bluuebunny/crossref_metadata_2025 huggingface dataset:
The state of the art in non‐pharmacological interventions for developmental stuttering. Part 1: a systematic review of effectiveness
Authors: Baxter Susan , Johnson Maxine , Blank Lindsay , Cantrell Anna , Brumfitt Shelagh , Enderby Pam , Goyder Elizabeth
Published: June 2015

Background

The growing range of available treatment options for people who stutter presents a challenge for clinicians, service managers and commissioners, who need to have access to the best available treatment evidence to guide them in providing the most appropriate interventions. While a number of reviews of interventions for specific populations or a specific type of intervention have been carried out, a broad‐based systematic review across all forms of intervention for adults and children was needed to provide evidence to underpin future guidelines, inform the implementation of effective treatments and identify future research priorities.

Aims

To identify and synthesize the published research evidence on the clinical effectiveness of the broad range of non‐pharmacological interventions for the management of developmental stuttering.

Methods & Procedures

A systematic review of the literature reporting interventions for developmental stuttering was carried out between August 2013 and April 2014. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for the identification of relevant studies included electronic database searching, reference list checking, citation searching and hand searching of key journals. Appraisal of study quality was performed using a tool based on established criteria for considering risk of bias. Due to heterogeneity in intervention content and outcomes, a narrative synthesis was completed.

Main Contribution

The review included all available types of intervention and found that most may be of benefit to at least some people who stutter. There was evidence, however, of considerable individual variation in response to these interventions. The review indicated that effects could be maintained following all types of interventions (although this was weakest with regard to feedback and technology interventions).

Conclusions

This review highlights a need for greater consensus with regard to the key outcomes used to evaluate stuttering interventions, and also a need for enhanced understanding of the process whereby interventions effect change. Further analysis of the variation in effectiveness for different individuals or groups is needed in order to identify who may benefit most from which intervention.
Towards Inclusive Learning Environments (TILE): Developing the ‘Roadmap for the Inclusion of Students with Special Educational Needs in Vocational Education and Workplace Settings’
Authors: Smith Andy , Bell Sheena
Published: June 2015

Twenty years after UNESCO's Salamanca Statement enshrined international action for provision for children, youth and adults with special educational needs within the regular educational system, this article presents the current underpinning international and national UK context for developing inclusion in vocational education and training and workplace settings. This context is explored through the justification for developing an EU‐funded project entitled ‘Towards Inclusive Learning Environments (TILE)’ and the creation of an associated audit tool, the ′Roadmap for Inclusion′, by a partnership group consisting of universities and VET settings from Finland, the Czech Republic, Estonia and England.
Policy–practice gap in participation of students with disabilities in the education and training programme of Ethiopia: policy content analysis
Authors: Malle Abebe Yehualawork , Pirttimaa Raija , Saloviita Timo
Published: June 2015

This study explores the extent to which the issue of special educational and training needs for persons with disabilities is addressed in the education and training policy of Ethiopia, with a specific focus on technical and vocational education and training (TVET). Focus group discussions and interviews were used to assess the content of the policy and related strategic documents, as well as legal frameworks and implementation instruments, in terms of the principle of inclusion. A pair of focus group discussions involved 22 members of the management and governance of four networks and eight indigenous, disability‐focused, non‐governmental organisations. Moreover, 14 high‐profile experts from the ministry were interviewed. Most participants agreed that the issue of disability was not addressed appropriately in issues of strategy and prioritisation. Six recommendations are presented for enhancing the inclusion of individuals with disabilities in education and vocational training.
Source Tracking and Succession of Kimchi Lactic Acid Bacteria during Fermentation
Authors: Lee Se Hee , Jung Ji Young , Jeon Che Ok
Published: June 2015

This study aimed at evaluating raw materials as potential lactic acid bacteria (LAB) sources for kimchi fermentation and investigating LAB successions during fermentation. The bacterial abundances and communities of five different sets of raw materials were investigated using plate‐counting and pyrosequencing. LAB were found to be highly abundant in all garlic samples, suggesting that garlic may be a major LAB source for kimchi fermentation. LAB were observed in three and two out of five ginger and leek samples, respectively, indicating that they can also be potential important LAB sources. LAB were identified in only one cabbage sample with low abundance, suggesting that cabbage may not be an important LAB source. Bacterial successions during fermentation in the five kimchi samples were investigated by community analysis using pyrosequencing. LAB communities in initial kimchi were similar to the combined LAB communities of individual raw materials, suggesting that kimchi LAB were derived from their raw materials. LAB community analyses showed that species in the genera Leuconostoc, Lactobacillus, and Weissella were key players in kimchi fermentation, but their successions during fermentation varied with the species, indicating that members of the key genera may have different acid tolerance or growth competitiveness depending on their respective species.
Diverse Profiles of N‐acyl Homoserine l‐Lactones, Biofilm, Virulence Genes and Integrons in Food‐Borne Aeromonas Isolates
Authors: Nagar Vandan , Sinha Vibha , Bandekar Jayant R.
Published: June 2015

