bluuebunny/crossref_metadata_2025 huggingface dataset:
PLK1 and HOTAIR Accelerate Proteasomal Degradation of SUZ12 and ZNF198 during Hepatitis B Virus–Induced Liver Carcinogenesis
Authors: Zhang Hao , Diab Ahmed , Fan Huitao , Mani Saravana Kumar Kailasam , Hullinger Ronald , Merle Philippe , Andrisani Ourania
Published: April 2015

Elucidating mechanisms of hepatitis B virus (HBV)–mediated hepatocarcinogenesis is needed to gain insights into the etiology and treatment of liver cancer. Cells where HBV is replicating exhibit increased expression of Plk1 kinase and reduced levels of two transcription repression factors, SUZ12 and ZNF198. SUZ12 is an essential subunit of the transcription repressive complex PRC2. ZNF198 stabilizes the transcription repressive complex composed of LSD1, Co-REST, and HDAC1. These two transcription repressive complexes are held together by binding the long noncoding RNA HOTAIR. In this study, we linked these regulatory events mechanistically by showing that Plk1 induces proteasomal degradation of SUZ12 and ZNF198 by site-specific phosphorylation. Plk1-dependent ubiquitination of SUZ12 and ZNF198 was enhanced by expression of HOTAIR, significantly reducing SUZ12 and ZNF198 stability. In cells expressing the HBV X protein (HBx), downregulation of SUZ12 and ZNF198 mediated global changes in histone modifications. In turn, HBx-expressing cells propagated an altered chromatin landscape after cell division, as exemplified by changes in histone modifications of the EpCAM promoter, a target of PRC2 and LSD1/Co-REST/HDAC1 complexes. Notably, liver tumors from X/c-myc bitransgenic mice exhibited downregulation of SUZ12 and ZNF198 along with elevated expression of Plk1, HOTAIR, and EpCAM. Clinically, similar effects were documented in a set of HBV-related liver tumors consistent with the likelihood that downregulation of SUZ12 and ZNF198 leads to epigenetic reprogramming of infected hepatocytes. Because both Plk1 and HOTAIR are elevated in many human cancers, we propose that their combined effects are involved in epigenetic reprogramming associated broadly with oncogenic transformation. Cancer Res; 75(11); 2363–74. ©2015 AACR.
Inflammatory Markers and Risk of Epithelial Ovarian Cancer by Tumor Subtypes: The EPIC Cohort
Authors: Ose Jennifer , Schock Helena , Tjønneland Anne , Hansen Louise , Overvad Kim , Dossus Laure , Clavel-Chapelon Françoise , Baglietto Laura , Boeing Heiner , Trichopolou Antonia , Benetou Vassiliki , Lagiou Pagona , Masala Giovanna , Tagliabue Giovanna , Tumino Rosario , Sacerdote Carlotta , Mattiello Amalia , Bueno-de-Mesquita H. B(as). , Peeters Petra H. M. , Onland-Moret N. Charlotte , Weiderpass Elisabete , Gram Inger T. , Sánchez Soledad , Obon-Santacana Mireia , Sànchez-Pérez Maria-José , Larrañaga Nerea , Castaño José María Huerta , Ardanaz Eva , Brändstedt Jenny , Lundin Eva , Idahl Annika , Travis Ruth C. , Khaw Kay-Tee , Rinaldi Sabina , Romieu Isabelle , Merritt Melissa A. , Gunter Marc J. , Riboli Elio , Kaaks Rudolf , Fortner Renée T.
Published: April 2015

Background: Evidence suggests an etiologic role for inflammation in ovarian carcinogenesis and heterogeneity between tumor subtypes and anthropometric indices. Prospective studies on circulating inflammatory markers and epithelial invasive ovarian cancer (EOC) have predominantly investigated overall risk; data characterizing risk by tumor characteristics (histology, grade, stage, dualistic model of ovarian carcinogenesis) and anthropometric indices are sparse.

Methods: We conducted a nested case–control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate C-reactive protein (CRP), IL6, and EOC risk by tumor characteristics. A total of 754 eligible EOC cases were identified; two controls (n = 1,497) were matched per case. We used multivariable conditional logistic regression to assess associations.

Results: CRP and IL6 were not associated with overall EOC risk. However, consistent with prior research, CRP >10 versus CRP ≤1 mg/L was associated with higher overall EOC risk [OR, 1.67 (1.03–2.70)]. We did not observe significant associations or heterogeneity in analyses by tumor characteristics. In analyses stratified by waist circumference, inflammatory markers were associated with higher risk among women with higher waist circumference; no association was observed for women with normal waist circumference [e.g., IL6: waist ≤80: ORlog2, 0.97 (0.81–1.16); waist >88: ORlog2, 1.78 (1.28–2.48), Pheterogeneity ≤ 0.01].

Conclusions: Our data suggest that high CRP is associated with increased risk of overall EOC, and that IL6 and CRP may be associated with EOC risk among women with higher adiposity.

