bluuebunny/crossref_metadata_2025 huggingface dataset:
Can a barcode scanner for blood collection improve patient identification integrity in the emergency department? A prospective before‐and‐after study
Authors: Spain David , Crilly Julia , Pierce John , Steele Michael , Scuffham Paul , Keijzers Gerben
Published: January 2015

Objective

To describe the effect of interventions designed to improve patient identification (PI) during pathology collection in the ED.

Methods

A prospective before‐and‐after intervention study was conducted between June 2009 and June 2010 in a regional ED in Queensland, Australia. Interventions aimed to improve PI and specimen labelling, and consisted of: (i) education alone; and (ii) education plus an armband scanner that voice‐prompted collector behaviour. Main outcomes measured included: frequency of correct key behaviours (KBs) during specimen collection, pathology integrity errors and cost of interventions.

Results

Data from 282 ED pathology collections were analysed (before: n = 115, after with education: n = 95, after with education plus armband scanner: n = 72). KBs for PI and labelling improved significantly following education plus armband scanner use. Application of armbands before sample collection increased (36% vs 90%, P < 0.001), as did asking the patient to state their name (25% vs 93%, P < 0.001) and date of birth (22% vs 93%, P < 0.001). These results were similar, albeit less pronounced, when the effect of education only was assessed. No primary patient misidentification was detected in this small study. The annual costs for a hospital to adopt the education programme with and without the armband scanner were $104 045 and $5330 respectively.

Conclusion

ED staff had poor behaviours for identifying patients and labelling pathology specimens before intervention. These safety behaviours were considered an assumed skill. Education alone improved critical KBs markedly that was further augmented by the armband scanner. The cost to adopt education alone is relatively low compared to the addition of armband scanner technology.
Consumer Assessment of Beef Tenderloin Steaks from Various USDA Quality Grades at 3 Degrees of Doneness
Authors: O'Quinn Travis G. , Brooks J. Chance , Miller Markus F.
Published: January 2015

A consumer study was conducted to determine palatability ratings of beef tenderloin steaks from USDA Choice, USDA Select, and USDA Select with marbling scores from Slight 50 to 100 (USDA High Select) cooked to various degrees of doneness. Steaks were randomly assigned to 1 of 3 degree of doneness categories: very‐rare, medium‐rare, or well‐done. Consumers (N = 315) were screened for preference of degree of doneness and fed 4 samples of their preferred doneness (a warm‐up and one from each USDA quality grade treatment in a random order). Consumers evaluated steaks on an 8‐point verbally anchored hedonic scale for tenderness, juiciness, flavor, and overall like as well as rated steaks as acceptable or unacceptable for all palatability traits. Quality grade had no effect (P > 0.05) on consumer ratings for tenderness, juiciness, flavor, and overall like scores, with all traits averaging above a 7 (“like very much”) on the 8‐point scale. In addition, no differences (P > 0.05) were found in the percentage of samples rated as acceptable for all palatability traits, with more than 94% of samples rated acceptable for each trait in all quality grades evaluated. Steaks cooked to well‐done had lower (P < 0.05) juiciness scores than steaks cooked to very‐rare or medium‐rare and were rated lower for tenderness (P < 0.05) than steaks cooked to a very‐rare degree of doneness. Results indicate consumers were not able to detect differences in tenderness, juiciness, flavor, or overall like among beef tenderloin steaks from USDA Choice and Select quality grades.
Evolutionary factors affecting the cross‐species utility of newly developed microsatellite markers in seabirds
Authors: Moodley Yoshan , Masello Juan F. , Cole Theresa L. , Calderon Luciano , Munimanda Gopi K. , Thali Marco R. , Alderman Rachael , Cuthbert Richard J. , Marin Manuel , Massaro Melanie , Navarro Joan , Phillips Richard A. , Ryan Peter G. , Suazo Cristián G. , Cherel Yves , Weimerskirch Henri , Quillfeldt Petra
Published: January 2015

Microsatellite loci are ideal for testing hypotheses relating to genetic segregation at fine spatio‐temporal scales. They are also conserved among closely related species, making them potentially useful for clarifying interspecific relationships between recently diverged taxa. However, mutations at primer binding sites may lead to increased nonamplification, or disruptions that may result in decreased polymorphism in nontarget species. Furthermore, high mutation rates and constraints on allele size may also with evolutionary time, promote an increase in convergently evolved allele size classes, biasing measures of interspecific genetic differentiation. Here, we used next‐generation sequencing to develop microsatellite markers from a shotgun genome sequence of the sub‐Antarctic seabird, the thin‐billed prion (Pachyptila belcheri), that we tested for cross‐species amplification in otherPachyptilaand related sub‐Antarctic species. We found that heterozygosity decreased and the proportion of nonamplifying loci increased with phylogenetic distance from the target species. Surprisingly, we found that species trees estimated from interspecificFSTprovided better approximations of mtDNArelationships among the studied species than those estimated usingDC, even thoughFSTwas more affected by null alleles. We observed a significantly nonlinear second order polynomial relationship between microsatellite and mtDNAdistances. We propose that the loss of linearity with increasing mtDNAdistance stems from an increasing proportion of homoplastic allele size classes that are identical in state, but not identical by descent. Therefore, despite high cross‐species amplification success and high polymorphism among the closely relatedPachyptilaspecies, we caution against the use of microsatellites in phylogenetic inference among distantly related taxa.
A unigene set for European beech (Fagus sylvatica L.) and its use to decipher the molecular mechanisms involved in dormancy regulation
Authors: Lesur Isabelle , Bechade Alison , Lalanne Céline , Klopp Christophe , Noirot Céline , Leplé Jean‐Charles , Kremer Antoine , Plomion Christophe , Le Provost Grégoire
Published: January 2015