Aeromonas are regarded as opportunistic as well as primary pathogens of humans and fish, and are associated with gastroenteritis and septicemia in humans. Production of N‐acyl‐homoserine lactone (AHL) signal molecules and biofilm was determined in 22 Aeromonas isolates, from different food products in India, using thin‐layer chromatography (TLC) analysis and microtiter‐plate assay, respectively. Overall, highly heterogeneous patterns of AHL production were observed, with the production of N‐butanoyl homoserine lactone (C4‐HSL) and N‐hexanoyl homoserine lactone (C6‐HSL) by the majority (81.8%) of Aeromonas food isolates. Moreover, putative N‐pentanoyl homoserine lactone (C5‐HSL), N‐heptanoyl homoserine lactone (C7‐HSL), and N‐octanoyl homoserine lactone (C8‐HSL) were produced by 72.7%, 27.3%, and 9.1% of isolates, respectively. This is the 1st report of production of C7‐HSL by Aeromonas species. Aeromonas food isolates were highly variable in their biofilm forming abilities with majority of them as weak biofilm producers in 2 different media, TSB and M9 minimal medium supplemented with 0.4% glucose. The genes encoding for putative virulence factors, glycerophospholipid cholesterol acyltransferase (gcat), heat‐labile cytotonic enterotoxin (alt), heat‐stable cytotonic enterotoxin (ast), serine protease (ser), polar flagella (fla), and lateral flagella (lafA) were present in 95.5%, 59.1%, 22.7%, 81.8%, 77.3%, and 22.7% of the strains, respectively. Class 1 integrons (100 to 3000 bp) were found in 68.2% of food isolates; whereas, 50% isolates contained class 2 integrons (150 to 1600 bp). This study provides a baseline data on the diversity of AHLs, biofilm forming ability and presence of virulence genes and integrons in Aeromonas food isolates from India.
Ecological transcriptomics – a non‐lethal sampling approach for endangered fire salamanders
Authors: Czypionka Till , Krugman Tamar , Altmüller Janine , Blaustein Leon , Steinfartz Sebastian , Templeton Alan R. , Nolte Arne W.
Published: June 2015

The analysis of transcriptomes is well‐established and increasingly affordable in studies at the interface of ecology and evolution. Expression analysis of thousands of genes in parallel reveals functions and pathways involved in relevant phenotypic differentiation. The application of such methods typically involves the sacrifice of the analysed organisms, which is potentially subject to ethical and legal constraints. As an alternative to lethal sampling, transcriptome analyses can be performed using small biopsies of dispensable tissues.

It has to be verified, however, to what extent such results are representative of the whole organism. Here, we use a custom microarray to compare transcriptomes of tail‐clip samples with those of the remaining whole body of fire salamander larvae (Salamandra salamandra). The microarray was calibrated using target RNA to validate the performance of each probe. We varied water temperature to test whether the thermal response in gene expression can be characterized in both types of sample.

A large fraction (51%) of the differentially expressed genes showed parallel changes for both tail clips and whole bodies in response to temperature. While sets of differentially expressed were not identical, they largely belonged to the same functional categories. The gene functions thus revealed a common thermal response of larvae irrespective of the sampled tissue. This included an overexpression of mitochondrial transcripts, an expected thermal acclimatization response of ectotherms. Hence, ecological transcriptomics based on small biopsies represent an alternative to the analysis of lethally sampled tissues in situations where the sacrifice of individuals is not an option.
Long‐term monitoring reveals declines in an endemic predator following invasion by an exotic prey species
Authors: Fukuda Y. , Tingley R. , Crase B. , Webb G. , Saalfeld K.
Published: June 2015

Invasive predators can cause population declines in native prey species, but empirical evidence linking declines of native predators to invasive prey is relatively rare. Here, we document declines in an Australian freshwater crocodile Crocodylus johnstoni population following invasion of a toxic prey species, the cane toad Rhinella marina. Thirty‐five years of standardized spotlight surveys of four segments of a large river in northern Australia revealed that the density of freshwater crocodiles decreased following toad invasion and continued to decline thereafter. Overall, intermediate‐sized freshwater crocodiles (0.6–1.2 m) were most severely impacted. Densities of saltwater crocodiles Crocodylus porosus increased over time and were generally less affected by toad arrival, although toad impacts were inconsistent across survey sections and size classes. Across the entire river, total freshwater crocodile densities declined by 69.5% between 1997 and 2013. Assessments of the status of this species within other large river systems in northern Australia, where baseline data are available from before the toads arrived, should be prioritized. Our findings highlight the importance of long‐term monitoring programmes for quantifying the impacts of novel and unforeseen threats.
Antenatal screening for hepatitis C: Universal or risk factor based?
Authors: Wilson Erin , Beckmann Michael
Published: June 2015

Background

There is no clear consensus on whether antenatal screening for hepatitis C (HCV) should be universal, or based on an assessment of risk factors.

Aim

To report the HCV status and risk factors for HCV amongst women delivering at a tertiary metropolitan hospital in order to better understand the implications of changing from universal to risk factor based HCV screening.

