bluuebunny/crossref_metadata_2025 huggingface dataset:
Thailand’s national universal developmental screening programme for young children: action research for improved follow-up
Authors: Morrison Joanna , Chunsuwan Issarapa , Bunnag Petch , Gronholm Petra C , Lockwood Estrin Georgia
Published: January 2018

Introduction

In low-income and middle-income countries, it is estimated that one in every three preschool-age children are failing to meet cognitive or socioemotional developmental milestones. Thailand has implemented a universal national developmental screening programme (DSPM) for young children to enable detection of developmental disorders and early intervention that can improve child health outcomes. DSPM implementation is being hampered by low attendance at follow-up appointments when children fail the initial screening.

Methods

Action research, using qualitative methods was conducted with 19 caregivers, 5 health workers and 1 chief at two Health Promotion Hospitals to explore the factors affecting attendance at follow-up appointments. Transcripts and notes were analysed using descriptive content analysis. Findings were then discussed with 48 health workers, managers, researchers and policymakers.

Results

The high workload of health workers during busy vaccination clinics, and inadequate materials prevented clear communication with caregivers about the screening, how to stimulate child development and the screening result. Caregivers, particularly grandparents, had a lack of understanding about how to stimulate child development, and did not fully understand failed screening results. Caregivers felt blamed for not stimulating their child’s development, and were either worried that their child was severely disabled, or they did not believe the screening result and therefore questioned its usefulness. This led to a lack of attendance at follow-up appointments.

Conclusion

Task-sharing, mobile health (mhealth), community outreach and targeted interventions for grandparent caregivers might increase awareness about child development and screening, and allow health workers more time to communicate effectively. Sharing best practices, communication training and mentoring of DSPM workers coupled with mhealth job aids could also improve caregiver attendance at follow-up. Engagement of caregivers in understanding the barriers to attendance at follow-up and engagement of stakeholders in the design and implementation of interventions is important to ensure their effectiveness.
Is there a social gradient of sarcopenia? A meta-analysis and systematic review protocol
Authors: Green Darci , Duque Gustavo , Fredman Nick , Rizvi Aoun , Brennan-Olsen Sharon Lee
Published: January 2018

Introduction

Sarcopenia (or loss of muscle mass and function) is a relatively new area within the field of musculoskeletal research and medicine. Investigating whether there is a social gradient, including occupation type and income level, of sarcopenia, as observed for other diseases, will contribute significantly to the limited evidence base for this disease. This new information may inform the prevention and management of sarcopenia and widen the evidence base to support existing and future health campaigns.

Methods and analysis

We will conduct a systematic search of the databases PubMed, Ovid, CINAHL, Scopus and EMBASE to identify articles that investigate associations between social determinants of health and sarcopenia in adults aged 50 years and older. Eligibility of the selected studies will be determined by two independent reviewers. The methodological quality of eligible studies will be assessed according to predetermined criteria. Established statistical methods to identify and control for heterogeneity will be used, and where appropriate, we will conduct a meta-analysis. In the event that heterogeneity prevents numerical synthesis, a best evidence analysis will be employed. This systematic review protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines and will be registered with the International Prospective Register of Systematic Reviews (PROSPERO).

Ethics and dissemination

This systematic review will use published data, thus ethical permissions will not be required. In addition to peer-reviewed publication, our results will be presented at (inter)national conferences relevant to the field of sarcopenia, ageing and/or musculoskeletal health and disseminated both electronically and in print.

PROSPERO registration number

CRD42017072253.
Is postoperative bracing after pedicle screw fixation of spine fractures necessary? Study protocol of the ORNOT study: a randomised controlled multicentre trial
Authors: Smits Arjen Johannes , Deunk Jaap , Stadhouder Agnita , Altena Mark Cornelis , Kempen Diederik Hendrik Ruth , Bloemers Frank Willem
Published: January 2018

Introduction

The most common surgical treatment of traumatic spine fractures is through a posterior approach using pedicle screws and rods. Postoperative treatment protocols including the use of postoperative orthoses however differ between hospitals and surgeons. A three-point hyperextension orthosis is designed to support proper posture and unload the anterior column. Some motion remains when wearing an orthosis, and its main value in postoperative treatment is therefore believed to be pain relief and patient confidence. This could consequently shorten recovery time. On the other hand, an orthosis could also lead to muscle weakness and slow down recovery. Any orthosis-related complications might also be avoided. Additionally, recent studies on conservative fracture treatment show no difference in radiological outcomes with or without an orthosis. To date, no randomised studies have been performed on the use of postoperative orthoses.

Methods and analysis

Patients undergoing posterior fixation with pedicle screws for a traumatic thoracolumbar fracture (T7–L4) will be included in this randomised controlled multicentre non-inferiority trial. Forty-six patients will be randomised 1:1 to one of the two parallel groups; one group will wear a postoperative orthosis for 6 weeks followed by 6 weeks of weaning and one group will not wear an orthosis. The primary outcome is pain at 6 weeks reported on the Numerical Rating Scale. Secondary outcomes consist of pain on other moments, analgesic use, complications and length of hospital stay, quality of life (EuroQuol 5 Dimensions), back pain-related function (Oswestry Disability Index) and radiological outcomes with a follow-up of 1 year. Orthosis compliance is monitored weekly in the orthosis group.