Systematic sequencing is the method of choice for generating genomic resources for molecular marker development and candidate gene identification in nonmodel species. We generated 47 357 Sanger ESTs and 2.2M Roche‐454 reads from five cDNA libraries for European beech (Fagus sylvatica L.). This tree species of high ecological and economic value in Europe is among the most representative trees of deciduous broadleaf forests. The sequences generated were assembled into 21 057 contigs with MIRA software. Functional annotations were obtained for 85% of these contigs, from the proteomes of four plant species, Swissprot accessions and the Gene Ontology database. We were able to identify 28 079 in silico SNPs for future marker development. Moreover, RNAseq and qPCR approaches identified genes and gene networks regulated differentially between two critical phenological stages preceding vegetative bud burst (the quiescent and swelling buds stages). According to climatic model‐based projection, some European beech populations may be endangered, particularly at the southern and eastern edges of the European distribution range, which are strongly affected by current climate change. This first genomic resource for the genus Fagus should facilitate the identification of key genes for beech adaptation and management strategies for preserving beech adaptability.
Killer Robots: Why the US should Lead the Ban
Authors: Garcia Denise
Published: January 2015

Killer robots are systems that can choose targets without further human intervention. The US should take the lead at the United Nations in creating specific new global norms and clarify expectations and universally agreed behavior. The US is the only country in a strong enough position to take the lead to stop a technology that will mean the loss of humanity in decisions of war and peace. The time to act is now before unpredictable proliferation occurs. A preventive ban on offensive killer robots is the vital first step in setting a principled limit to killing‐yielding automation and is a critical tool in the effort to regulate other robotics and nascent technology that could destabilize international peace and security. The potential for fully autonomous weapons systems to be advantageous is unpromising. Fully autonomous weapons systems do not appear to offer military advantages for modern warfare that would be compliant with international law. Four branches of international law require attention here, and examined together, they serve as a foundational bedrock that has historically been used to constrain violence in war: the law of state responsibility, the law on the use of force, international humanitarian law and human rights law.
Epidermal growth factor receptor variant III mutation in Chinese patients with squamous cell cancer of the lung
Authors: Duan Jianchun , Wang Zhijie , Bai Hua , An Tongtong , Zhuo Minglei , Wu Meina , Wang Yuyan , Yang Lu , Wang Jie
Published: January 2015

Background

The aim of this study was to investigate the distribution of epidermal growth factor receptor (EGFR)vIII mutation in Chinese non‐small cell lung cancer (NSCLC) patients and to explore the likely relationship between EGFRvIII mutation and response to EGFR‐tyrosine kinase inhibitors (TKIs) in squamous cell carcinoma (SCC).

Methods

Samples were derived from two patient cohorts: (i) 114 early‐stage NSCLC who received surgical resection; and (ii) 31 advanced‐stage SCC who received EGFR‐TKI EGFRvIII. EGFR and V‐Ki‐ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations were detected by reverse transcription polymerase chain reaction (RT‐PCR), denaturing high‐performance liquid chromatography, and PCR‐restriction fragment length polymorphism, respectively. The associations of EGFRvIII, EGFR, and KRAS mutations with clinical outcome of EGFR‐TKI treatment were evaluated using the Kaplan‐Meier method, descriptive analysis, and multi‐variable Cox regression analysis.

Results

In the first cohort, EGFRvIII mutation was detected in eight of 114 (7.0%) patients, including 11.1% (6/54) SCC and 3.6% (2/55) adenocarcinomas (ADC) (P = 0.269). In the second cohort, five (16.1%) and 10 out of 31 advanced SCC presented EGFRvIII and EGFR mutations, respectively. No appreciable discrepancy of progression‐free survival or disease control rate was detected between the patients with and without EGFRvIII mutation (P > 0.05). However, longer median overall survival (OS) was observed in patients harboring EGFRvIII compared to those without EGFRvIII, although the difference did not reach statistical significance.

Conclusion

The frequency of EGFRvIII mutation in SCC was higher than in ADC. SCC patients harboring EGFRvIII mutations had a tendency for prolonged OS.
Multiple Mechanisms Influencing the Relationship Between Alcohol Consumption and Peer Alcohol Use
Authors: Edwards Alexis C. , Maes Hermine H. , Prescott Carol A. , Kendler Kenneth S.
Published: January 2015

Background

Alcohol consumption is typically correlated with the alcohol use behaviors of one's peers. Previous research has suggested that this positive relationship could be due to social selection, social influence, or a combination of both processes. However, few studies have considered the role of shared genetic and environmental influences in conjunction with causal processes.