Materials and Methods

An audit of practice was performed at Mater Mothers' Hospitals (Brisbane) using routinely collected data from 2007 to 2013 (n = 57,659). The demographic and clinical characteristics of HCV‐positive women (n = 281) were compared with those with a negative result (n = 57,378), and compared for the presence or absence of risk factors for HCV.

Results

From a cohort of 57,659 women, 281 (0.5%) women were HCV positive. HCV‐positive women were more likely to have received blood products (10.0 vs 3.1%; P < 0.001), have a history of illicit drug use (72.2 vs 9.8%; P < 0.001), and have at least one risk factor for HCV infection (92 vs 17%; P < 0.001). Of the HCV‐positive women, only seven of the 281 (2.5%) had no identifiable risk factor, whilst most (83%) HCV‐negative women did not have any documented risk factor for HCV infection.

Conclusion

Most women testing positive for HCV antibodies have identifiable risk factors; however, a small number will not be detected if a risk factor based screening approach is adopted. The benefits of universal screening must be weighed against the potential cost savings of a risk factor based screening program.
Holding a stillborn baby: the view from a specialist perinatal bereavement service
Authors: Wilson Patricia A. , Boyle Frances M. , Ware Robert S.
Published: June 2015

Background

Stillbirth is a profoundly distressing event. Little evidence exists to guide best practice bereavement care in the perinatal setting.

Aims

To document parents' experiences and outcomes in relation to seeing and holding a stillborn baby at a hospital with a specialist perinatal bereavement service.

Materials and Methods

Prospective cohort study of 26 mothers and 11 fathers who experienced a stillbirth at the Mater Mothers' Hospital, Brisbane from September 2007–December 2008. Mailed self‐report questionnaires were completed at 6–8 weeks and 6 and 13 months postloss. Validated measures assessed regret regarding the decision to see and hold the baby, parental grief and mental health.

Results

Of 78 fetal deaths, 26 mothers and 11 fathers participated. Most (20 mothers; 9 fathers) chose to see and hold their stillborn infant. Little regret was reported, irrespective of the decision. For mothers, seeing and holding was associated with higher ‘active grief’ at 6–8 weeks (mean difference (MD) = 10.5; 95% CI = 3.3–17.8; P < 0.01), 6 months (MD = 8.0; 95% CI = 0.6–15.4; P = 0.03) and 13 months (MD = 9.9; 95% CI = 1.8–17.9; P = 0.01), but not with ‘not coping’ or ‘despair’, or mental health. Fathers reported poorer mental health but small numbers mean estimates are imprecise.

Conclusions

More intense grief does not equate with poorer mental health for mothers who choose to see and hold a stillborn infant. Fathers' experiences warrant further study. Supported decision‐making is important for bereaved parents, and rigorous evaluation of bereavement care is essential.
Gynaecological laparoscopy deaths in Australia
Authors: Lawson Gerald
Published: June 2015

Aim

To determine the incidence and clinical features of laparoscopic gynaecological deaths in Australia.

Materials and Methods

Gynaecological laparoscopic mortality data were obtained from the National Coronial Information Systems (NCIS) and Australian State Coroners Courts, for the period July 1 2000 to December 31 2012.

Results

Eighteen deaths were identified, providing a mortality rate of approximately 1 per 70,000 laparoscopic procedures. The commonest cause of death was from bowel perforation, most of which were unrecognised during the operation.

Conclusion

Gynaecologists should be trained to recognise and manage the rare event of laparoscopic perforation of a viscus or a blood vessel.
Dual Antiplatelet Therapy of Clopidogrel and Aspirin in Secondary Prevention of Ischemic Stroke: Evidence and Indications
Authors: Su Ya , Cheng Xin , Dong Qiang
Published: June 2015

Nowadays the dual antiplatelet therapy (DAPT) becomes more widely used in patients with ischemic stroke. Nevertheless, controversies exist for indications of DAPT. In view of evidence‐based medicine analysis, patients with high‐risk transient ischemic attack and minor stroke, severe symptomatic intracranial artery stenosis, symptomatic intracranial and extracranial artery stenosis causing artery‐to‐artery embolism, ischemic stroke attributed to aortic arch plaques, high‐risk atrial fibrillation not suitable for oral anticoagulants, intracranial and extracranial stent implantation, and ischemic stroke with acute coronary syndrome may gain great benefit from DAPT of clopidogrel and aspirin. In clinical practice, individualized antiplatelet therapy strategies should be taken by weighing risks of ischemia and hemorrhage.
The effects of physical activity interventions on preventing weight gain and the effects on body composition in young adults with intellectual disabilities: systematic review and meta‐analysis of randomized controlled trials
Authors: Harris L. , Hankey C. , Murray H. , Melville C.
Published: June 2015