Ethics and dissemination

The institutional review board (METc VUmc) approved this study on 11 October 2016 under case number 2016.389. After completion of the trial, the results will be offered to an international scientific journal for peer-reviewed publication.

Trial registration number

NCT03097081and NTR6285; Pre-results.
Concealment of type 1 diabetes at work in Finland: a mixed-method study
Authors: Hakkarainen Pirjo , Munir Fehmidah , Moilanen Leena , Räsänen Kimmo , Hänninen Vilma
Published: January 2018

Objectives

To explore the possible reasons for concealing type 1 diabetes (T1D) at work.

Methods

The main set of data came from a cross-sectional survey (response rate 49.3%), the participants of which were 688 wage earners with T1D. Concealment of T1D was measured by asking respondents have they ever during their working career hidden their diabetes from their (A) colleagues and (B) line manager. Furthermore, semistructured interviews (n=20) were conducted to obtain deeper understanding. Questionnaire data were analysed using logistic regression analyses and qualitative interviews with inductive thematic analysis.

Results

About 30% of wage earners with T1D had concealed their condition during their working career from their colleagues and almost 20% from their line manager. Individuals aged 18–44 years age were more likely to conceal their T1D from their colleagues than older workers during their working career. Not disclosing T1D to the extended family (OR 5.24 (95% CI 2.06 to 13.35)), feeling an outsider at work (OR 2.47 (95% CI 1.58 to 3.84)), being embarrassed by receiving special attention at work (OR 1.99 (95% CI 1.33 to 2.96)) and neglecting treatment at work (OR 1.59 (95% CI 1.01 to 2.48)) were all associated with concealment of T1D from colleagues. The youngest age group of 18–24 years were more likely to conceal their T1D from their line managers than the older age groups during their working career. Not disclosing T1D to the extended family (OR 4.41 (95% CI 1.72 to 11.32)), feeling like an outsider at work (OR 2.51 (1.52 to 4.14)) and being embarrassed by receiving special attention at work (OR 1.81 (95% CI 1.13 to 2.91)) were associated with concealment of T1D from line managers. From the interviews, five main themes related to concealment emerged, expressing fears related to the consequences of telling: (1) being perceived as weak, (2) job discrimination, (3) unwanted attention, (4) being seen as a person who uses their T1D for seeking advantages and (5) losing privacy.

Conclusions

A considerable proportion of wage earners with T1D are concealing their diagnosis often because of feelings associated with stigma. Both overemphasis and underestimation of T1D at work by the colleagues or line manager may lead to concealing T1D and may thus be harmful to self-management of T1D. The obstacles in disclosing T1D might be diminished by giving adequate information at the workplace about the condition and its significance.
Modern management of perianal fistulas in Crohn’s disease: future directions
Authors: Kotze Paulo Gustavo , Shen Bo , Lightner Amy , Yamamoto Takayuki , Spinelli Antonino , Ghosh Subrata , Panaccione Remo
Published: January 2018

Perianal fistulae in patients with Crohn’s disease (CD) can be associated with significant morbidity resulting in negative impact on quality of life. The last two decades have seen significant advancements in the management of perianal fistulas in CD, which has evolved into a multidisciplinary approach that includes gastroenterologists, colorectal surgeons, endoscopists and radiologists. Despite the introduction of new medical therapies such as antitumour necrosis factor and novel models of care delivery, the best fistula healing rates reported with combined medical and surgical approaches are approximately 50%. More recently, newer biologics, cell-based therapies as well as novel endoscopic and surgical techniques have been introduced raising new hopes that outcomes can be improved upon. In this review, we describe the modern management and the most recent advances in the management of complex perianal fistulising CD, which will likely impact clinical practice. We will explore optimal use of both older and newer biological agents, as well as new data on cell-based therapies. In addition, new techniques in endoscopic and surgical approaches will be discussed.
Management of patients on antithrombotic agents undergoing emergency and elective endoscopy: joint Asian Pacific Association of Gastroenterology (APAGE) and Asian Pacific Society for Digestive Endoscopy (APSDE) practice guidelines
Authors: Chan Francis K L , Goh Khean-Lee , Reddy Nageshwar , Fujimoto Kazuma , Ho Khek Yu , Hokimoto Seiji , Jeong Young-Hoon , Kitazono Takanari , Lee Hong Sik , Mahachai Varocha , Tsoi Kelvin K F , Wu Ming-Shiang , Yan Bryan P , Sugano Kentaro
Published: January 2018

This Guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society for Digestive Endoscopy (APSDE). It was developed in response to the increasing use of antithrombotic agents (antiplatelet agents and anticoagulants) in patients undergoing gastrointestinal (GI) endoscopy in Asia. After reviewing current practice guidelines in Europe and the USA, the joint committee identified unmet needs, noticed inconsistencies, raised doubts about certain recommendations and recognised significant discrepancies in clinical practice between different regions. We developed this joint official statement based on a systematic review of the literature, critical appraisal of existing guidelines and expert consensus using a two-stage modified Delphi process. This joint APAGE-APSDE Practice Guideline is intended to be an educational tool that assists clinicians in improving care for patients on antithrombotics who require emergency or elective GI endoscopy in the Asian Pacific region.
Systematic review of drowning in India: assessment of burden and risk
Authors: Lukaszyk Caroline , Ivers Rebecca Q , Jagnoor Jagnoor
Published: January 2018

Aim

To examine the burden and risk factors for fatal and non-fatal drowning in India.