Impact: Our data add to global evidence that ovarian carcinogenesis may be promoted by an inflammatory milieu. Cancer Epidemiol Biomarkers Prev; 24(6); 951–61. ©2015 AACR.
T-cell Expression of IL10 Is Essential for Tumor Immune Surveillance in the Small Intestine
Authors: Dennis Kristen L. , Saadalla Abdulrahman , Blatner Nichole R. , Wang Shuya , Venkateswaran Vysak , Gounari Fotini , Cheroutre Hilde , Weaver Casey T. , Roers Axel , Egilmez Nejat K. , Khazaie Khashayarsha
Published: April 2015

IL10 is attributed with immune-suppressive and anti-inflammatory properties, which could promote or suppress cancer in the gastrointestinal tract. Loss of IL10 exacerbates colonic inflammation, leading to colitis and cancer. Consistent with this, transfer of IL10-competent regulatory T cells (Treg) into mice with colitis or hereditary polyposis protects against disease, while IL10-deficient mice are predisposed to polyposis with increased colon polyp load. Little is known about the protective or pathogenic function of IL10 in cancers of the small intestine. We found CD4+ T cells and CD4+ Foxp3+ Tregs to be the major sources of IL10 in the small intestine and responsible for the increase in IL10 during polyposis in the APCΔ468 mouse model of hereditary polyposis. Targeted ablation of IL10 in T cells caused severe IL10 deficiency and delayed polyp growth. However, these polyps progressively lost cytotoxic activity and eventually progressed to cancer. Several observations suggested that the effect was due to the loss of IFNγ-dependent immune surveillance. IL10-incompetent CD4+ T cells failed to secrete IFNγ when stimulated with polyp antigens and were inefficient in T-helper-1 (TH1) commitment. By contrast, the TH17 commitment was unaffected. These findings were validated using mice whose T cells overexpress IL10. In these mice, we observed high intra-polyp cytotoxic activity and attenuation of polyposis. Thus, expression of IL10 by T cells is protective and required for immune surveillance in the small intestine. Cancer Immunol Res; 3(7); 806–14. ©2015 AACR.
Depressive Symptoms at Discharge from Rehabilitation Predict Future Cardiovascular-Related Hospitalizations
Authors: Meyer Fiorenza Angela , Hugentobler Eva , Stauber Stefanie , Wilhelm Matthias , Znoj Hansjörg , von Känel Roland
Published: April 2015

Objectives: Depression is associated with poor prognosis in patients with cardiovascular disease (CVD). We hypothesized that depressive symptoms at discharge from a cardiac rehabilitation program are associated with an increased risk of future CVD-related hospitalizations. Methods: We examined 486 CVD patients (mean age = 59.8 ± 11.2) who enrolled in a comprehensive 3-month rehabilitation program and completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). At follow-up we evaluated the predictive value of depressive symptoms for CVD-related hospitalizations, controlling for sociodemographic factors, cardiovascular risk factors, and disease severity. Results: During a mean follow-up of 41.5 ± 15.6 months, 63 patients experienced a CVD-related hospitalization. The percentage of depressive patients (HADS-D ≥8) decreased from 16.9% at rehabilitation entry to 10.7% at discharge. Depressive symptoms at discharge from rehabilitation were a significant predictor of outcome (HR 1.32, 95% CI 1.09-1.60; p = 0.004). Patients with clinically relevant depressive symptoms at discharge had a 2.5-fold increased relative risk of poor cardiac prognosis compared to patients without clinically relevant depressive symptoms independently of other prognostic variables. Conclusion: In patients with CVD, depressive symptoms at discharge from rehabilitation indicated a poor cardiac prognosis.
Long-Term Analysis of Ab-2 (Clone SN3b) Immunoreactivity as a Prognostic Factor in Breast Carcinoma
Authors: Winzer Klaus-Jürgen , Bellach Joachim , Kristiansen Glen
Published: April 2015

Background: CD24 expression has been described as a significant prognostic factor in multiple solid tumours. Most of these studies have, however, been undertaken using the Ab-2 antibody (clone SN3b), which detects a CD24-associated carbohydrate, and not the CD24 protein itself. Although its biological identity remains unclear, its prognostic significance means that detection of this carbohydrate may, nonetheless, be clinically relevant. Methods: 133 breast carcinomas were selected (pT1-2 pN0-2 M0, no secondary carcinoma, no contralateral carcinoma) from a previous SN3b expression study on a larger cohort of breast carcinomas. After updating data on follow-up observations, we carried out univariate and multivariate analysis of the prognostic significance of SN3b for total and breast cancer-specific survival. Results: A statistically significant correlation between cytoplasmic SN3b immunoreactivity and positive node status was found. Cytoplasmic SN3b also has node status-independent prognostic significance. Total survival exhibits a statistically significant dependency on cytoplasmic SN3b even for pN0 cases. Conclusion: The independent prognostic value of CD24 as detected by Ab-2/clone SN3b could replace the diagnostic axillary dissection in breast carcinoma patients if this was confirmed in further studies. Also, clarifying the exact epitope of this interesting antibody is more than warranted.
The physiologic anticoagulant and anti-inflammatory role of heparins and their utility in the prevention of pregnancy complications
Authors: Mastrolia Salvatore Andrea , Mazor Moshe , Holcberg Gershon , Leron Elad , Beharier Ofer , Loverro Giuseppe , Erez Offer
Published: April 2015

