bluuebunny/crossref_metadata_2025 huggingface dataset:
Webcam Sites: The Documentary Genre Moves Online?
Authors: Hight Craig
Published: March 2018

The broad focus of this article is the examination of the relationship between recent television documentary forms and online factual forms. This relationship is shaped by a wider acceptance of factual media as a cultural form, and is marked by negotiation and appropriation from both sides. Webcam sites are discussed as key online sites where there is an appropriation of documentary aesthetics as part of an apparent development of distinctive digital factual forms. These online factual forms are notable partly for their replication of early photographic discourse, but especially for an acknowledgment of various forms of pleasure and performance within their exploration of the interactive and participatory possibilities of hypertext narrative. This emphasis on pleasure, performance and participation is a continuation of the marked changes in audience engagement that characterise documentary hybrids such as docu-soap.
Real New Formats of Television: Looking at Big Brother
Authors: Bell Phillip
Published: March 2018

Recent ‘reality TV’ formats, such as Channel Ten's Big Brother, exhibit many features of ethnography, and attend to ‘real’ aspects of human behaviour in ways reminiscent of experimental psychological simulations of institutional roles conducted in the 1960s. Reality TV integrates and re-mixes genres of observational cinema and of game shows and situation comedy, purporting to reveal the very nature of people stripped of their conventional social support and competing for biological or social rewards. Yet these formats construct tight, artificial recontextualisations of existing social practices (around sex, courtship, work). Controlled, scripted games are therefore played out which beg the question of how ‘naturally’ people do (or should) behave, both in ‘reality’ and on television.
Court on Camera: Television Coverage of Australian Legal Proceedings
Authors: Johnston Jane
Published: March 2018

Despite widespread legal analysis and critical review over the past 20 years, television access into the Australian court system has been slow and piecemeal, with Australia falling behind Canadian and New Zealand initiatives in this area. A recent major report into camera access in the Federal Court has refocused attention on this area, but analysis continues to be primarily from a legal perspective rather than a media one. This paper considers the televised court coverage in Australia to this point, analyses change in the international environment and suggests possible futures for the televising of Australian courts, while also attempting to lay some foundations for discussion beyond the legal, and into the media, domain.
Evaluation of the influence of building façade design on the acoustic characteristics and auditory perception of urban spaces
Authors: Calleri Cristina , Shtrepi Louena , Armando Alessandro , Astolfi Arianna
Published: March 2018

Auditory perception has been proved to have an influence on how we live and move through places and on the use of public spaces. However, despite the numerous studies that have focused on the theme of soundscape and auditory perception of urban spaces, these aspects have not been studied in connection with the design of the building surrounding such spaces. This study focuses on the influence of façade design on acoustic characteristics of an urban space and on the subjective spatial perception of the users. Simulations and auralizations have been conducted through ODEON software (v.13) on the virtual model of a small square of Turin (Italy). Different absorption and scattering coefficients of façade upholsteries have been applied to the façades of the building surrounding the square, choosing from a pool of typical building façade materials. Results of a listening test have proved that the absorption coefficient of the façades has an influence on the subjective perception of space wideness. Moreover, multiple regression analysis has been conducted in order to find a mathematical relation between space wideness perception and objective acoustic parameters. It was shown that the relation between the perceptual aspects and the objective parameters is strongly dependent on the listening position.
International Students’ Perceptions and Experiences of British Drinking Cultures
Authors: Thurnell-Read Thomas , Brown Lorraine , Long Philip
Published: March 2018

While the increased scale and importance of international students to the UK Higher Education sector is now well established, little is known about the ways in which students from non-UK countries experience and interact with the heavy drinking culture that predominates on and near many British universities. Drawing on qualitative interviews, this article analyses the perceptions, attitudes, and experiences of British drinking cultures held by international students studying on postgraduate courses at a UK university. Students report prior awareness of alcohol consumption being important to British culture and recount both positive and negative experiences of witnessing and, for many, participating in drinking alcohol. Students make ready comparisons with the drinking habits and attitudes of their own culture. Further still, many made a distinction between the public house, or ‘pub’, as a welcoming and friendly social space, and bars and nightclubs, where a far greater risk of exposure to violence and harassment was perceived. The article provides theoretical insights to support future and more wide-ranging research into mobile drinking cultures and also suggests practical implications to inform stakeholders with interests in the welfare of international students in the UK in relation to the provision of effective and proactive policies which address the impact of British drinking cultures on international student integration and well-being.
Active ageing, emotional care and the threat of stigma: Identity management in older adults using sleeping medication long-term
Authors: Smith Georgia , Farrimond Hannah
Published: March 2018