Methods

Relevant literature was identified through a systematic search of 19 electronic databases and 19 national and global, institutional, organisational and government sources of injury data. Search terms used pertained to drowning, injury, trauma, morbidity and mortality in India.

Results

A total of 16 research articles and five data sources were included in the review. Three national data sources provided counts of drowning deaths, reporting a range of 1348–62 569 drowning deaths per year. A further three national data sources provided information on drowning-related morbidity; however, each source presented different outcome measures making comparison difficult. Ten research studies investigated risk factors associated with drowning in India. Key risk factors reported were male gender, young age (0–5 years) and individuals residing in the North-Eastern part of the country who have high exposure to water sources within community settings.

Conclusion

Drowning-related morbidity and mortality have a significant impact on India, with risk factors identified for this setting similar to those within other low-income and middle-income countries. Regional data which look beyond routinely collected data are required to accurately investigate the burden and impact of drowning, to inform targeted, context-specific approaches for drowning reduction initiatives
DMC1 mutation that causes human non-obstructive azoospermia and premature ovarian insufficiency identified by whole-exome sequencing
Authors: He Wen-Bin , Tu Chao-Feng , Liu Qiang , Meng Lan-Lan , Yuan Shi-Min , Luo Ai-Xiang , He Fu-Sheng , Shen Juan , Li Wen , Du Juan , Zhong Chang-Gao , Lu Guang-Xiu , Lin Ge , Fan Li-Qing , Tan Yue-Qiu
Published: January 2018

Background

The genetic causes of the majority of male and female infertility caused by human non-obstructive azoospermia (NOA) and premature ovarian insufficiency (POI) with meiotic arrest are unknown.

Objective

To identify the genetic cause of NOA and POI in two affected members from a consanguineous Chinese family.

Methods

We performed whole-exome sequencing of DNA from both affected patients. The identified candidate causative gene was further verified by Sanger sequencing for pedigree analysis in this family. In silico analysis was performed to functionally characterise the mutation, and histological analysis was performed using the biopsied testicle sample from the male patient with NOA.

Results

We identified a novel homozygous missense mutation (NM_007068.3: c.106G>A, p.Asp36Asn) in DMC1, which cosegregated with NOA and POI phenotypes in this family. The identified missense mutation resulted in the substitution of a conserved aspartic residue with asparaginate in the modified H3TH motif of DMC1. This substitution results in protein misfolding. Histological analysis demonstrated a lack of spermatozoa in the male patient’s seminiferous tubules. Immunohistochemistry using a testis biopsy sample from the male patient showed that spermatogenesis was blocked at the zygotene stage during meiotic prophase I.

Conclusions

To the best of our knowledge, this is the first report identifying DMC1 as the causative gene for human NOA and POI. Furthermore, our pedigree analysis shows an autosomal recessive mode of inheritance for NOA and POI caused by DMC1 in this family.
Leg stereotypy syndrome: phenomenology and prevalence
Authors: Lotia Mitesh , York Michele K , Strutt Adriana M , Jankovic Joseph
Published: January 2018

Objectives

To describe the phenomenology and prevalence of leg stereotypy syndrome (LSS), characterised chiefly by repetitive, rhythmical, stereotypic leg movement, especially when sitting.

Methods

We sought to characterise LSS in two groups of subjects: (1) general population (GP) group, defined as individuals accompanying patients during their visits to Baylor College of Medicine Parkinson’s Disease Center and Movement Disorders Clinic who are not genetically related to the patients; and (2) movement disorders (MD) group, composed of consecutive patients with diagnoses of restless legs syndrome, Parkinson’s disease, Tourette syndrome and tardive dyskinesia.

Results

There were 92 participants enrolled in this study; 7% of 57 individuals in the GP group and 17% of those in the MD group met the diagnostic criteria for LSS. The mean age of individuals with LSS was 44.5 (±11.9) years and mean age at onset of LSS was 17.5 (±5.7) years. In half of the individuals, the ‘shaking’ involved predominantly one leg. All had a positive family history of similar disorder and none had diurnal variation. The seven-item Leg Stereotypy Syndrome Questionnaire was developed as a screening tool to aid in differentiating LSS from other movement disorders.

Conclusions

LSS is a common condition, occurring in up to 7% of otherwise healthy individuals, and it is even more common in patients with hyperkinetic movement disorders. Although it phenomenologically may overlap with other stereotypic disorders, we argue that it is a distinct, familial, neurological syndrome.
Oligogenic genetic variation of neurodegenerative disease genes in 980 postmortem human brains
Authors: Keogh Michael J , Wei Wei , Aryaman Juvid , Wilson Ian , Talbot Kevin , Turner Martin R , McKenzie Chris-Anne , Troakes Claire , Attems Johannes , Smith Colin , Al Sarraj Safa , Morris Chris M , Ansorge Olaf , Pickering-Brown Stuart , Jones Nick , Ironside James W , Chinnery Patrick F
Published: January 2018

Background

Several studies suggest that multiple rare genetic variants in genes causing monogenic forms of neurodegenerative disorders interact synergistically to increase disease risk or reduce the age of onset, but these studies have not been validated in large sporadic case series.