Methods

This study uses data from a sample of male twins (N = 1,790) who provided retrospective reports of their own alcohol consumption and their peers' alcohol‐related behaviors, from adolescence into young adulthood (ages 12 to 25). Structural equation modeling was employed to compare 3 plausible models of genetic and environmental influences on the relationship between phenotypes over time.

Results

Model fitting indicated that one's own alcohol consumption and the alcohol use of one's peers are related through both genetic and shared environmental factors and through unique environmental causal influences. The relative magnitude of these factors, and their contribution to covariation, changed over time, with genetic factors becoming more meaningful later in development.

Conclusions

Peers' alcohol use behaviors and one's own alcohol consumption are related through a complex combination of genetic and environmental factors that act via correlated factors and the complementary causal mechanisms of social selection and influence. Understanding these processes can inform risk assessment as well as improve our ability to model the development of alcohol use.
Prevalence of Alcohol‐Interactive Prescription Medication Use Among Current Drinkers: United States, 1999 to 2010
Authors: Breslow Rosalind A. , Dong Chuanhui , White Aaron
Published: January 2015

Background

The majority of Americans consume alcoholic beverages. Alcohol interacts negatively with numerous commonly prescribed medications. Yet, on a population level, little is known about use of alcohol‐interactive (AI) prescription medications among drinkers. The purpose of our study was to determine the prevalence of AI prescription medication use among current drinkers in the U.S. population.

Methods

Data were from the National Health and Nutrition Examination Survey (NHANES 1999 to 2010); 26,657 adults aged ≥20 years had data on past year alcohol consumption and past month prescription medication use. Analyses were adjusted for covariates: age, race/ethnicity, education, marital status, and smoking. Statistical procedures accounted for survey stratification, clustering, and nonresponse. Analyses were weighted to be nationally representative.

Results

The unadjusted total prevalence of AI medication use was 42.8% (95% confidence interval [CI] 41.5 to 44.0). Among current drinkers, adjusted prevalence was 41.5% (CI 40.3 to 42.7). Among participants aged ≥65 total prevalence of AI medication use was 78.6% (CI 77.3 to 79.9) and adjusted prevalence among current drinkers was 77.8% (CI 75.7 to 79.7). The AI medications most commonly used by current drinkers were cardiovascular agents, central nervous system agents, and metabolic agents.

Conclusions

Our results suggest that there could be substantial simultaneous exposure to alcohol and AI prescription medications in the U.S. population. Given the adverse health risks of combining alcohol with AI prescription medications, future efforts are needed to collect data to determine actual simultaneous prevalence.
Challenges of working and living in a new cultural environment: A snapshot of international medical graduates in rural Tasmania
Authors: Terry Daniel R. , Lê Quynh
Published: January 2015

Objectives

To highlight the experiences and challenges of international medical graduates (IMGs) living and working in rural and remote Tasmania, and how this informs their acculturation and retention in the state.

Design

This paper reports the findings from the Tasmanian IMG questionnaire, which was administered both in hardcopy and online format to all known IMGs within the state. A total of 105 questionnaires were returned, representing a response rate of 30.0%.

Results

IMGs were from the 30 countries and the majority were under 49 years of age, had migrated in the past 10 years, with over half having worked in the state for less than 2 years. Many IMGs indicated that they were satisfied with their current employment, the medical facilities, the friendliness of their patients and the friendliness of the community where they lived, and would like to stay much longer in Tasmania.

Conclusions

Many IMGs have previously lived and worked in rural areas and are reasonably satisfied with their current employment and lifestyle in Tasmania. However, the following factors play an important part in their views and attitudes: employment satisfaction, access to schools, employment for spouse or partner and access to cultural or religious foods and goods. Nevertheless, beyond employment satisfaction, employment itself, coupled with career pathway and training opportunities, were highlighted as contributory factors for leaving Tasmania.
Noninvasive Detection of Functional Myocardial Ischemia: Multifunction Cardiogram Evaluation in Diagnosis of Functional Coronary Ischemia Study (MED‐FIT)
Authors: Kawaji Tetsuma , Shiomi Hiroki , Morimoto Takeshi , Nishikawa Ryusuke , Yano Mariko , Higami Hirooki , Tazaki Junichi , Imai Masao , Saito Naritatsu , Makiyama Takeru , Shizuta Satoshi , Ono Koh , Kimura Takeshi
Published: January 2015

Background

Multifunction cardiogram (MCG) is a computer‐enhanced, resting electrocardiogram analysis developed to detect hemodynamically relevant coronary artery disease (CAD). Based on data from previous studies suggesting excellent diagnostic accuracy in detecting CAD, MCG (approved by the Food and Drugs Administration) received a Current Procedure Terminology (CPT) code in 2010 in United States. However, there is no previous study validating MCG by using fractional flow reserve (FFR) as the reference standard.

