bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term selection for litter size in swine results in shifts in allelic frequency in regions involved in reproductive processes
Authors: Trenhaile M. D. , Petersen J. L. , Kachman S. D. , Johnson R. K. , Ciobanu D. C.
Published: May 2016

High‐density genotype data were analyzed in three lines of swine that express substantial variation in sow fertility to uncover regions of the genome potentially influenced during selection for litter size traits. The experimental lines examined include the Nebraska Index Line (NIL), which has been subjected to long‐term selection for litter size; a control line derived from the same population that founded NIL; and a commercial Duroc × Hampshire (D × H) population, in which no selection for litter size was practiced. Regions of the genome potentially affected by selection for litter size traits in NIL were determined by multiple lines of evidence, including altered allelic frequency compared to the other lines, loss of heterozygosity and relative extended haplotype homozygosity. Additionally, a genome‐wide association study for litter size traits was conducted in a population based on NIL and commercial maternal line genetics. Several genomic regions identified as putative signatures of selection overlapped with QTL for litter size traits. One of these regions, located on SSC2 (13–14 Mb), includes the candidate gene P2X3R, which plays a role in implantation and sustained release of hormones associated with reproductive processes. Sequencing identified synonymous SNPs in P2X3R that are fixed in NIL but polymorphic with nearly equal frequencies in the D × H line, indicating a potential role of P2X3R in sow fertility. These results suggest that data derived from these lines can help to uncover and understand a portion of the genetic variance associated with fertility traits in swine.
Using proportional modeling to evaluate irrigator preferences for market‐based water reallocation
Authors: Loch Adam , Boxall Peter , Wheeler Sarah Ann
Published: May 2016

Irrigators’ policy preferences for water reallocation programs usually take the form of proportional data, where one option will be relatively more or less favored than another in the composition of a government's total budget apportionment to address water reform. This study applies a zero‐one inflated beta regression to model Murray–Darling Basin irrigators’ preferences for market‐based water policy programs. Market‐based arrangements are more likely to provide efficient solutions to water reallocation problems, particularly where future uncertainty and appropriate pricing induce irrigator preferences for such programs. Our modeling of drivers of irrigator preferences for government expenditure on market‐based programs identified different determinants of zero (a corner solution) and proportional outcomes for the reallocation of Murray–Darling Basin water. In addition, the proportional modeling identifies some variables (namely, state regional influences, the type of farm production and recent debt, low income, or water allocation stressors) that increase engagement with market‐based programs. Interestingly, while price variables are important and statistically significant, they appear to be less relevant to program engagement than other influences.
STAT3 inhibition prevents lung inflammation, remodeling, and accumulation of Th2 and Th17 cells in a murine asthma model
Authors: Gavino A. C. , Nahmod K. , Bharadwaj U. , Makedonas G. , Tweardy D. J.
Published: May 2016

Background

STAT3 drives development of Th17 cells and cytokine production by Th2 and Th17 cells, which contribute to asthma. Alternative asthma treatments are needed, especially for the Th17 phenotype. We sought to determine whether C188‐9, a small‐molecule STAT3 inhibitor, can block Th2 and Th17 cell expansion and cytokine production to prevent house dust mite (HDM)‐induced airway inflammation and remodeling.

Methods

Three groups of C57BL/6 mice were treated intranasally (IN) and intraperitoneally (IP) daily for 3 weeks with the following: (i) vehicle 1 IN and vehicle 2 IP, (ii) HDM IN and vehicle 2 IP, or (iii) HDM IN and C188‐9 IP. Sections of lung were stained with Alcian Blue/PAS and examined microscopically. Total (t) STAT3, STAT3 phosphorylated on Y705 (pSTAT3), IL‐17, IL‐13, IL‐5, and IL‐4 levels were measured in lung protein extracts and serum using Luminex beads. Frequencies of Th2‐type and Th17‐type lymphocytes were assessed in lungs and bronchoalveolar lavage fluid (BALF) by multiparametric flow cytometry.

Results

HDM inhalation markedly increased airway goblet cell numbers and thickness of the epithelium and subepithelial smooth muscle layer, which was accompanied in the whole lung by increased pSTAT3, IL‐4, IL‐5, IL‐13, and IL‐17, and % CD4+ T cells that produce IL‐5, IL‐13, and IL‐17. HDM inhalation also increased serum IL‐4 and IL‐17 levels and increased BALF % CD4+ T cells that produce IL‐5 and IL‐13. Remarkably, treatment with C188‐9 normalized each endpoint.

Conclusion

HDM‐induced airway inflammation, remodeling, and Th2/Th17‐type cell accumulation involve STAT3 activation that can be prevented by C188‐9 treatment.
Bacteriological study in perianal abscess is not useful and not cost‐effective
Authors: Xu Roland W. , Tan Ker‐Kan , Chong Choon‐Seng
Published: May 2016

Background

The detection of gut organisms in perianal abscesses has been postulated to suggest an underlying communication with the anal canal. However, recent studies appear to contradict this observation. The aim of this study is to determine the value of bacteriological studies in perianal abscesses.

Methods

A retrospective study of all patients who have had a surgical drainage of their perianal abscesses with concomitant microbiological examination from January 2010 to December 2012 was performed. Patients with known underlying anal fistula, Crohn's disease or previous perianal operations were excluded.

