bluuebunny/crossref_metadata_2025 huggingface dataset:
“Bad jobs”: a case study of toilet attendants
Authors: Adriaenssens Stef , Hendrickx Jef
Published: March 2019

Purpose

The purpose of this paper is to contribute to the knowledge of precarious and low-quality jobs with the study of toilet attendants, an ideal typical case of low-wage manual service workers who are excluded from secure wages, decent working conditions, and employment protection.

Design/methodology/approach

An extensive survey with standardized questionnaires (n=107) and in-depth interviews (n=10) of toilet attendants in Belgian towns, mostly Brussels and Ghent. Results are compared to the work quality of low-skilled workers, and the within-group position of necessity workers is analysed.

Findings

Toilet attendants definitely occupy “bad jobs”, measured by the higher prevalence of informal and false self-employed statuses, more intense work-life conflicts and verbal aggression from clients, and a lower job satisfaction. In all these respects, they perform worse than other low-skilled workers. Concurrently, there is a strong within-group divide between necessity workers and those who see the job as an opportunity. Despite a similar job content, necessity workers less often earn a decent wage, suffer more from customer aggression, lack social support and pleasure from work. Mechanisms related to self-selection and the absence of intrinsic rewards explain these in-group differences.

Originality/value

This contribution indicates, first, that job insecurity spills over into poor working conditions, work-life conflicts, and customer aggression. Furthermore, it documents that jobs are not necessarily bad in themselves, but become problematic when taken up by people with too few choices and too pressing socio-economic needs. Problems of sub-standard jobs are not merely job problems but problems of workers in a certain position.
Foodservice quality in South African hospitals: patient experiences
Authors: Ncube Lindiwe Julia , Letsoalo Maupi Eric
Published: March 2019

Purpose

This paper presents an interpretive data analysis from a superordinate study that aimed to determine foodservice satisfaction. The purpose of this paper is to determine inpatient hospital foodservice experiences.

Design/methodology/approach

The authors used secondary data obtained from 419 respondents: (225 (53.70 per cent) males, 178 (42.48 per cent) females and 16 (3.82 per cent) undisclosed) participants. A comparative, quantitative and cross-sectional approach was applied to provide insight into hospital foodservice experiences. The Wilcoxon–Mann–Whitney test, interpreted at 0.05 error rate, was used to compare male and female patient experiences.

Findings

Male patients had significantly higher rank-sum scores than female patients in almost all items (p<0.0001). The study revealed that hospital personnel, especially foodservice staff, had an unsatisfactory communication approach.

Originality/value

This is the first South African study that compares female and male inpatient foodservice perceptions. Hospital managers and stakeholders may need to consider patient’s gender, as a significant factor that is associated with patient experiences, when embarking on improving foodservice systems.
Context matters: juvenile correctional confinement and psychosocial development
Authors: Schaefer Shelly , Erickson Gina
Published: March 2019

Purpose

The purpose of this paper is to investigate how adolescent arrest and correctional confinement impact psychosocial development during the transition to adulthood.

Design/methodology/approach

The research uses a US-based sample of 12,100 youth in junior and high school and again in early adulthood. Factor analyses determine measurement of psychosocial maturity (PSM) and subsequently compare baseline and subsequent psychosocial development in a multivariate framework for males and females.

Findings

Findings show that net of socio-demographic and delinquency-related controls, all three groups have similar baseline psychosocial measures pre-confinement but by early adulthood (ages 18–25) there are significant differences between the two justice-involved groups for multiple measure of psychosocial well-being, net of any differences at baseline. Differences are exacerbated for females.

Research limitations/implications

Results suggest the need for juvenile correctional facilities to incorporate programming that allows juveniles to build psychosocial skills through activities that mirror typical adolescent responsibilities, behaviors and tasks.