Accumulating evidence supports the concept of increased thrombin generation, placental vascular lesions, and inflammation as crucial points in the development of the great obstetrical syndromes [preeclampsia, intrauterine growth restriction (IUGR), preterm labor (PTL), preterm prelabor rupture of membranes (PROM), fetal demise and recurrent abortions]. In light of this, the role of heparins for primary or secondary prevention of these syndromes is becoming more and more apparent, mainly due to the antithrombotic and anti-inflammatory effects of heparins. There is agreement regarding the use of heparin in the prevention of gestational complications in patients with antiphospholipid syndrome, while its use for other obstetrical complications is under debate. In the present review we will describe the physiologic role of heparins on coagulation and inflammation and we will discuss current evidence regarding the use of heparins for the prevention/ treatment of obstetrical syndromes.
Vascular Wall Progenitor Cells in Health and Disease
Authors: Psaltis Peter J. , Simari Robert D.
Published: April 2015

The vasculature plays an indispensible role in organ development and maintenance of tissue homeostasis, such that disturbances to it impact greatly on developmental and postnatal health. Although cell turnover in healthy blood vessels is low, it increases considerably under pathological conditions. The principle sources for this phenomenon have long been considered to be the recruitment of cells from the peripheral circulation and the re-entry of mature cells in the vessel wall back into cell cycle. However, recent discoveries have also uncovered the presence of a range of multipotent and lineage-restricted progenitor cells in the mural layers of postnatal blood vessels, possessing high proliferative capacity and potential to generate endothelial, smooth muscle, hematopoietic or mesenchymal cell progeny. In particular, the tunica adventitia has emerged as a progenitor-rich compartment with niche-like characteristics that support and regulate vascular wall progenitor cells. Preliminary data indicate the involvement of some of these vascular wall progenitor cells in vascular disease states, adding weight to the notion that the adventitia is integral to vascular wall pathogenesis, and raising potential implications for clinical therapies. This review discusses the current body of evidence for the existence of vascular wall progenitor cell subpopulations from development to adulthood and addresses the gains made and significant challenges that lie ahead in trying to accurately delineate their identities, origins, regulatory pathways, and relevance to normal vascular structure and function, as well as disease.
A new genus of African tiger moths, with a review of the Amsacta melanogastra Holland species group (Lepidoptera, Erebidae)
Authors: DUBATOLOV VLADIMIR V.
Published: April 2015

The relationships of Afrotropical tiger moths remain relatively poorly analyzed (see Goodger & Watson 1995), despite some noticeable new generic descriptions (see Goodger & Watson 1995, Dubatolov 2006a, 2006b, 2009, 2009, Dubatolov & Haynes 2008). While studying series of tiger moths from the Natural History Museum and Manchester Museum, some specimens of “Diacrisia” epicaste Fawcett, 1915 (synonyms include “Spilosoma” occidentalis Bartel, 1903 and “Amsacta” melanogastra Holland, 1897) were found to have genitalia unlike any known Spilosomina genus, and are transferred to a newly described genus as follows.
Description of three new species of Pentelicus Howard (Hymenoptera: Encyrtidae) from India, with a key to world species
Authors: MANICKAVASAGAM S. , CHAITANYA T. KRISHNA
Published: April 2015

Three new species of Pentelicus Howard (Hymenoptera: Encyrtidae) are described from Tamil Nadu, India: P. funiculatus sp. nov., P. punctatus sp. nov. and P. depunctatus sp. nov. A revised key to the world species of Pentelicus is also provided.
Vegetation Dynamics on the Tibetan Plateau (1982–2006): An Attribution by Ecohydrological Diagnostics
Authors: Cai Danlu , Fraedrich Klaus , Sielmann Frank , Zhang Ling , Zhu Xiuhua , Guo Shan , Guan Yanning
Published: April 2015

Vegetation greenness distributions [based on remote sensing normalized difference vegetation index (NDVI)] and their change are analyzed as functional vegetation–climate relations in a two-dimensional ecohydrological state space spanned by surface flux ratios of energy excess (U; loss by sensible heat H over supply by net radiation N) versus water excess (W; loss by discharge Ro over gain by precipitation P). An ecohydrological ansatz attributes state change trajectories in (U, W) space to external (or climate) and internal (or anthropogenic) causes jointly with vegetation greenness interpreted as an active tracer. Selecting the Tibetan Plateau with its complex topographic, climate, and vegetation conditions as target area, ERA-Interim weather data link geographic and (U, W) state space, into which local remote sensing Global Inventory Modeling and Mapping Studies (GIMMS) data (NDVI) are embedded; a first and second period (1982–93 and 1994–2006) are chosen for change attribution analysis. The study revealed the following results: 1) State space statistics are characterized by a bimodal distribution with two distinct geobotanic regimes (semidesert and steppe) of low and moderate vegetation greenness separated by gaps at aridity D ~ 2 (net radiation over precipitation) and greenness NDVI ~ 0.3. 2) Changes between the first and second period are attributed to external (about 70%) and internal (30%) processes. 3) Attribution conditioned joint distributions of NDVI (and its change) show 38.2% decreasing (61.8% increasing) area cover with low (moderate) greenness while high greenness areas are slightly reduced. 4) Water surplus regions benefit most from climate change (showing vegetation greenness growth) while the energy surplus change is ambiguous, because ecohydrological diagnostics attributes high mountainous regions (such as the Himalayas) as internal without considering the heat storage deficit due to increasing vegetation.
Effects of Target Prevalence and Speech Intelligibility on Visual Search Performance
Authors: Yu Ruifeng , Yang Lindong , Liu Chang
Published: April 2015