Results

A total of 164 patients, median age of 42.0 years (range 8–87) comprising of 78.7% males formed the study group. Gut organisms were cultured in 143 (87.2%) samples while 12 (7.3%) demonstrated skin organisms and nine did not yield any bacterial growth (5.5%). Twenty‐nine (17.7%) patients developed anal fistula and 34 (20.7%) patients had a recurrence of the perianal abscess. The median follow‐up period was 1450 (14–2391) days. There was no significant association between the presence of gut organism and development of fistulas (odds ratio = 0.48; 95% confidence interval = 0.17–1.37) or recurrence of perianal abscess (odds ratio = 1.66; 95% confidence interval = 0.46–6.01).

Conclusion

Bacteriological culture in perianal abscess is not useful for predicting the development of anal fistula or abscess recurrence. Hence, there is no need to perform this investigation on a routine basis.
Review article: acute severe ulcerative colitis – evidence‐based consensus statements
Authors: Chen J.‐H. , Andrews J. M. , Kariyawasam V. , Moran N. , Gounder P. , Collins G. , Walsh A. J. , Connor S. , Lee T. W. T. , Koh C. E. , Chang J. , Paramsothy S. , Tattersall S. , Lemberg D. A. , Radford‐Smith G. , Lawrance I. C. , McLachlan A. , Moore G. T. , Corte C. , Katelaris P. , Leong R. W. ,   IBD Sydney Organisation and the Australian Inflammatory Bowel Diseases Consensus Working Group
Published: May 2016

Background

Acute severe ulcerative colitis (ASUC) is a potentially life‐threatening complication of ulcerative colitis.

Aim

To develop consensus statements based on a systematic review of the literature of the management of ASUC to improve patient outcome.

Methods

Following a literature review, the Delphi method was used to develop the consensus statements. A steering committee, based in Australia, generated the statements of interest. Three rounds of anonymous voting were carried out to achieve the final results. Acceptance of statements was pre‐determined by ≥80% votes in ‘complete agreement’ or ‘agreement with minor reservation’.

Results

Key recommendations include that patients with ASUC should be: hospitalised, undergo unprepared flexible sigmoidoscopy to assess severity and to exclude cytomegalovirus colitis, and be provided with venous thromboembolism prophylaxis and intravenous hydrocortisone 100 mg three or four times daily with close monitoring by a multidisciplinary team. Rescue therapy such as infliximab or ciclosporin should be started if insufficient response by day 3, and colectomy considered if no response to 7 days of rescue therapy or earlier if deterioration. With such an approach, it is expected that colectomy rate during admission will be below 30% and mortality less than 1% in specialist centres.

Conclusion

These evidenced‐based consensus statements on acute severe ulcerative colitis, developed by a multidisciplinary group, provide up‐to‐date best practice recommendations that improve and harmonise management as well as provide auditable quality assessments.
Sex differences in mortality among patients admitted with affective disorders in North Norway: a 33‐year prospective register study
Authors: Høye Anne , Nesvåg Ragnar , Reichborn‐Kjennerud Ted , Jacobsen Bjarne K.
Published: May 2016

Objective

Previous studies from North Norway showed significantly increased mortality in patients with schizophrenia and personality disorder. The aim of the present study was to investigate total and cause‐specific mortality in inpatients with affective disorder in a 33‐year follow‐up cohort, with a specific focus on sex differences.

Methods

Based on a hospital case register covering all admissions to psychiatric hospital in the two northernmost counties in Norway from 1980 to 2012, 790 men and 866 women with major depressive disorder and 331 men and 514 women with bipolar disorder were included. The cohort was linked to the Norwegian Cause of Death Registry. The relative mortality in men compared to women was tested using Cox regression with attained age as the time variable. The standardized mortality ratio (SMR) of the patients when compared to the general population in Norway was calculated.

Results

Patients with affective disorders had twice the mortality of the general Norwegian population [SMR = 2.1, 95% confidence interval (CI): 1.9–2.3]. For major depressive disorder, the SMR for total mortality was higher among men (2.6, 95% CI: 2.2–3.0) than women (1.8, 95% CI: 1.5–2.1). For bipolar disorder, no difference was seen between men and women. The SMR for suicide among women showed an increasing trend throughout the period 1980–1990: 20.0 (95% CI: 10.4–38.4); 1991–2001: 27.0 (95% CI: 15.7–46.2); 2002–2012: 40.4 (95% CI: 23.0–71.2).

Conclusions

The substantially increased mortality in patients with affective disorders in Norway has been persistent over a period of 33 years, despite extensive reforms in psychiatric health care. Indications of increasing SMR for suicide in women call for further research.
Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort
Authors: Lambert Christophe G , Mazurie Aurélien J , Lauve Nicolas R , Hurwitz Nathaniel G , Young S Stanley , Obenchain Robert L , Hengartner Nicolas W , Perkins Douglas J , Tohen Mauricio , Kerner Berit
Published: May 2016

Objectives

Thyroid abnormalities in patients with bipolar disorder (BD) have been linked to lithium treatment for decades, yet other drugs have been less well studied. Our objective was to compare hypothyroidism risk for lithium versus the anticonvulsants and second‐generation antipsychotics commonly prescribed for BD.

