FM.
Factors Associated With Inadequate Effectiveness of a Multidisciplinary Disease Management Program in Heart Failure Patients Stratified by Galectin 3 Level
Authors: Liu Min-Hui , Wang Chao-Hung , Chiou Ai-Fu , Yang Ning-I , Kuo Li-Tang
Published: July 2016

Objective:

This study investigated whether multidisciplinary disease management programs (MDPs) exert the same effects in heart failure (HF) patients across risk levels stratified by galectin-3 (Gal-3) level and what factors are associated with inadequate effectiveness of MDP.

Methods:

We used a longitudinal follow-up design based on a previous randomized trial. A total of 355 stabilized hospitalized HF patients were enrolled. The effects of MDP on death and HF-related rehospitalization were analyzed according to Gal-3 levels.

Results:

During the 4-year follow-up, Gal-3 levels predicted mortality and composite events ( p < .001). Multivariable analysis demonstrated the event-lowering effect of MDP (hazard ratio [HR] = 0.49, p = .001 for death and HR = 0.50, p < .001 for composite events). However, the effect of MDP was inadequate for those with high Gal-3 levels (≥17.9 ng/ml), whose 4-year composite event rate was 43% in the MDP arm. Further analysis showed that, in patients with Gal-3 ≥ 17.9 ng/ml, the independent factors associated with a high composite event rate were no MDP, older age, worse New York Heart Association functional class, no angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker use, higher predischarge natriuretic peptide levels, and wider QRS complexes.

Conclusions:

The effectiveness of MDP for HF patients at high risk was inadequate. Our findings identified the characteristics of these MDP nonresponders. Better integration of advanced care plans based on strategies guided by Gal-3 level is needed to improve care quality.
An Approach to Urinary Incontinence for Dermatologists
Authors: Ladha Malika , Wagg Adrian , Dytoc Marlene
Published: July 2016

Incontinence-associated dermatitis (IAD) is a condition often encountered by dermatologists. IAD is an inflammatory skin condition secondary to prolonged urine exposure—it is a dermatologic sequela of urinary incontinence. Incontinence should not be dismissed simply as an age-related disorder; rather, it is due to a number of pathologic conditions that can be either reversible or manageable. It is thus critical to identify and treat the underlying causes of urinary incontinence. Clinical management of this common medical issue restores normality to patients’ lives while also preventing future dermatologic complications. In this article, we aim to provide dermatologists with an overview of IAD and an approach to the diagnosis and initial management of urinary incontinence.
Telehealth clinics increase access to care for adults with cystic fibrosis living in rural and remote Western Australia
Authors: Wood Jamie , Mulrennan Siobhain , Hill Kylie , Cecins Nola , Morey Sue , Jenkins Sue
Published: July 2016

Introduction

A significant proportion (15%, n = 28) of the adults with cystic fibrosis (CF) in Western Australia (WA) live in rural and remote areas and have difficulty accessing specialist care at the state adult CF centre, located in Perth. We aimed to increase access by offering telehealth clinics, and evaluate the impact on health outcomes.

Methods

Telehealth clinics were offered via videoconference over a 12-month period, with uptake and satisfaction measured at the end of the intervention. Participants could still attend in person clinics at the CF centre if requested. Other outcomes comprised healthcare utilisation (HCU), spirometry, weight and health-related quality of life.

Results

In 21 participants, total clinic visits increased from 46 (median (range) per participant 2 (0–6)) in the 12-month period preceding the study to 100 (5 (2–8), p < 0.001) during the intervention. Of the 100 clinics in total, 66 were delivered via telehealth. Satisfaction with telehealth was high and most (94%) participants agreed that telehealth is a good way to deliver CF care. An increase in intravenous antibiotic days (incident rate ratio (IRR) 2.3, p = 0.03) and hospital admission days (IRR 3.7, p = 0.01) was observed. There was an improvement in the vitality domain of the Cystic Fibrosis Questionnaire – Revised ( p < 0.05).