Visual search is commonly performed in the control rooms of several industries such as nuclear power plants, flight control, security screening, and monitoring. In this study, the effects of target prevalence and speech intelligibility on visual search performance were investigated. A 2 (target prevalence: low versus high) × 3 (speech transmission index = 0 versus 0.51 versus 0.69) mixed design experiment was conducted. Target prevalence was a between-subject variable, whereas the speech transmission index was a within-subject variable. A total of 32 participants participated in simulated X-ray screening tasks in different speech intelligibility conditions. Results revealed that both the target prevalence and the speech transmission index level had significant effects on visual search performance. The reaction time was shorter and the miss error rate was higher under low target prevalence condition than in high target prevalence condition. Compared with no speech condition (speech transmission index = 0), the reaction time of the participants increased significantly with the presence of intelligible speech in an acoustic environment. Performance loss was greatest when the speech transmission index was 0.51. The interaction effect of target prevalence and speech transmission index level was also significant. Proper measures should be taken to reduce unfavorable effects of low target prevalence and intelligible speech in acoustic environment on visual search performance in control rooms.
Militias in Civil Wars
Authors: Jentzsch Corinna , Kalyvas Stathis N. , Schubiger Livia Isabella
Published: April 2015

Militias are an empirical phenomenon that has been overlooked by current research on civil war. Yet, it is a phenomenon that is crucial for understanding political violence, civil war, post-conflict politics, and authoritarianism. Militias or paramilitaries are armed groups that operate alongside regular security forces or work independently of the state to shield the local population from insurgents. We review existing uses of the term, explore the range of empirical manifestations of militias, and highlight recent findings, including those supplied by the articles in this special issue. We focus on areas where the recognition of the importance of militias challenges and complements current theories of civil war. We conclude by introducing a research agenda advocating the integrated study of militias and rebel groups.
Dynamic mechanical analysis, surface chemistry and morphology of alkali and enzymatic retted kenaf fibers
Authors: Ramesh Dinesh , Ayre Brian G , Webber Charles L , D'Souza Nandika Anne
Published: April 2015

Bast fibers grow in the bark layer of many plants and have been used for textiles and cordage for over 6000 years. Bast fibers are expanding into new markets of non-woven fabrics and composite materials, and a comparative assessment of surface reactive groups and mechanical properties after different retting procedures is of value. Here, bast fiber of kenaf ( Hibiscus cannabinus L., Malvaceae) were prepared by (1) alkali retting with 2% NaOH and (2) enzymatic retting with pectinase, and compared with commercially-available fiber retted by the natural microbe population in ocean water. Fiber structure was analyzed by fluorescence and electron microscopy; fiber chemistry was assessed by Raman and X-ray photoelectron spectroscopy, and by carbohydrate analysis; and mechanical properties were determined by dynamic mechanical analysis. Collectively, these show that enzymatic and microbial retting preserve the natural fiber structure and result in superior mechanical properties compared with alkali retting, which disrupts structure and degrades quality. The impacts of the retting procedure on fiber chemistry, morphology and mechanical properties are discussed.
Asking for action or information? Crosslinguistic comparison of interrogative functions in early child Cantonese and Mandarin
Authors: Li Hui , Wong Eileen Chin Mei , Tse Shek Kam , Leung Shing On , Ye Qianling
Published: April 2015

Request for information (RfI) is believed to be the universally dominant function of young children’s questioning, whereas request for action (RfA) has been reported to be the leading interrogative form used in early child Cantonese. The possibility of crosslinguistic variability prompts further research and comparison with additional languages. This study compares the interrogatives elicited from two early Chinese language corpora: Early Childhood Cantonese Corpus (ECCC) and Early Childhood Mandarin (ECMC). Altogether, 1214 and 942 question types were elicited from ECCC and ECMC, respectively. Analyses indicated that: (1) all the interrogative functions identified in an earlier study of Cantonese were also observed in the early Mandarin interrrogatives; and (2) both RfA (49.9%) and RfI (45.5%) were the most frequently observed functions of early child Chinese interrogatives. This crosslinguistic evidence suggests that follow-up studies are needed to further explore the possible influences of language, culture and communication tasks on children’s uses of interrogative forms.
Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients
Authors: Dowhan Lindsay , DeChicco Robert , Welsh Renee , Wehner Rebecca , Habib Monica , Hipskind Peggy , Cresci Gail
Published: April 2015