Methods

Multifunction cardiogram Evaluation in Diagnosis of Functional coronary Ischemia sTudy (MED‐FIT) was designed as a single‐center, prospective study enrolling 100 stable patients with suspected CAD scheduled for coronary angiography. The primary and secondary analyses evaluated the diagnostic performance of the MCG severity score to detect functional myocardial ischemia by FFR ≤0.80, and angiographically significant coronary stenosis (percent diameter stenosis ≥50%) by quantitative coronary angiography.

Results

The current analysis set consisted of 91 patients in whom MCG data with adequate quality was obtained. The prevalence of positive functional myocardial ischemia and angiographically significant stenosis in the current study was 42.7% and 41.8%, respectively. Area under the receiver operating characteristics curve (AUC) of the MCG severity score for functional myocardial ischemia and angiographically significant stenosis was low (AUC 0.51, 95% confidence interval [CI] 0.38–0.63, and AUC 0.58, 95%CI 0.46–0.70, respectively). Sensitivity, and specificity of the MCG severity score for functional myocardial ischemia and angiographically significant stenosis was also low (32%/67%, and 37%/72%) using a cutoff value of 4.0.

Conclusions

Diagnostic performance of the MCG severity score was poor for both functional myocardial ischemia, and angiographically significant stenosis.
Cardiac Awake Extracorporeal Life Support—Bridge to Decision?
Authors: Sommer Wiebke , Marsch Georg , Kaufeld Tim , Röntgen Philipp , Beutel Gernot , Tongers Joern , Warnecke Gregor , Tudorache Igor , Schieffer Bernhard , Haverich Axel , Kühn Christian
Published: January 2015

Severe acute heart failure requires immediate intensive care unit (ICU) treatment, but prognosis and outcome of further treatment regimens largely depends on the preprocedural status of the patient. Especially, multiorgan failure including mechanical ventilation are unfavorable predictors of clinical outcome. Here, we report a strategy of immediate initiation of extracorporeal life support (ECLS) in awake and spontaneously breathing patients with acute heart failure to achieve early multiorgan recovery and gain sufficient time for further treatment planning. Twenty‐three patients with severe cardiac failure refractory to standard medical management underwent ECLS treatment, after first clinical signs of cardiac failure appeared to avoid mechanical ventilation. Hemodynamic parameters and renal and liver functions were monitored. Outcome at 1 and 6 months was determined. Patients 46.1 ± 15.5 years of age were placed on ECLS due to various underlying diagnosis: ischemic heart disease (n = 6), dilatative cardiomyopathy (n = 4), myocarditis (n = 2), graft failure following heart transplantation (n = 6), or other diseases (n = 5). ECLS lasted 11.9 ± 12.9 days. Hemodynamic stabilization was achieved immediately after ECLS initiation. Vasopressors were reduced subsequently and the cardiac situation improved indicated by central venous saturation, which increased from 38.5 ± 11.3% before to 74.26 ± 8.4% (P < 0.0001) 24 h after ECLS initiation. Similarly, serum lactate levels decreased from 4.7 ± 4.6 to 1.7 ± 1.51 mmol/L (P = 0.003). Cumulative 30‐day survival was 87.5%, and 6‐month survival was 70.8%. In acute cardiac failure, early ECLS treatment is a safe, feasible treatment in awake patients allowing a gain of time for final decision. Moreover, this strategy avoids complications associated with sedation and mechanical ventilation and leads to recovery of secondary organ function, enabling destination therapy.
Effect of colesevelam on faecal bile acids and bowel functions in diarrhoea‐predominant irritable bowel syndrome
Authors: Camilleri M. , Acosta A. , Busciglio I. , Boldingh A. , Dyer R. B. , Zinsmeister A. R. , Lueke A. , Gray A. , Donato L. J.
Published: January 2015

Background

About one‐third of patients withIBS‐diarrhoea (irritable bowel syndrome‐D) have evidence of increased bile acid synthesis or excretion.

Aims

To assess effects of thebile acidsequestrant, colesevelam, on faecal excretion ofBAs, hepaticBAsynthesis and diarrhoea inIBS‐D; to appraise whether individual or random stool samples accurately reflect 48‐h total faecalbile acidexcretion and proportions of the mainbile acidsexcreted and to study the faecal fat excretion in response to colesevelam.

Methods

A single‐centre, unblinded, single‐dose trial of effects of colesevelam, 1875 mg [3 tablets (625 mg tablets)] orally, twice daily, for 10 days on total 48‐h faecalbile acidexcretion and fasting serum C4 (7α‐hydroxy‐4‐cholesten‐3‐one; surrogate of hepaticbile acidsynthesis). Stool diaries documented bowel functions for 8 days prior and 8 days during colesevelam treatment. Stool 48‐h samples and fasting serum were collected for faecal fat, faecalbile acidand serum C4.

Results

Colesevelam was associated with significantly increased faecal totalbile acidexcretion and deoxycholic acid excretion, increased serum C4 and more solid stool consistency. There was a significant inverse correlation between number of bowel movements per week and the totalbile acidsequestered into stool during the last 48 h of treatment. Random stool samples did not accurately reflect 48‐h total or individual faecalbile acidexcretion. Sequestration ofbile acidsby colesevelam did not increase faecal fat.