The aim of this study was to examine the literature on randomized controlled trials examining the efficacy of physical activity interventions to prevent weight gain and the effects on body composition in young adults with intellectual disabilities.A systematic search of Medline, Emabse, CINHAL, PsychINFO, Cochrane library and ERIC was conducted from 1946 to September 2014. Eligibility criteria included; randomized controlled trials of a physical activity intervention: objective measure of body weight and body composition; young adults (age range 16–24 years) with intellectual disabilities. Six studies met the eligibility criteria. The interventions varied in their prescription of physical activity including aerobic and strength‐based activities. The mean duration of the interventions was 15.3 (range 10–21 weeks). There was no significant effect of physical activity interventions on body weight (weighted mean difference: −0.17 kg, 95% confidence interval, −1.04 kg to 0.72 kg) and body composition outcomes. The meta‐analysis showed that physical activity interventions did not prevent weight gain in young adults with intellectual disabilities. Published studies are inadequate to form firm conclusions. Future longer term studies of interventions specifically designed for this population group are required to elucidate the effects of physical activity interventions on body composition and the prevention of weight gain in young adults with intellectual disabilities.
5As Team obesity intervention in primary care: development and evaluation of shared decision‐making weight management tools
Authors: Osunlana A. M. , Asselin J. , Anderson R. , Ogunleye A. A. , Cave A. , Sharma A. M. , Campbell‐Scherer D. L.
Published: June 2015

Despite several clinical practice guidelines, there remains a considerable gap in prevention and management of obesity in primary care. To address the need for changing provider behaviour, a randomized controlled trial with convergent mixed method evaluation, the 5As Team (5AsT) study, was conducted. As part of the 5AsT intervention, the 5AsT tool kit was developed. This paper describes the development process and evaluation of these tools. Tools were co‐developed by the multidisciplinary research team and the 5AsT, which included registered nurses/nurse practitioners (n = 15), mental health workers (n = 7) and registered dieticians (n = 7), who were previously randomized to the 5AsT intervention group at a primary care network in Edmonton, Alberta, Canada. The 5AsT tool development occurred through a practice/implementation‐oriented, need‐based, iterative process during learning collaborative sessions of the 5AsT intervention. Feedback during tool development was received through field notes and final provider evaluation was carried out through anonymous questionnaires. Twelve tools were co‐developed with 5AsT. All tools were evaluated as either ‘most useful’ or ‘moderately useful’ in primary care practice by the 5AsT. Four key findings during 5AsT tool development were the need for: tools that were adaptive, tools to facilitate interdisciplinary practice, tools to help patients understand realistic expectations for weight loss and shared decision‐making tools for goal setting and relapse prevention. The 5AsT tools are primary care tools which extend the utility of the 5As of obesity management framework in clinical practice.
What do dental students know about trauma?
Authors: AlZoubi Fahad , Mannocci Francesco , Newton Tim , Manoharan Andiappan , Djemal Serpil
Published: June 2015

Aim

To assess the baseline knowledge, knowledge acquisition and retention of dental undergraduate students in dental trauma, and the impact of a lecture on their level of confidence in managing traumatic dental injuries.

Material and methods

A total of 145 dental undergraduate students from King's College London were invited to attend a lecture on dental trauma. The participants were asked to complete a questionnaire on dental trauma before (T0), immediately after (T1) and 6 months (T2) following a 1‐h lecture.

Results

Seventy of the 145 students participated in the study. The level of knowledge at T0, T1 and T2 was 64.9%, 83.2% and 69.5%, respectively. The increase in score was statistically significant between T0 and T1, and between T0 and T2. A significant decrease in score was also found between T1 and T2. Sex, level of education and whether or not the participants received previous teaching in dental trauma were not significant in predicting a change in score. The level of confidence increased significantly from 2.14 at T0 to 3.13 at T2. Participants who received teaching in dental trauma previous to the lecture were significantly more confident at T0.

Conclusions

Lectures are effective at improving the knowledge and retention of knowledge of dental undergraduate students in dental trauma. However, retention of the knowledge is time limited suggesting that education should be repeated after a certain period of time to ensure that a high level of knowledge is maintained.
To Be or Not to Be Patent: The Relationship Between Migraine and Patent Foramen Ovale
Authors: Kahya Eren Nihan , Bülbül Nazlı G. , Yakar Tülüce Selcen , Nazlı Cem , Beckmann Yeşim
Published: June 2015

Objective/Background

Migraine is a common neurological disorder with an uncertain pathogenesis. A pathophysiological link has been proposed between the migraine headache and patent foramen ovale (PFO). However, the data about the association of migraine with the presence of PFO are conflicting. The study aims to prospectively investigate the prevalence of PFO in patients with migraine compared with that of control subjects.

Methods

A total of 203 migraineous patients and 212 control subjects with similar demographic characteristics to that of case subjects regarding age and gender were included in the study. Transthoracic echocardiography with agitated saline injection was used to evaluate the presence of PFO. PFO was judged to be present if any microbubble was seen in the left cardiac chambers within the first 5 cardiac cycles from the maximum right atrial opacification at rest or after provocative maneuvers.