Methods

Administrative claims data on 24,574 patients with BD were analyzed with competing risk survival analysis. Inclusion criteria were (i) one year of no prior hypothyroid diagnosis nor BD drug treatment, (ii) followed by at least one thyroid test during BD monotherapy on lithium carbonate, mood‐stabilizing anticonvulsants (lamotrigine, valproate, oxcarbazepine, or carbamazepine) or antipsychotics (aripiprazole, olanzapine, risperidone, or quetiapine). The outcome was cumulative incidence of hypothyroidism per drug, in the presence of the competing risk of ending monotherapy, adjusted for age, sex, physician visits, and thyroid tests.

Results

Adjusting for covariates, the four‐year cumulative risk of hypothyroidism for lithium (8.8%) was 1.39‐fold that of the lowest risk therapy, oxcarbazepine (6.3%). Lithium was non‐statistically significantly different from quetiapine. While lithium conferred a higher risk when compared to all other treatments combined as a group, hypothyroidism risk error bars overlapped for all drugs. Treatment (p = 3.86e‐3), age (p = 6.91e‐10), sex (p = 3.93e‐7), and thyroid testing (p = 2.79e‐87) affected risk. Patients taking lithium were tested for hypothyroidism 2.26–3.05 times more frequently than those on other treatments.

Conclusions

Thyroid abnormalities occur frequently in patients with BD regardless of treatment. Therefore, patients should be regularly tested for clinical or subclinical thyroid abnormalities on all therapies and treated as indicated to prevent adverse effects of hormone imbalances on mood.
DYNAMICS BETWEEN NORTH AMERICAN AND EUROPEAN AGRICULTURAL FUTURES PRICES DURING TURMOIL AND FINANCIALIZATION
Authors: Adämmer Philipp , Bohl Martin T. , von Ledebur Ernst‐Oliver
Published: May 2016

North American and European agricultural futures markets faced significant changes in recent years, i.e., the financialization which originated in the USA, the increase of futures trading in Europe and the recent price turmoils in international commodity markets. We analyse the long‐ and short‐run dynamics between North American and European agricultural futures prices during these institutional changes. The empirical results show that the US markets lead in terms of price transmissions and volatility spillovers. US markets, however, predominantly react to deviations from the long‐run equilibrium which indicates a rising impact of European agricultural markets on a global scale.
Between a cap and a higher price: Modelling the price of dairy quotas under price ceiling legislation
Authors: Chernoff Alex W.
Published: May 2016

This paper considers various policy alternatives to price ceiling legislation in the market for production quotas in the dairy farming sector in Quebec. I develop a model of farmers’ demand for quotas and estimate a structural parameter that is required for the counterfactual experiments. Using my econometric results and the modelled equilibrium price, I estimate the price of dairy quotas over the period 1993–2011. The counterfactual experiments indicate that the price of quotas could be reduced to the ceiling price through a 4.16% expansion of the aggregate supply of quotas, or through moderate trade liberalization of Canadian dairy products.
Predictive value of E/A and E/E′ Doppler indexes for cardiac events in heart transplant recipients
Authors: Ambrosi Pierre , Macé Loic , Habib Gilbert
Published: May 2016

Background

Doppler‐derived indexes associated with high left ventricular filling pressures are risk factors for cardiac events in various populations. The aim of this study was to evaluate the predictive value of two of these Doppler indexes during the long‐term follow‐up of heart transplantation.

Methods and Results

In this cohort study, we measured E/A ratio combining early filling velocity (E) with late filling velocity (A) and E/E′ ratio combining E wave with relaxation velocity on tissue doppler (E′) in 122 transplant heart recipients, 6.9±5.9 years after transplantation. The patients were followed for 97±32 months after Doppler measurements. We found an E/A>2 in 68 patients and an E/E′>15 in 23 patients. Forty patients had a cardiac event (cardiac death, retransplantation, acute coronary events, hospitalization for heart failure, treated acute rejection episodes, and coronary revascularization procedures) during the follow‐up. In multivariate analysis, E/A and E/E′ were significantly associated with cardiac events (hazard ratio 2.2, 95% CI: 1.1–4.4; P=.02 and hazard ratio 2.3, 95% CI: 1.1–4.8; P=.02, respectively). E/E′, E/A, and significant coronary stenoses were the strongest predictors of cardiac events.

Conclusions

E/A and E/E′ Doppler indexes may be used to predict cardiac events during the long‐term follow‐up of heart transplant recipients.
Measuring Corruption in China: An Expenditure‐based Approach Using Household Survey Data
Authors: Zhong Hai
Published: May 2016

Most existing micro‐level empirical analyses of corruption rely on administrative records, special‐purpose surveys or field experiments, which can be difficult or very costly to obtain in some situations. In this paper, we apply an expenditure‐based method of quantifying the extent of corruption in a particular country using household survey data. This method utilizes discrepancies between consumption and reported income to measure corruption. Another contribution of this paper is that it provides the first objective estimate of the extent of corruption in China. We use a quadratic clothing expenditure function to estimate the extent of corruption in China in 2002.
Genome engineering tools for building cellular models of disease
Authors: Lin Jennie , Musunuru Kiran
Published: May 2016

With the recent development of methods for genome editing of human pluripotent stem cells, study of the genetic basis of human diseases has been rapidly advancing. Genome‐edited differentiated stem cells have provided new and more accurate insights into genomic underpinnings of diseases for which there have not been adequate treatments, and moving toward clinical application of genome editing holds great promise for acceleration of therapeutic translation. Here, we review recent advances in genome‐editing technologies and their application to human biology in disease modeling and beyond.
Invasive willows drive instream community structure
Authors: McInerney Paul J. , Rees Gavin N. , Gawne Ben , Suter Phil , Watson Garth , Stoffels Rick J.
Published: May 2016

Exotic invasive species are known to influence taxonomic communities and ecological processes. Few studies have examined the impact on taxonomic communities across trophic levels because it is time consuming and requires a wide range of identification skills.