Background: The Academy of Nutrition and Dietetics and American Society the Parenteral and Enteral Nutrition (ASPEN) Consensus Statement recommends a standardized set of diagnostic characteristics to identify adult malnutrition. Due to lack of a consensus definition and challenges with measurements, physical function or performance has traditionally been difficult to assess. The purpose of this study was to determine whether manual muscle testing (MMT) performed by registered dietitians (RDs) can be used as a surrogate measurement of muscle strength and function in hospitalized patients. Method: Patients admitted to the heart failure service on the cardiac stepdown units at the Cleveland Clinic Main Campus in Cleveland, Ohio, were eligible for the study, and those who met the inclusion criteria underwent handgrip strength (HGS) testing and evaluation of nutrition status using the Academy/ASPEN Characteristics Recommended for the Identification of Adult Malnutrition. MMT was then performed within 24 hours by a different study investigator blinded to the HGS and malnutrition assessment results. Results: It was found that HGS and MMT overall were in agreement for 84% of patients and that MMT had a high sensitivity (98%) but low specificity (13%). Conclusion: This study shows feasibility for RDs to perform MMT on patients to determine muscle strength and functioning. Future practice application may be to incorporate MMT into screening criteria for patients being evaluated for malnutrition and reserve HGS testing only for patients with an abnormal MMT.
A Horrible Experiment
Authors: Weiss Michael H.
Published: April 2015

A patient presented to my office who had been tortured in the course of a wartime medical experiment many years ago. Seeing him prompted me to explore my personal reaction to his case and to reflect on the history of the ethics of medical experimentation in the 20th century.
Worker Youth and Everyday Violence in the Post-Stalin Soviet Union
Authors: Tsipursky Gleb
Published: April 2015

The essay explores the implications of a new campaign launched by the Soviet authorities against violent youth behaviour, especially amongst working-class youngsters, after Stalin's death in 1953. Relying largely on official sources from the archives, newspapers and other publications, and also on personal sources such as interviews and memoirs, the study explores what the new campaign reveals about everyday working-class youth violence in the post-Stalin Soviet Union. The new initiative represented part of a broader Thaw-era endeavour to reinvigorate the attempt to construct a socialist version of modernity, specifically by reforming the population's everyday way of life, in a fashion perceived as helping to create model citizens, ‘New Soviet People’. The findings contribute to a recent re-evaluation of the Thaw as a time not only of liberalizing reforms, but also of new coercive elements. Further, working-class violence reveals the extent of class differences in the supposedly classless Soviet Union, with working-class youth behaviour departing from the official model of normative conduct, predicated upon middle-class standards. The article focuses on male violence in particular, providing a glimpse of a working-class masculinity that is at variance with the officially prescribed model of socialist masculinity. By showing the frequency of collective violence amongst young workers, the author also questions the official discourse's frequent depictions of collectivism as a panacea for delinquency. Nonetheless, this account does not equate worker violence with conscious opposition to the government. Instead, it positions such behaviour within a wider context of the traditional working-class male youth milieu.
Becoming Dangerous: Everyday Violence in the Industrial Milieu of Late-Socialist Romania
Authors: Morar-Vulcu Călin
Published: April 2015

In this article, I examine the extent to which everyday violence was a matter of public order in the 1970s and 1980s in Romania's ‘industrial milieu’. Starting from the assumption that public order is an integral part of a monopoly on the use of physical force, I analyse unexceptional, nonlethal violence because, as a borderline phenomenon with both public and private aspects, it can illuminate our understanding of the implementation of legitimating practices in late socialism. Focusing mainly on cases of violence among male workers in the 1970s in Călan, a ‘mono-industrial’ town whose economy was dominated by a metallurgical plant, I examine how everyday violence was dealt with by various institutions, including the law enforcement system (the police, prosecutors and courts), the plant administration and various levels of the party structure. In this context, everyday violence was apparently linked to the private sphere and to stereotypical male normalcy, along with alcohol consumption, and consequently it was not deemed a matter of public order. The situation changed progressively in the late 1970s and early 1980s, when, after the worker protests in Lupeni (1977) and Motru (1981), the authorities began to infer a causal link between everyday violence and protest.
Delirium as letting go: An ethnographic analysis of hospice care and family moral experience
Authors: Wright David Kenneth , Brajtman Susan , Cragg Betty , Macdonald Mary Ellen
Published: April 2015

Background:

Delirium is extremely common in dying patients and appears to be a major threat to the family’s moral experience of a good death in end-of-life care.

Aim:

To illustrate one of the ways in which hospice caregivers conceptualize end-of-life delirium and the significance of this conceptualization for the relationships that they form with patients’ families in the hospice setting.

Design:

Ethnography.

Setting/participants:

Ethnographic fieldwork was conducted at a nine-bed, freestanding residential hospice, located in a suburban community of Eastern Canada. Data collection methods included 15 months of participant observation, 28 semi-structured audio-recorded interviews with hospice caregivers, and document analysis.

Results:

Hospice caregivers draw on a culturally established framework of normal dying to help families come to terms with clinical end-of-life phenomena, including delirium. By offering explanations about delirium as a natural feature of the dying process, hospice caregivers strive to protect for families the integrity of the good death ideal.

