bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Rotational Thromboelastography Findings in Pseudoexfoliation Syndrome Patients and Healthy Controls
Authors: Goren Sahin Deniz , Sahin Afsun , Akay Olga M.
Published: June 2016

Purpose:

Rotational thromboelastography (ROTEM) is a useful test for studying the characteristics of fibrin clot formation. As patients with pseudoexfoliation (PEX) have an increased risk for thrombotic events, clot-forming dysfunction may play a role. The aim of this study is to compare ROTEM findings in PEX syndrome patients with age-matched and sex-matched healthy controls.

Patients and Methods:

A total of 21 patients with PEX syndrome and 22 age-matched and sex-matched healthy controls were included. All study participants underwent detailed ophthalmologic and systemic medical examination, including blood pressure measurement, hemoglobin-hematocrit levels, platelet count, coagulation parameters including prothrombin time, activated partial thromboplastin time, fibrinogen levels, and D-dimer levels. Peripheral blood samples were collected and analyzed with ROTEM Coagulation Analyzer.

Results:

The mean age of patients with PEX and controls was 66.5±8.3 and 65.9±9.5 years, respectively (P=0.7). The 2 groups did not differ with respect to age, sex, hemoglobin, hematocrit, platelet numbers, prothrombin time, activated partial thromboplastin time, fibrinogen levels, D-dimer levels, and glucose levels. When extrinsic thromboelastometry results were analyzed, PEX patients showed a significantly decreased clotting time when compared with healthy controls (79.8 vs. 98.0 s; P=0.01), indicating faster clot formation. Other ROTEM parameters did now show any difference between the 2 groups.

Conclusions:

PEX patients showed faster clotting time when compared with healthy controls. This fibrin clot formation dysfunction may lead to vascular thrombotic events in these patients. Further studies are needed to elucidate the exact underlying mechanism of thrombosis seen in PEX patients.
Testing a Model to Reveal the Predictive Mechanism of Care-Seeking Decisions Among Patients With Acute Myocardial Infarction
Authors: Li Polly W.C. , Yu Doris S.F.
Published: June 2016

Background:

Extensive research has been conducted to examine the factors affecting care-seeking decisions in patients with acute myocardial infarction (AMI). Such a decision-making process is multifactorial, and its underlying mechanism is yet to be determined.

Objectives:

Our aim was to test a theoretically integrated model to identify the mechanisms underlying patients’ care-seeking decisions in the context of AMI.

Methods:

On the basis of both empirical and theoretical evidence, we proposed that patients’ care-seeking decisions are driven by 2 sequential perceptual-cognitive processes concerned with illness labeling and interpretation, as well as the contextual influences of perceived barriers to care seeking and cues from others. A sample of 301 patients was recruited to test this model using structural equation modeling.

Results:

The model testing revealed good fit with the data (χ
2 = 38.48, df = 30, P = .72; root-mean-square error of approximation = 0.03, normed fit index = 0.96, nonnormed fit index = 0.98, and comparative fit index = 0.99) and explained 46% of the variance in AMI care-seeking delay. Successful action relied on whether patients could correctly attribute the symptom experience to AMI, were aware of their own susceptibility to the condition, and had a good understanding of how the disease manifested itself. Lowering perceived barriers and positive cues from others in advising care seeking played favorable roles to promote care-seeking behaviors.

Conclusions:

This integrative theoretical model is shown to be valid in explaining care-seeking delay among AMI patients and can guide the development of interventions to promote appropriate care-seeking behaviors among high-risk individuals.
Perception of disease burden and treatment satisfaction in patients with ulcerative colitis from outpatient clinics in Spain: UC-LIFE survey
Authors: Carpio Daniel , López-Sanromán Antonio , Calvet Xavier , Romero Cristina , Cea-Calvo Luis , Juliá Berta , Argüelles-Arias Federico
Published: June 2016

Objectives

Ulcerative colitis (UC) conditions patients’ everyday life. With this survey, we aimed to assess the perceived disease burden, preferred treatment attributes, and treatment satisfaction reported by Spanish UC patients.

Methods

Consecutive unselected UC patients aged at least 18 years were recruited from outpatient hospital clinics. Patients completed the survey at home, returning it by postmail. With test-like questions, they described UC behavior, preferences, and satisfaction with treatment.

Results

Of 585 patients invited, 436 (75%) returned the survey (mean age 46 years, 53% men). Of these, 47.1% described their disease during the past year as ‘controlled or nearly controlled’, 28.0% as ‘symptoms not impairing everyday life,’ and 24.9% ‘disruptive symptoms’. Only 8.7% reported the complete absence of symptoms during the previous year, and 18.8, 30.7, and 47.4%, respectively, described at least one hospital admission, emergency room visit, or nonscheduled visit because of UC activity. Urgency of defecation was the most disruptive symptom. The most important therapy attribute was continuous control of symptoms (44.6%). Most patients (78.8%) were ‘very satisfied’ or ‘satisfied’ with current treatment, even those reporting a high burden of symptoms.