Here, we examined the impacts of invasive willow trees (Salix spp.) on microbial and macroinvertebrate composition using a combination of high resolution ecogenomic and classical approaches. Aquatic communities were compared and contrasted between stream reaches with and without willow infestation in three temperate Australian streams.

Willows significantly altered in‐stream fungal, algal and macroinvertebrate communities. Macroinvertebrate diversity was similar between riparian types. Willow‐infested sites were characterised by lower macroinvertebrate abundance and Australian biotic index scores, indicating the presence of taxa generally more tolerant to pollution.

At invaded sites, grazers were replaced by generalist collector–gatherer taxa and the proportions of macroinvertebrate functional‐feeding groups (FFG) were altered such that the primary trophic pathway was changed from an autotrophic algal‐based pathway to a heterotrophic, detrital‐based pathway.

Riparian invasion by willows may change the primary source of energy from autotrophy to heterotrophy in small streams, with knock‐on effects on community structure across trophic levels.
Gluten weight in ancient and modern wheat and the reactivity of epitopes towards R5 and G12 monoclonal antibodies
Authors: Gélinas Pierre , McKinnon Carole
Published: May 2016

Differences in the level of coeliac‐active gluten epitopes in wheat might have some significance for individuals reporting noncoeliac gluten sensitivity. The aim of this study was to compare the reactivity of epitopes towards ELISA R5 and G12 monoclonal antibodies in ancient (emmer; Khorasan wheat; spelt) and modern wheat (common bread wheat; durum), and to check whether the bread‐making process leads to the degradation of epitopes. Data from ELISA R5 and G12 did not match gluten dry weight in wheat. Bread dough fermentation and extensive baking did not change the reactivity of coeliac‐active epitopes towards monoclonal antibodies. Compared to hexaploid bread‐type wheat (spelt; common bread wheat), ancient and modern pasta‐type tetraploid wheat (emmer; Khorasan; durum) had less epitopes reactive towards ELISA R5 and G12 and might be preferable for wheat‐sensitive individuals looking for food with reduced coeliac‐active epitopes.
Liver test abnormalities in patients admitted for severe psoriasis: prevalence and associated risk factors
Authors: Finet A. , Viguier M. , Chazouillères O. , Amatore F. , Paul C. , Richard M.A. , Chosidow O. , Bachelez H. , Sbidian E. ,   the Groupe de Recherche sur le Psoriasis de la Société Française de Dermatologie
Published: May 2016

Background

Few epidemiologic data are available regarding biologic liver abnormalities during psoriasis flares.

Objectives

The aim of this study was to assess the prevalence of biological liver test abnormalities (LTA) in a psoriasis population and the risk factors associated with LTA.

Methods

A retrospective cross‐sectional study in four hospital dermatology tertiary care centres included patients admitted for severe psoriasis flare between 1st January 2010 and 31st December 2011. During the same period, a control population was selected comprising patients admitted for contact and/or atopic eczema. Data were collected on hospital records and biology software. LTA was defined as serum AST and/or ALT and/or ALP concentration above the upper normal limit (UNL) and/or GGT concentration above 2 UNL. Prevalence of LTA with 95% confidence intervals (95% CI) was compared between the psoriatic and control populations. Factors associated with LTA at P < 0.05 were considered for the final multivariate logistic regression model.

Results

Two hundred and forty psoriasis patients and 96 eczema control patients were included. One hundred and fifty‐five(64.6%) of the psoriasis patients were male, aged 55 years on average (±17.6); 192 (80.0%) had plaque‐type psoriasis (PV) and 52 (21.6%) had localized (n = 32) or generalized (n = 20) pustular psoriasis (PP). Prevalence of LTA was 36% (95% CI, 30–42) in the psoriatic population, significantly higher than in controls (17%, 95% CI 9.5–25). Risk factors independently associated with LTA comprised PV (OR 3.79; 95% CI 1.48–9.65), PP (OR 3.80; 95% CI 1.40–10.25) and previously diagnosed liver disease (underlying hepatic steatosis, viral hepatitis or excessive alcohol consumption) (OR 3.88; 95% CI 2.02–7.45). No association was found with systemic antipsoriatic drug therapies.

Conclusion

In severe psoriasis, liver impacting comorbidities and/or specific psoriatic inflammation, the latter mostly in PP cases, more than drug‐related liver toxicity, appears to predominantly account for LTA. Clinicians should be aware of this, to avoid unjustified withdrawal of useful systemic drugs.
Tuberculids: cutaneous indicator diseases of Mycobacterium tuberculosis infection in young patients
Authors: Hallensleben N.D.L. , de Vries H.J.C. , Lettinga K.D. , Scherpbier H.J.
Published: May 2016

Background

In the past years the incidence of tuberculosis has dropped significantly in most parts of Europe and the presentation of symptomatic tuberculosis cases have become increasingly rare. With the recent influx of refugees in Europe coming from tuberculosis endemic areas like the Middle East and Africa, it is expected that the incidence of tuberculosis will increase.