Originality/value

The authors compare PSM development for three groups of adolescents: non-justice-involved youth, youth who were arrested but not confined before age 18 (arrested non-confined), and delinquent youth who served time in out-of-home correctional placement before age 18 (confined) to compare development and changes in psychosocial development over time. Further, the authors examine the interaction of gender and confinement to explore if the context of confinement disrupts PSM development differently for females.
Vulnerability to domestic physical violence among married women in Indonesia
Authors: Putra I Gusti Ngurah Edi , Pradnyani Putu Erma , Parwangsa Ni Wayan Putri Larassita
Published: March 2019

Purpose

Due to the gender norms in Indonesia, married women are vulnerable to domestic violence perpetrated by their husband. With a paucity of studies on this issue, the purpose of this paper is to explore the vulnerability to domestic physical violence among married women in Indonesia by measuring the acceptance of being beaten by their husband and factors associated with married women’s approvals were also identified.

Design/methodology/approach

Secondary data analysis of three rounds of Indonesia Demographic and Health Survey in 2002/2003, 2007 and 2012 was performed. Data were analyzed descriptively to reveal the trend of women’s acceptance and binary logistic regression was applied to identify determinants.

Findings

Women’s acceptance of wife beating in some circumstances experienced an increase during 2002–2012. Determinants varied by type of beating justification. Overall, determinants fell into three groups of women’s, husband’s and household’s characteristics.

Originality/value

This study helps to identify determinants of women’s vulnerability to domestic physical violence and suggests some substantial approaches to address this pressing issue.
Barriers on access to and use of adolescent health services in Ghana
Authors: Abuosi Aaron Asibi , Anaba Emmanuel Anongeba
Published: March 2019

Purpose

The purpose of this paper is to explore perceived barriers to accessing and using adolescent health services in Ghana.

Design/methodology/approach

The study was a qualitative study adopting a case study design. In total, 24 adolescents were recruited from four adolescent health facilities in Tema, a suburb of Ghana, using convenient sampling. In-depth interviews with respondents were conducted coupled with the taking of field notes and personal observations. Data collection took place between January and May 2017. Data were transcribed, managed and coded for themes. Thematic analysis was guided by Braun and Clarke’s (2006) Framework.

Findings

The findings of this study revealed that majority of the respondents were females (54 percent) older adolescents (above 15 years (60 percent), students (79 percent)), had junior high school education and stayed with their biological parent(s) (70 percent). Adolescents in this study perceived four main barriers that restrict their access to or use of adolescent health services. The barriers were found at the facility level, provider level, community level and personal level.

Originality/value

The findings of this study provide evidence-based information for planning adolescent health care interventions that would improve adolescents’ access to and use of health services in Ghana.
A tale of two SMIPs: equity and fixed income
Authors: Howe Thomas S. , Kotomin Vladimir , Liao Min-Yu (Stella) , Varma Abhishek
Published: March 2019

Purpose

The purpose of this paper is to document and compare the characteristics of two student-managed investment funds at the University.

Design/methodology/approach

This study uses a case study approach to achieve this purpose.

Findings

Consistent with other studies, this study finds considerable differences in funding, oversight and the structure of the courses in which the students manage the portfolios. This is the case even though the portfolios are managed by students in courses offered by the same department at the same university.

Originality/value

This study presents different possible ways of obtaining funds and structuring courses in which the students manage investment portfolios.
Behavioral-related firm characteristics, risks and determinants of stock returns
Authors: Prombutr Wikrom , Phengpis Chanwit
Published: March 2019

Purpose

This paper aims to investigate a relatively new anomaly of investment growth and revisits well-known anomalies of size and value. It aims to answer two main research questions. First, can covariance risks (i.e. factor loadings) be excluded from being determining variables that drive return premiums and explain stock returns? Second, from a behavioral finance standpoint, the authors examine whether using firm characteristics is a more practical and accessible approach and also meets the necessary and sufficient conditions to analyze stock returns.

Design/methodology/approach

The authors create the investment-growth-based factor (LMH) which is defined as the return difference between low and high investment growth portfolios. The authors then incorporate the LMH factor along with other characteristic-based factors and their loadings into characteristic-balanced portfolio and three-factor model tests.

Findings

The authors find that covariance risks on investment growth, size and value are not necessary as determining variables. Instead, they find that behavioral-related firm characteristics of investment growth, size and value are necessary and sufficient as determinants of return premiums and stock returns.

Practical implications

The results have practical and useful implications for investors in their stock portfolio analysis and selection because firm characteristics are relatively more available than covariance risks that need estimation and typically contain measurement errors.