Methods

We analysed 980 neuropathologically characterised human brains with Alzheimer’s disease (AD), Parkinson’s disease-dementia with Lewy bodies (PD-DLB), frontotemporal dementia-amyotrophic lateral sclerosis (FTD-ALS) and age-matched controls. Genetic variants were assessed using the American College of Medical Genetics criteria for pathogenicity. Individuals with two or more variants within a relevant disease gene panel were defined as ‘oligogenic’.

Results

The majority of oligogenic variant combinations consisted of a highly penetrant allele or known risk factor in combination with another rare but likely benign allele. The presence of oligogenic variants did not influence the age of onset or disease severity. After controlling for the single known major risk allele, the frequency of oligogenic variants was no different between cases and controls.

Conclusions

A priori, individuals with AD, PD-DLB and FTD-ALS are more likely to harbour a known genetic risk factor, and it is the burden of these variants in combination with rare benign alleles that is likely to be responsible for some oligogenic associations. Controlling for this bias is essential in studies investigating a potential role for oligogenic variation in neurodegenerative diseases.
Poststroke psychosis: a systematic review
Authors: Stangeland Helle , Orgeta Vasiliki , Bell Vaughan
Published: January 2018

A preregistered systematic review of poststroke psychosis examining clinical characteristics, prevalence, diagnostic procedures, lesion location, treatments, risk factors and outcome. Neuropsychiatric outcomes following stroke are common and severely impact quality of life. No previous reviews have focused on poststroke psychosis despite clear clinical need. CINAHL, MEDLINE and PsychINFO were searched for studies on poststroke psychosis published between 1975 and 2016. Reviewers independently selected studies for inclusion, extracted data and rated study quality. Out of 2442 references, 76 met inclusion criteria. Average age for poststroke psychosis was 66.6 years with slightly more males than females affected. Delayed onset was common. Neurological presentation was typical for stroke, but a significant minority had otherwise ‘silent strokes’. The most common psychosis was delusional disorder, followed by schizophrenia-like psychosis and mood disorder with psychotic features. Estimated delusion prevalence was 4.67% (95% CI 2.30% to 7.79%) and hallucinations 5.05% (95% CI 1.84% to 9.65%). Twelve-year incidence was 6.7%. No systematic treatment studies were found. Case studies frequently report symptom remission after antipsychotics, but serious concerns about under-representation of poor outcome remain. Lesions were typically right hemisphere, particularly frontal, temporal and parietal regions, and the right caudate nucleus. In general, poststroke psychosis was associated with poor functional outcomes and high mortality. Poor methodological quality of studies was a significant limitation. Psychosis considerably adds to illness burden of stroke. Delayed onset suggests a window for early intervention. Studies on the safety and efficacy of antipsychotics in this population are urgently needed.
Determining the educational impact of the introduction of practice-based small group learning within an intraprofessional group of doctors
Authors: Willman Antony Sean
Published: January 2018

Introduction

Practice-Based Small Group Learning (PBSGL) is a system for continuing professional development introduced into Wessex Region Defence Primary Healthcare (DPHC) as the Salisbury Plain PBSGL group in 2012. This is a mixed intraprofessional group comprising general practitioners (GPs), GP trainers, general practice specialist registrars (GPSTs) and general duties medical officers (GDMOs).

Methods

An anonymised online questionnaire and thematic analysis was undertaken to assess the educational impact of PBSGL in such a mixed-role group reflecting military general practice.

Results

A positive effect of PBSGL was demonstrated and further enhanced by the intraprofessional composition. Positive peer support effects were demonstrated for all members of the cohort regardless of role.

Conclusion

PBSGL is an essential pillar for supporting all doctors working within DPHC. Further qualitative evaluation of cohorts of GDMOs, GPSTs and mixed-role groups as well as the development of standardised questionnaires is recommended.
How good are doctors at introducing themselves? #hellomynameis
Authors: Gillen Peter , Sharifuddin Sue Faye , O’Sullivan Muireann , Gordon Alison , Doherty Eva M
Published: January 2018

Background

This explorative study was triggered by the ‘#hellomynameis’ campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices were associated with patient perceptions of the doctor/patient interaction.

Method

A patient ‘exit’ survey was undertaken following doctor–patient consultations in both acute (surgical and medical assessment units) and elective settings (outpatient clinics). The survey was carried out over a 5-month period by three trained clinical observers.

Results

A total of 353 patients were surveyed. There were 253 outpatients and 100 inpatients surveyed. There were 121 outpatients (47.8%) who attended a surgeon, 73 were medical (28.8%), while 59 (23.3%) were divided between obstetrics, gynaecology and ophthalmology. One hundred acute presentations were surveyed: 52% in the emergency department, 20% to the acute medical assessment unit, 21% attended the acute surgical assessment unit and 7% attended other specialties/departments.