Objectives

Cutaneous symptoms are important hallmarks that can be of aid for the correct diagnosis of an underlying disease, like tuberculosis.

Methods

We describe 2 young patients with tuberculids, respectively lichen scrofulosorum and papulonecrotic tuberculids, caused by a systemic Mycobacterium tuberculosis infection.

Results

Tuberculids are cutaneous immunological reactions triggered by a Mycobacterium tuberculosis infection elsewhere in the body. The three main manifestations of cutaneous tuberculids are: lichen scrofulosorum, papulonecrotic tuberculids and erythema induratum of Bazin. Whereas the latter is more common, the first two presentations are rare.

Conclusion

It is of importance that clinicians, including dermatologists, are aware of the spectrum of clinical presentations of tuberculosis to halt this destructive and highly contagious disease early in its course.
Structural model of self‐care agency in patients with diabetes: A path analysis of the Instrument of Diabetes Self‐Care Agency and body self‐awareness
Authors: Waki Sachiko , Shimizu Yasuko , Uchiumi Kyoko , Asou Kawai , Kuroda Kumiko , Murakado Naoko , Seto Natsuko , Masaki Harue , Ishii Hidetoki
Published: May 2016

Aim

The aim of this study was to examine a causal model of self‐care agency by exploring the relationship between the structure of “body self‐awareness” and the structure of the Instrument of Diabetes Self‐Care Agency (IDSCA).

Methods

The participants were 353 patients with diabetes. The internal consistency of the six items for body self‐awareness was examined by calculating the factor structure using principal factor analysis and Cronbach's alpha. In order to examine the relationship between the seven factors in the IDSCA, a path analysis was conducted.

Results

With regard to the factor structure, the factor loading of these five items was 0.511–0.743 (α = 0.739). In the path analysis, “body self‐awareness” was influenced by the “ability to acquire knowledge” and had a direct effect (0.33) on the “motivation to self‐manage”, while “motivation to self‐manage” had an effect (−0.32) on the “ability to self‐manage”. The Goodness‐of‐Fit Index was 0.974.

Conclusion

“Body self‐awareness” plays a part in the self‐care operation process and serves as an intermediary factor to enable the performance of self‐care operations by making the most use of self‐care agency. Moreover, striking a proper balance between self‐management that is focused on the treatment of diabetes and a person's ability for self‐management of diabetes was found to be important.
Managing Work Across Shifts: Not All Shifts Are Equal
Authors: Rodwell John , Fernando Julian
Published: May 2016

Purpose

Despite the prevalence of shiftwork, the mechanisms underlying its effects on nurses’ well‐being and adaptation to the shifts are not fully understood. This study examines whether the characteristics of the person, particularly chronotype, and aspects of the situation (i.e., shift schedule and the nature of work on each shift for each work context) affect job‐specific and general well‐being above and beyond potential confounds such as age and negative affectivity (NA).

Design

Primarily surveys of Australian nurses (N = 446) in three contexts (general acute hospital, maternity hospital, aged care).

Conclusions

The findings highlight the role of nurses’ dispositional characteristics, especially NA and in certain contexts chronotype, as well as the need to consider the nature of the work conducted on each shift within a context.

Clinical Relevance

Nurse managers need to consider the nature of the work conducted on each shift, whether to look at balancing workloads or setting up processes for handling spikes in workload, especially administration.
Family involvement in emergency department discharge education for older people
Authors: Palonen Mira , Kaunonen Marja , Åstedt‐Kurki Päivi
Published: May 2016

Aims and objectives

To report findings concerning family involvement in emergency department discharge education for older people.

Background

The current trend of population ageing in Western countries has caused an increase in emergency department visits. Due to the continuing improvement in the mental and physical status of older people, they are frequently discharged home. Proper discharge education enables older people and their families to better understand how they can cope with the medical issue at home. Given the lack of research, we know relatively little about the significance of family involvement in older people's emergency department discharge education.

Design

A descriptive qualitative design was used.

Methods

Qualitative thematic interviews of seven older patients, five family members and fifteen nurses were conducted. Data were analysed using content analysis.

Results

Family involvement in discharge education was seen as turbulent. The experiences were twofold: family involvement was acknowledged, but there was also a feeling that family members were ostracised. Families were seen as a resource for nurses, but as obliged initiators of their own involvement.

Conclusions

Our findings suggest that family members are not considered participants in emergency department care. For a family‐friendly approach, actions should be taken on both individual and organisational levels.

Relevance to clinical practice

The findings support healthcare providers and organisation leaders in promoting family involvement in discharge education for older people. Families can be encouraged to be involved without feeling responsible for the interaction.
Intentional Rounding: a staff‐led quality improvement intervention in the prevention of patient falls
Authors: Morgan Lauren , Flynn Lorna , Robertson Eleanor , New Steve , Forde‐Johnston Carol , McCulloch Peter
Published: May 2016

Aims and objectives

This study designed and evaluated the use of a specific implementation strategy to deliver a nursing staff‐led Intentional Rounding intervention to reduce inpatient falls.