Amid fears about the medicalisation of old age, the high prevalence of sleeping medication use in older cohorts is a significant public health concern. Long-term use is associated with a plethora of negative effects, such as cognitive impairment and risk of addiction. However, little is known about the lived experience of older adults using sleeping medication longer term. Episodic interviews lasting approximately 90 minutes were conducted with 15 independently living adults, aged 65–88 years, who were using sedative-hypnotic or tricyclic sleeping medication for more than 11 years on average. Thematic analysis shows that participants divided their rationale for use into two temporal periods: (1) to ensure physical ability in the daytime and (2) to ensure emotional stability at night. Long-term sleeping medication was thus characterised as a form of ‘emotional self-management’ of the negative emotions associated with later life, blotting out feelings of loss and loneliness by inducing sleep. Participants feared loss of access to their medication ‘supply’, employing strategies to ensure its continuity, while expressing shame about their dependence. However, identity management, in the form of explanations, minimisations and social comparisons, functioned to downplay their addiction. Through this, long-term sleeping medication users were able to elude the spoiled identities and multiple stigmas of both the ‘out of control’ addict and the unsuccessful older adult by asserting a positive identity; that of the ‘new’ older adult, actively medicating for success both day and night.
‘Ayn mika: Traumatic experience, social invisibility, and emotional distress of sub-Saharan women with precarious status in Morocco
Authors: Mekki-Berrada Abdelwahed
Published: March 2018

Morocco has become a permanent transit country for tens of thousands of sub-Saharan migrants heading to Europe. Many of these migrants are women who have a precarious legal status and can no longer reach Europe, whose borders have been considerably securitized since September 11, 2001. They also have no wish to risk their lives again returning south across the Sahara Desert. This paper discusses the results of an exploratory research project conducted in Morocco on the relationships between the sub-Saharan migrant women’s traumatic experiences, social invisibility, and emotional distress in the context of a massive securitization of Euro-Mediterranean borders.
The family–centre partnership disconnect: Creating reciprocity
Authors: Hadley Fay , Rouse Elizabeth
Published: March 2018

The purpose of this article is to examine the disconnect happening in relation to family–centre partnerships. Developing partnerships with families is hotly debated and provides challenges for educators teaching in the early childhood sector. Using a comparative case study analysis, several research studies conducted in the states of New South Wales and Victoria, Australia, are examined to illustrate these disconnects. These issues are examined within Belonging, Being and Becoming: The Early Years Learning Framework for Australia, a national framework that is common to all programs across Australia, which identifies practice, principles and learning outcomes for young children. This disconnect is related to the language that is used by the early childhood staff and misunderstood by the parents, the ways communication occurs and its ineffectiveness. The article argues that there is a need to move beyond the current rhetoric of engaging in partnerships with families to a space that allows for transparency, reciprocity and new language.
Values added in speciality coffee
Authors: Morland Leigh
Published: March 2018

This conceptual article explores the notion of ‘values added’ in the emerging context of speciality coffee. Previous studies have not considered the impact of shared values across the sector, through the supply chain to coffee shops. It is proposed that shared values contribute to differentiation in speciality coffee, resulting in distinctive coffee products and coffee shop experiences. ‘Values added’ are explored through the Aboriginal meaning system of songlines. This represents a playful approach to contextual theorizing, providing a new way of identifying and understanding the transfer of shared values across the sector. Four categories of shared values are identified relating to: ‘ecology’, ‘journey’, ‘integration’ and ‘attention to detail’, which are used to inform a values-added conceptual framework. Finally, the study makes recommendations for further research within the context of speciality coffee, emphasizing the importance using and aligning theory to enhance the understanding of differentiation.
Vital correspondence: Exploring tactile experience with resident-focused mandalas in long-term care (Innovative practice)
Authors: Graham Megan E. , Fabricius Andréa
Published: March 2018

The materiality of long-term care and its relationship to a resident’s identity is often overlooked. In response to the call for more attention to the meaningful aspects of doing art, the tactile experience of residents with dementia is considered in the context of a mandala project at a Canadian seniors’ long-term care facility. The significance of making mandalas for residents is explored through three key themes: identity integration through gesture, the importance of artistic discernment and decision-making, and the value of corresponding with recalcitrant materials. Residents’ experiences are analysed through a phenomenological lens.
Affordances for 1- to 3-year-olds’ risky play in Early Childhood Education and Care
Authors: Kleppe Rasmus
Published: March 2018

This article focuses on how Early Childhood Education and Care institutions provide for 1- to 3-year-olds’ risky play—a previously little researched topic—utilizing data from an exploratory, small-scale study investigating aspects of risky play in the age-group. The main findings describe how three essentially different Early Childhood Education and Care centers provide different opportunities for risky play. These environments are assessed with the theoretical concept of affordance and suggest that versatile, flexible, and complex environments and equipment—with little objective risk—are optimal for children’s risky play in this age-group. Being a new topic, the affordance assessment is discussed in relation to a standardized measurement, the Infant-Toddler Environment Rating Scale—Revised edition. Findings indicate that the two approaches partly coincide but also that there are discrepancies. Interpretations and implications are discussed.
Development and Evaluation of the Inventory of New College Student Adjustment
Authors: Watson Joshua C. , Lenz A. Stephen
Published: March 2018