Conclusion

Half of the patients considered their UC as ‘controlled or nearly controlled’ and the degree of satisfaction with their therapies was high. However, they reported a high burden of symptoms and resource consumption during the previous year. These findings indicate that patients may get used to living with symptoms, underestimating the potential of therapy for achieving a complete remission. Urgency of defecation was mentioned as highly disrupting and should probably be included in scores and patient-reported outcomes.
Time-Out and Checklists
Authors: Lyons Vanessa Ervin , Popejoy Lori L.
Published: June 2016

Surgical safety checklists were introduced to improve patient safety. Urban and rural hospitals are influenced by differing factors, but how these factors affect patient care is unknown. This study examined time-out and checklist processes in rural and urban operating rooms and found that although checklist use has been adopted in many organizations, use is inconsistent across both settings. An understanding of these variations is needed to improve utilization.
Critical Access Hospital Use of TeamSTEPPS to Implement Shift-Change Handoff Communication
Authors: Natafgi Nabil , Zhu Xi , Baloh Jure , Vellinga Kelli , Vaughn Thomas , Ward Marcia M.
Published: June 2016

Implementation of handoff as part of TeamSTEPPS initiatives for improving shift-change communication is examined via qualitative analysis of on-site interviews and process observations in 8 critical access hospitals. Comparing implementation attributes and handoff performance across hospitals shows that the purpose of implementation did not differentiate between high and low performance, but facilitators and barriers did. Staff involvement and being part of the “big picture” were important facilitators to change management and buy-in.
Dos and don’ts for hospital cleaning
Authors: Dancer Stephanie J.
Published: June 2016

Purpose of review

More evidence is emerging on the role of cleaning and decontamination for reducing hospital-acquired infection. Timely and adequate removal of environmental pathogens leads to measurable clinical benefits for patients. This article considers studies published from 2013 examining hospital decontamination technologies and evidence for cost-effectiveness.

Recent findings

Novel biocides and cleaning products, antimicrobial coatings, monitoring practices and automated equipment are widely accessible. They do not necessarily remove all environmental pathogens, however, and most have yet to be comprehensively assessed against patient outcome. Some studies are confounded by concurrent infection control and/or antimicrobial stewardship initiatives. Few contain data on costs.

As automated dirt removal is assumed to be superior to human effort, there is a danger that traditional cleaning methods are devalued or ignored. Fear of infection encourages use of powerful disinfectants for eliminating real or imagined pathogens in hospitals without appreciating toxicity or cost benefit. Furthermore, efficacy of these agents is compromised without prior removal of organic soil. Microbiocidal activity should be compared and contrasted against physical removal of soil in standardized and controlled studies to understand how best to manage contaminated healthcare environments.
First case report of pulmonary nocardiosis caused by Nocardia mexicana
Authors: kuchibiro Tomokazu , Ikeda Takeshi , Nakanishi Hirotaka , Morishita Yukiko , Houdai Katsuyuki , Ito Junko , Gonoi Tohru
Published: June 2016

Introduction:

Nocardia species usually cause opportunistic infections, and the frequency of these infections is increasing owing to the growing population of immunocompromised hosts. However, Nocardia species may sometimes cause an infection disease in immunocompetent hosts. Nocardia mexicana infections are the least common and are very rare.

Case presentation:

Herein, we report the first case of a pulmonary infection with N. mexicana in a 61-year-old Japanese woman with a history of hyperlipidaemia and bronchiectasis and a 6-month history of non-productive hacking cough. A sample of bronchial lavage fluid obtained by bronchofiberscopy showed filamentous branching gram-positive rods and acid-fast filamentous branching rods, and a colony of suspected Nocardia was cultured. Based on 16S rRNA, gyrB,
rpoB, secA1 and hsp65 gene sequence analyses and biochemical and physiological properties, the strain was identified as N. mexicana. The strain was resistant to the antimicrobial agents amoxicillin-clavulanic acid, clarithromycin, minocycline, gentamycin, tobramycin, ciprofloxacin and trimethoprim-sulfamethoxazole. The patient was treated with biapenem followed by intravenous amikacin and oral linezolid.

Conclusion:

Despite its rarity, the species require attention owing to the existence of multidrug-resistant strains.
The impact of structural variation on human gene expression
Authors: Chiang Colby , Scott Alexandra J. , Davis Joe R. , Tsang Emily K. , Li Xin , Kim Yungil , Damani Farhan N. , Ganel Liron ,   GTEx Consortium, Montgomery Stephen B. , Battle Alexis , Conrad Donald F. , Hall Ira M.
Published: June 2016