Conclusion

According to the returned forms, 79% of doctors (n=279) introduced themselves to patients. Eleven per cent (39) of doctors did not introduce themselves, and 8.5% of patients (30) were unsure whether the doctor had introduced themselves. Five patients left their response blank.

Consultants were significantly more likely (P=0.02) to introduce themselves or shake hands than non-consultant hospital doctors. Gender had no bearing (P=0.43) on introductions or handshakes regardless of grade of doctor.

Three hundred and seventeen patients (89.7%) felt that an introduction had made a positive difference to their healthcare visit. Thirty patients (8.5%) felt it did not make a difference and 8 patients (2.2%) were unsure or failed to answer.

This study has highlighted the importance of introductions to patients. Definite evidence of an introduction was documented in 79% of patients with 14.5% either not receiving or could not recall whether an introduction had been made on repeat visits. 6.5% stated that they did not receive an introduction.
Does intracranial pressure management hurt more than it helps in traumatic brain injury?
Authors: Adams Charles A , Stein Deborah M , Morrison Jonathan J , Scalea Thomas M
Published: January 2018

Traumatic brain injury (TBI) is the leading cause of death after traumatic injury. Raised intracranial pressure (ICP) is particularly associated with poor TBI outcomes, prompting clinicians to monitor this parameter, using it to guide therapies aimed at reducing pressures. Despite this approach being recommended by several bodies such as the Brain Trauma Foundation and the American College of Surgeons, the evidence demonstrating that ICP-guided therapy improves outcome is limited. The topic was debated at the 36th Annual Point/Counterpoint Acute Care Surgery Conference and the following article summarizes the discussants points of view along with a summary of the evidence.

Level of evidence

Level III.
Osteoprotegerin Is Associated With Major Bleeding But Not With Cardiovascular Outcomes in Patients With Acute Coronary Syndromes: Insights From the PLATO (Platelet Inhibition and Patient Outcomes) Trial
Authors: Ueland Thor , Åkerblom Axel , Ghukasyan Tatevik , Michelsen Annika E. , Aukrust Pål , Becker Richard C. , Bertilsson Maria , Himmelmann Anders , James Stefan K. , Siegbahn Agneta , Storey Robert F. , Kontny Frederic , Wallentin Lars ,   the PLATO (Platelet Inhibition and Patient Outcomes) Trial Investigators
Published: January 2018

Background

Elevated levels of osteoprotegerin, a secreted tumor necrosis factor–related molecule, might be associated with adverse outcomes in patients with coronary artery disease. We measured plasma osteoprotegerin concentrations on hospital admission, at discharge, and at 1 and 6 months after discharge in a predefined subset (n=5135) of patients with acute coronary syndromes in the PLATO (Platelet Inhibition and Patient Outcomes) trial.

Methods and Results

The associations between osteoprotegerin and the composite end point of cardiovascular death, nonprocedural spontaneous myocardial infarction or stroke, and non–coronary artery bypass grafting major bleeding during 1 year of follow‐up were assessed by Cox proportional hazards models. Event rates of the composite end point per increasing quartile groups at baseline were 5.2%, 7.5%, 9.2%, and 11.9%. A 50% increase in osteoprotegerin level was associated with a hazard ratio (
HR
) of 1.31 (95% confidence interval [CI], 1.21–1.42) for the composite end point but was not significant in adjusted analysis (ie, clinical characteristics and levels of C‐reactive protein, troponin T,
NT
‐pro
BNP
[N‐terminal pro‐B‐type natriuretic peptide], and growth differentiation factor‐15). The corresponding rates of non–coronary artery bypass grafting major bleeding were 2.4%, 2.2%, 3.8%, and 7.2%, with an unadjusted
HR
of 1.52 (95% CI, 1.36–1.69), and a fully adjusted
HR
of 1.26 (95% CI, 1.09–1.46). The multivariable association between the osteoprotegerin concentrations and the primary end point after 1 month resulted in an
HR
of 1.09 (95% CI, 0.89–1.33); for major bleeding after 1 month, the
HR
was 1.33 (95% CI, 0.91–1.96).

Conclusions

In patients with acute coronary syndrome treated with dual antiplatelet therapy, osteoprotegerin was an independent marker of major bleeding but not of ischemic cardiovascular events. Thus, high osteoprotegerin levels may be useful in increasing awareness of increased bleeding risk in patients with acute coronary syndrome receiving antithrombotic therapy.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00391872.
Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease
Authors: Arya Shipra , Binney Zachary , Khakharia Anjali , Brewster Luke P. , Goodney Phil , Patzer Rachel , Hockenberry Jason , Wilson Peter W. F.
Published: January 2018

Background

Black race has been shown to be a risk factor for amputation in peripheral artery disease (PAD); however, race has been argued to be a marker for socioeconomic status (
SES
) rather than true disparity. The aim of this study is to study the impact of race and
SES
on amputation risk in
PAD
patients.