Discussion

Telehealth had good uptake and increased clinic attendance in adults with CF living in rural and remote WA, and had high satisfaction amongst participants. The increase in HCU, resulting from increased detection and treatment of exacerbations, may improve long-term outcomes in this population.
Impact localization by a multi-radio sink–based wireless sensor network for large-scale structures
Authors: Ren Yuanqiang , Yuan Shenfang , Qiu Lei , Mei Hanfei
Published: July 2016

With the rapid development of wireless sensor network technology, more and more researchers have been interested in taking advantages of wireless sensor network to reduce weight and cost and to solve the installing problem of the wired structural health monitoring systems. A number of wireless-based structural health monitoring methods have been developed over the years to ensure the safety of large-scale structures. However, little research has been reported on wireless impact monitoring of large-scale composite structures due to the limitations of ordinary monitoring methods and wireless sensor networks. In this article, a wireless multi-radio sink which can access multiple communication channels is developed and adopted to build an impact monitoring wireless sensor network. Besides, a corresponding network architecture with an energy-weighted factor–based localization method adopted is presented to enable impact localization within the whole monitoring scope of the network. To verify the performance of the impact monitoring wireless sensor network, the experiments are performed on complex aircraft composite structures and the experimental results prove the effectiveness of the proposed wireless sensor network.
Further Field Evidence for Minimax Play
Authors: Dohmen Thomas , Sonnabend Hendrik
Published: July 2016

This article provides evidence for mixed strategy play in a natural setting, using data from penalty kicking in professional German soccer. A penalty kick is a two-person constant-sum game. We distinguish two strategies for both players, namely, choosing left or right and verify empirically that the two main requirements for the existence of a Nash equilibrium in mixed strategies are met: (1) the expected payoffs are equal across strategies and (2) we cannot reject the hypothesis that players choose their actions randomly.
Alterations in zebrafish development induced by simvastatin: Comprehensive morphological and physiological study, focusing on muscle
Authors: Campos Laise M , Rios Eduardo A , Guapyassu Livia , Midlej Victor , Atella Georgia C , Herculano-Houzel Suzana , Benchimol Marlene , Mermelstein Claudia , Costa Manoel L
Published: July 2016

The cholesterol synthesis inhibitor simvastatin, which is used to treat cardiovascular diseases, has severe collateral effects. We decided to comprehensively study the effects of simvastatin in zebrafish development and in myogenesis, because zebrafish has been used as a model to human diseases, due to its handling easiness, the optical clarity of its embryos, and the availability of physiological and structural methodologies. Furthermore, muscle is an important target of the drug. We used several simvastatin concentrations at different zebrafish developmental stages and studied survival rate, morphology, and physiology of the embryos. Our results show that high levels of simvastatin induce structural damage whereas low doses induce minor structural changes, impaired movements, and reduced heart beating. Morphological alterations include changes in embryo and somite size and septa shape. Physiological changes include movement reduction and slower heartbeat. These effects could be reversed by the addition of exogenous cholesterol. Moreover, we quantified the total cell number during zebrafish development and demonstrated a large reduction in cell number after statin treatment. Since we could classify the alterations induced by simvastatin in three distinct phenotypes, we speculate that simvastatin acts through more than one mechanism and could affect both cell replication and/or cell death and muscle function. Our data can contribute to the understanding of the molecular and cellular basis of the mechanisms of action of simvastatin.
Narrative Research Evolving
Authors: Bruce Anne , Beuthin Rosanne , Sheilds Laurene , Molzahn Anita , Schick-Makaroff Kara
Published: July 2016

Narrative research methodology is evolving, and we contend that the notion of emergent design is vital if narrative inquiry (NI) is to continue flourishing in generating new knowledge. We situate the discussion within the narrative turn in qualitative research while drawing on experiences of conducting a longitudinal narrative study. The philosophical tensions encountered are described, as our understanding and application of narrative approaches evolved. We outline challenges in data collection and analysis in response to what we were learning and identify institutional barriers within ethics review processes that potentially impede emergent approaches. We conclude that researchers using NI can, and must, pursue unanticipated methodological changes when in the midst of conducting the inquiry. Understanding the benefits and institutional barriers to emergent aspects of design is discussed in this ever-maturing approach to qualitative research.
How to warn: ‘Outside-in warnings’ of Western governments about violent conflict and mass atrocities
Authors: Meyer Christoph O. , Otto Florian
Published: July 2016