Originality/value

The paper has practical value to investors in their stock portfolio analysis and selection. Methodologically, in contrast to prior studies that do not directly use the investment growth to control for portfolio characteristics, the use of the newly created LMH factor and its loadings allows us to directly and properly test if the investment growth anomaly is related to the investment growth characteristic that is hypothesized to drive return premiums and determine stock returns from behavioral finance perspectives.
Time‐frequency decomposition of seismic signals via quantum swarm evolutionary matching pursuit
Authors: Semnani Amir , Wang Liang , Ostadhassan Mehdi , Nabi‐Bidhendi Majid , Araabi Babak Nadjar
Published: March 2019

Matching pursuit belongs to the category of spectral decomposition approaches that use a pre‐defined discrete wavelet dictionary in order to decompose a signal adaptively. Although disengaged from windowing issues, matching point demands high computational costs as extraction of all local structure of signal requires a large size dictionary. Thus in order to find the best match wavelet, it is required to search the whole space. To reduce the computational cost of greedy matching pursuit, two artificial intelligence methods, (1) quantum inspired evolutionary algorithm and (2) particle swarm optimization, are introduced for two successive steps: (a) initial estimation and (b) optimization of wavelet parameters. We call this algorithm quantum swarm evolutionary matching pursuit. Quantum swarm evolutionary matching pursuit starts with a small colony of population at which each individual, is potentially a transformed form of a time‐frequency atom. To attain maximum pursuit of the potential candidate wavelets with the residual, the colony members are adjusted in an evolutionary way. In addition, the quantum computing concepts such as quantum bit, quantum gate, and superposition of states are introduced into the method. The algorithm parameters such as social and cognitive learning factors, population size and global migration period are optimized using seismic signals. In applying matching pursuit to geophysical data, typically complex trace attributes are used for initial estimation of wavelet parameters, however, in this study it was shown that using complex trace attributes are sensitive to noisy data and would have lower rate of convergence.

The algorithm performance over noisy signals, using non‐orthogonal dictionaries are investigated and compared with other methods such as orthogonal matching pursuit. The results illustrate that quantum swarm evolutionary matching pursuit has the least sensitivity to noise and higher rate of convergence. Finally, the algorithm is applied to both modelled seismograms and real data for detection of low frequency anomalies to validate the findings.
Complex frequency‐shifted multi‐axial perfectly matched layer for frequency‐domain seismic wavefield simulation in anisotropic media
Authors: Zhao Zhencong , Chen Jingyi
Published: March 2019

Seismic anisotropy has an important influence on seismic data processing and interpretation. Although the frequency‐domain seismic wavefield simulation has a problem of solving the large scale linear sparse matrix due to the computational limitations, it has some advantages over the time‐domain seismic wavefield simulation including efficient inversion using only a limited number of frequency components and easy implementation of multiple sources. To accurately simulate seismic wave propagation in the frequency domain, we also need to choose the absorbing boundary conditions to absorb artificial reflections from edges of the model as we do in the time domain. Compared with the classical boundary conditions including the perfectly matched layer and complex frequency‐shifted perfectly matched layer, the complex frequency‐shifted multi‐axial perfectly matched layer has been proven to effectively suppress the unwanted reflections at grazing incidence and solve the instability problem in the time‐domain seismic numerical modelling in anisotropic elastic media. In this paper, we propose to extend the complex frequency‐shifted multi‐axial perfectly matched layer absorbing boundary condition to the frequency‐domain seismic wavefield simulation in anisotropic elastic media. To test the validity of our proposed algorithm, we compare the results (snapshots and seismograms) of the frequency‐domain seismic wavefield simulation with those of the time‐domain modelling. The model studies indicate that the complex frequency‐shifted multi‐axial perfectly matched layer absorbing boundary condition is stable in the frequency‐domain seismic wavefield simulation in anisotropic media, and provides better absorbing performance than the complex frequency‐shifted perfectly matched layer boundary condition.
The working alliance in stuttering treatment: a neglected variable?
Authors: Sønsterud Hilda , Kirmess Melanie , Howells Kirsten , Ward David , Feragen Kristin Billaud , Halvorsen Margrethe Seeger
Published: March 2019

Background

Multiple factors can influence the working alliance and treatment outcome in speech and language therapy. The ‘working alliance’ is an important concept in treatment and can be described as the degree to which a treatment dyad is engaged in collaborative, purposive work. To date, relatively little attention has been paid to this concept within speech and language treatment in general, and within stuttering treatment research in particular.