The Inventory of New College Student Adjustment (INCA) was developed to assist college student personnel in assessing adjustment difficulties experienced by first-year college students. A sample of 474 first-year college students (282 women, 59%; 192 men, 41%) enrolled in a first-year seminar course at a medium-sized 4-year university in the central southern region of the United States completed the INCA. Exploratory and confirmatory factor analyses confirmed a two-factor scale explaining 47.17% of the variance in scores. Convergent validity analyses support the INCA as a sufficiently valid measure suitable for use as a brief screening tool in both research and practice settings.
Replicating Criterion Validity in Science Content for the Combination of Critical Content Monitoring and Sentence Verification Technique
Authors: Mooney Paul , Lastrapes Renée E.
Published: March 2018

The purpose of the research was to replicate commonality analysis for two measures: critical content monitoring and sentence verification technique. Participants were 967 fourth-, fifth-, and sixth-grade students across seven public primary schools in a southeastern U.S. district. The predictor variables were administered as benchmarks 3 times in an academic year. Predictor scores were compared with science content test and reading comprehension scores from the Stanford Achievement Test–Tenth Edition abbreviated online form and a statewide accountability test. Commonality analysis results indicated that scores from both critical content monitoring and sentence verification technique added unique variance to explanatory models, replicating previous findings. In most cases, critical content monitoring scores provided the greatest percentage of unique and common variance to model explanations.
Including the Consumer and Environment in Occupational Therapy Treatment Planning
Authors: Brown Catana , Bowen Robin E.
Published: March 2018

This study was designed to examine the extent to which occupational therapists include the consumer and the environment in treatment planning. Twenty-nine registered occupational therapists who subscribe to the Mental Health Specialty Interest Section or the Physical Disabilities Specialty Interest Section completed treatment plans based on a single case study. The treatment plans were analyzed based on goal setting and treatment activities. Data indicated therapists frequently identified goals not addressed by the consumer and demonstrated limited consideration of the context in the selection of treatment activities. Therapists identified as many short-term goals not related to the consumer's stated goal as they identified goals that were related to the consumer's goal. T-test comparisons indicated that therapists significantly more often selected simulated over real activities and activities aimed at changing the person over activities aimed at changing the environment. These preliminary results from a small, self-selected sample suggest that current occupational therapy treatment planning is not consistent with consumer-oriented practice models.
Challenges When Using Grounded Theory
Authors: Timonen Virpi , Foley Geraldine , Conlon Catherine
Published: March 2018

The grounded theory (GT) method is widely applied, yet frequently misunderstood. We outline the main variants of GT and dispel the most common myths associated with GT. We argue that the different variants of GT incorporate a core set of shared procedures that can be put to work by any researcher or team from their chosen ontological and epistemological perspective. This “shared core” of the GT method is articulated as the principles of (1) taking the word “grounded” seriously, (2) capturing and explaining context-related social processes, (3) pursuing theory through engagement with data, and (4) pursuing theory through theoretical sampling. In this article, we have put forward, in a nutshell, a distillation of core principles underpinning existing GT approaches that can aid further engagement with the different variants of GT. We are motivated by the wish to make GT more comprehensible and accessible, especially for researchers who are new to the method.
The integration of transabdominal ultrasound simulators into an ultrasound curriculum
Authors: Orr KE , Hamilton SC , Clarke R , Adi MY , Gutteridge C , Suresh P , Freeman SJ
Published: March 2018

Introduction

Simulation is increasingly used throughout medicine. Within ultrasound, simulators are more established for learning transvaginal and interventional procedures. The use of modern high-fidelity transabdominal simulators is increasing, particularly in centres with large trainee numbers. There is no current literature on the value of these simulators in gaining competence in abdominal ultrasound. The aim was to investigate the impact of a new ultrasound curriculum, incorporating transabdominal simulators into the first year of training in a UK radiology academy.

Methods

The simulator group included 13 trainees. The preceding cohort of 15 trainees was the control group. After 10 months, a clinical assessment was performed to assess whether the new curriculum resulted in improved ultrasound skills. Questionnaires were designed to explore the acceptability of simulation training and whether it had any impact on confidence levels.

Results

Trainees who had received simulator-enriched training scored higher in an objective clinical ultrasound assessment, which was statistically significant ( p = 0.0463). End confidence scores for obtaining diagnostic images and demonstrating pathology were also higher in the simulation group. All trainees stated that transabdominal simulator training was useful in early training.