The literature on the warning-response gap in conflict prevention over-emphasizes political will as the crucial variable, whereas warning is not considered problematic. This article makes the case for distinguishing more clearly signs and indications from actual warnings. Furthermore the article argue that the quality of warnings matters for achieving at least partial persuasive success with decision-makers. The article identify key factors limiting or enhancing warning impact, focusing on source credibility, message content and communication mode. They argue that warning communicators need to take credibility problems more seriously, invest more time in identifying, understanding and building relationships with the most relevant recipients and tailor warnings accordingly in terms of content, timing and communication mode. If organizations lack the capacity to provide credible prescriptions on how to act, they should concentrate on high quality reporting to enhance rather than damage their credibility.
Transforming Identities
Authors: Carver Cynthia L.
Published: July 2016

Since 1997, the Great Lakes Academy has provided leadership development for more than 800 teachers in a large metropolitan region of the Upper Midwest. Graduates of the 2-year program often describe their experience as transformative, life changing, and profound. To understand the meaning and impact of this transformation, the author used Mezirow’s theory of transformative learning as a lens for analyzing the written reflections of recent graduates and interviews with teachers who completed the program 2 years earlier. Study findings highlight the importance of identity transformation as a critical step in the preparation of teacher leaders.
Quantifying Coach Confirmation
Authors: Cranmer Gregory A. , Brann Maria , Weber Keith
Published: July 2016

The lack of appropriate measurement to assess athlete-coach interaction and athletes’ psychological states has historically plagued sport studies research (i.e., an encompassing term for sport psychology, management, sociology, and communication) and may partially explain the lack of empirical research regarding athlete-coach interaction within the emerging field of sport communication. Without valid and reliable tools to assess athlete-coach interactions, understanding the antecedents and outcomes of these relationships, which is a central aim of sport communication research, cannot be accomplished. This article develops and demonstrates validity for a measure of the coach confirmation instrument (CCI) via two studies. In Study 1, an exploratory factor analysis and parallel analysis produced a 15-item, two-factor measure (challenge and acceptance). In Study 2, a confirmatory factor analysis confirmed this two-factor structure had an acceptable-to-good fit using a variety of fit indices. Additionally, preliminary degrees of validity for the CCI were demonstrated through Pearson correlations with athletes’ feeling of being confirmed, coach satisfaction, and perceptions of coach verbal aggression. Collectively, these studies indicate the CCI is a structurally stable measure, which demonstrates good reliability and initial degrees of face, concurrent, convergent, discriminant, and content validity.
How I treat hepatitis C virus infection in patients with hematologic malignancies
Authors: Torres Harrys A. , McDonald George B.
Published: July 2016

Hepatitis C virus (HCV) infection is not uncommon in cancer patients. Over the past 5 years, treatment of chronic HCV infection in patients with hematologic malignancies has evolved rapidly as safe and effective direct-acting antivirals (DAAs) have become the standard-of-care treatment. Today, chronic HCV infection should not prevent a patient from receiving cancer therapy or participating in clinical trials of chemotherapy because most infected patients can achieve virologic cure. Elimination of HCV from infected cancer patients confers virologic, hepatic, and oncologic advantages. Similar to the optimal therapy for HCV-infected patients without cancer, the optimal therapy for HCV-infected patients with cancer is evolving rapidly. The choice of regimens with DAAs should be individualized after thorough assessment for potential hematologic toxic effects and drug-drug interactions. This study presents clinical scenarios of HCV-infected patients with hematologic malignancies, focusing on diagnosis, clinical and laboratory presentations, complications, and DAA therapy. An up-to-date treatment algorithm is presented.
Management algorithm for failed gastric pull up reconstruction of laryngopharyngectomy defects: Case report and review of the literature
Authors: Butskiy Oleksandr , Anderson Donald W. , Prisman Eitan
Published: July 2016