Results

Mean age of the patients was 37.2 ± 9.8 years and 93% were female. Migraine with aura was present in 32% (n = 65) of the patients. The prevalence of PFO was similar in patients with migraine and the control subjects (42% vs 44%; odds ratio 0.90, 95% confidence interval 0.61‐1.33, P = .61). Likewise, the prevalence of PFO was similar in migraineurs patients with or without aura (41% vs 42%; odds ratio 0.95, 95% confidence interval 0.51‐1.76, P = .87).

Conclusion

This study suggest that PFO is not more common in patients with migraine compared with healthy subjects. Therefore, our findings suggest that the relationship between migraine headache and the presence of PFO is questionable.
Liver toxicity and risk of discontinuation in HIV/hepatitis C virus‐coinfected patients receiving an etravirine‐containing antiretroviral regimen: influence of liver fibrosis
Authors: Casado JL , Mena A , Bañón S , Castro A , Quereda C , Moreno A , Pedreira J , Moreno S
Published: June 2015

Objectives

The aim of the study was to establish the risk of liver toxicity in HIV/hepatitis C virus (HCV)‐coinfected patients receiving etravirine, according to the degree of liver fibrosis.

Methods

A prospective cohort study of 211 HIV‐infected patients initiating an etravirine‐containing regimen was carried out. HCV coinfection was defined as a positive HCV RNA test, and baseline liver fibrosis was assessed by transient elastography. Hepatotoxicity was defined as clinical symptoms, or an aspartate aminotransferase (AST) or alanine aminotransferase (ALT) value > 5‐fold higher than the upper limit of normal if baseline values were normal, or 3.5‐fold higher if values were altered at baseline.

Results

Overall, 145 patients (69%) were HCV coinfected, with a lower nadir (165 versus 220 cells/μL, respectively; p = 0.03) and baseline (374 versus 498 cells/μL, respectively; p = 0.04) CD4 count than monoinfected patients. Etravirine was mainly used with two nucleoside reverse transcriptase inhibitors (129; 61%) or with a boosted protease inhibitor (PI) (28%), with no significant differences according to HCV serostatus. Transient elastography in 117 patients (81%) showed a median (range) stiffness value of 8.25 (3.5–69) kPa, with fibrosis stage 1 in 43 patients (37%) and fibrosis stage 4 in 28 patients (24%). During an accumulated follow‐up time of 449.3 patient‐years (median 548 days), only one patient with advanced fibrosis (50.8 kPa) had grade 3–4 liver toxicity (0.7%). Transaminases changed slightly, with no significant differences compared with baseline fibrosis, and nine and six patients had grade 1 and 2 transaminase increases, respectively. Also, HCV coinfection was not associated with a higher risk of discontinuation (25% discontinued versus 21% of monoinfected patients; p = 0.39, log‐rank test) or virological failure (8% versus 12%, respectively; p = 0.4).

Conclusions

Our data suggest that etravirine is a safe option for HIV/HCV‐coinfected patients, including those with significant liver fibrosis.
What is a Stereotype? What is Stereotyping?
Authors: Beeghly Erin
Published: June 2015

If someone says, “Asians are good at math” or “women are empathetic,” I might interject, “you're stereotyping” in order to convey my disapproval of their utterance. But why is stereotyping wrong? Before we can answer this question, we must better understand what stereotypes are and what stereotyping is. In this essay, I develop what I call the descriptive view of stereotypes and stereotyping. This view is assumed in much of the psychological and philosophical literature on implicit bias and stereotyping, yet it has not been sufficiently defended. The main objection to the descriptive view is that it fails to include the common‐sense idea that stereotyping is always objectionable. I argue that this is actually a benefit of the view. In the essay's final part, I put forward two hypotheses that would validate the claim that stereotyping is always morally or epistemically wrong. If these hypotheses are false—which is very likely—we have little reason to build moral or epistemic defect into the very idea of a stereotype. Moreover, we must abandon the seemingly attractive claim that judging individuals based on group membership is intrinsically wrong.
Development of fermented Hericium erinaceus juice with high content of L‐glutamine and L‐glutamic acid
Authors: Woraharn Sasimar , Lailerd Narissara , Sivamaruthi Bhagavathi Sundaram , Wangcharoen Wiwat , Peerajan Sartjin , Sirisattha Sophon , Chaiyasut Chaiyavat
Published: June 2015

Fermented plant beverages (FPB) with a high content of desirable principle components are served as functional foods from several years. Hericium erinaceus is famous for its antimicrobial, antioxidant, antihypertensive and antidiabetic nature. Accordingly, the current study was aimed to produce fermented H. erinaceus juice with a high content of L‐glutamine (Gln) and L‐glutamic acid (GA) through lactic acid bacteria (LAB) isolated from fermented Thai foods. LAB isolates were screened and identified the potent protease‐producing bacteria Enterococcus faecalis (G414/1) that facilitate the production of Gln and GA through protein hydrolysis. Box–Behnken design (BBD) and response surface methodology (RSM) were adapted for the optimisation of conditions for the increased production of Gln and GA during fermentation of H. erinaceus. We succeeded with an optimum concentration of cofactor (CaCl2), pH and temperature for improved protease activity and subsequent Gln and GA production. The ability of isolated E. faecalis strain to produce Gln and GA was demonstrated in this study. Further, upstream processes like strain improvement and media optimisation will direct the way to produce enriched H. erinaceus based FPB.
Protective effect of advanced age on post‐ERCP pancreatitis and unplanned hospitalisation
Authors: Maitin‐Casalis N. , Neeman T. , Thomson A.
Published: June 2015