Methods and Results

Patients with incident
PAD
in the national Veterans Affairs Corporate Data Warehouse were identified from 2003 to 2014 (N=155 647). The exposures were race and SES (measured by median income in residential ZIP codes). The outcome was incident major amputation. Black veterans were significantly more likely to live in low‐
SES
neighborhoods and to present with advanced
PAD
. Black patients had a higher amputation risk in each
SES
stratum compared with white patients. In Cox models (adjusting for covariates), black race was associated with a 37% higher amputation risk compared with white race (hazard ratio: 1.37; 95% confidence interval, 1.30–1.45), whereas low
SES
was independently predictive of increased risk of amputation (hazard ratio: 1.12; 95% confidence interval, 1.06–1.17) and showed no evidence of interaction with race. In predicted amputation risk analysis, black race and low
SES
continued to be significant risk factors for amputation regardless of
PAD
presentation.

Conclusions

Black race significantly increases the risk of amputation within the same
SES
stratum compared with white race and has an independent effect on limb loss after controlling for comorbidities, severity of
PAD
at presentation, and use of medications.
Postsecondary Education, Neighborhood Disadvantage, and Crime: An Examination of Life Course Relative Deprivation
Authors: Dennison Christopher R. , Swisher Raymond R.
Published: January 2018

The growing importance of a college degree for economic stability, coupled with increasing educational inequality in the United States, suggest potential criminogenic implications for downward educational mobility. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), this article examines the associations between intergenerational educational mobility, neighborhood disadvantage in adulthood, and crime. Drawing on the few extant studies of educational mobility and crime, as well as social comparison theory, it tests whether the consequences of downward educational mobility are moderated by neighborhood contexts. Results suggest that downward mobility is associated with increases in crime, and most strongly in more advantaged neighborhoods. The implications of these findings for future research on social mobility, education, and crime are discussed.
Coping Strategies and Posttraumatic Growth in Prison
Authors: Vanhooren Siebrecht , Leijssen Mia , Dezutter Jessie
Published: January 2018

Recent qualitative studies have highlighted posttraumatic growth as a profound change in offenders’ self-perception, relationship qualities, purposes, and meaning in life. We examined coping strategies as possible predictors of posttraumatic growth during incarceration in a sample of 365 prisoners. Coping strategies such as seeking emotional support, religious coping, and searching for meaning predicted posttraumatic growth in a positive way. Psychotherapy and chaplaincy were associated with higher levels of posttraumatic growth. Behavioral disengagement predicted posttraumatic growth in a negative way.
Adolescents’ subjective well-being: The role of adolescents’ and mothers’ time perspectives
Authors: Măirean Cornelia , Diaconu-Gherasim Loredana R
Published: January 2018

This study investigated the relations between adolescents’ and their mothers’ time perspectives and adolescents’ subjective well-being. The sample included 104 adolescents (72.1% girls), aged between 15 and 17 years and their mothers ( M = 42.67, SD = 5.66). Adolescents completed scales measuring their life events, time perspective, depressive symptoms and life satisfaction. Mothers also fill in a scale assessing their time perspective. The results showed that adolescents who reported higher levels of negative events in their life also reported higher levels of depressive symptoms and lower levels of life satisfaction. Moreover, adolescents’ depressive symptoms were significantly positively associated with their past negative time perspective, but significantly negatively correlated with past positive time perspective. Further, adolescents’ life satisfaction was negatively associated with their past negative but positively with past positive time perspectives. Concerning maternal time perspective, only fatalist present perspective was significantly negatively related with adolescents’ life satisfaction. The findings provide evidence about the role of the adolescents’ and mothers’ time perspective in explaining the adolescents’ subjective well-being.
The Effect of Paternalistic Leadership on Job Performance and Intention to Leave the Job
Authors: Ugurluoglu Ozgur , Aldogan Ece Ugurluoglu , Turgut Meryem , Ozatkan Yonca
Published: January 2018

The purpose of this study is to examine paternalistic leadership behaviours’ impact on job performance and on intention to leave the job of the employees. Study sample consists of 267 medical and administrative personnel working at a university hospital in Ankara, Turkey. In order to collect data, Paternalistic Leadership Questionnaire developed by Cheng, Chou, Wu, Huang and Farh (2004), Job Performance Questionnaire developed by Kirkman and Rossen (1999) and Intention to Leave the Job Questionnaire adapted from Walsh, Ashford and Hill (1985) were used. SPSS 21.0 was used for all statistical analysis. It has been found that paternalistic leadership dimensions have direct impact on job performance and intention to leave the job of the employees. It can be suggested that leaders at healthcare organizations can emphasize benevolence if they wish to positively influence their subordinates’ job performance and that leaders at hospitals can emphasize benevolence and morality over behaviours if they wish to minimize the intention to leave the job. Since there is limited research on the relationship between paternalistic leadership and job performance and intention to leave the job, it is thought this study will contribute to the literature.
Activated Factor 7 Versus 4-Factor Prothrombin Complex Concentrate for Critical Bleeding Post–Cardiac Surgery
Authors: Mehringer Sarah L. , Klick Zachary , Bain Jonathan , McNeely Elizabeth B. , Subramanian Sreekumar , Pass Lawrence J. , Drinkwater Davis , Reddy V. Seenu
Published: January 2018