Structural variants (SVs) are an important source of human genetic diversity but their contribution to traits, disease, and gene regulation remains unclear. The Genotype-Tissue Expression (GTEx) project presents an unprecedented opportunity to address this question due to the availability of deep whole genome sequencing (WGS) and multi-tissue RNA-seq data from 147 individuals. We used comprehensive methods to identify 24,157 high confidence SVs, and mapped cis expression quantitative trait loci (eQTLs) in 13 tissues via joint analysis of SVs, single nucleotide (SNV) and short insertion/deletion (indel) variants. We identified 24,801 eQTLs affecting the expression of 10,101 distinct genes. Based on haplotype structure and heritability partitioning, we estimate that SVs are the causal variant at 3.3-7.0% of eQTLs, which is nearly an order of magnitude higher than prior estimates from low coverage WGS and represents a 26- to 54-fold enrichment relative to their scarcity in the genome. Expression-altering SVs also have significantly larger effect sizes than SNVs and indels. We identified 787 putatively causal SVs predicted to directly alter gene expression, most of which (88.3%) are noncoding variants that show significant enrichment at enhancers and other regulatory elements. By evaluating linkage disequilibrium between SVs, SNVs and indels, we nominate 49 SVs as plausible causal variants at published genome-wide association study (GWAS) loci. Remarkably, 29.9% of the common SV-eQTLs are not well tagged by flanking SNVs, and we observe a notable abundance (relative to SNVs and indels) of rare, high impact SVs associated with aberrant expression of nearby genes. These results suggest that comprehensive WGS-based SV analyses will increase the power of both common and rare variant association studies.
HIV-1gag-polmRNA localization regulates the site of virion assembly
Authors: Becker Jordan T. , Sherer Nathan M.
Published: June 2016

HIV-1 full-length, unspliced genomic RNAs (gRNAs) serve both as mRNAs encoding the Gag and Gag-Pol capsid proteins as well as the genetic material packaged by Gag into virions that assemble at the plasma membrane (PM). Whether localized Gag synthesis contributes to assembly at the PM is unknown. Here we show that artificially tethering gRNAs or surrogategag-pol mRNAs to non-PM membranes or the actin cytoskeleton can markedly affect Gag’s distribution in the cytoplasm, causing aberrant subcellular sites of assembly and severe reductions to virus particle output. Onlygag-polmRNAs competent for translation were capable of altering Gag’s distribution within the cell, and the activity mapped to twocis-acting RNA regulatory elements; the 5’ packaging signal (Psi) bound by Gag and, unexpectedly, the Rev response element (RRE) that regulates the nuclear export of gRNAs and other intron-retaining viral RNAs. Taken together, our results suggest a model wherein localized translation of gRNAs at the PM helps to compartmentalize Gag-gRNA interactions, thereby promoting efficient genome encapsidation.

AUTHOR SUMMARY

The spatial distribution of messenger RNAs (mRNAs) within the cytoplasm can be a crucial determinant of gene expression. Here we provide evidence that a devastating viral pathogen, human immunodeficiency virus type 1 (HIV-1), exploits localized translation to favor the formation of infectious, transmissible virions at the surface of infected cells. Artificially tethering viral mRNAs encoding the Gag and Gag-Pol capsid proteins (gag-polmRNAs) to alternative regions of the cell such as cytoplasmic vesicles or the actin cytoskeletion markedly alters Gag subcellular distribution, perturbs sites of assembly, and reduces virus particle production. These and additional findings suggest a model for HIV-1 assembly wherein localized Gag/Gag-Pol translation coupled to confined interactions between Gag and viral genomes ensures infectious virion production at the right place and the right time. Perturbing HIV-1 mRNA subcellular localization could represent a novel antiviral strategy.
Effect of X-ray irradiation on ancient DNA in sub-fossil bones – Guidelines for safe X-ray imaging
Authors: Immel Alexander , Le Cabec Adeline , Bonazzi Marion , Herbig Alexander , Temming Heiko , Schuenemann Verena J. , Bos Kirsten I. , Langbein Frauke , Harvati Katerina , Bridault Anne , Pion Gilbert , Julien Marie-Anne , Krotova Oleksandra , Conard Nicholas J. , Muenzel Susanne C. , Drucker Dorothée G. , Viola Bence , Hublin Jean-Jacques , Tafforeau Paul , Tafforeau Paul
Published: June 2016

Sub-fossilised remains may still contain highly degraded ancient DNA (aDNA) useful for palaeogenetic investigations. Whether X-ray computed [micro-] tomography ([μ]CT) imaging of these fossils may further damage aDNA remains debated. Although the effect of X-ray on DNA in living organisms is well documented, its impact on aDNA molecules is unexplored.

Here we investigate the effects of synchrotron X-ray irradiation on aDNA from Pleistocene bones. A clear correlation appears between decreasing aDNA quantities and accumulating X-ray dose-levels above 2000 Gray (Gy). We further find that strong X-ray irradiation reduces the amount of nucleotide misincorporations at the aDNA molecule ends. No representative effect can be detected for doses below 200 Gy. Dosimetry shows that conventional μCT usually does not reach the risky dose level, while classical synchrotron imaging can degrade aDNA significantly. Optimised synchrotron protocols and simple rules introduced here are sufficient to ensure that fossils can be scanned without impairing future aDNA studies.
DNA sequence properties that predict susceptibility to epiallelic switching
Authors: Catoni Marco , Griffiths Jayne , Becker Claude , Zabet Nicolae Radu , Bayon Carlos , Dapp Mélanie , Lieberman-Lazarovich Michal , Weigel Detlef , Paszkowski Jerzy
Published: June 2016