Background

As the median age of Australia's population rises, endoscopic retrograde cholangiopancreatography (ERCP) is becoming increasingly used in the elderly. However, ERCP remains associated with serious complications including post‐ERCP pancreatitis (PEP), which often necessitate unplanned hospital admission. Although previous research has demonstrated a protective effect of age against PEP, inconsistencies have arisen in recent studies. In addition to age, post‐ERCP complication rates have been previously shown to be affected by various factors including longer procedure duration and high‐risk indications.

Aim

The aim of this study was to investigate the rates of PEP and unplanned hospital admission or prolongation of hospital stay (UHAP) across age groups and their relation to procedure duration and indication.

Methods

Prospective analysis of 1284 consecutive ERCP on patients aged 20–101 years performed at a tertiary referral centre.

Results

Advanced age (>80 years) was associated with a significantly lower risk of both PEP (P = 0.02) and UHAP (P < 0.05) compared with patients aged 50–79 years. Rates of PEP and UHAP differed significantly according to indication (P < 0.01) and longer procedure duration similarly increased the risk of both complications (P < 0.01). However, there were no significant differences between age groups in terms of the proportion of patients with ‘high‐risk’ indications. Importantly, age remained a significant negative predictor of PEP even after adjusting for procedure duration (P = 0.04).

Conclusions

The protective effect of age against PEP and UHAP is not due to confounding by high‐risk indications or increased procedure duration. ERCP may be a relatively safe option for our growing cohort of elderly patients.
Duality for higher order variational control programming problems
Authors: Sharma Sarita
Published: June 2015

In this article, a variational control problem is considered. We introduce the concept of higher order ‐convex function for a continuous case. Further, we formulate higher order mixed‐type dual for the considered problem and obtain appropriate duality results using aforesaid assumptions.
Shock Compression of Boron Carbide: A Quantum Mechanical Analysis
Authors: Taylor DeCarlos E.
Published: June 2015

The shock Hugoniot of boron carbide, from 0 to 80 GPa, has been obtained using first principles quantum mechanics (density functional theory) and molecular dynamics simulation. The Hugoniot for six different structures which vary by structure or stoichiometry were computed and compared to experimental data. The effect of stoichiometry, and structural variation within a given stoichiometry, are shown to have marked effects on the shock properties with some compositions displaying bilinear behavior in the computed shock velocity‐particle velocity profiles while others show a continuous Hugoniot curve with no evidence of a phase transition over the pressure range considered in this work. Two structures, B12(CBC) and B11Cp(CCB), have predicted phase transition pressures lying within the 40–50 GPa range suggested experimentally. It is shown that the phase transition is driven by deformation of the 3‐atom chain within the boron carbide crystal structure which induces a discontinuous volume change at the critical shock pressure. The effect of defects, in the form of chain vacancies, on the shock response is presented and the ability of shear to significantly lower the phase transition pressure, in accord with experimental observation, is demonstrated.
The Assembly of TiO2 Nanoparticles into Micrometer‐Sized Structures, Photocatalytically Active Under UV and Vis Light
Authors: Žunič Vojka , Škapin Srečo D. , Suvorov Danilo
Published: June 2015

Micrometer‐sized structures consisting of TiO2 nanoparticles were prepared using the sol–gel technique in combination with the structure‐directing agent triethanolamine (TEA). The interaction of the TEA with the hydrolyzed sol–gel products led to the formation of TEA titanate complexes, which then enabled the assembly of sol–gel‐precipitated nanosized powders. A subsequent thermal treatment of these powders resulted in the formation of micrometer‐sized structures consisting of TiO2 anatase and rutile nanoparticles. To characterize the prepared powders, FTIR spectroscopy, XRD analysis, the Brunauer‐Emmett‐Teller method (sBET), UV–Vis spectrometry and electron microscopy (FE‐SEM, and TEM) were employed. The photocatalytic degradation of the azo dye known as methylene blue was monitored under UV and Vis irradiation and showed that the micrometer‐sized structures consisting of TiO2 nanoparticles exhibited a similar photocatalytic activity to submicrometer‐sized structures consisting of TiO2 nanoparticles prepared without TEA.
Defining attributes of patient safety through a concept analysis
Authors: Kim Linda , Lyder Courtney H. , McNeese‐Smith Donna , Leach Linda Searle , Needleman Jack
Published: June 2015

Aim

The aim of this study was to report an analysis of the concept of patient safety.

Background

Despite recent increase in the number of work being done to clarify the concept and standardize measurement of patient safety, there are still huge variations in how the term is conceptualized and how to measure patient safety data across various healthcare settings and in research.