Conclusions

This initial study shows that embedded into a curriculum, transabdominal ultrasound simulators are an acceptable training method that can result in improved ultrasound skills and higher confidence levels. Using simulators early in training could allow trainees to master the basics, improve their confidence, enabling them to get more educational value from clinical ultrasound experience while reducing the impact of training on service provision.
“Letting go of the raft” – The art of spiritual leadership in contemporary organizations from a Buddhist perspective using skilful means
Authors: Chi Vu Mai , Gill Roger
Published: March 2018

Organizations are diverse workplaces where various beliefs, values and perceptions are shared to varying extents. How can spiritual leadership induce altruistic love and intrinsic motivation among diverse members within the organization and without being regarded as really yet another covert, sophisticated form of corporate exploitation of human vulnerability reflective of the “dark side” of organizations and leadership? This paper explores an approach to spiritual leadership from a Buddhist perspective focusing on the power of skilful means to tackle such concerns. In organizational pursuits such as appearance, reputation, fame, power, recognition and even leader–follower relationships are associated mostly with objectives and expectations, known in Buddhism as “attachment”. In Buddhism, however, any kind of attachment may be a source of suffering that eventually leads to negative consequences. In reviewing the dark side of spiritual leadership practices and how Buddhism is commoditized for organizational purposes, we reaffirm on the importance of the notion of non-attachment in Buddhism. We unpack the application of the Buddhist metaphor of “the raft”, non-attachment and other Buddhist stories of skilful means in spiritual leadership and their contribution to leadership studies.
An inquiry into what organised difficult advance care planning conversations in a Scottish residential care home using institutional ethnography
Authors: Reid Lorna , Kydd Angela , Slade Bonnie
Published: March 2018

Aim

This paper provides an institutional ethnographic analysis of how advance care planning discussions, which included advance decisions about serious illness, hospital admission and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms, were systematically placed into the hands of senior social care workers (SSCWs) in a residential care home (RCH). RCHs are care settings where there are no on-site nurses, and access to hospital and/or community doctors and nurses is limited.

Methods

The paper traces the organising features of day-to-day work gathered from interviews with SSCWs ( n = 4) and others ( n = 6) whose (well-intentioned) work shaped what happened in the RCH.

Results

It shows how the experience of SSCWs was socially organised to happen as it did as they (and others) complied with powerful organising texts such as national and local policy documents, care plans and audit forms. The paper concludes that although SSCWs decision-making conversations were out of alignment with the national DNACPR policy, they cannot simply be described as poor practice. This is because they were socially organised by a complex web of institutional practices related to the occupancy rate in the RCH, the inspection process of the care home scrutiny body, the quality assurance process of the RCH company, the funding of palliative care education, and powerful political and fiscal drives to reduce spending on over-75s. These practices had little to do with the actual care needs of RCH residents or the actual support needs of RCH staff.

Conclusions

The paper points towards necessary policy changes. It also highlights how ‘competent’ work driven by ideological institutional practices can result in ethically troubling situations in day-to-day working life. This emphasises the importance of carefully examining the social organisation of situations typically described as poor practice if we are to understand how they are (re)produced. It also offers a different account of care home deaths than is typically presented in the professional literature.
Rule-based processes in generalisation and peak shift in human fear conditioning
Authors: Ahmed Ola , Lovibond Peter F
Published: March 2018

Two experiments explored the role of verbalisable rules in generalisation of human differential fear conditioning with electric shock as the aversive stimulus. Two circles of different sizes served as conditioned stimuli (CS+ and CS–), before testing with a range of circle sizes. In Experiment 1, shock expectancy ratings followed a peak-shifted unimodal gradient, with maximum ratings at a test value further along the dimension from CS+ in the opposite direction to CS–. However, differentiable gradients were observed when participants were divided on the basis of the rules they reported using during the task (linear and similarity). Experiment 2 was designed to counter the contradictory feedback arising from extinction testing by removing the shock electrodes during the test phase. A more linear overall gradient was observed, and sub-groups defined by self-reported rules showed distinct gradients that were congruent with their rules. These results indicate that rule-based processes are influential in generalisation of conditioned fear along simple stimulus dimensions, and may help explain generalisation phenomena that have traditionally been attributed to automatic, similarity-based processes.
Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible
Authors: Parulekar Prashant , Neil-Gallacher Ed , Harrison Alex
Published: March 2018

Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.
Successful pregnancy in a recipient of an ABO-incompatible renal allograft
Authors: Rao Nitesh N , Wilkinson Chris , Morton Mark , Bennett Greg D , Russ Graeme R , Coates Patrick T , Jesudason Shilpa
Published: March 2018