Transgenerationally heritable epialleles are defined by the stable propagation of alternative transcriptional states through mitotic and meiotic cell cycles. Given that the propagation of DNA methylation at CpG sites, mediated in Arabidopsis by MET1, plays a central role in epigenetic inheritance, we examined genome-wide DNA methylation in partial and complete loss-of-functionmet1mutants. We interpreted the data in relation to transgenerational epiallelic stability and provide evidence that DNA sequence features such as density of CpGs and genomic repetitiveness can be used to predict susceptibility to epiallelic switching. The importance of these rules was confirmed by analyses of common epialleles in natural Arabidopsis accessions and verified in rice.
Diversity of Sericostomatidae (Trichoptera) Caddisflies in the Montseny Mountain Range
Authors: Macher Jan Niklas , Weiss Martina , Beermann Arne J. , Leese Florian
Published: June 2016

Biodiversity is under threat by the ongoing global change and especially freshwater ecosystems are under threat by intensified land use, water abstraction and other anthropogenic stressors. In order to monitor the impacts that stressors have on freshwater biodiversity, it is important to know the current state of ecosystems and species living in them. This is often hampered by lacking knowledge on species and genetic diversity due to the fact that many taxa are complexes of several morphologically cryptic species. Lacking knowledge on species identity and ecology can lead to wrong biodiversity and stream quality assessments and molecular tools can greatly help resolving this problem. Here, we studied larvae of the caddisfly family Sericostomatidae in the Montseny mountains on the Iberian Peninsula. We expected to find cryptic species and that species would not occur in syntopy due to different ecological niches. We sampled 44 stream sites and sequenced 247 larval specimens for the barcoding region of the mitochondrial cytochrome c oxidase gene. A modeling approach was used to assess the bioclimatic preferences of the found species. Two molecular groups were identified. One could be assigned toSchizopelex furciferaand one toSericostomaspp. We did find both taxa in syntopy in >50% of sampling sites and could show that the taxa prefer similar bioclimatic conditions. A reexamination of larval specimens showed thatSericostomaandSchizopelexlarvae could not be unambiguously identified to the genus level. Overall, our results show the importance of including molecular tools into biodiversity assessments in order to correctly identify the species diversity of a region and to prevent wrong assessment results.
Initiation of Retina Regeneration By a Conserved Mechanism of Adult Neurogenesis
Authors: Rao Mahesh , Didiano Dominic , Patton James G.
Published: June 2016

Retina damage or disease in humans often leads to reactive gliosis, preventing the formation of new cells and resulting in visual impairment or blindness. Current efforts to repair damaged retinas are inefficient and not capable of fully restoring vision. Conversely, the zebrafish retina is capable of spontaneous regeneration upon damage, using Müller glia (MG) derived progenitors. Understanding how zebrafish MG initiate regeneration may help develop new treatments that prompt mammalian retinas to regenerate. Here we show that inhibition of GABA signaling facilitates initiation of MG proliferation. GABA levels decrease following damage, and MG are positioned to detect the decrease. Using pharmacological and genetic approaches we demonstrate that GABAA receptor inhibition stimulates regeneration in undamaged retinas while activation inhibits regeneration in damaged retinas. GABA induced proliferation causes upregulation of regeneration associated genes. This is the first evidence that neurotransmitters control retina regeneration in zebrafish through an evolutionarily conserved mechanism of neurogenesis.
Predicting Targeted Cancer Therapeutics
Authors: Wise Aaron , Cobanoglu Murat Can
Published: June 2016

Motivation:Cancer is a complex and evolving disease, making it difficult to discover effective treatments. Traditional drug discovery relies on high-throughput screening on reductionist models in order to enable the testing of 105or 106compounds. These assays lack the complexity of the human disease. Functional assays overcome this limitation by testing drugs on human tumors, however they can only test few drugs, and remain restricted to diagnostic use. An algorithm that identifies hits with fewer experiments could enable the use of functional assays forde novodrug discovery.

Results:We developed a novel approach that we termed ‘algorithmic ideation’ (AI) to select experiments, and demonstrated that this approach discovers hits 104times more effectively than brute-force screening. The algorithm trains on known drug-target-disease associations assembled as a tensor, built from the (public) TCGA and STITCH databases and predicts novel associations. We evaluated our tensor completion approach using a temporal cutoff with data prior to 2012 used as training data, and data from 2012 to 2015 used as testing data. Our approach achieved 104-fold more efficient hit discovery than the traditional brute-force high-throughput screening. We further tested the method in a sparse, low data regime by removing up to 90% of the training data, and demonstrated the robustness of the approach. Finally we test predictive performance on drugs with no previously known interactions, and the algorithm demonstrates 103-fold improvement in this challenging problem. Thus algorithmic ideation can potentially enable targeted antineoplastic discovery on functional assays.

Availability:Freely accessible athttps://bitbucket.org/aiinc/drugx.