Conclusions

Colesevelam increases delivery ofbile acidsto stool while improving stool consistency, and increases hepaticbile acidsynthesis, avoiding steatorrhoea in patients withIBS‐D. Overall effects are consistent with luminalbile acidsequestration by colesevelam.
Vulnerabilities and displacements: adaptation and mitigation to climate change as a new development mantra
Authors: Bose Pablo S
Published: January 2015

The past decade has witnessed significant growth across the globe of domestic and international initiatives designed to ameliorate both existing and potential impacts of climate change. The threat of altered environments and possibility of mass migrations of people have spurred intensive planning as well as the commitment of considerable resources to addressing such threats. Indeed, the primacy of climate change adaptation and mitigation efforts and planning has become so pronounced that one might argue that this is a new and pre‐eminent form of development in the international arena. As with previous developmental preoccupations such as progress, modernity, gender, microcredit, participation and good governance, climate change adaptation and mitigation is today a central part of the development mantra. In this paper I examine the ‘climate change turn’ in development work by focusing on the case of Bangladesh, a country often discussed in both scholarly literature and popular discourse as one of the most vulnerable countries in the world to the possible effects of climate change. Images of rising waters, flooded fields and displaced farmers in the region have become an iconic symbol deployed during debates on climate change both locally and globally. As a result Bangladesh has emerged as a laboratory of sorts in which a series of national‐level strategic plans, projects, programmes, trust funds and financing schemes are being designed and tested in partnership with international donors and development agencies, all built around the idea of climate change and resilience. Looking specifically at some of the most marginalised communities in Bangladesh – such as char dwellers and slum populations – I question in this paper what impact these efforts to combat climate change may have, in particular the possibility of being displaced not by climate change but rather by development processes meant to ameliorate its effects.
Association between Cardiovascular Drugs and Chronic Kidney Disease in Non‐Institutionalized Elderly Patients
Authors: Becquemont Laurent , Bauduceau Bernard , Benattar‐Zibi Linda , Berrut Gilles , Bertin Philippe , Bucher Sophie , Corruble Emmanuelle , Danchin Nicolas , al‐Salameh Abdallah , Derumeaux Geneviève , Doucet Jean , Falissard Bruno , Forette Francoise , Hanon Olivier , Pasquier Florence , Pinget Michel , Ourabah Rissane , Piedvache Celine
Published: January 2015

Concern about the renal safety of commonly used cardiovascular drugs with demonstrated clinical benefit appears to be an obstacle to their use in the elderly. The objective was to describe the relationship between cardiovascular drugs and chronic kidney disease (CKD) in elderly individuals in the real‐life setting. This is an ancillary study of the prospective non‐interventional S.AGE (aged individuals) cohort. General physicians were free to prescribe any drug their patients needed. The participants were non‐institutionalized patients aged 65 years and older treated by their primary physician for either chronic pain or atrial fibrillation or type 2 diabetes mellitus. The estimated glomerular filtration rate (eGFR) derived from the CKD‐EPI formula was determined at inclusion and every year during 2 years of follow‐up. This study comprised 2505 patients aged 77.8 ± 6.2 years. At inclusion, the factors associated with CKD (eGFR < 60 ml/min/1.73 m2) in multivariate analysis were age, female gender, hypertension, heart failure, history of atherothrombotic disease and renin angiotensin system blockers, loop diuretics and calcium channel inhibitors. Introduction of each of these three drug classes during the follow‐up period led to only a small decrease in the eGFR: −3.8 ± 12.7 (p < 0.0006), −2.2 ± 12.0 (p < 0.003) and −1.0 ± 13.4 ml/min./1.73 m2 (NS), respectively. Only the introduction of loop diuretics was associated with CKD (OR 1.91, 95% CI: 1.25–2.90; p = 0.002). Renal safety of cardiovascular drugs in the elderly appears acceptable and should not be a barrier to their use.
Synthesis and Evaluation of Millepachine Amino Acid Prodrugs With Enhanced Solubility as Antitumor Agents
Authors: Wu Yuzhe , Cao Dong , Wang Fang , Ma Liang , Gao Ge , Chen Lijuan
Published: January 2015

A series of amino acid derivatives of millepachine were designed, synthesized, and evaluated for their solubility and antiproliferation ability against tumor. The glycine derivative compound 7a exhibited the best potency and possessed long‐term inhibitory capability on cell viability. It was also confirmed that 7a could arrest the cell cycle at G2/M phase and trigger apoptosis. Furthermore, indirect immunofluorescence staining revealed antitubulin property of 7a, which is consistent with the previously reported derivatives of millepachine. In vivo, 7a suppressed tumor growth in an MDA‐MB‐231 xenograft tumor model. In summary, the exploit of 7a was a successful approach directed by the concept of generating amino acid prodrugs with increased bioavailability.
Children's Participation, Childhood Publics and Social Change: A Review
Authors: Nolas Sevasti‐Melissa
Published: January 2015