Kidney transplantation restores fertility in patients with end-stage renal disease, with many successful pregnancies after kidney transplantation being reported. However, there are little data regarding pregnancy in women transplanted under modern-era desensitisation protocols that utilise rituximab, plasma exchange and intravenous immunoglobulin, including ABO-incompatible transplants. Pregnancies in ABO-incompatible recipients can pose new challenges from an immunological perspective. Here, we report a case of successful pregnancy using in vitro fertilisation, in a renal transplant recipient who underwent desensitisation two years prior, that included use of rituximab and plasma exchange to receive an ABO-incompatible transplant from her husband and subsequent father of the baby. We believe this was the first case of successful pregnancy after ABO-incompatible kidney transplantation in Australia and New Zealand. This case also highlights the difficulties faced in conception following transplantation and demonstrates that in vitro fertilisation utilising ovulation induction can be successfully utilised for conception in this cohort. This recipient also had gestational diabetes, worsening renal function and preterm delivery which are important complications often seen in pregnancies of solid organ transplant recipients.
Henoch-Schonlein purpura in pregnancy: A case report
Authors: Côté Jean-Maxime , Meunier Rosalie-Sélène , Tremblay Jan-Alexis , Weber Florence , Mahone Michèle
Published: March 2018

Henoch-Schonlein purpura is a relatively common pediatric vasculitis. Very few cases of Henoch-Schonlein purpura during pregnancy have been described. Henoch-Schonlein purpura is variable in its presentation, from completely benign to possibly catastrophic complications. This rarely encountered condition in adults can also be a recurrence of a previous childhood disease. We present a case of a pregnant 40-year-old woman with Henoch-Schonlein purpura, resulting in a viable birth with no fetal complications. Her presentation is discussed in detail and a general presentation of Henoch-Schonlein purpura is explored, with particular attention to its rare onset during pregnancy.
Multi-hazard resistance capacity of precast segmental columns under impact and cyclic loading
Authors: Zhang Xihong , Hao Hong , Li Chao
Published: March 2018

Using precast segmental concrete columns in structures improves the construction efficiency and site safety, leads to better construction quality, and reduces the construction cost, site disruption and environmental impact. The performance of segmental columns to resist earthquake and impact loads is not well studied yet. As a structure might be subjected to such loads during its service life, understanding its resistance capacities is essential for structural safety. This article reports the findings of our recent studies on the response of precast segmental columns with unbonded prestress tendons. Pendulum impact test and uniaxial cyclic test were conducted on quarter-scale segmental columns. The seismic performance and impact-resistant capacity were evaluated experimentally and compared with a reference conventional monolithic column. Test results showed that under cyclic loading, segmental columns exhibited better deformation ability and smaller residual drift; under impact loading, segmental columns also showed better self-centring capacity and less residual displacement. By introducing concrete shear key, the shear resistance at segmental joint could be improved; however, shear key would also result in more concrete segment damage owing to stress concentration.
Pleuroparenchymal fibroelastosis presenting with pneumothorax
Authors: Lin Yen-Yu , Hsu Wen-Hu , Wu Mei-Han , Chou Teh-Ying
Published: March 2018

A 47-year-old woman presented with spontaneous right side pneumothorax. Image studies showed consolidations and reticular opacities involving the pleural and subpleural regions of bilateral lungs. Wedge biopsy specimens of right upper, middle and lower lobes showed fibrosis of the visceral pleura and subpleural area in all three lobes, more significant in the upper lobe. Elastic Van Gieson stain showed a pattern of alveolar septal elastosis with intra-alveolar fibrosis. The clinical presentation and pathological findings are compatible with pleuroparenchymal fibroelastosis, a rare and distinct type of interstitial lung disease. This entity is different from usual interstitial pneumonia by its relationship to pleura, upper lobe predominance and temporal homogeneity. It is different from non-specific interstitial pneumonia by its pleural involvement and scanty inflammatory cell infiltration. Pleuroparenchymal fibroelastosis is a slowly progressive disease; about half of the patients die in 10 years. No curative treatment is available at present time.
Lifestyle factors and risk for colorectal polyps and cancer at index colonoscopy in a FIT‐positive screening population
Authors: Colussi Dora , Fabbri Margherita , Zagari Rocco Maurizio , Montale Amedeo , Bazzoli Franco , Ricciardiello Luigi
Published: March 2018

Background

Many countries have adopted the fecal immunochemical test (FIT) as the primary colorectal cancer (CRC) screening tool; however, its accuracy is limited. Epidemiological studies have shown that obesity and type 2 diabetes increase risk for the disease.

Objective

The objective of this article is to evaluate the association of colorectal polyps and cancer with comorbidities and lifestyle factors in a population that is part of a FIT‐based CRC screening program.

Methods

Between 2005 and 2013, we analyzed 3894 FIT + patients who underwent total colonoscopy. The impact of lifestyle factors on polyps and cancer was assessed using individuals with a negative colonoscopy as the control group. A multivariate logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

We collected data from 3894 FIT + patients. Obesity (OR 1.29; 95% CI 1.05–1.60) and smoking (OR 1.45; 95% CI 1.24–1.71) were significantly associated with high‐risk adenomas. Smoking and heavy alcohol drinking were both independently associated with high risk of CRC (OR 1.50; 95% CI 1.10–2.04 and OR 2.29; 95% CI 1.15–4.58) and colon cancer alone (OR 1.43; 95% CI 1.01–2.02 and OR 3.09; 95% CI 1.53–6.23). Positivity to first round of FIT was associated with high‐risk adenomas (OR 1.47; CI 95% 1.26–1.71) and CRC (OR 1.74; 95% CI 1.29–2.36). No associations were found for diabetes.