Aims

To investigate the role of the working alliance within stuttering treatment, and to evaluate whether the quality of the working alliance correlated with clients’ concept of motivation and treatment outcomes 6 months post‐therapy.

Methods & Procedures

Eighteen adults (21‐61 years) participated in this multiple single‐case treatment study, with treatment facilitated by an experienced speech and language therapist. The working alliance was investigated using the Working Alliance Inventory—Short Version Revised (WAI‐SR), an Extended version of the Client Preferences for Stuttering Treatment (CPST‐E), the Overall Assessment of Speakers’ Experience of Stuttering—Adult version (OASES‐A), the Wright & Ayre Stuttering Self‐Rating Profile (WASSP) and the Hospital Anxiety and Depression Scale (HADS).

Outcomes & Results

Analyses demonstrated significant associations between the working alliance and client motivation (r = 0.781) and treatment outcomes (r = 0.644) 6 months post‐treatment. The association between client‐led goals and therapy tasks appeared particularly important.

Conclusions & Implications

: The working alliance between speech and language therapists and persons who stutter matters. Within the alliance, the level of client–clinician agreement on treatment goals and therapy tasks may be of greater importance than the bond between client and clinician. Further research with greater numbers of participants is warranted.
Making space for ‘the social’: connecting sociology and professional practices in urban lighting design
Authors: Entwistle Joanne , Slater Don
Published: March 2019

Lighting is increasingly recognized as a significant social intervention by both lighting professionals and academic social scientists. However, what counts as ‘the social’ is diverse and contested, with consequences for what kind of ‘social’ is performed or invented. Based on a long‐term research programme, we argue that collaboration between sociologists and lighting professionals requires negotiating discourses and practices of ‘the social’. This paper explores the quality and kinds of spaces made for ‘the social’ in professional practices and academic collaborations, focusing on two case studies of urban lighting that demonstrate how the space of ‘the social’ is constrained and impoverished by an institutionalized division between technical and aesthetic lighting. We consider the potential role of sociologists in making more productive spaces for ‘the social’ in urban design, as part of the central sociological task of ‘inventing the social’ (Marres, Guggenheim and Wilkie 2018) in the process of studying it.
The mirror and the hammer: the politics of resacralization
Authors: Samuels Andrew
Published: March 2019

The paper consists of the opening chapter of Andrew Samuels’ book The Political Psyche, published in 1993, together with a retrospective introduction. In the chapter, the author discussed the possibilities and limitations of applying depth psychological thinking to social and political problematics. He situates the attempt to make such applications within a wider movement to refresh and reform Western political endeavours. He terms this wider project ‘resacralization’. The author cautions against psychological reductionism and a simplistic approach to market‐based capitalism, calling for a transformation of the latter to the degree possible. He links sociopolitical criticism and psychological writings on numinous experience, thereby connecting the worlds of politics and depth psychology without losing their separate and unique qualities.
The analyst and analysand as citizens in the world
Authors: Peresso Patrizia
Published: March 2019

Beginning with Jung's reflections on individuation as a starting point, this article examines the analytic relationship in the context of our current reality. The latter exerts pressures of all sorts that do not favour individuation. Indeed, geopolitical commentators see present‐day society as marked globally by excessive self‐love that seeks to dominate, at the expense of the other. Given that such forms of dominance are now also very prevalent in the workplace, this article examines how to help the increasing number of individuals with highly successful professional careers who suffer from this pressure and who then seek analysis. ‘Progressive movement’, an indicator of and incentive to change, is examined by studying the narrative processes emerging from dream activity ‐ including dreaming with the hands in the sand tray ‐ in the co‐transference. The article highlights how ‘progressive movement’, founded on narrative Competence and on the reflective function, may generate experiences of ‘realistic hope’. The latter signals the start of an individuation process in the analytic couple and, simultaneously, the transformation of both the analyst and the analysand into good enough ‘citizens in the world’.
The judicialisation of EMU politics: Resistance to the EU's new economic governance mechanisms at the domestic level
Authors: SAURUGGER SABINE , FONTAN CLEMENT
Published: March 2019