Contact:quejebo@gmail.com,mcancobanoglug@gmail.com
Oligogenic Adaptation, Soft Sweeps, and Parallel Melanic Evolution inDrosophila melanogaster
Authors: Bastide Héloïse , Lange Jeremy D. , Lack Justin B. , Amir Yassin , Pool John E.
Published: June 2016

Unraveling the genetic architecture of adaptive phenotypic divergence is a fundamental quest in evolutionary biology. InDrosophila melanogaster,high-altitude melanism has evolved in separate mountain ranges in sub-Saharan Africa, potentially as an adaptation to UV intensity. We investigated the genetic basis of this melanism in three populations using a new bulk segregant analysis mapping method. Although hundreds of genes are known to affect cuticular pigmentation inD. melanogaster,we identified only 19 distinct QTLs from 9 mapping crosses, with several QTL peaks being shared among two or all populations. Surprisingly, we did not find wide signals of genetic differentiation (Fst) between lightly and darkly pigmented populations at these QTLs, in spite of the pronounced phenotypic difference in pigmentation. Instead, we found small numbers of highly differentiated SNPs at the probable causative genes. A simulation analysis showed that these patterns of polymorphism are consistent with selection on standing genetic variation (leading to “soft sweeps“). Our results thus support a role for oligogenic selection on standing genetic variation in driving parallel ecological adaptation.
Drosophilasensory cilia lacking MKS-proteins exhibit striking defects during development but only subtle defects in adults
Authors: Pratt Metta B. , Titlow Joshua S. , Davis Ilan , Barker Amy R. , Dawe Helen R. , Raff Jordan W. , Roque Helio
Published: June 2016

Cilia are conserved organelles that have important motility, sensory and signalling roles. The transition zone (TZ) at the base of the cilium is critical for cilia function, and defects in several TZ proteins are associated with human congenital ciliopathies such as Nephronophthisis (NPHP) and Meckel Gruber syndrome (MKS). In several species, MKS and NPHP proteins form separate complexes that cooperate with Cep290 to assemble the TZ, but flies lack an obvious NPHP complex. We show that MKS proteins in flies are spatially separated from Cep290 at the TZ, and that flies mutant for individualMKSgenes fail to recruit other MKS proteins to the TZ, while Cep290 appears to be recruited normally. Although there are abnormalities in microtubule and membrane organisation in developingMKSmutant cilia, these defects are less apparent in adults, where sensory cilia and sperm flagella function quite normally. Thus, surprisingly, MKS proteins are not essential for cilia or flagella function in flies.
The urban domino effect: a conceptualization of cities’ interconnectedness of risk
Authors: Wamsler Christine , Brink Ebba
Published: June 2016

Purpose

Cities are both at risk and the cause of risk. The interconnectedness of urban features and systems increases the likelihood of complex disasters and a cascade or “domino” effect from related impacts. However, the lack of research means that our knowledge of urban risk is both scarce and fragmented. Against this background, the purpose of this paper is to examine the unique dynamics of risk in urban settings.

Design/methodology/approach

Based on literal reading, grounded theory and systems analysis, this conceptual paper presents a framework for understanding and addressing urban risk. It conceptualizes how interdependent, interconnected risk is shaped by urban characteristics and exemplifies its particularities with data and analysis of specific cases. From this, it identifies improvements both in the content and the indicators of the successor to the Hyogo Framework for Action (HFA2) that will be adopted in 2015.

Findings

While it is common to see disasters as “causes”, and the destruction of the built environment as “effects”, this paper highlights that the intricate links between cities and disasters cannot be described by a unidirectional cause-and-effect relationship. The city–disasters nexus is a bidirectional relationship, which constantly shapes, and is shaped by, other processes (such as climate change).

Practical implications

This paper argues that in-depth knowledge of the links between cities’ characteristic features, related systems and disasters is indispensable for addressing root causes and mainstreaming risk reduction into urban sector work. It enables city authorities and other urban actors to improve and adapt their work without negatively influencing the interconnectedness of urban risk.

Originality/value

This paper presents a framework for understanding and addressing urban risk and further demonstrates how the characteristics of the urban fabric (physical/spatial, environmental, social, economic and political/institutional) and related systems increase risk by: intensifying hazards or creating new ones, exacerbating vulnerabilities and negatively affecting existing response and recovery mechanisms.
Measuring disaster resilience in communities and households
Authors: Arbon Paul , Steenkamp Malinda , Cornell Victoria , Cusack Lynette , Gebbie Kristine
Published: June 2016

Purpose

This paper aims to discuss the development of two toolkits that were designed to help communities and households measure their level of disaster resilience and provide practical tools to help them increase and maintain these levels.

Design/methodology/approach

The toolkits were developed across two studies, with the community toolkit development being undertaken first. A literature review was conducted to develop a definition and model of community disaster resilience; and a Scorecard was designed to assess levels of existing community disaster resilience. The definition and Scorecard were reviewed and refined with the help of two communities before a final version was trialled in four communities across Australia. The household toolkit project followed a similar approach, with trialling being undertaken in conjunction with two non-government organisations that carry out outreach work in the community.

Findings

The development and trial of the Scorecards was extremely valuable. The conclusion voiced by communities and reached by the study project teams was that the user-friendly Scorecard is a workable tool for people to assess their household and community disaster resilience and to come together to plan what might further strengthen resilience. Critical to the Scorecards’ success was an understanding of the purpose of the assessment tool and the meaning of resilience.