Background

Gastric pull up remains a popular reconstructive option for pharyngoesophagectomy defects extending to thoracic inlet. Gastric necrosis is a dreaded complication of gastric pull up reconstruction and few studies report on management of this complication. MEDLINE, EMBASE, and Web of Science™ databases were searched for publications in the last 25 years on gastric pull up reconstruction following pharyngoesophagectomy. The rates of complications related to gastropharyngeal anastomosis were extracted, and methods of managing gastric necrosis were noted. Forty seven case series were identified reporting on the use of gastric pull up for reconstruction of pharyngoesophageal defects. Mortality rate varied from 0 to 33 % with a weighted average of 8.6 %. In 39 % of patients, mortality was either caused or directly related to failure of the gastropharyngeal anastomosis. The reported rate of gastric necrosis ranged from 0 to 24 % resulting in a 28 % mortality. Options for managing gastric necrosis included: temporary cervical diversion, free jejunum flap, colonic interposition, tubed radial forearm flap, deltopectoralis and pectoralis myocutaneous flaps.

Case presentation

We present the first case of an anterolateral thigh flap rescue of gastric necrosis after gastric pull up reconstruction. The case report is followed by a review of literature on management of gastric pull up failures.

Conclusion

Based on the extracted information, we propose an algorithm for managing gastric pull up failure following pharyngoesophageal reconstruction.
Late IL-3–induced phenotypic and functional alterations in human basophils require continuous IL-3 receptor signaling
Authors: Kämpfer Sacha S , Odermatt Andrea , Dahinden Clemens A , Fux Michaela
Published: July 2016

Cytokines of the GM-CSF family signal via the same receptor subunit (βc) and, thus, have overlapping effects on cells that express all cytokine-specific α-chains (IL-3Rα, IL-5Rα, GM-CSFRα), such as human basophils, whose rapid effector functions are similarly enhanced by IL-3, IL-5, and GM-CSF. However, previous work has shown that IL-3, but not IL-5 and GM-CSF, supports and induces allergy-associated functions of human basophils at later time points. This includes induction of Th2 cytokine and chemokine secretion, high-affinity IgE receptor–independent leukotriene C4 (LTC4) formation, expression of enzymes (e.g., RALDH2, granzyme B), and kinases (e.g., Pim1). Here, we address the question of why IL-3, but not IL-5 or GM-CSF, is capable of inducing these late responses in human basophils, and we investigate the mechanism that underlies the unique regulatory capacity of IL-3. We find that IL-3, IL-5, and GM-CSF rapidly activate the same canonical signaling cascades in a qualitatively identical manner with comparable strength, but we identify signaling duration as major discriminating factor. IL-5 and GM-CSF rapidly down-regulate surface levels of their receptors within minutes, concomitant with a rapid decay in signaling molecule activation and time-dependent loss of ability of these cytokines to prime basophils for functional responses. By contrast, IL-3 hardly down-regulates the α-chain of its receptor without depleting the common β-chain, which enables extraordinarily sustained signaling events, predominantly the activation of Stat5. Of interest, acute IL-3 signaling is not sufficient to induce persistent phenotypical and functional changes in human basophils. Induction of these functional late responses depends on continuous IL-3 receptor activation and signaling.
Social support and protection from depression: systematic review of current findings in Western countries
Authors: Gariépy Geneviève , Honkaniemi Helena , Quesnel-Vallée Amélie
Published: July 2016

Background

Numerous studies report an association between social support and protection from depression, but no systematic review or meta-analysis exists on this topic.

Aims

To review systematically the characteristics of social support (types and source) associated with protection from depression across life periods (childhood and adolescence; adulthood; older age) and by study design (cross-sectionalv. cohort studies).

Method

A systematic literature search conducted in February 2015 yielded 100 eligible studies. Study quality was assessed using a critical appraisal checklist, followed by meta-analyses.