Design

Concept analysis.

Data sources

A literature search was conducted through PubMed and Cumulative Index to Nursing and Allied Health Literature, Plus using the terms ‘patient safety’ in the title and ‘concept analysis,’ ‘attributes’ or ‘definition’ in the title and or abstract. All English language literature published between 2002–2014 were considered for the review.

Methods

Walker and Avant's method guided this analysis.

Results

The defining attributes of patient safety include prevention of medical errors and avoidable adverse events, protection of patients from harm or injury and collaborative efforts by individual healthcare providers and a strong, well‐integrated healthcare system. The application of Collaborative Alliance of Nursing Outcomes indicators as empirical referents would facilitate the measurement of patient safety.

Conclusion

With the knowledge gained from this analysis, nurses may improve patient surveillance efforts that identify potential hazards before they become adverse events and have a stronger voice in health policy decision‐making that influence implementation efforts aimed at promoting patient safety, worldwide. Further studies are needed on development of a conceptual model and framework that can aid with collection and measurement of standardized patient safety data.
Normative Empire Europe: The European Union, its Borderlands, and the ‘Arab Spring’
Authors: Del Sarto Raffaella A.
Published: June 2015

Focusing on the EU's relations with its periphery, this paper takes issue both with persistent ‘normative’ conceptions of the EU's international role in the European Studies literature and with the constructivist–rationalist divide in IR theory. The conceptualization of the EU – a vast, composite and ever‐expanding entity with ‘fuzzy’ borders – as an empire of sorts bridges the theoretical divide and offers a powerful explanation of the EU's behaviour vis‐à‐vis its vicinity. Through the transfer of rules and practices beyond its borders, the EU is indeed engaged in ‘normative’ policies, which however primarily serve the security and economic interests of the EU and its Member States. Thus, the EU's (allegedly) norm‐based behaviour is in itself a utility‐maximizing strategy, which also serves the construction of a normative identity. The EU's response to the Arab uprisings serves to illustrate the argument, with the concept of ‘empire’ resolving the puzzle of seemingly inconsistent EU policies.
Ingestion of food pellets containing Escherichia coli overexpressing the heat‐shock protein DnaK protects Penaeus vannamei (Boone) against Vibrio harveyi (Baumann) infection
Authors: Sinnasamy S , Mat Noordin N , MacRae T H , Ikhwanuddin bin Abdullah M , Bossier P , bin Abdul Wahid M E , Noriaki A , Sung Y Y
Published: June 2015

Feeding aquatic animals with bacterial encapsulated heat‐shock proteins (Hsps) is potentially a new method to combat vibriosis, an important disease affecting aquatic animals used in aquaculture. Food pellets comprised of shrimp and containing Escherichia coli overexpressing either DnaK‐DnaJ‐GrpE, the prokaryotic equivalents of Hsp70‐Hsp40‐Hsp20, or only DnaK were fed to juveniles of the white leg shrimp Penaeus vannamei, and protection against pathogenic Vibrio harveyi was determined. Maintaining pellets at different temperatures for varying lengths of time reduced the number of live adhering E. coli, as did contact with sea water, demonstrating that storage and immersion adversely affected bacterial survival and attachment to pellets. Feeding P. vannamei with E. coli did not compromise their survival, indicating that the bacteria were not pathogenic to shrimp. Feeding P. vannamei with pellets containing bacteria overproducing DnaK (approximately 60 cells g−1 pellets) boosted P. vannamei survival twofold against V. harveyi, suggesting that DnaK plays a role in Vibrio tolerance. Pellets containing DnaK were effective in providing protection to P. vannamei for up to 2 weeks before loss of viability and that DnaK encapsulated by these bacteria enhanced shrimp resistance against Vibrio infection.
Experiences of care by Australians with a diagnosis of borderline personality disorder
Authors: Lawn S. , McMahon J.
Published: June 2015

Accessible summary

Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and service providers who support them.

This paper reports on the results of a survey of 153 people with a diagnosis of BPD about their experiences of attempting to receive support in managing this mental health condition. It provides their perceptions of a range of experiences not reported in the existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types.

People with a diagnosis of BPD continue to experience significant discrimination when attempting to get their needs met within both public and private health services. Further education for nurses and other health professionals is indicated to address pervasive negative attitudes towards people with a diagnosis of BPD.