Progress in the implementation of children's participation rights in England is reviewed and situated within a broader agenda of social change. The article argues that much of the energy for ‘change for children’ has resided within a governance pathway across policy, practice and research. An alternative perspective is offered by re‐connecting children's rights debates to those of social movements and asking whether childhood publics are possible, what they might look like and where they might be found. It is concluded that a cross‐national and longitudinal perspective grounded in everyday life is likely to provide a more nuanced understanding of the change for children.
Quality of life and psychosocial impact of scarring and non‐scarring alopecia in women
Authors: Katoulis Alexandros C. , Christodoulou Christos , Liakou Aikaterini I. , Kouris Anargyros , Korkoliakou Panagiota , Kaloudi Eythymia , Kanelleas Antonios , Papageorgiou Charalabos , Rigopoulos Dimitrios
Published: January 2015

Background

Alopecia is a common dermatological condition with mostly cosmetic consequences that, nevertheless, has significant psychological and psychosocial impact.

Objective

To assess the impact of alopecia on quality of life and certain psychological domains and to compare it between scarring and non‐scarring alopecia in Greek adult women.

Patients and methods

Forty‐four women, aged 18–70 years, with scarring (n = 19) or non‐scarring alopecia (n = 25) were recruited. All patients were evaluated by Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self‐esteem Scale (RSES) and UCLA Loneliness Scale (UCLA‐LS).

Results

Women with scarring alopecia had higher scores in DLQI, HADS and UCLA‐ LS and lower scores in RSES, compared to women with non‐scarring alopecia. A statistically significant difference between the two groups was documented for DLQI (p = 0.0067), HADS (p = 0.0008), and HADS‐Anxiety (HADS‐A) (p < 0.05) and HADS‐Depression (HADS‐D) (p < 0.01) subscales.

Conclusions

The psychological burden is heavier and quality of life is more severely impaired among women with scarring alopecia compared with non‐scarring alopecia, probably depicting the poorer prognosis of the former.
Potential application of interventional endoscopic ultrasonography for the treatment of esophageal and gastric varices
Authors: Hikichi Takuto , Obara Katsutoshi , Nakamura Shin‐ichi , Irisawa Atsushi , Ohira Hiromasa
Published: January 2015

Interventional endoscopic ultrasonography (EUS) has been developed mainly for the treatment of pancreaticobiliary disorders (e.g. cyst drainage for pancreatic pseudocysts, biliary drainage for malignant biliary obstruction, and celiac plexus neurolysis). Recently, the application of interventional EUS has been expanded to a new field, the treatment of gastrointestinal varices. There have been several studies examining this new technique for the treatment of esophageal and gastric varices. In the present review, we have summarized the current status of interventional EUS for the treatment of esophageal and gastric varices (e.g. EUS‐guided coil deployment for gastric varices) and clarified the clinical feasibility of this procedure.
Cost‐effectiveness analysis of adding pharmacists to primary care teams to reduce cardiovascular risk in patients with Type 2 diabetes: results from a randomized controlled trial
Authors: Simpson S. H. , Lier D. A. , Majumdar S. R. , Tsuyuki R. T. , Lewanczuk R. Z. , Spooner R. , Johnson J. A.
Published: January 2015

Background

Adding pharmacists to primary care teams significantly improved blood pressure control and reduced predicted 10–year cardiovascular risk in patients with Type 2 diabetes. This pre‐specified sub‐study evaluated the economic implications of this cardiovascular risk reduction strategy.

Methods

One‐year outcomes and healthcare utilization data from the trial were used to determine cost‐effectiveness from the public payer perspective. Costs were expressed in 2014 Canadian dollars and effectiveness was based on annualized risk of cardiovascular events derived from theUKPDSRisk Engine.

Results

The 123 evaluable trial patients included in this analysis had a mean age of 62 ( ± 11) years, 38% were men, and mean diabetes duration was 6 ( ± 7) years. Pharmacists provided 3.0 ( ± 1.9) hours of additional service to each intervention patient, which cost $226 ( ± $1143) per patient. The overall one‐year per‐patient costs for healthcare utilization were $190 lower in the intervention group compared with usual care [95% confidence interval (CI): ‐$1040, $668). Intervention patients had a significant 0.3% greater reduction in the annualized risk of a cardiovascular event (95%CI: 0.08%, 0.6%) compared with usual care. In the cost‐effectiveness analysis, the intervention dominated usual care in 66% of 10 000 bootstrap replications. At a societal willingness‐to‐pay of $4000 per 1% reduction in annual cardiovascular risk, the probability that the intervention was cost‐effective compared with usual care reached 95%. A sensitivity analysis using multiple imputation to replace missing data produced similar results.