Courts are increasingly asked to deal with fundamental political disagreements in liberal democracies. Because of its political salience and the extent of its consequences, the crisis of the Economic and Monetary Union (EMU) has exposed such fundamental disagreements between and within its member states, which numerous plaintiffs have brought before domestic courts and the Court of Justice of the European Union (CJEU). This article analyses this judicialisation of the EMU crisis. Using a database on lawsuits introduced in all 28 member states with regard to crisis measures and the new EMU governance mechanisms introduced since 2010, the authors study which actors use the courts and under which circumstances. Based on a combination of judicialisation and political economy approaches, the article develops a series of assumptions on actors’ motivations in order to understand the reasons for judicialisation in debtor and creditor countries.
Iliopsoas Abscess in Hemodialysis Patients With End‐Stage Kidney Disease
Authors: Kawai Yusuke , Banshodani Masataka , Moriishi Misaki , Sato Tomoyasu , Shintaku Sadanori , Masaki Takao , Kawanishi Hideki
Published: March 2019

Iliopsoas abscess in HD patients is rare. We examined nine HD patients with iliopsoas abscess (six men and five diabetes mellitus cases) treated between 2005 and 2015. Mean age and dialysis vintage at onset were 72 years and 109 months, respectively. Of the nine patients, four had lumbar orthopedic diseases, and two had all components of the classic triad of iliopsoas abscess at onset. All nine patients underwent percutaneous drainage, while seven underwent antimicrobial therapy. The most common pathogenic bacterium was methicillin‐resistantStaphylococcus aureus(MRSA) (n = 5). Four patients had multilocular recurrence on the same side as the initial abscess and did not undergo CT before drainage catheter removal. Five patients died in the hospital, in which three died due to infectious diseases by MRSA. We suggest percutaneous drainage as the first‐line therapy for HD patients with iliopsoas abscess and recommend combining antimicrobial therapy for MRSA, because of poor prognosis.
Neferine in the Lotus Plumule Potentiates the Antitumor Effect of Imatinib in Primary Chronic Myeloid Leukemia Cells In Vitro
Authors: Zhang Yalan , Xiao Yuhang , Dong Qixing , Ouyang Wenjuan , Qin Qun
Published: March 2019

Imatinib, the prototype BCR‐ABL tyrosine kinase inhibitor (TKI), is the first‐line treatment for Philadelphia chromosome‐positive chronic myeloid leukemia (CML) in the chronic phase. However, a subgroup of patients exhibit poor response or experience relapse. This issue may be overcome by combination therapy using natural compounds. Neferine, a major bisbenzylisoquinoline alkaloid extracted from “lotus plumule” (seed embryo of lotus) commonly used in traditional Chinese medicine and tea, was used herein in the combination treatment of CML. The MTT assay showed that neferine exerted cytotoxicity in primary CML cells in a dose‐dependent manner. Moreover, low concentrations of neferine (4 and 8 µM) sensitized primary CML cells to imatinib (CI < 1), and significantly decreased its IC50 from 0.70 ± 0.10 to 0.32 ± 0.06 µM and 0.16 ± 0.02 µM, respectively. Cotreatment of neferine and imatinib significantly decreased the expression of BCR‐ABL protein and its molecular chaperone heat shock protein 90 (Hsp90) mRNA and protein levels, and further decreased phospho‐extracellular regulated protein kinase 1/2 (p‐Erk1/2) and myeloid cell leukemia (Mcl‐1) expression. These results suggest that neferine might be a potential imatinib sensitizer in CML treatment.