Originality/value

The toolkits take an all-hazards approach and help community members, individuals and local policymakers to set priorities, allocate funds and develop emergency and disaster management programmes that build local community resilience.
Understanding risk: what makes a risk assessment successful?
Authors: Murnane Richard , Simpson Alanna , Jongman Brenden
Published: June 2016

Purpose

Understanding risk is more than just modeling risk; it requires an understanding of the development and social processes that underlie and drive the generation of disaster risk. Here, in addition to a review of more technical factors, this paper aims to discuss a variety of institutional, social and political considerations that must be managed for the results of a risk assessment to influence actions that lead to reductions in natural hazard risk.

Design/methodology/approach

The technical approaches and the institutional, social and political considerations covered in this paper are based on a wide range of experiences gleaned from case studies that touch on a variety of activities related to assessing the risks and impacts of natural hazards, and from the activities of the World Bank’s Global Facility for Disaster Reduction and Recovery.

Findings

Risk information provides a critical foundation for managing disaster risk across a wide range of sectors. Appropriate communication of robust risk information at the right time can raise awareness and trigger action to reduce risk. Communicating this information in a way that triggers action requires an understanding of the developments and social processes that underlie and drive the generation of risk, as well as of the wider Disaster Risk Management (DRM) decision-making context.

Practical implications

Prior to the initiation of a quantitative risk assessment one should clearly define why an assessment is needed and wanted, the information gaps that currently prevent effective DRM actions and the end-users of the risk information. This requires developing trust through communication among the scientists and engineers performing the risk assessment and the decision-makers, authorities, communities and other intended users of the information developed through the assessment.

Originality/value

This paper summarizes the technical components of a risk assessment as well as the institutional, social and political considerations that should be considered to maximize the probability of successfully reducing the risk defined by a risk assessment.
Queueing management and improving customer experience: empirical evidence regarding enjoyable queues
Authors: Liang Chih-Chin
Published: June 2016

Purpose

The purpose of this study is that service sectors sectors create queues intentionally as a promotional strategy. Potential buyers might become actual customers after witnessing and joining queues. However, the effectiveness of company promotional activities involving queues remains unclear. Despite the innovativeness of this marketing strategy, few companies have adopted this approach, owing to the lack of research on how waiting influences customer behaviors toward waiting in queues.

Design/methodology/approach

Therefore, this study identifies four factors of customer willingness to stand in a queue using questionnaire survey: company promotional activities, improvement of waiting environment, company’ reactions to the queue and customers’ perceptions regarding waiting time.

Findings

This study identifies causal relationships among the aforementioned factors. The results of this investigation reveal that a company’s promotional activities significantly and indirectly reduce customers’ perceived waiting time by improving the waiting environment. Analytical results also show that a company’s queuing management can indirectly reduce customers’ perceived waiting time by improving the waiting environment.

Originality/value

Based on the analytical results concerning causal relationships, improving the waiting environment is critical to affecting positively customers’ perceptions regarding waiting time. Queuing management can indirectly reduce customers’ perceived waiting time by improving the waiting environment. A company’s promotional activities can indirectly reduce customers’ perceived waiting time by improving the waiting environment. Customers who enjoy both the waiting environment and the promotional activities experience much shorter perceived waiting time.
Lethal Epistaxis
Authors: Byard Roger W.
Published: June 2016

Epistaxis or nosebleed refers to bleeding from the nostrils, nasal cavity, or nasopharynx. Occasional cases may present with torrential lethal hemorrhage. Three cases are reported to demonstrate particular features: Case 1: A 51‐year‐old woman with lethal epistaxis with no obvious bleeding source; Case 2: A 77‐year‐old man with treated nasopharyngeal carcinoma who died from epistaxis arising from a markedly neovascularized tumor bed; Case 3: A 2‐year‐old boy with hemophilia B who died from epistaxis with airway obstruction in addition to gastrointestinal bleeding. Epistaxis may be associated with trauma, tumors, vascular malformations, bleeding diatheses, infections, pregnancy, endometriosis, and a variety of different drugs. Careful dissection of the nasal cavity is required to locate the site of hemorrhage and to identify any predisposing conditions. This may be guided by postmortem computerized tomographic angiography (PCTA). Despite careful dissection, however, a source of bleeding may never be identified.
Clinical and Research Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society for Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group
Authors: Collins Sean P. , Levy Phillip D. , Martindale Jennifer L. , Dunlap Mark E. , Storrow Alan B. , Pang Peter S. , Albert Nancy M. , Felker G. Michael , Fermann Gregory J. , Fonarow Gregg C. , Givertz Michael M. , Hollander Judd E. , Lanfear David E. , Lenihan Daniel J. , Lindenfeld JoAnn M. , Peacock W. Frank , Sawyer Douglas B. , Teerlink John R. , Butler Javed
Published: June 2016

Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with hypertensive AHF (H‐AHF) represent a clinical phenotype with distinct pathophysiologic mechanisms that result in elevated ventricular filling pressures. To optimize treatment response and minimize adverse events in this subgroup, we propose that clinical management be tailored to a conceptual model of disease that is based on these mechanisms. This consensus statement reviews the relevant pathophysiology, clinical characteristics, approach to therapy, and considerations for clinical trials in ED patients with H‐AHF.
Predictors of surgical approach for the management of renal cell carcinoma: a population‐based study from New South Wales
Authors: Patel Manish I. , Strahan Stephen , Bang Albert , Vass Justin , Smith David P.
Published: June 2016

Background

The simultaneous adoption of laparoscopy and partial nephrectomy (PN) has been reported to result in unintended consequences. We aim to examine the contemporary (2001–2009) trends in use of PN and laparoscopy within a population‐wide database.