Results

Sources of support varied across life periods, with parental support being most important among children and adolescents, whereas adults and older adults relied more on spouses, followed by family and then friends. Significant heterogeneity in social support measurement was noted. Effects were weaker in both magnitude and significance in cohort studies.

Conclusions

Knowledge gaps remain due to social support measurement heterogeneity and to evidence of reverse causality bias.
Impact of personality status on the outcomes and cost of cognitive–behavioural therapy for health anxiety
Authors: Sanatinia Rahil , Wang Duolao , Tyrer Peter , Tyrer Helen , Crawford Mike , Cooper Sylvia , Loebenberg Gemma , Barrett Barbara
Published: July 2016

Background

Health anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT).

Aims

To test the impact of personality status using ICD-11 criteria on the clinical and cost outcomes of treatment with cognitive–behavioural therapy for health anxiety (CBT-HA) and standard care over 2 years.

Method

Personality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years.

Results

In total, 381 patients (86%) had some personality dysfunction with 184 (41%) satisfying the ICD criteria for personality disorder. Those with no personality dysfunction showed no treatment differences (P= 0.90) and worse social function with CBT-HA compared with standard care (P<0.03) whereas all other personality groups showed greater improvement with CBT-HA maintained over 2 years (P<0.001). Less benefit was shown in those with more severe personality disorder (P<0.05). Costs were less with CBT-HA except for non-significant greater differences in those with moderate or severe personality disorder.

Conclusions

The results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term.
Quality of Patient-Provider Communication Among Cancer Survivors: Findings From a Nationally Representative Sample
Authors: Chawla Neetu , Blanch-Hartigan Danielle , Virgo Katherine S. , Ekwueme Donatus U. , Han Xuesong , Forsythe Laura , Rodriguez Juan , McNeel Timothy S. , Yabroff K. Robin
Published: July 2016

Purpose:

Although patient-provider communication is an essential component of health care delivery, little is known about the quality of these discussions among patients with cancer.

Methods:

Data are from the 2011 Medical Expenditure Panel Survey Experiences with Cancer survey among 1,202 adult cancer survivors. We evaluated discussions with any provider after a cancer diagnosis about: (1) follow-up care; (2) late or long-term treatment effects; (3) lifestyle recommendations, such as diet, exercise, and quitting smoking; and (4) emotional or social needs. Using a response scale ranging from “did not discuss” to “discussed in detail,” a summary score was constructed to define communication quality as high, medium, or low. Patient factors associated with the quality of provider discussions were examined using multivariable polytomous logistic regression analyses.

Results:

At the time of the survey, approximately one half of the patients (46%) were either within 1 year (24.1%) or between 1 and 5 years (22.0%) of treatment. More than one third of cancer survivors reported that they did not receive detailed communication about follow-up care, and more than one half reported that they did not receive detailed communication regarding late or long-term effects, lifestyle recommendations, or emotional and social needs. Only 24% reported high-quality communication for all four elements, indicating that the vast majority experienced suboptimal communication. In multivariable analysis, survivors reporting a high communication quality with providers included those who were within 1 year of treatment, between the ages of 18 and 64 years, non-Hispanic black or other ethnicity, and married.

Conclusion:

Study findings demonstrate gaps in the communication quality experienced by cancer survivors in the United States and help identify survivors for targeted interventions.
Management of Depression in Patients With Cancer: A Clinical Practice Guideline
Authors: Li Madeline , Kennedy Erin B. , Byrne Nelson , Gérin-Lajoie Caroline , Katz Mark R. , Keshavarz Homa , Sellick Scott , Green Esther
Published: July 2016

Purpose:

This report updates the Cancer Care Ontario Program in Evidence-Based Care guideline for the management of depression in adult patients with cancer. This guideline covers pharmacologic, psychological, and collaborative care interventions, with a focus on integrating practical management tools to assist clinicians in delivering appropriate treatments for depression in patients with cancer.