Background

Patient falls are a common cause of harm during hospital treatment. Intentional Rounding has been proposed as a potential strategy for prevention, but has not received much objective evaluation. Previous work has suggested that logical interventions to improve patient care require an integrated implementation strategy, using teamwork training and systems improvement training, to instigate positive change and improvement.

Methods

Customised Intentional Rounding was implemented and evaluated as part of a staff‐led quality improvement intervention to reduce falls on a neuroscience ward. Intentional Rounding was instigated using a prespecified implementation strategy, which comprised of: (1) engagement and communication activities, (2) teamwork and systems improvement training, (3) support and coaching and (4) iterative Plan‐Do‐Check‐Act cycles. Process (compliance with hourly visiting to patients by staff) and outcome (incidence of falls) measures were recorded pre‐ and postintervention. Falls measured on the active ward were compared with incidence of falls in 50 wards across the rest of the same Trust.

Results

There was a 50% reduction in patient falls on the active ward vs. a minimal increase across the rest of the Trust (3·48%). Customised Intentional Rounding, designed by staff specifically for the context, appeared to be effective in reducing patient falls.

Conclusions

Improvement programmes based on integrating teamwork training and staff‐led systems redesign, together with a preplanned implementation strategy, can deliver effective change and improvement.

Relevance to clinical practice

This study demonstrates, through the implementation of a specific strategy, an effective improvement intervention to reduce patient falls. It provides insight into the effective design and practical implementation of integrated improvement programmes to reduce risk to patients at the frontline.
Pre‐pregnancy body mass index, height and physical activity are associated with rate of gestational weight gain among Malaysian mothers
Authors: Yong Heng Yaw , Mohd Shariff Zalilah , Koo Shi Jia , Binti Sa'ari Norul Syurafak
Published: May 2016

Aim

Both inadequate and excessive weight gain during pregnancy can have immediate and long‐term health risks for women and infants. This study investigated rate of gestational weight gain (GWG) and its associated factors in Malaysian pregnant women.

Methods

This cross‐sectional study was conducted at maternal and child health clinics in Selangor and Negeri Sembilan between November 2010 and April 2012. A pre‐tested questionnaire was used to obtain sociodemographic, obstetric, dietary intake and physical activity information. Current weight and height were measured using standard procedures. GWG rate was calculated as the average weekly weight gain in that particular trimester of pregnancy and further categorized according to the Institute of Medicine (IOM) recommendations.

Results

Mean GWG rate for all pre‐pregnancy BMI categories in the second and third trimesters was higher than the IOM recommendations. Overweight women (adjusted OR, 4.26; 95%CI: 1.92–9.44) and women <153 cm tall (adjusted OR, 1.96; 95%CI: 1.21–3.18) tend to have inadequate GWG rate. Women with high pre‐pregnancy body mass index (BMI; ≥25.0 kg/m2; overweight: adjusted OR, 3.88; 95%CI: 2.12–7.09; obese: adjusted OR, 2.34; 95%CI: 1.28–4.29) and low physical activity (adjusted OR, 1.74; 95%CI: 0.77–3.97) were two–threefold more likely to have excessive GWG.

Conclusion

Both inadequate and excessive GWG can have detrimental effects on the health of mothers and infants. Pre‐pregnancy BMI, height and physical activity should be emphasized in prenatal care to ensure that women have adequate GWG rate.
Paired boxed gene 1 expression: A single potential biomarker for differentiating endometrial lesions associated with favorable outcomes in patients with endometrial carcinoma
Authors: Liu Li‐Chun , Lai Hung‐Cheng , Chou Yu‐Ching , Huang Rui‐Lan , Yu Mu‐Hsien , Lin Chi‐Pin , Tsai Wen‐Chiuan , Chiang Kai‐Jo , Wang Yu‐Chi , Chao Tai‐Kuang
Published: May 2016

Aim

Paired boxed gene 1 (PAX1) has previously been reported to be a methylation‐silenced gene in cases of cervical and ovarian cancers. We evaluated the expression of PAX1 in normal endometrium, endometrial hyperplasia and endometrial carcinoma (EC), and investigated the prognostic value of PAX1 expression in patients with EC.

Methods

We conducted a hospital‐based retrospective review of PAX1 distribution immunohistochemically in 201 samples of endometrium from biopsy or hysterectomy. PAX1 immunoreactivity was classified into low and high score groups based upon the extent and intensity of staining.

Results

There was intense intranuclear staining for PAX1 in premalignant endometrial lesions. A high PAX1 score was observed in a high percentage of samples of normal endometrium (93.3%), in endometrial hyperplasia without atypia (97.2%) and in endometrial atypical hyperplasia (87.5%), but this level was found in only one‐third of the EC samples (30.1%). The PAX1 protein score was significantly higher in samples of premalignant endometrial lesions compared with those of EC (P < 0.001). Importantly, a higher PAX1 score in EC cases was correlated with good overall survival, with a hazard ratio of 0.22 for death (95% confidence interval, 0.05–0.96).