Conclusion

In our FIT + population, lifestyle factors are significantly associated with the risk of carrying high‐risk adenomas and CRC. In the future, studies could be aimed at finding better screening strategies through the development of clinical algorithms based on lifestyle changes/comorbidities.
Years of life lost due to malignant neoplasms of the digestive system in Poland in the years 2000–2014
Authors: Paciej-Gołębiowska Paulina , Pikala Małgorzata , Maniecka-Bryła Irena
Published: March 2018

Background

Every fourth death that occurs in Poland is caused by a malignant neoplasm. A particularly negative epidemiological situation relates to colorectal cancers; in 2015 they constituted the fifth most important cause of years of life lost (YLL) in Poland.

Objective

We aimed to analyse YLL due to malignant neoplasms of the digestive system in Poland in between 2000 and 2014.

Methods

The study material included a database containing information gathered from 5,601,568 death certificates of Poles who died in 2000–2014. YLLs were calculated with the use of the standard expected years of life lost index (SEYLL).

Results

In the 15‐year study period, malignant neoplasms of the digestive system contributed to 213,041 deaths in males and 177,644 deaths in females, which corresponded to a loss of 158.6 years per 10,000 men and 105.3 years per 10,000 women. Neoplasms of the large intestine (23.6%), stomach (22.0%) and pancreas (17.4%) contributed the most. A time trend analysis revealed (p < 0.05) a growing tendency of YLLs due to neoplasms of the large intestine and pancreas, and a decreasing trend due to neoplasms of the stomach.

Conclusion

Malignant neoplasms of the digestive system, especially of the large intestine, are becoming a more common cause of premature mortality in Poland.
A study of dysphagia symptoms and esophageal body function in children undergoing anti‐reflux surgery
Authors: Omari T , Connor F , McCall L , Ferris L , Ellison S , Hanson B , Abu-Assi R , Khurana S , Moore D
Published: March 2018

Background

The role of high‐resolution esophageal impedance manometry (HRIM) for establishing risk for dysphagia after anti‐reflux surgery is unclear. We conducted a prospective study of children with primary gastroesophageal reflux (GER) disease, for whom symptoms of dysphagia were determined pre‐operatively and then post‐operatively and we examined for features that may predict post‐operative dysphagia.

Methods

Thirteen children (aged 6.8–15.5 years) undergoing work‐up prior to 360o Nissen fundoplication were included in the study. A dysphagia score assessed symptoms at pre‐operative study and post‐operatively (mean 1.4 years). A HRIM procedure recorded 5‐ml liquid, 5‐ml viscous and 2‐cm solid boluses. We assessed esophageal motility, esophago‐gastric junction (EGJ) morphology, EGJ contractility and pressure‐flow variables indicative of bolus distension pressures and bolus clearance pressures. A composite pressure‐flow index score was also derived.

Results

Pre‐operative pressure‐flow index was positively correlated with post‐operative dysphagia score (viscous bolus r = 0.771, p < 0.005). Of three variables that comprise the pressure‐flow index, the ramp pressure measured during bolus clearance was the main driver of the effect seen (viscous bolus r = 0.819, p < 0.005).

Conclusions

In order to mitigate symptoms in relation to anti‐reflux surgery, dysphagia symptoms and esophageal function need to be pre‐operatively assessed. In patients with normal motility, an elevated pressure‐flow index may predict post‐operative dysphagia.
Demographic and clinical features distinguish subgroups of diverticular disease patients: Results from an Italian nationwide registry
Authors: Carabotti Marilia , Cuomo Rosario , Barbara Giovanni , Pace Fabio , Andreozzi Paolo , Cremon Cesare , Annibale Bruno
Published: March 2018

Background

Clinical features and lifestyle factors associated with diverticulosis compared to diverticular disease (DD), either symptomatic uncomplicated diverticular disease (SUDD) or in patients who have had previous diverticulitis (PD), are unclear.

Objective

The objective of this article is to compare cross‐sectionally demographic and clinical features and quality of life (QoL) in diverticulosis, SUDD and PD patients.

Methods

The REMAD Registry is a prospective, observational, multicentre, cohort study. Patients were categorised according to: diverticulosis; SUDD (recurrent abdominal symptoms attributed to diverticula in absence of overt inflammation) and PD (≥1 previous diverticulitis).