Methods:

Recommendations were developed by synthesizing information from extant guidelines and reviews and searching for randomized controlled trials from the date of database inception (1964 for MEDLINE and 1974 for EMBASE) to January 2015. Quality assessment of guidelines and systematic reviews were conducted by using the Appraisal of Guidelines for Research and Evaluation II (AGREE II), Assessment of Multiple Systematic Reviews (AMSTAR), and Cochrane Risk of Bias tools. Final recommendations were developed through a standardized Program in Evidence-Based Care multidisciplinary expert and knowledge user review process.

Results:

Two high-quality relevant clinical practice guidelines, eight pharmacologic trials, nine psychological trials, and eight collaborative care intervention trials composed the evidence base upon which the recommendations were developed. Eight specific recommendations were made to establish a standard of care for the management of depression in patients with cancer. The recommendations and practical management tools were reviewed as being well organized and helpful, although systemic barriers to implementation were identified.

Conclusion:

This updated guideline supports the previous general recommendation that patients with cancer who have depression may benefit from psychological and/or pharmacologic interventions, without evidence for the superiority of any specific treatment over another. New recommendations for a collaborative care model that incorporates a stepped care approach suggest that multidisciplinary mental health care restructuring may be required for optimal management of depression.
Electronic Release of Pathology and Radiology Results to Patients: Opinions and Experiences of Oncologists
Authors: Winget Marcy , Haji-Sheikhi Farnoosh , Brown-Johnson Cati , Rosenthal Eben L. , Sharp Christopher , Buyyounouski Mark K. , Asch Steven M.
Published: July 2016

Purpose:

There is an emerging standard to provide patients rapid electronic access to elements of their medical records. Although surveys of patients generally support it, this practice is controversial among oncologists, because few empiric data are available for scenarios of potentially life-threatening conditions like cancer. We report the views of oncologists about patient electronic access to radiology and pathology results that could potentially indicate disease progression.

Methods:

Four months before oncologists were surveyed, final results of radiology/pathology reports were routinely made available to patients online through a secure portal after a 7-day, hold to provide clinicians time to review and communicate results with the patients. Mixed methods were used to assess physician attitudes and experiences toward this change.

Results:

One hundred twenty-nine oncologists were surveyed, and 82 (64%) responded. A small majority (54%) responded that the release of reports was somewhat or very beneficial for patients who received normal radiology/pathology results before discussion with a physician, but 87% said it was somewhat or very harmful for patients to receive abnormal results before discussion. Forty-nine percent reported that release of reports had a somewhat or very negative impact on communication with their patients.

Conclusion:

Almost half of oncologists reported that sharing digital radiology and pathology records had a negative impact on their communication with patients. Patient surveys in similar cancer populations would complement the physician perspective. Efforts are needed to improve consensus among oncologists and patients on how to best communicate such results in a timely fashion.
3D correlative light and electron microscopy of cultured cells using serial blockface scanning electron microscopy
Authors: Russell Matthew R. G. , Lerner Thomas R. , Burden Jemima J. , Nkwe David O. , Pelchen-Matthews Annegret , Domart Marie-Charlotte , Durgan Joanne , Weston Anne , Jones Martin L. , Peddie Christopher J. , Carzaniga Raffaella , Florey Oliver , Marsh Mark , Gutierrez Maximiliano G. , Collinson Lucy M.
Published: July 2016

The processes of life take place in multiple dimensions, but imaging these processes in even three dimensions is challenging. Here we describe a workflow for 3D correlative light and electron microscopy (CLEM) of cell monolayers using fluorescence microscopy to identify and follow biological events, combined with serial blockface scanning electron microscopy to analyse the underlying ultrastructure. The workflow encompasses all steps from cell culture to sample processing, imaging strategy and 3D image processing/analysis. We demonstrate successful application of the workflow to three studies, each aiming to better understand complex and dynamic biological processes, including bacterial and viral infections of cultured cells and formation of entotic cell-in-cell structures commonly observed in tumours. Our workflow revealed new insight into the replicative niche of Mycobacterium tuberculosis in primary human lymphatic endothelial cells, HIV-1 in human monocyte-derived macrophages, and the composition of the entotic vacuole. The broad application of this 3D CLEM technique will make it a useful addition to the correlative imaging toolbox for biomedical research.