Conclusions

PAX1 protein expression is a potential histopathology biomarker for the differential diagnosis of malignant and premalignant endometrial lesions. PAX1 is also a potential prognostic marker in cases of EC.
Residential Instability, Family Support, and Parent–Child Relationships Among Ethnically Diverse Urban Families
Authors: Riina Elizabeth M. , Lippert Adam , Brooks‐Gunn Jeanne
Published: May 2016

From a social disorganization standpoint, neighborhood residential instability potentially brings negative consequences to parent–child relationship qualities, but family social support and racial/ethnic identity may modify this association. Using data (n = 3,116) from the Project on Human Development in Chicago Neighborhoods, this study examines associations between neighborhood residential instability and parent–child warmth and conflict, whether family social support moderates associations between residential instability and parent–child relationships, and variation by race/ethnicity. Multilevel models reveal that residential instability undermines parent–child relationship qualities, particularly for non‐White individuals. Family support is a protective factor for families in less stable neighborhoods and specifically buffers the association between neighborhood residential instability and reduced parent–child warmth. Among Hispanics, family support mitigates the association between residential instability and heightened parent–child conflict. Findings highlight residential instability as a detriment to parent–child relationships; families in unstable neighborhoods may benefit from family social support.
EXPLORING DEPRESSION AMONGST KIDNEY TRANSPLANT RECIPIENTS: A LITERATURE REVIEW
Authors: Veater Nicola Lusia , East Linda
Published: May 2016

Background

Despite the benefits of receiving a donor kidney, there is evidence of persistent depression amongst the transplant population. Healthcare professionals should endeavour to put in place strategies for the prevention, identification and management of depression.

Objectives

To critically examine recent research concerning the prevalence, detection and impact of depression amongst kidney transplant recipients, leading to recommendations for practice improvement.

Design

The ‘matrix method’ was used to identify and review relevant literature. An online search was performed using three electronic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE® and Web of Science. The search limits were that the papers reported the findings of primary research studies, published in English in a peer‐reviewed journal; involved adult participants and were published between 2000 and 2015. Following critical appraisal of the included studies, a review matrix was produced that identified four emerging themes.

Results

The review confirmed that kidney transplant recipients experience less depression than those who receive other renal replacement therapies. However, depressive illness is still more common amongst kidney transplant recipients than the general population. There are many risk factors for depression and there is evidence of an association between depression and mortality in the transplant population. Routine screening for depression is highly recommended yet rarely seen in practice.

Conclusion

Increasing awareness and educating healthcare professionals about depression amongst kidney transplant recipients is essential to allow for earlier identification and treatment. Screening could provide earlier detection of depression and allow for higher social and psychological support for these patients. Further intervention studies and longitudinal assessments would enhance the understanding of the development and effective management of depressive symptoms.
CAN NEW LIGHT RAIL REDUCE PERSONAL VEHICLE CARBON EMISSIONS? A BEFORE‐AFTER, EXPERIMENTAL‐CONTROL EVALUATION IN LOS ANGELES
Authors: Boarnet Marlon G. , Wang Xize , Houston Douglas
Published: May 2016

This paper uses a before‐after, experimental‐control group method to evaluate the impacts of the newly opened Expo light rail transit line in Los Angeles on personal vehicle greenhouse gas (GHG) emissions. We applied the California Air Resources Board's EMFAC 2011 emission model to estimate the amount of daily average CO2 emissions from personal vehicle travel for 160 households across two waves, before and after the light rail opened. The 160 households were part of an experimental–control group research design. Approximately half of the households live within a half‐mile of new Expo light rail stations (the experimental group) and the balance of the sampled households live beyond a half‐mile from Expo light rail stations (the control group). Households tracked odometer mileage for all household vehicles for seven days in two sample waves, before the Expo Line opened (fall, 2011) and after the Expo Line opened (fall, 2012). Our analysis indicates that opening the Expo Line had a statistically significant impact on average daily CO2 emissions from motor vehicles. We found that the CO2 emission of households who reside within a half‐mile of an Expo Line station was 27.17 percent smaller than those living more than a half‐mile from a station after the opening of the light rail, while no significant difference exists before the opening. A difference‐in‐difference model suggests that the opening of the Expo Line is associated with 3,145 g less of household vehicle CO2 emissions per day as a treatment effect. A sensitivity analysis indicates that the emission reduction effect is also present when the experimental group of households is redefined to be those living within a kilometer from the new light rail stations.
Building Vocabulary Knowledge in Preschoolers Through Shared Book Reading and Gameplay
Authors: Hassinger‐Das Brenna , Ridge Katherine , Parker Amira , Golinkoff Roberta Michnick , Hirsh‐Pasek Kathy , Dickinson David K.
Published: May 2016

This study moves beyond previous investigations to examine whether an educational intervention combining shared book reading with a vocabulary game increases children's vocabulary knowledge. Four‐year‐olds (N = 44) were randomly assigned to dyads in either an intervention (shared book reading plus vocabulary review game) or comparison condition (shared book reading, after‐reading vocabulary review, and game that did not teach vocabulary). After two 30‐min sessions, results demonstrated that the intervention condition outperformed the comparison condition on measures of receptive and expressive knowledge of taught vocabulary words. Children in the intervention group who scored the lowest at pretest on the receptive measure saw the most gains in taught word knowledge. Findings suggest that combining vocabulary gameplay with shared book reading improved children's learning of the vocabulary words in comparison to a comparison group.
“We Define Ourselves”: 1.5‐Generation Undocumented Immigrant Activist Identities and Insurgent Discourse
Authors: Seif Hinda
Published: May 2016