Conclusion:

Within hospice culture, there is usefulness to deemphasizing delirium as a pathological neuropsychiatric complication, in favor of acknowledging delirious changes as signs of normal dying. This has implications for how we understand the role of nurses and other caregivers with respect to delirium assessment and care, which to date has focused largely on practices of screening and management.
A comparison of liver fat content as determined by magnetic resonance imaging-proton density fat fraction and MRS versus liver histology in non-alcoholic fatty liver disease
Authors: Idilman Ilkay S , Keskin Onur , Celik Azim , Savas Berna , Halil Elhan Atilla , Idilman Ramazan , Karcaaltincaba Musturay
Published: April 2015

Background

Many imaging methods have been defined for quantification of hepatic steatosis in non-alcoholic fatty liver disease (NAFLD). However, studies comparing the efficiency of magnetic resonance imaging-proton density fat fraction (MRI-PDFF), magnetic resonance spectroscopy (MRS), and liver histology for quantification of liver fat content are limited.

Purpose

To compare the efficiency of MRI-PDFF and MRS in the quantification of liver fat content in individuals with NAFLD.

Material and Methods

A total of 19 NAFLD patients underwent MRI-PDFF, MRS, and liver biopsy for quantification of liver fat content. The MR examinations were performed on a 1.5 HDx MRI system. The MRI protocol included T1-independent volumetric multi-echo gradient-echo imaging with T2* correction and spectral fat modeling and MRS with STEAM technique.

Results

A close correlation was observed between liver MRI-PDFF- and histology- determined steatosis (r = 0.743, P < 0.001) and between liver MRS- and histology-determined steatosis (r = 0.712, P < 0.001), with no superiority between them (ƶ = 0.19, P = 0.849). For quantification of hepatic steatosis, a high correlation was observed between the two MRI methods (r = 0.986, P < 0.001). MRI-PDFF and MRS accurately differentiated moderate/severe steatosis from mild/no hepatic steatosis ( P = 0.007 and 0.013, respectively), with no superiority between them (AUCMRI-PDFF = 0.881 ± 0.0856 versus AUCMRS = 0.857 ± 0.0924, P = 0.461).

Conclusion

Both MRI-PDFF and MRS can be used for accurate quantification of hepatic steatosis.
What are the Benefits of Leisure? An Exploration Using the Leisure Satisfaction Scale
Authors: Di Bona Laura
Published: April 2015

No occupational therapy study appears to have identified comprehensively the influence of different variables on the leisure experience. This study aimed to establish: (1) if there was a difference in the needs satisfied by leisure between people of different ages, sex, and relationship and parental status (people with or without or cohabiting with a partner or children); (2) whether or not different needs were satisfied by different leisure activities; and (3) whether the adapted form of the Leisure Satisfaction Scale (LSS) (Beard and Ragheb 1980) measured leisure satisfaction.

Sixty-five nurses completed an adapted form of the LSS for three leisure activities that they engaged in and rated their overall satisfaction with leisure on a scale of 1 to 10. Relevant demographic details were requested. The data were analysed using non-parametric statistics. The findings lent support to the use of the adapted form of the LSS as a valid measure of leisure satisfaction. The findings suggested that leisure satisfaction was not affected by demographic factors, but they supported previous findings that leisure satisfaction was affected by different leisure activities.

This study supported the therapeutic use of carefully selected activities to meet individual needs. It also suggested the potential benefit of using the LSS (Beard and Ragheb 1980) in occupational therapy. However, further research to develop related knowledge is needed.
Compliance with Prescribed Adaptive Equipment: A Literature Review
Authors: Wielandt Trish , Strong Jenny
Published: April 2015

This article describes a literature review that examined the topic of the postdischarge compliance of individuals with prescribed adaptive equipment. Assisting individuals to accomplish tasks relevant to their activities of daily living and thereby achieve functional independence is central to the role of occupational therapy. The prescription of adaptive equipment is a frequently used intervention. The rationale for prescribing adaptive equipment is that it maximises a client's functional potential, allows for independence in activities of daily living and fosters confidence as a result of being able to accomplish such tasks.

All studies that surveyed compliance with prescribed adaptive equipment between 1963 and 1996 were reviewed. The factors that reportedly affect compliance by individuals can be considered under five discrete categories: medical-related, client-related, equipment-related, assessment-related and training-related. On the basis of the findings of this literature review, recommendations are made for further research, specifically investigating methods that therapists could incorporate into current practice to address the problem of non-compliance with prescribed adaptive equipment.
The Empowerment of Clients through Preoperative Education
Authors: Spalding Nicola
Published: April 2015

The literature suggests that the education of clients is, in theory, an empowering process (Stewart 1994, Opie 1998). The empowerment of clients has been encouraged by the British Government and is seen as central to the occupational therapy process (Stewart 1994). In this initial case study of the empowerment of clients awaiting a total hip replacement, the data were gathered from four occupational therapists working in different preoperative education programmes. The aim of the study was to explore the ways in which these programmes were empowering for the clients.