Practical application

In China, Lotus plumule, the green embryo of lotus, is used as a tea and as a source of herbal medicine in the treatment of anxiety, insomnia, spermatorrhea, and thirst. Additional, neferine, a bisbenzylisoquinoline alkaloid extracted from lotus plumule has been shown to have antitumor potential. Herein, the effect of neferine and imatinib cotreatment on primary CML cells obtained from CML patients was assessed, with a synergistic effect being observed between the two compounds. Therefore, neferine might be a promising natural compound to potentiate imatinib in CML patients.
Current understanding of the role of gut dysbiosis in type 1 diabetes
Authors: Abdellatif Ahmed M. , Sarvetnick Nora E.
Published: March 2019

Type 1 diabetes (T1D) is a chronic autoimmune disorder that results from destruction of the insulin‐producing pancreatic β‐cells. The disease mainly affects juveniles. Changes in the composition of the gut microbiota (dysbiosis) and changes in the properties of the gut barrier have been documented in T1D subjects. Because these factors affect immune system functions, they are likely to play a role in disease pathogenesis. However, their exact role is currently not fully understood and is under intensive investigation. In this article we discuss recent advancements depicting the role of intestinal dysbiosis on immunity and autoimmunity in T1D. We also discuss therapies aimed at maintaining a healthy gut barrier as prevention strategies for T1D.
Insecticidal activity of mixtures ofBacillus thuringiensiscrystals with plant oils ofSinapis albaandAzadirachta indica
Authors: Konecka Edyta , Kaznowski Adam , Tomkowiak Damian
Published: March 2019

The main purpose of this study was to determine the insecticidal activity of mixtures ofBacillus thuringiensiscrystalline toxins and plant substances that could contribute to create a new bioinsecticide of high efficiency. We decided to determine the toxicity of crystals ofB. thuringiensisMPU B9 isolate, azadirachtin (NeemAzal), mustard oil and their mixtures against lepidopteran pests:Cydia pomonella,Spodoptera exiguaandDendrolimus pini. The interaction of the components in mixtures against insects was evaluated and their utility in plant protection was assessed. The crystals and plant substances showed synergistic effect against all insect species. The occurrence of synergism between two components depended on the ratio of their concentration in mixtures. Slight amount of one of the components added to the mixture led to enhanced toxicity of the preparation. The supplementation of mustard oil withB. thuringiensistoxins from up to 0.3% of the mixture resulted in more than twofold higher observed mortality of L1 larvae ofD. piniin comparison with expected mortality. The beneficial insecticidal effect of the mustard oil and crystals mixture was also noted when crystals comprised up to 1.3% and from 7 to 20% against L1 caterpillars ofC. pomonellaand L3 larvae ofS. exigua, respectively. The insecticidal efficient effect was achieved when mixture ofB. thuringiensiscrystals and azadirachtin was used against the three species of lepidopteran pests. The combinations in which components interacted synergistically against caterpillars are potentially useful for making a new bioinsecticide for controlling lepidopteran pests in plant protection.
Neutrophil‐to‐lymphocyte ratio as indicator to severe complication after pancreaticoduodenectomy or distal pancreatectomy
Authors: Ida Mitsuru , Tachiiri Yuka , Sato Mariko , Kawaguchi Masahiko
Published: March 2019

Background

Pancreaticoduodenectomy and distal pancreatectomy are complex procedures with high rates of post‐operative complications. We evaluated the factors associated with post‐operative complications, focusing on pre‐operative hematologic markers such as the neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and prognostic nutritional index.

Methods

Data from patients (≥age 20) who underwent pancreaticoduodenectomy or distal pancreatectomy between January 2013 and December 2017 at a Japanese tertiary hospital were retrospectively reviewed. Patients who failed to complete the operation and those who underwent additional procedure were excluded. The primary outcome was reoperation and unplanned intensive care unit admission before first discharge, and secondary outcome was the length of hospital stay. Multivariate analysis was used to identify explanatory factors associated with post‐operative complications. The differences in length of hospital stay were compared with the Mann‐Whitney U test.

Results

Of 238 eligible patients, 208 with a median age of 71 years were included in the analysis. The median values [1st interquartile range, 3rd interquartile range] of the neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and prognostic nutritional index were 2.65 [1.69, 4.04], 247 [146, 407], and 46.0 [42.0, 49.7], respectively. Eleven patients (5.3%) experienced post‐operative complications. The neutrophil‐to‐lymphocyte ratio (odds ratio, 1.13; 95% confidence interval, 1.02‐1.26; P = 0.03) and blood loss volume (odds ratio per 100 mL, 1.11; 95% confidence interval, 1.00‐1.22; P = 0.039) were independently associated with post‐operative complications. Post‐operative complications contributed to longer hospital stays (19 [15, 28] vs 33 [22, 65] days, P = 0.005).