This article examines the construction of 21st‐century language and identities in an era of global displacement and social media when increasing numbers of youth are growing up undocumented. Building on prior research on anti‐immigrant rhetoric, it is based on participant observation, interviews, and document analysis conducted with Latin@ activists in California (1999–2001) and Illinois (2010–2014). Language has been central to the U.S. undocumented youth movement, as 1.5.‐generation immigrant activists creatively use self‐naming for empowerment. New, positive identities help young immigrants to challenge anti‐immigrant rhetoric and love themselves, locate and support each other, and advocate for assistance and rights. Activist identities have changed over time along with changing political contexts and strategies, moving from close alignment with legislative efforts to increasing recognition of intersectional, marginalized, and transnational social locations.
Associations of Infant Subcutaneous Fat Mass with Total and Abdominal Fat Mass at School‐Age: The Generation R Study
Authors: Santos Susana , Gaillard Romy , Oliveira Andreia , Barros Henrique , Abrahamse‐Berkeveld Marieke , van der Beek Eline M. , Hofman Albert , Jaddoe Vincent W. V.
Published: May 2016

Background

Skinfold thickness enables the measurement of overall and regional subcutaneous fatness in infancy and may be associated with total and abdominal body fat in later childhood. We examined the associations of subcutaneous fat in infancy with total and abdominal fat at school‐age.

Methods

In a population‐based prospective cohort study among 821 children, we calculated total subcutaneous fat (sum of biceps, triceps, suprailiacal, and subscapular skinfold thicknesses) and central‐to‐total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat) at 1.5 and 24 months. At 6 years, we measured fat mass index (total fat/height3), central‐to‐total fat ratio (trunk fat/total fat), and android‐to‐gynoid fat ratio (android fat/gynoid fat) by dual‐energy X‐ray absorptiometry and preperitoneal fat mass area by abdominal ultrasound.

Results

Central‐to‐total subcutaneous fat ratio at 1.5 months was positively associated with fat mass index and central‐to‐total fat ratio at 6 years, whereas both total and central‐to‐total subcutaneous fat ratio at 24 months were positively associated with all childhood adiposity measures. A 1‐standard‐deviation scores higher total subcutaneous fat at 24 months was associated with an increased risk of childhood overweight (odds ratio 1.70, 95% confidence interval 1.36, 2.12). These associations were weaker than those for body mass index and stronger among girls than boys.

Conclusions

Subcutaneous fat in infancy is positively associated with total and abdominal fat at school‐age. Our results also suggest that skinfold thicknesses add little value to estimate later body fat, as compared with body mass index.
Plastic pollution challenges in marine and coastal environments: from local to global governance
Authors: Vince Joanna , Hardesty Britta Denise
Published: May 2016

Plastic pollution in the marine and coastal environment is a challenging restoration and governance issue. Similar to many environmental problems, marine plastic pollution is transboundary and therefore the governance solutions are complex. Although the marine environment is unlikely to return to the condition it was in before the “plastic era,” it is an example of an environmental restoration challenge where successful governance and environmental stewardship would likely result in a healthier global oceanic ecosystem. We argue that a holistic, integrated approach that utilizes scientific expertise, community participation, and market‐based strategies is needed to significantly reduce the global plastic pollution problem.
Slow dissent and the emotional geographies of resistance
Authors: Murrey Amber
Published: May 2016

Anger, grief, regret and shame are some of the myriad ways that people narrate a decade of life along the Chad‐Cameroon Oil Pipeline. These stories reveal a perceptive and collective socio‐political awareness situated within multifaceted emotional geographies of resistance. In spite of resistance narratives, explicit and collective resistance practices remain uncommon. As people struggle and live within composite landscapes of structural violence along the pipeline, particular processes and mechanisms of uneven power influence the tendency for resistance struggles to be slow, impromptu or labour based. In this comparative ethnographic analysis, I consider the political environment that shapes socio‐political emotional ties in Nanga, particularly its socio‐political positioning as ‘the village of the First Lady’. In this case, people in proximate positions vis‐à‐vis the ruling family experience heightened oppression(s) and dispossession(s), at the same time that they report feeling little political recourse. In Kribi, on the other hand, responses to the pipeline can be described as defiant withdrawals, demonstrated through a series of unconnected refusals. Although resistance practices along the pipeline have not been visible or successful in an established sense, emotional geographies of resistance elucidate long‐term struggles to survive (i.e., slow dissent), including the accumulation of a collective emotional consciousness grounded in an awareness of historical patterns of injustice.
Engaging communities in managing multiple hazards: Reflections from small islands in North Sulawesi, Indonesia
Authors: Rampengan Mercy M.F. , Law Lisa , Gaillard J.C. , Boedhihartono Agni Klintuni , Sayer Jeffrey
Published: May 2016

Participatory methods are a common approach for giving voice to local communities in hazard and disaster research. Drawing on a study that trialled and modified a range of participatory methods in North Sulawesi, eastern Indonesia, this paper reflects on how such methods help document the capacities of small island communities. We assessed capacity from a sustainable livelihoods perspective, identifying the assets that enable villagers to cope with hazards. This overall approach promoted a discourse of strengths and resourcefulness, contrasting with vulnerability and needs‐assessment approaches common to government and non‐governmental organizations, which tend to focus on weaknesses and can sometimes fuel undeliverable expectations of funding. We provide a critical reflection on participatory methods and their significance for researchers, policy makers and funding agencies working with communities in hazard‐prone regions.