Semi-structured interviews were undertaken with each participant. The occupational therapists' descriptions and discussions of their programmes, and the content of the invitation letters that they sent to clients, were analysed to assess any empowerment strategies. The findings suggest six different strategies that could be used to empower clients awaiting a total hip replacement. The findings will be used to design a preoperative education programme that empowers such clients.
Chronic Fatigue Syndrome: All in the Mind? An Occupational Therapy Perspective
Authors: Moore Lucy
Published: April 2015

This study aimed to establish the attitudes of occupational therapists towards chronic fatigue syndrome. Previously, no study had investigated the attitudes of health professionals towards this condition, which may be a factor in maintaining the uncertainty surrounding chronic fatigue syndrome.

Twenty occupational therapists practising in either physical or mental health settings were recruited to this study. In order to achieve a depth of knowledge not gained by previous studies, the data were collected through a combination of quantitative and qualitative methodology by using a structured questionnaire and a semi-structured interview; the findings were analysed statistically and thematically. At variance with the literature, the results revealed a neutral to positive attitude towards chronic fatigue syndrome, with no significant difference in responses from participants practising in physical or mental health settings.

A unique and valuable role was clearly identified for the profession of occupational therapy within the wider multidisciplinary framework. However, as 16 (80%) of the participants had met individuals with chronic fatigue syndrome, the lack of knowledge and need for further education and training were highlighted. Continuing professional development is fundamental in order to provide appropriate, sensitive and holistic services in the future for all individuals with chronic fatigue syndrome.
Research and Development Board: The Research Assessment Exercise — Implications for the Future of Occupational Therapy
Authors: Ilott Irene , White Elizabeth
Published: April 2015

The Research Assessment Exercise (RAE) is one of the most important policies that determine public expenditure of nearly one billion pounds in higher education. Although a minority of occupational therapy personnel are involved, all have an investment in the outcomes which support evidence-based services. This report outlines the Research and Development Board's responses to the Higher Education Funding Council's consultation exercises since 1997. The aim is to highlight the implications of this policy for supporting a research-active community, able to contribute to the development of the profession. Particular attention is given to the collaborative approach taken as a member of the Joint Therapies Research Group.

A longer-term, pragmatic strategy is described as part of the preparation for the next RAE in 2001 and beyond. This fits with the current fundamental review of research funding and policy and the recognition of the damage inflicted upon emergent disciplines and health service research by previous RAEs.
Managing Carer Stress: An Evaluation of a Stress Management Programme for Carers of People with Dementia
Authors: Mitchell Eileen
Published: April 2015

This article examines the effect of carer stress management using the Carers' Checklist (Hodgson et al 1998) as a measure of outcome. Pre-course and post-course questionnaires were used with carers, identified by health and social services professionals, who agreed to attend a structured stress management course. Seven out of the 10 identified carers, who resided in the West Dorset area, participated. Only one carer's wife was a resident in a nursing home; the others were caring actively at home.

The main measures of outcome were the burden of care, including social, financial and physical demands in terms of the carers' own experience, and their level of understanding of stress management techniques.

The carers who attended demonstrated a better awareness and understanding of stress and its management following the course. Positive measures of outcome were also determined by a decrease in the carers' rating in frequency of dementia-related problems, carer burden of dementia-related problems and overall carer burden.

The findings confirm that structured stress management can reduce carer burden and offer better coping strategies through raising carers' awareness and understanding.
Confessions of an Occupational Therapist Who Became a Detective
Authors: Yerxa Elizabeth J
Published: April 2015

This life history of an occupational therapist traces her evolution from a biomedical technician to a ‘detective’, who searches for new ideas that will support clinical practice and enable the profession to achieve its potential contribution to humankind. These ideas focus on ‘homo occupacio’, the occupational human: an agent who sets goals, makes choices and becomes competent through engagement in occupation. Concepts such as motivation, self-organisation, skill development, resource reclamation, brain evolution, repertoires of daily routines, environmental management and defining health as the capacity to achieve one's valued goals illuminate occupation. The contexts in which people carry out their rounds of occupation also require study in order for occupational therapists to pose a ‘just right’ level of environmental challenge, enabling people to make an adaptive response in user-friendly environments. Recommended sources for new ideas are, first, self-reports of people who live with impairments and, second, literature from non-medical disciplines that share occupational therapy's holistic, integrated and optimistic view of people.

The writings of people who live with chronic conditions reveal that they are not being served well by the current biomedical system. In contrast, scholarly detective work could foster occupational therapy that enhances satisfaction in daily living, influences health, reclaims resources and enables equality of capability for myriads of the world's populations.

A keynote address, given on 8 September 1999 at the Inaugural United Kingdom Occupational Science Symposium, held at the College of Ripon and York St John, York.
Occupational Deprivation: Global Challenge in the New Millennium
Authors: Whiteford Gail
Published: April 2015

Occupational deprivation is a relatively new term which describes a state in which people are precluded from opportunities to engage in occupations of meaning due to factors outside their control. As we face the new millennium, it seems likely that, due to widespread social and economic change as well as increasing civil unrest, occupational deprivation will be experienced by increasing numbers of people globally.