Results

A total of 1217 patients (57.9% diverticulosis, 24.7% SUDD and 17.4% PD) were included. Compared to diverticulosis, female gender was associated to SUDD (OR 1.94; 95% CI: 1.43–2.62) and PD (OR 1.79; 95% CI: 1.24–2.56); age ≤ 60 years was associated to PD (OR 2.10; 95% CI: 1.42–3.08 vs diverticulosis, OR 1.57; 95% CI: 1.01–2.45 vs SUDD). PD patients showed an association with past bleeding (OR 29.29; 95% CI: 8.17–104.98 vs diverticulosis, OR 16.84; 95% CI: 3.77–75.25 vs SUDD). Compared to diverticulosis, family history for diverticula was associated to PD (OR 1.88; 95% CI: 1.27–2.78). Patients with diverticulosis showed higher QoL scores, both physical (p = 0.0001 and 0.0257) and mental (p < 0.0001 and 0.0038), in comparison to SUDD and PD.

Conclusion

Family history for diverticula and history of bleeding distinguish diverticulosis from DD. These clinical features should be kept in mind in the management of DD.
The distribution of HLA DQ2 and DQ8 haplotypes and their association with health indicators in a general Danish population
Authors: Kårhus Line Lund , Thuesen Betina H , Skaaby Tea , Rumessen Jüri J , Linneberg Allan
Published: March 2018

Background

Human leukocyte antigen (HLA) DQ2 and DQ8 are important risk factors for some autoimmune diseases such as celiac disease (CD), but their possible role in other diseases and health conditions is not fully explored.

Objectives

The objective of this article is to examine the distribution of HLA DQ2 and HLA DQ8 in an adult general population, and their association with health indicators (diseases, symptoms and biomarkers).

Methods

In this cross‐sectional, population‐based study, 2293 individuals were screened for HLA DQ2 and DQ8; CD‐associated alleles (DQA*0201*03*05/DQB*02*0301/0304*0302/0305) and DQB1*02 homozygosity were determined for screen‐positive participants. The National Patient Registry provided diagnosis information.

Results

A total of 47.7% (1093/2293) individuals were positive for DQ2 and/or DQ8: 31.2% (716/2293) only DQ2, 11.9% (273/2293) only DQ8, 4.1% (93/2293) both DQ2 and DQ8. Among nine individuals diagnosed with CD, 89.9% (8/9) had DQ2.5cis, 22.2% (2/9) DQ8 and 22.2% (2/9) DQ2.2 (two both DQ2 and DQ8). HLA DQ2.5 was associated with higher thyroid‐stimulating hormone levels, while DQ2/DQ8‐positive participants had significantly lower prevalence of irritable bowel syndrome (IBS). DQ2/DQ8 were strongly associated with CD, but no other registry‐based diagnoses.

Conclusion

In this general Danish population, 47.7% were HLA DQ2/DQ8 positive and thus potentially at risk for CD. All individuals with CD were DQ2/DQ8 positive; the majority DQ2.5. Surprisingly, DQ2/DQ8‐positivity was associated with lower IBS prevalence.
The face of internet recruitment: Evaluating the labor markets of online crowdsourcing platforms in China
Authors: Li Xiaojun , Shi Weiyi , Zhu Boliang
Published: March 2018

Zhubajie/Witmart and other online crowdsourcing platforms have proliferated in China, and researchers have increasingly used them for subject recruitment. One critical question remains, however: what is the generalizability of the findings based on these online samples? In this study, we benchmark the demography of an online sample from Zhubajie to nationally representative samples and replicate commonly asked attitudinal questions in national surveys. We find that online respondents differ from the general population in many respects. Yet, the differences become smaller when comparison is made with the internet users in benchmark surveys. Importantly, when predicting attitudes, our online sample with post-stratification weights is able to produce similar coefficients in most cases as these internet-active subsamples. Our study suggests that online crowdsourcing platforms can be a useful tool for subject recruitment, especially when researchers are interested in making inferences about Chinese netizens. We further analyze the political and social desirability issues of online subjects. Finally, we discuss caveats of using crowdsourcing samples in China.
A mixed methods study of the experience of older adults with multimorbidity in a Care Coordination Program
Authors: Scholz Mellum Jean , Martsolf Donna , Glazer Greer , Martsolf Grant , Tobias Barbara
Published: March 2018

Introduction

Care Coordination Programs are designed to streamline services for older adults with multimorbidity. The Triple Aim, a conceptual model for the design and evaluation of healthcare models, stipulates that a balance of three aims—reducing costs, improving population health, and improving patient experience—are needed for high-quality, value-based care. Research is beginning to show that coordinating care across the continuum of care reduces costs and improves the health of the multimorbid older adult population. Yet little is known about older adults’ experience of care and their overall assessment of interactions with healthcare providers across the length of time of these interactions in a Care Coordination Program.