Methods

All renal cell carcinomas diagnosed between 2001 and 2009 in New South Wales, Australia, were identified from the Central Cancer Registry. Records of treatment were electronically linked. All patients with localized renal cell carcinoma who underwent surgical treatment were selected for this study (3771 patients). Follow‐up was to the end of 2010. Multivariable logistic regression analysis was used to determine predictors of PN and laparoscopy.

Results

In the entire cohort, 150 (4%), 495 (13%), 1516 (40%) and 1610 (43%) received laparoscopic PN, open PN, laparoscopic radical nephrectomy (RN) and open RN, respectively. Between the years 2001 and 2009, there was a gradual increase in the use of PN except between 2005 and 2007. Between 2001 and 2009, a rapid uptake of laparoscopy was observed. Multivariable analysis demonstrated that age (OR: 0.99 (0.98–0.99)), year of surgery (OR: 1.15 (1.11–1.19)), comorbidity (OR: 1.40 (1.12–1.76)) and hospital case load >8/year (OR: 2.39 (1.49–3.81)) predicted use of PN. Year of surgery (OR: 1.19 (1.15–1.21)), comorbidity (OR: 0.70 (0.58–0.85)), non‐teaching hospital (OR: 0.70 (0.53–0.93)), private hospital (OR: 1.86 (1.45–2.38)) and hospital case load > 8/year (OR: 3.36 (2.22–5.09)) predicted use of laparoscopy.

Conclusion

The unintended decrease in PN associated with increased use of laparoscopic RN had reversed by 2009. Hospital case load predicts the use of PN and laparoscopy.
Justice and care in the city: uncovering everyday practices through research volunteering
Authors: Williams Miriam J
Published: June 2016

In urban theory our knowledge of actually existing justice practices in the city are limited. In contrast, our collective knowledge of the ways an ethic of care is practised is better developed. In this paper I argue for the need to value care in conceptualisations of the just city by mobilising the unification of care‐thinking and justice‐thinking in a way that accepts that both care and justice may (or may not) be practised as situated responses to injustice and neglect, and as other ways of doing/thinking/being the city. I argue that researcher volunteering can help reveal actually existing justice and care in the city in their situated context. Drawing on a research project that documents everyday practices of care and justice at Alfalfa House Food Cooperative, Sydney, Australia, I use the example of waste to explore the ways actually existing care and justice are practised. My aim is to expose how, within everyday urban community organisations, the transformative and relational expressions of care and justice can be revealed through researcher volunteering. By focusing on the actually existing expressions of care and justice in the city we might begin to see how the just (and caring) city is being made and remade in the here and now.
Is a family‐centred initiative a family‐centred service? A case of a Conductive Education setting for children with cerebral palsy
Authors: Schenker R. , Parush S. , Rosenbaum P. , Rigbi A. , Yochman A.
Published: June 2016

Background

From the moment a child is diagnosed as having cerebral palsy, families have to cope on a daily basis with the multifaceted challenges of life‐long disability management. Family‐centred service is embraced as a ‘best practice’ model because of accumulating evidence supporting its positive influence on parents and children's outcomes. Nevertheless, research comparing parent and provider perspectives on family‐centred practices of educational service providers in education settings is scarce. The aims of this study were to compare the extent to which parents and conductors experience the service delivery in Tsad Kadima, the Association for Conductive Education in Israel, as being family‐centred, as well as comparing parents’ perception of different educational settings as being family‐centred.

Methods

Measurements of family‐centeredness, the Israeli Measure of Processes of Care for families (MPOC‐20) and for service providers (MPOC‐SP), were administrated to 38 teacher conductors and 83 families of children with cerebral palsy (aged 1–14), from different conductive educational settings.

Results

Parents and conductors perceive Conductive Education service as being highly family centred in most domains, rating respectful and supportive care the highest and providing general information the lowest, thus indicating an area where improvements should be made. Parents perceived the service they receive to be more family‐centred than conductor's perception about their own activities. In addition, educational setting (day care, pre‐school and school) was found to be associated with parent's scores.

Conclusions

The current study, which is the first to examine family‐centred service provision in a conductive special education setting, from the perspectives of both parents and conductors, provides significant evidence for high‐quality services in these settings.
Associations between recurrent musculoskeletal pain and visits to the family doctor (GP) and specialist multi‐professional team in 74 Norwegian youth with cerebral palsy
Authors: Ramstad K. , Jahnsen R. , Diseth T. H.
Published: June 2016

Background

Musculoskeletal pain in cerebral palsy (CP) is common, but probably undertreated. The aim of the study was to explore if recurrent musculoskeletal pain (RMP) related to the CP condition was associated with visits to the family doctor [general practitioner (GP)] and specialist habilitation centre in youth with CP.