This article describes the conceptual origins of occupational deprivation, presents definitions of the term and discusses specific populations that may be vulnerable to being occupationally deprived. Global, contextual issues of economic reform and technological advances are addressed with specific reference to these populations. Finally, consideration is given as to how an understanding of occupational deprivation is of relevance to occupational therapy and its concern with social and occupational justice.
The Centrality of Occupation during Life Transitions
Authors: Blair Sheena E E
Published: April 2015

This article seeks to examine the nature and experience of transitions in life. It explores pertinent theoretical underpinning and considers the ways in which people manage and adapt to change. In particular, it attempts to synthesise the ideas from the psychology of transition with those from occupational science. Throughout, the article is informed by the contributions both from experiential workshops over the last 5 years (including one held at the Inaugural United Kingdom Occupational Science Symposium in York in 1999) and from students who have chosen an elective level 3 module entitled ‘Adult Development — Life Transitions and Crisis' in a BSc/BSc(Hons) Occupational Therapy programme. Among the conclusions from those experiences is the acknowledgement of the centrality and personal meaning of occupation at the point of transition.
Single-System Design: An Effective Strategy for Evaluating Clinical Change
Authors: Joshi Anjali S
Published: April 2015

Documentation and research are two essential factors for the growth of any profession and, therefore, have priority in occupational therapy. Documentation is the key to the communication of the clinical services rendered by the occupational therapist to clients and to other members of the professional team (Gillette 1982, Ottenbacher and York 1984).

Single-system research, sometimes referred to as single-subject research, is a quantitative research method. In single-system research, the efficacy of a certain intervention can be evaluated in a systematic way by studying one subject in a single setting (Ottenbacher 1984). A therapist can make use of any therapeutic technique to work in a single-system design.

Gillette (1982, p499) stated: ‘Each occupational therapy clinic is a virtually untouched laboratory, a storehouse of evidence that, properly recorded, analysed and published, would serve to confirm the value of occupational therapy as a health care service.’

This article describes the application of single-system design in a clinical setting. The client discussed was treated using sensory integrative therapy. The purpose of this article is to show how a selected behaviour can be recorded and measured effectively using a single-system design.
A Revised Occupational Therapy Definition of Client-Centred Practice
Authors: Sumsion Thelma
Published: April 2015

This paper reports on the second phase of a research project to determine a British occupational therapy definition of client-centred practice. Sixty-seven occupational therapists participated in nine focus groups, structured according to the nominal group technique. These groups involved therapists working in social services, mental health, learning disabilities, paediatrics, neurology, a wheelchair service and with elderly clients and there were two groups in general medicine.

A hundred and sixty-five components of client-centred practice were generated and subsequently analysed to form seven themes. Frequencies and medians of the components ranked in the top five were also calculated. In addition, three questions were asked to solicit opinions on the definition that was created in the first phase of this study and frequencies were also determined from these responses. All these data were used to inform revisions to the definition created in phase one. This revised definition was then reviewed by members of the Council of the College of Occupational Therapists as the final validating group. The resulting final definition will enable therapists to determine whether or not they are using a client-centred approach.
Rehabilitation in Severe Ideomotor Apraxia Using Sensory Stimulation Strategies: A Single-Case Experimental Design Study
Authors: Butler Jenny
Published: April 2015

This study was designed to evaluate the treatment of a young head-injured woman with ideomotor apraxia. An ABA (baseline, intervention, baseline) single-case experimental design was employed to evaluate the impact of sensory stimulation on motor performance, using a range of measures including a simple timed task and active finger and hand movements measured by goniometry.

A key finding was the extent of variance in performance day by day in both the baseline and intervention phases, although a reduction in that variability was achieved in the intervention phase of the study. Improvements were noted in motor performance across all the measures in the intervention phase of the study, although such improvements could not be attributed to sensory stimulation procedures alone. Improvements in motor performance were found immediately following sensory stimulation procedures, but no carryover was noted from one day to the next. This study suggests that practice in motor performance could enhance specific actions in people with ideomotor apraxia.
Can Entry Qualifications be Used to Predict Fieldwork and Academic Outcomes in Occupational Therapy and Physiotherapy Students?
Authors: Howard Lynne , Jerosch-Herold Christina
Published: April 2015

This paper examines the relationships between the entry qualifications and the fieldwork score, academic score and final degree score of a group of 168 occupational therapy and physiotherapy students.

The data were gathered from spreadsheets showing the results of students' practical and written assignments and their final degree score computed from these. Details of entry qualifications were obtained from students' personal files. Statistical analyses were carried out on the data obtained to support or refute hypotheses generated by the literature search.

It was found that the physiotherapy students with A-levels had higher average scores on entry than the occupational therapy students but that, over the 3 years of their degree, this discrepancy disappeared and there was no significant difference in either fieldwork score or final degree score between the two sets of students. A statistically significant difference was, however, found between the final academic scores of physiotherapy students entering with qualifications other than A-levels, mostly BTEC, and those with A-levels.

The results suggest that entry qualifications are poor predictors of both fieldwork and academic outcomes and support the School of Occupational Therapy and Physiotherapy at the University of East Anglia in its policy of a flexible approach to entry requirements; however, careful monitoring should be continued.