Methods

To gain a deeper understanding of older adults’ experience with a Care Coordination Program, this concurrent mixed methods research study analyzed 201 older adults’ assessment of their chronic illness care using the Patient Assessment of Chronic Illness Care (PACIC+). A subset of 30 older adults also participated in a telephone interview to collect qualitative data.

Results

The experience of older adults with multimorbidity in a Care Coordination Program was related to two factors: (1) professional actions and (2) professional attitudes. Actions that improved patients’ experience of care were communication, coordination, and addressing fundamental problems. Professional attitudes that improved their experience of care included being compassionate, knowledgeable and professional, mutually respectful, and positive and encouraging.

Discussion

To improve patient experience, Care Coordination Programs must design and measure their efforts related to the actions and the attitudes of their care team, especially primary care physicians and care coordinators.
Gender differences in the relationship of weight-based stigmatisation with motivation to exercise and physical activity in overweight individuals
Authors: Sattler Krystal M , Deane Frank P , Tapsell Linda , Kelly Peter J
Published: March 2018

Weight stigma is related to lower levels of motivation to exercise in overweight and obesity. This study explored the nature of the relationship between stigma, motivation to exercise and physical activity while accounting for gender differences. Participants were 439 adults with overweight and obesity (mean body mass index = 32.18 kg/m2, standard deviation = 4.09 kg/m2). Females reported significantly more frequent stigma experiences than males. Mediation models found a conditional direct effect of weight stigma for males, with higher frequency of stigma experiences related to higher levels of walking and vigorous physical activity. A conditional indirect effect was found for females for walking, moderate and vigorous levels of physical activity, with higher weight stigma related to lower autonomous motivation, and lower levels of physical activity. Findings suggest that males and females are affected differently by weight-stigma experiences.
Diabetes Empowerment Council: Integrative Pilot Intervention for Transitioning Young Adults With Type 1 Diabetes
Authors: Weigensberg Marc J , Vigen Cheryl , Sequeira Paola , Spruijt-Metz Donna , Juarez Magaly , Florindez Daniella , Provisor Joseph , Peters Anne , Pyatak Elizabeth A
Published: March 2018

Background

The transition of young adults with type 1 diabetes (T1D) from pediatric to adult care is challenging and frequently accompanied by worsening of diabetes-related health. To date, there are no reports which prospectively assess the effects of theory-based psycho-behavioral interventions during the transition period neither on glycemic control nor on psychosocial factors that contribute to poor glycemic control. Therefore, the overall aim of this study was to develop and pilot test an integrative group intervention based on the underlying principles of self-determination theory (SDT), in young adults with T1D.

Methods

Fifty-one young adults with T1D participated in an education and case management-based transition program, of which 9 took part in the Diabetes Empowerment Council (DEC), a 12-week holistic, multimodality facilitated group intervention consisting of “council” process based on indigenous community practices, stress-reduction guided imagery, narrative medicine modalities, simple ritual, and other integrative modalities. Feasibility, acceptability, potential mechanism of effects, and bio-behavioral outcomes were determined using mixed qualitative and quantitative methods.

Results

The intervention was highly acceptable to participants, though presented significant feasibility challenges. Participants in DEC showed significant reductions in perceived stress and depression, and increases in general well-being relative to other control participants. Reduction in perceived stress, independent of intervention group, was associated with reductions in hemoglobin A1C. A theoretical model explaining the effects of the intervention included the promotion of relatedness and autonomy support, 2 important aspects of SDT.

Conclusions

The DEC is a promising group intervention for young adults with T1D going through transition to adult care. Future investigations will be necessary to resolve feasibility issues, optimize the multimodality intervention, determine full intervention effects, and fully test the role of the underlying theoretical model of action. ClinicalTrials.gov Registration Number NCT02807155; Registration date: June 15, 2016 (retrospectively registered)
A Recurrent Platinum Refractory Ovarian Cancer Patient With a Partial Response After RRx-001 Resensitization to Platinum Doublet
Authors: Cottrill Hope , Cason Stephanie , Caroen Scott , Oronsky Bryan , Donaldson Elvis
Published: March 2018

This case report describes the clinical course of a heavily pretreated patient enrolled on the Phase II QUADRUPLE THREAT clinical trial (NCT02489903) with recurrent metastatic epithelial ovarian cancer that was previously treated with a platinum doublet and that benefited from another reintroduction of a platinum doublet after a brief priming period with RRx-001. Platinum-taxane combination is the initial treatment of choice in ovarian cancer and the “go-to regimen” for patients with recurrent, platinum-sensitive disease. However, platinum resistance is an inevitable and uniformly fatal development. One of the “Holy Grails” in ovarian cancer, besides early detection, is to reverse this resistance and retreat with a platinum doublet regimen. Because of the correlation between therapeutic resistance and poor clinical outcomes, this case, which potentially demonstrates a new avenue of anticancer development in epithelial ovarian cancer provided it is repeatable with other ovarian patients, was felt to merit a report.