Conclusions

Within a randomized trial, adding pharmacists to primary care teams was a cost‐effective strategy for reducing cardiovascular risk in patients with Type 2 diabetes. In most circumstances, this intervention may also be cost saving.
Salinity and geomorphology drive long‐term changes to local and regional fish assemblage attributes in the lower Pecos River, Texas
Authors: Cheek Christopher A. , Taylor Christopher M.
Published: January 2015

River systems throughout arid regions worldwide have been heavily impacted by human activities, resulting in long‐term ecological consequences. The lower Pecos River in the Trans‐Pecos region of Texas is no exception, having undergone anthropogenic changes that include decreased flow, elevated salinity, species loss and species invasion. We compared historical and contemporary fish assemblage attributes from the Pecos River at local (site‐specific) and regional (Trans‐Pecos region) scales across a 24‐year time period. Fish assemblage data were collected in October 1987 and 2011, by seining at 15 sites spanning 430 km of the river in Texas. Additionally, we examined contemporary environmental conditions to determine species–environment relationships. We found that fish assemblages were significantly different between time periods, likely due to increased salinisation in the upper half of the study region. Decreased species richness, species replacement and increases in euryhaline species were documented in the upstream sites. Freshwater springs lower the salinity and maintain flows in the downstream reach, allowing for maintenance of the native fish fauna. Careful management of regional aquifers, irrigation practices and petroleum waste water will be necessary for protecting biodiversity and environmental flows in the lower Pecos River.
A database survey of equine tumours in the United Kingdom
Authors: Knowles E. J. , Tremaine W. H. , Pearson G. R. , Mair T. S.
Published: January 2015

Reasons for performing study

Survey data on equine tumours are sparse compared with other species and may have changed over time.

Objectives

To describe the most frequently diagnosed equine tumours recorded by a diagnostic pathology laboratory over 29 years, to identify background factors associated with tumour type, and to identify any changes in the tumours diagnosed or the background of cases submitted during the study period.

Study design

Observational; cross‐sectional analysis of records of a diagnostic pathology laboratory.

Methods

The records of all neoplastic equine histology submissions to the University of Bristol (January 1982–December 2010) were accessed from a database, and a list of diagnoses compiled. The 6 most commonly diagnosed tumour types were analysed using logistic regression to identify background factors associated with tumour type. The overall population of equine tumour submissions and the relative frequency of diagnosis of the most common tumour types were compared between decades.

Results

There were 964 cases included. The most frequently diagnosed tumours were: sarcoid (24% cases), squamous cell carcinoma (SCC) (19%), lymphoma (14%), melanoma (6%), gonadal stromal tumour (6%) and mast cell tumour (MCT) (4%). With sarcoid, Thoroughbred/Thoroughbred cross and gelding as reference categories: increasing age was significantly associated with the odds of each of the other tumour types, mares were at reduced risk of SCC, Arab/Arab cross had a higher risk of MCT, Cob/Cob cross had an increased risk of SCC and MCT, and ponies had an increased risk of melanoma. The mean age of submissions increased in each successive decade and the breed composition became broader. Sarcoids and lymphoma formed a smaller proportion of diagnoses in later decades.

Conclusions

The types of tumours submitted to this laboratory have changed over the last 3 decades. Current data inform clinicians and researchers and further studies are warranted to follow trends.

The Summary is available in Chinese – see Supporting information.
The Resource Center for Separating and Divorcing Families: Interdisciplinary Perspectives on A Collaborative and Child‐Focused Approach to Alternative Dispute Resolution
Authors: Taylor Melinda , Harper Stacy , Jurecko Lori , Melowsky Julie , Towler Chelsea
Published: January 2015

The Resource Center for Separating and Divorcing Families (RCSDF) is a teaching model for providing interdisciplinary services to separating and divorcing families. The model was developed by the Honoring Families Initiative at the Institute for the Advancement of the American Legal System at the University of Denver. Services are provided by graduate and law students at the University of Denver, working side‐by‐side with a supervising licensed attorney, psychologist, and social worker. The experiential and interdisciplinary model of teaching and providing direct client services is the first of its kind in the United States. RCSDF students and staff seek to empower parents to make positive decisions about their family's future in a supportive and educational environment.

Key Points for the Family Court Community

The current system of preparing graduate and law students for careers in family law is in need of improvement. This article provides information for educators and the family law community about the impact of interdisciplinary and experiential learning for students.

Parents going through the transition of separation or divorce experience psychological and financial stressors that can create serious behavioral and adjustment issues for their children. The RCSDF works in a holistic manner with parents and children to minimize the levels of stress and anxiety during the transition.
Reforming Relocation Law: An Evidence‐Based Approach
Authors: Parkinson Patrick , Cashmore Judy
Published: January 2015

In recent years, there has been much discussion within international fora about the need for a greater consensus on how to approach relocation cases. Empirical research on the lived experience of parents and children who have been through relocation disputes has an important role to play in providing an evidence base for decisions on policy. In this article, we summarize the findings of a 5‐year prospective longitudinal study of relocation disputes in Australia and make recommendations in the light of this and other research evidence concerning a new approach to relocation law. We argue that there should be no presumptions. Nonetheless there is an appropriate place for legislative or appellate guidance on how to approach these disputes. “Good faith” should be irrelevant to decision making, and children should not be placed in the center of the conflict. The adjudication of relocation disputes should be on the basis of asking three questions: First, how close is the relationship between the nonresident parent and the child and how important is that relationship developmentally to the child? Second, if the relocation is to be permitted, how viable are the proposals for contact with the nonresident parent? Third, if the relationship between the child and the nonresident parent is developmentally important to the child and is likely to be diminished if the move is allowed, then (a) what are the viable alternatives to the parents living a long distance apart? and (b) is a move with the primary caregiver the least detrimental alternative?