Background: Recombinant and plasma-derived factor products, such as activated factor seven (rFVIIa) and four-factor prothrombin complex concentrate (4-factor PCC), have been used off-label for bleeding after cardiac surgery, but little evidence has been published regarding their efficacy and safety. Objective: To determine whether there is a difference in chest tube output in patients who have received 4-factor PCC or rFVIIa for critical postoperative bleeding associated with cardiovascular surgery. Methods: A retrospective chart review was conducted utilizing the electronic medical record system at a 657-bed community, tertiary care hospital in Nashville, Tennessee. Nonpregnant patients ≥18 years of age experiencing significant bleeding during cardiac surgery who received either PCC or rFVIIa perioperatively or postoperatively between April 2015 through December 2016 were eligible for inclusion. Patients were excluded if they received 4-factor PCC or rFVIIa for any indication other than bleeding during cardiac surgery or if they received both agents. Results: Data conclude that there is no significant difference in chest tube output 24 hours postoperatively between patients treated with 4-factor PCC or rFVIIa. There was no difference in bleeding, thromboembolic events, or re-exploration between the rFVIIa and 4-factor PCC groups, but there was a difference in units of fresh frozen plasma administered and hospital length of stay. Conclusion: 4-Factor PCC may be an equally efficacious alternative to rFVIIa for patients experiencing significant bleeding during cardiac surgery. There is no difference in chest tube output; therefore, there is no difference in bleeding—either at 24 hours postoperatively or total.
Who Are You Writing for? Differences in Response to Blog Design Between Scientists and Nonscientists
Authors: Gardiner Anna , Sullivan Miriam , Grand Ann
Published: January 2018

Science blogs have been advocated as potential mediators between science and nonscientist readers; however, they are mostly read by other scientists, with little research on how blogs can be made more appealing for nonscientists. We compared four possible treatments of a science blog post (text-only, humor, images and video). Nonscientists recalled more information when images were included compared to humor, while scientists performed worse with text-only than with video. Nonscientists enjoyed the images treatment most, while scientists preferred the video treatment. Adding images to blog posts is recommended as an easy method of increasing recall and enjoyment among readers.
The critical moment of transition: Staying with and acting on newly gained self- and social awareness
Authors: Svalgaard Lotte
Published: January 2018

By providing a holding environment to acknowledge sensitivities and address emotions, leadership programs prove to be powerful spaces for increasing self- and social awareness. However, the challenge is for one to maintain the newly gained self- and social awareness after leaving the holding environment and entering a context characterized by activity and performance. This is a frequently debated challenge for both academics and providers of management learning. Yet, critical moments in this transition remain under-exposed and under-researched. The contribution of this article is a research study—within the context of an international MBA program—of MBA students applying their knowledge from a Leadership Stream in an international consultancy project. This article contributes to the theory and practice of management learning by providing a lens through which subjective experience of critical moments of transition can be understood. In addition it develops the notion of ‘mindful avoidance’, and points to a major and neglected space in the design of management education.
Hospital readmissions and the day of the week
Authors: Verma Aman , Rochefort Christian , Powell Guido , Buckeridge David
Published: January 2018

Objectives

Patients discharged from hospitals on a Friday (Friday discharges) are readmitted sooner (a shorter time-to-emergency-readmission) than those discharged on any other day of the week. To evaluate the cost-effectiveness of increasing weekend capacity, the effect estimate of Friday discharge on time-to-emergency-readmission needs to be precise. However, precise effect estimation is complicated by the confounding effect of differing healthcare-seeking behaviour and admission practices, and therefore different admission probability, by day of the week. The objective of this research was to examine how differing admission probability by day of the week influences the effect of discharge day on time-to-emergency-readmission.

Methods

We used a Markov model to determine how day of the week admission probability would theoretically affect the time-to-emergency-readmission for Friday and Wednesday discharges. We tested this in a cohort of patients who have had a history of respiratory illness, using a Cox proportional hazards model to fit the time-to-emergency-readmission to any Quebec hospital as a function of the day of the week of discharge and admission. We fitted another Cox model with an additional time-varying covariate for the current day of the week, to model differing admission probabilities by day of the week.

Results

Our Markov model showed that if admission probability is lower on the weekends, Friday discharges will be readmitted later (longer time-to-emergency-readmission) than Wednesday discharges. Using hospital admission data, we found that Friday discharges were readmitted slightly earlier than Wednesday discharges (HR: 1.03, 95% CI: (1.02, 1.05)). After adding a time-varying covariate for the current day of the week, the length of time-to-emergency-readmission for a Friday discharge increased, but it was still earlier than a Wednesday discharge (HR: 1.04, 95% CI: (1.01, 1.07)).