Conclusion

The neutrophil‐to‐lymphocyte ratio and blood loss volume were significantly associated with post‐operative complications, leading to prolonged hospitalization.
Cognitive and emotional impairments underpinning suicidal activity in patients with mood disorders: an fMRI study
Authors: Malhi G. S. , Das P. , Outhred T. , Gessler D. , John Mann J. , Bryant R.
Published: March 2019

Objective

Mood disorders are strongly associated with suicide, the prevention of which is predicated on timely detection of suicidal activity (ideation, behaviour). Building on our previous work, we sought to determine the nature of neural responses to an emotional‐cognitive task in patients with varying degrees of suicidal activity.

Method

Seventy‐nine patients with mood disorders were assessed clinically and scanned using fMRI. Neural responses to an Emotional Face‐Word Stroop task were compared with 66 healthy controls. We identified regions of interest from seven key networks and examined responses to incongruent stimuli (Happy face‐‘Sad’ word; Sad face‐‘Happy’ word).

Results

In comparison with healthy controls, patients had differential activity during both incongruent conditions. When examining for associations with suicidal activity within the patient group, those with higher scores had decreased default mode network activity for Happy face‐‘Sad’ word manipulation, and increased basal ganglia network activity for Sad face‐‘Happy’ word manipulation, after controlling for patient characteristics.

Conclusion

The fMRI findings suggest that suicidal activity in patients with mood disorders may be underpinned by cognitive–emotional deficits. These findings have implications for future suicide research and for achieving a deeper understanding of suicidal activity that may ultimately inform clinical detection and management.
Photovoice in aged care: What do residents value?
Authors: Miller Evonne , Buys Laurie , Donoghue Geraldine
Published: March 2019

Objectives

This paper visually explores older aged care resident's day‐to‐day lived experience, as well as providing a brief introduction to the participatory documentary photography method of photovoice.

Methods

Ten residents from one Australian residential aged care facility collaborated with researchers and care staff to photograph, reflect on and share their lives. Photographs were shortlisted in individual and group discussions.

Results

Residents' photographs and narratives provide a visual understanding of what they value. Photographs captured three core themes: the restorative joy of nature (frangipanis); active engagement through leisure activities (football); and the value of social interactions and connections, especially with fellow residents and staff (friendship).

Conclusions

As old age and aged care remain virtually invisible within popular visual culture, this research highlights the communicative value of participatory photography for challenging stereotypes, as well as the opportunities, challenges and value of visual methods with this cohort.
Precision medicine for the discovery of treatable mechanisms in severe asthma
Authors: Chung Kian Fan , Adcock Ian M.
Published: March 2019

Although the complex disease of asthma has been defined as being heterogeneous, the extent of its endophenotypes remains unclear. The pharmacological approach to initiating treatment has, until recently, been based on disease control and severity. The introduction of antibody therapies targeting the Type 2 inflammation pathway for patients with severe asthma has resulted in the recognition of an allergic and an eosinophilic phenotype, which are not mutually exclusive. Concomitantly, molecular phenotyping based on a transcriptomic analysis of bronchial epithelial and sputum cells has identified a Type 2 high inflammation cluster characterized by eosinophilia and recurrent exacerbations, as well as Type 2 low clusters linked with IL‐6 trans‐signalling, interferon pathways, inflammasome activation and mitochondrial oxidative phosphorylation pathways. Systems biology approaches are establishing the links between these pathways or mechanisms, and clinical and physiologic features. Validation of these pathways contributes to defining endotypes and treatable mechanisms. Precision medicine approaches are necessary to link treatable mechanisms with treatable traits and biomarkers derived from clinical, physiologic and inflammatory features of clinical phenotypes. The deep molecular phenotyping of airway samples along with noninvasive biomarkers linked to bioinformatic and machine learning techniques will enable the rapid detection of molecular mechanisms that transgresses beyond the concept of treatable traits.
Mood episodes are associated with increased cortical thinning: A longitudinal study of bipolar disorder type II
Authors: Zak Nathalia , Bøen Erlend , Boye Birgitte , Andreassen Ole A. , Doan Nhat Trung , Malt Ulrik F. , Westlye Lars T. , Elvsåshagen Torbjørn
Published: March 2019

Objectives

Previous studies found evidence for thinner frontotemporal cortices in bipolar disorder (BD), yet whether this represents a stable disease trait or an effect of mood episodes remains unknown. Here, we assessed the reproducibility of thinner frontotemporal cortices in BD type II, compared longitudinal changes in cortical thickness between individuals with BD type II and healthy controls (HCs), and examined the effect of mood episodes on cortical thickness change.