There is limited understanding of the experience of seeking and receiving treatment and care by people with a diagnosis of borderline personality disorder (BPD), their perceptions of barriers to care and the quality of services they receive. This study aimed to explore these experiences from the perspective of Australians with this diagnosis. An invitation to participate in an online survey was distributed across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 153 people with a diagnosis of BPD showed that they experience significant challenges and discrimination when attempting to get their needs met within both public and private health services, including general practice. Seeking help from hospital emergency departments during crises was particularly challenging. Metropolitan and rural differences, and gender differences, were also apparent. Community supports were perceived as inadequate to meet their needs. This study provides data on a range of experiences not reported in existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. Its findings can help inform better training for health professionals and better care for this population.
Effect of replacing corn with whole‐grain paddy rice and brown rice in broiler diets on growth performance and intestinal morphology
Authors: Sittiya J. , Yamauchi K. , Takata K.
Published: June 2015

The present study was conducted to investigate replacing corn with whole‐grain paddy rice (WPR) and whole–grain brown rice (BR) in broiler chicken diets and its effect on growth performance and histological structures of the intestinal villi. Marshall Chunky male chicks (14 days old) were divided into five groups with four replicates of four chicks each. In the dietary treatments, corn in the basal diet was replaced with WPR and BR. The chickens received five experimental diets consisting of corn, WPR and BR in ratios of 100:0:0 (Control), 50:0:50 (50Corn + 50BR), 50:25:25 (50Corn + 25WPR + 25BR), 25:50:25 (25Corn + 50WPR + 25BR) and 0:50:50 (50WPR + 50BR) respectively. Feed and water were provided ad libitum for 35 day. No significant differences were found in feed intake, body weight gain and feed efficiency among the treatment groups. The relative weights of the gizzard in the 50Corn + 25WPR + 25BR, 25Corn + 50WPR + 25BR and 50WPR + 50BR groups were significantly higher than that of the Control and 50Corn + 50BR groups (p < 0.05). The gizzard pH of the experimental groups was lower than those of Control (p < 0.05). The ileal crypt of birds on the Control diets was deeper (p < 0.05) than those observed in the experimental birds. Moreover, the ileal villus height: crypt depth ratio increased (p < 0.05) in the 50WPR + 50BR group (p < 0.05) compared with the Control group. No specific changes were observed in the epithelial cells on the duodenal apical surface among the groups except that the villus of the 25Corn + 50WPR + 25BR group had cell clusters. The jejunal and ileal villus apical surface of the experimental groups showed similar morphology to the Control group. These findings suggest that WPR and BR can totally replace corn in broiler diets without negatively affecting growth performance.
Open questions and recent advances in the control of a multi‐host infectious disease: animal tuberculosis
Authors: Gortázar Christian , Che Amat Azlan , O'Brien Daniel J.
Published: June 2015

Animal tuberculosis (TB) control is globally important for public health, economics and conservation. Wildlife species are often part of the Mycobacterium tuberculosis complex (MTC) maintenance community, complicating TB control attempts.

We describe the current knowledge on global TB distribution and the significance of wildlife hosts; identify insufficiently known aspects of host pathology, ecology and epidemiology; present selected time series in wildlife TB; and summarize ongoing research on TB control, providing additional insight on vaccination.

Six specific research needs are identified and discussed, namely: 1) complete the world map of wildlife MTC reservoirs and describe the structure of each local MTC host community; 2) identify the origin and behaviour of generalized diseased individuals within populations, and study the role of factors such as co‐infections, re‐infections and individual condition on TB pathogenesis; 3) quantify indirect MTC transmission within and between species; 4) define and harmonize wildlife disease monitoring protocols, and apply them in a way that allows proper population and prevalence trend comparisons in both space and time; 5) carry out controlled and replicated wildlife TB control experiments using single intervention tools; 6) analyse cost‐efficiency and consider knowledge transfer aspects in promising intervention strategies.

We believe that addressing these six points would push ahead our capacities for TB control. A remaining question is whether or not interventions on wildlife TB are at all justified. The answer depends on the local circumstances of each TB hotspot, and is likely to evolve during our collective progress towards TB control in livestock and in wildlife.
High genetic diversity declines towards the geographic range periphery of Adonis vernalis, a Eurasian dry grassland plant
Authors: Hirsch H. , Wagner V. , Danihelka J. , Ruprecht E. , Sánchez‐Gómez P. , Seifert M. , Hensen I.
Published: June 2015

Genetic diversity is important for species' fitness and evolutionary processes but our knowledge on how it varies across a species' distribution range is limited. The abundant centre hypothesis (ACH) predicts that populations become smaller and more isolated towards the geographic range periphery – a pattern that in turn should be associated with decreasing genetic diversity and increasing genetic differentiation. We tested this hypothesis in Adonis vernalis, a dry grassland plant with an extensive Eurasian distribution. Its life‐history traits and distribution characteristics suggest a low genetic diversity that decreases and a high genetic differentiation that increases towards the range edge. We analysed AFLP fingerprints in 28 populations along a 4698‐km transect from the geographic range core in Russia to the western range periphery in Central and Western Europe. Contrary to our expectation, our analysis revealed high genetic diversity (range of proportion of polymorphic bands = 56–81%, He = 0.168–0.238) and low genetic differentiation across populations (ΦST = 0.18). However, in congruence with the genetic predictions of the ACH, genetic diversity decreased and genetic differentiation increased towards the range periphery. Spanish populations were genetically distinct, suggesting a divergent post‐glacial history in this region. The high genetic diversity and low genetic differentiation in the remaining A. vernalis populations is surprising given the species' life‐history traits and points to the possibility that the species has been widely distributed in the studied region or that it has migrated from a diverse source in an East–West direction, in the past.