Conclusions

The lower admission probabilities on the weekend confound the effect of Friday discharge on time-to-emergency-readmission by increasing the time-to-emergency-readmission. This confounding effect causes an underestimate of the effect of Friday discharge on time-to-emergency-readmission.
Developing an entitativity measure and distinguishing it from antecedents and outcomes within online and face-to-face groups
Authors: Blanchard Anita L. , Caudill Leann E. , Walker Lisa Slattery
Published: January 2018

Entitativity, an individual’s recognition of a social unit as a group, is a fundamental group characteristic. However, past entitativity measures have not demonstrated their psychometric validity. We create and demonstrate initial psychometric validity for a new measure of entitativity as well as several of its antecedents. We demonstrate convergent and divergent validity of our entitativity measure (and the antecedents) in three studies of online and face-to-face groups in which people either observe a group or are members of a group. Results demonstrate that our measures of entitativity and its antecedents are robust across different group contexts. We also discuss the implications of the results of this research to advance entitativity theory.
Are You Thinking What I’m Thinking?: The Influence of Leader Style, Distance, and Leader–Follower Mental Model Congruence on Creative Performance
Authors: Griffith Jennifer A. , Gibson Carter , Medeiros Kelsey , MacDougall Alexandra , Hardy Jay , Mumford Michael D.
Published: January 2018

Leaders have been classified as having charismatic, ideological, or pragmatic (CIP) leadership styles, each characterized by distinct patterns in cognition and interaction. Although each CIP style has been shown to facilitate certain aspects of the creative process for followers, questions remain regarding the impact of leadership style on overall follower creative performance. One factor likely to influence this relationship is leader distance, composed of the physical distance, perceived social distance, and perceived task interaction among leaders and followers. Past research has also emphasized the role of leaders’ mental models as they relate to follower performance. Less understood, however, is how the mental models of followers may affect this process. Using the CIP model of leadership, this study explores leader distance and leader–follower mental model congruence on follower creative performance. Results indicated that while leadership style does not directly influence follower creativity, it interacts with leader distance to shape creative outcomes. Results further indicated that while general mental model congruence is not predictive, alignment on specific mental model dimensions contributes to enhanced creative performance among followers. Implications and future research directions are discussed.
Research on the 2-degree-of-freedom electromagnetic actuator in space
Authors: Liu Rongqiang , Yang Fei , Mu Xingke , Yue Honghao , Zhu Chenxi
Published: January 2018

To meet space science experiments in micro-gravity environment, micro-spacecraft vibration isolation technology was developed in recent years. A new kind of 2-degree-of-freedom electromagnetic actuator based on Lorentz principle was developed in this article. The composition and working principle of the actuator were introduced, the parametric model for electromagnetic actuator was established, the structural optimization was carried out with the help of genetic algorithm in the MATLAB toolbox, and the final optimal structural parameters were obtained. For achieving the magnetic induction intensity in radial and axial directions, theoretical model for electromagnetic characteristics of the 2-degree-of-freedom actuator was established, and the expression for electromagnetic force was obtained. A static electric–magnetic coupling simulation of the whole actuator and also the experiments for measuring magnetic induction and magnetic force were carried out, and the correctness of theoretical model was verified.
Modeling and stabilization of eccentric gravity machinery
Authors: Yao Wu-Sung
Published: January 2018

In general, eccentric gravity machinery is a rotation mechanism with eccentric pendulum mechanism, which can be used to convert continuously kinetic energy generated by gravity energy to electric energy. However, a stable rotated velocity of the eccentric gravity machinery is difficult to be achieved only using gravity energy. In this article, a stable velocity control system applied to eccentric gravity machinery is proposed. The dynamic characteristic of eccentric gravity machinery is analyzed and its mathematical model is established, which is used to design the controller. A stable running velocity of the eccentric gravity machinery can be operated by the controlled servomotor. Due to disturbances being periodic, repetitive controller is installed to velocity control loop. The stability performance and control performance of the repetitive control system are discussed. The iterative algorithm of the repetitive control is executed by a digital signal processor TI TMS320C32 floating-point processor. Simulated and experimental results are reported to verify the performance of the proposed eccentric gravity machinery control system.
Coach–athlete sexual relationships: Coaches’ opinions
Authors: Fasting Kari , Sand Trond S , Sisjord Mari K
Published: January 2018

The focus of this article is the opinions and attitudes towards coach–athlete sexual relationships presented through the voices of female (n = 24) and male (n = 12) elite-level coaches in Norway. The results are based on in-depth interviews and the data were developed around the following question: “There are examples of athletes that fall in love with their coach and about sexual relationships between a coach and an athlete—what are your reflections around such coach–athlete relationships?” The coaches found such relationships very problematic and unacceptable. When it occurs, openness, i.e. to talk about it, is important. But the rule of thumb was that the coach–athlete relationship had to come to an end. In their elite-coaching role, these coaches believed it is important to have strict rules and clear boundaries. Furthermore, they should be aware of the power that they have and not exploit it. The results are discussed with respect to the professionalization of the coaching role, and the importance of including ethics in the education of coaches.
Manipulating hemoglobin oxygenation using silica nanoparticles: a novel prospect for artificial oxygen carriers
Authors: Devineau Stéphanie , Kiger Laurent , Galacteros Frédéric , Baudin-Creuza Véronique , Marden Michael , Renault Jean Philippe , Pin Serge
Published: January 2018

Key Points

Silica nanoparticles act as an effector for human native and sickle cell hemoglobin while preserving their tetrameric structure. Manipulating hemoglobin oxygenation using nanoparticles opens the way for the rational design of hemoglobin-based oxygen carriers.