Key Points for the Family Court Community

Describes the findings of empirical research on relocation disputes in Australia on the lived experience of children and families postrelocation disputes.

Reviews various features of relocation law and proposals for reform in the light of this research evidence.

Proposes an approach to deciding relocation cases based upon three essential questions.
Reforming Relocation Law: A Reply to Prof. Thompson
Authors: Parkinson Patrick , Cashmore Judy
Published: January 2015

This article provides a response to Prof. Thomson's critique, noting many points of agreement and also the broader consensus that is emerging among experts in the field. The research evidence, and the wider body of knowledge on children's well‐being generally, supports the proposition that relocation is a risk factor for children after parental separation but provides no support for a general presumption either in favor of, nor against, relocation. Nor should it be assumed that the interests of children are the same as those of their primary caregiver. We defend our three questions arguing the need in an adult‐centric debate to focus resolutely on children's interests rather than on adult rights. Both Prof. Thompson's approach and our own involve guided decision making with the child's best interests as the paramount consideration—his through weak presumptions based upon research about how judges respond to relocation issues and ours through focused questions based on research on how parents and children respond to relocations issues. We do not consider that codifying the existing practices of the courts represents real reform. We identify various risks involved in using presumptions, but note that, in jurisdictions with limited publicly funded resources for individual case assessment, presumptions, burdens or guidelines may be needed to offer rough justice to impecunious parents.

Key Points for the Family Court Community

Notes points of emerging agreement on relocation within the research community

Explores the differences between the use of presumptions and focused questions and highlights the role of empirical research of the lived experience of children and families postrelocation disputes

Identifies how the level of public resourcing for the family law system may impact upon decisions about the substance of the law concerning relocation
A Mentalizing‐Based Approach to Family Mediation: Harnessing Our Fundamental Capacity to Resolve Conflict and Building an Evidence‐Based Practice for the Field*
Authors: Howieson Jill , Priddis Lynn
Published: January 2015

This article presents the results of a research study into mentalizing in family mediation. The study employed a mixed‐method approach, which included quantitative and qualitative empirical analysis of mediation transcripts and postmediation surveys. The research identified that, when the mediators adopted a mentalizing stance to facilitate the parties to engage their mentalizing capacities and, in particular, to mentalize for the child, the mediation process became more constructive and meaningful. The article makes recommendations for incorporating a mentalizing‐based approach into the research and education of mediation and building an evidence‐based practice for the field.

Key Points for the Family Court Community

Empirical evidence into the interventions used in family mediation

Introducing a mentalizing‐based approach to practice

Creating an environment for constructive family dispute resolution

Methods to keep the best interests of the child in mind in mediation
Does Level of Intimate Partner Violence and Abuse Predict the Content of Family Mediation Agreements?
Authors: Rossi Fernanda S. , Holtzworth‐Munroe Amy , Applegate Amy G.
Published: January 2015

This study investigated whether reported levels of intimate partner violence (IPV) and/or abuse (IPV/A) victimization are related to reaching agreement and to the content of mediation agreements of parties seeking to resolve family‐ and child‐related issues. Whether or not parties reached agreement was analyzed for 105 cases at a law school mediation clinic. Agreement content was coded for the 71 cases that reached agreement. Levels of IPV and IPV/A were determined separately for males and females, using a standardized measure. Regression models were utilized to examine reports of IPV or IPV/A as predictors. Results indicated that mediation may help families with a reported history of IPV and IPV/A address a variety of concerns; levels of partner violence/abuse predicted numerous issues in mediation agreements, including arrangements regarding legal custody, parenting time, holidays, child exchanges, interparental communication, safety restrictions, counseling referrals, child support, financial arrangements, and other miscellaneous topics (e.g., relocation). However, some findings were consistent with concerns raised about the use of mediation with parties reporting IPV and IPV/A; for example, increasing levels of male‐perpetrated IPV/A predicted increased likelihood of making an agreement to share legal custody. Further research is needed to resolve the longstanding debate of whether divorce mediation is an effective and safe process for parties demonstrating IPV/A.

Key Points for the Family Court Community

This study adds to the debate of whether divorce mediation is an effective and safe process for parties demonstrating IPV/A.

It examines whether reported levels of IPV and IPV/A victimization are related to reaching agreement and to the content of mediation agreements of parties seeking to resolve family‐ and child‐related issues.

Results provide some evidence that mediation may help families with a reported history of IPV and IPV/A address a variety of concerns.

However, some findings are consistent with concerns raised about the use of mediation with parties reporting IPV and IPV/A.

Findings have implications for the practice of family mediation with parties reporting a history of IPV or IPV/A.