Methods

Seventy‐four youth with CP (mean age 16.5 years, 40 boys) from the same geographical area were assessed by clinical examination, semi‐structured interview on pain (adolescent and parent together), the two questions on pain from the Child Health Questionnaire (parents only) and a structured interview on health care services. Gross Motor Function Classification System was level I 39%, level II 23%, level III 8% and levels IV and V 30%.

Results

Thirty‐five participants (47%) had visited their GP last year, and 49 (66%) had visited the specialist habilitation centre. The presence of RMP (n = 58; 78%) was not significantly associated with having visited the GP or the specialist habilitation centre. Still, in participants with RMP, increasing pain severity was associated with having visited the GP. Rest, massage, change of position and oral drugs were the most common measures taken to relieve RMP. Three adolescents with RMP did not take any measures to relieve pain.

Conclusion

Youth with RMP do take measures to relieve pain, but usually not in the direction of consulting the health care services available unless the pain is severe. Both youth with CP and their caregivers should be encouraged to discuss RMP with their professional network of care.
Analysis of FOXL2 detects three novel mutations and an atypical phenotype of blepharophimosis‐ptosis‐epicanthus inversus syndrome
Authors: Krepelova Anna , Simandlova Martina , Vlckova Marketa , Kuthan Pavel , Vincent Andrea L , Liskova Petra
Published: June 2016

Background

Mutations in FOXL2 are known to cause autosomal dominant blepharophimosis‐ptosis‐epicanthus inversus syndrome (BPES), variably associated with premature ovarian failure. In this study, we report results of mutational screening in a Czech and Slovak patient population with BPES.

Design

Case series.

Participants

Thirteen probands of Czech and one proband of Slovak origin with BPES and their available family members.

Methods

Sanger sequencing and multiplex ligation‐dependent probe amplification in 14 probands with BPES. Targeted mutational screening in first‐degree relatives.

Main Outcome Measures

Genetic characterization and phenotype evaluation in Czech and Slovak individuals with BPES and their family members.

Results

Eight different mutations were detected including three novel ones: c.5T>G; p.(Met2Arg), c.197C>A; p.(Ala66Glu) and c.701_702insTGCAGCCGCAGCGGCTGCAGCAGCTGCGGCTGCAGCCGC; p.(Ala222_Ala234dup). In one family, the molecular genetic cause of disease was not identified by the methodology used. In 13 pedigrees, a negative family history suggested a de novo origin, which could be confirmed by targeted mutational screening in four families. One 62‐year‐old female with the c.663_692dup30 mutation had an atypical phenotype presenting as moderate ptosis compensated by frontalis muscle contraction, no epicanthus inversus and no premature ovarian failure.

Conclusions

The de novo mutation rate in FOXL2 is exceptionally high compared with other dominant disorders manifesting with an ocular phenotype. In cases reporting a negative family history, careful examination of both parents is important to exclude mild features of the BPES phenotype.
Are interventions supporting separated parents father inclusive? Insights and challenges from a review of programme implementation and impact
Authors: Philip Georgia , O'Brien Margaret
Published: June 2016

This paper reviews divorce‐related parenting programmes, assessing the extent to which fathers are included and whether father inclusion influences outcomes. The paper also discusses limitations of the research evidence and implications for future intervention and evaluation design. Thirteen programmes met the criteria in the review period 2005–2012 but only four had been evaluated using randomized control trials or with independent measures from mothers and fathers. Analysis of these four programmes shows modest evidence of reduced couple‐conflict, improved coparenting and some evidence of improved child outcomes. Key issues raised are the need for improving the quantity and quality of demographic data about fathers; the importance of incorporating analysis by gender of parent into evaluation design and the value of developing and routinely using father‐related indicators to measure programme impact on men's parenting, fathering and co‐parental relationships.
Shrinking Spaces for the ‘Public’ in Contemporary Public Health
Authors: Qadeer Imrana , Baru Rama
Published: June 2016

This contribution joins the debate on the politics of global health, and specifically inequality in health. Focusing on three recent and pertinent reports, it examines two opposing perspectives for dealing with this inequality. Driven by the global financial crisis, one perspective attempts to validate the intervention of global capital through markets, technology and research funding in global health; it promotes a uniform model of universal health care based on medical care through insurances, public–private partnerships and a dominant private sector. The other perspective arises from the specific historical experiences of nation states in which health has been treated as a commodity. It highlights the negative impacts on global health of neoliberal reforms, such as reductions in welfare and increasing inequalities, and critiques the optimization of profits from health services, which undermines the government's role in health care. The article analyses the historical evolution of these perspectives and the two kinds of movements that emerged across the globe. Using the case of India, the authors argue that where neoliberalism prevails, health movements must link up with broader democratic and political movements that work for the realignment of structural inequalities and policy shifts for the well‐being of the majority.