Methods

Thirty‐three HCs and 29 individuals with BD type II underwent 3T magnetic resonance imaging at baseline, as published previously, and 2.4 years later, at follow‐up. Cross‐sectional and longitudinal analyses of cortical thickness were performed using Freesurfer, and relationships with mood episodes from baseline to follow‐up were assessed.

Results

Individuals with BD type II had thinner left and right prefrontal and left temporal cortex clusters at follow‐up (all corrected P < 0.001), consistent with baseline results. Both groups showed widespread longitudinal cortical thinning, and patients had increased thinning in a left temporal cortex cluster compared to HCs (corrected P < 0.001). Patients with more (>2) depressive episodes between baseline and follow‐up had greater left temporal cortical thinning than patients with fewer depressive episodes (corrected P < 0.05). In addition, patients with more depressive episodes had greater thinning in bilateral ventromedial prefrontal clusters relative to HCs (uncorrected P < 0.05), yet these results did not survive correction for multiple comparisons.

Conclusions

Together, these findings support reduced frontotemporal cortical thickness in BD type II and provide the first preliminary evidence for an association between depressive episodes and increased cortical thinning.
Hypothalamic‐pituitary axis irradiation dose thresholds for the development of hypopituitarism in adult‐onset gliomas
Authors: Kyriakakis Nikolaos , Lynch Julie , Orme Steve M. , Gerrard Georgina , Hatfield Paul , Short Susan C. , Loughrey Carmel , Murray Robert D.
Published: March 2019

Background

Childhood brain tumour survivors who receive cranial radiotherapy undergo regular surveillance for the development ofhypothalamic‐pituitary (HP) axis dysfunction. Much less attention has been given to radiation‐induced hypopituitarism in patients with malignant brain tumours of adult onset.

Design

Retrospective cohort study.

Patients/Measurements

We assessed the effects of cranial radiotherapy (cXRT) on pituitary function in 58 adults (32 male) with gliomas distant to the HP axis. The XRT dose exposure at the HP axis was correlated with individual axis dysfunction to establish dose thresholds.

Results

Mean age at cXRT was 41.2 ± 10.9 years and duration of endocrine follow‐up 8.2 ± 5.2 years. Mean XRT dose to the HP axis was 35.9 ± 15.5 Gy. Overall prevalence of radiation‐induced hypopituitarism was 84.5%. GH, LH/FSH, ACTH and TSH deficiency were present in 82.8%, 20.7%, 19% and 6.9% of patients, respectively. Hyperprolactinaemia was noted in 10.3% (n = 6) and was persistent in one case. GH deficiency and “any degree of hypopituitarism” positively correlated with the radiotherapy dose to the hypothalamic‐pituitary axis. HP axis XRT dose thresholds for the development of GHD, LH/FSH, ACTH and TSH deficiency were established at 10, 30, 32 and 40.8 Gy, respectively. A gradual increase in the prevalence of all anterior pituitary hormone deficits was observed throughout the follow‐up period.

Conclusions

Hypopituitarism post‐cXRT in adults with gliomas is a frequent, progressive and dose‐dependent phenomenon. Dose thresholds suggest long‐term endocrine surveillance is important where the HP axis XRT dose is higher than 30 Gy. Identification of deficits to allow early and appropriate hormone replacement therapy is important to improve well‐being in these individuals with limited prognosis.
Ridge alterations after implant placement in fresh extraction sockets or in healed crests: An experimental in vivo investigation
Authors: Vignoletti Fabio , Sanz‐Esporrin Javier , Sanz‐Martin Ignacio , Nuñez Javier , Luengo Fernando , Sanz Mariano
Published: March 2019

Objectives

To study the early and late bone healing around implants placed according to a flapless immediate (test) or flapped delayed (control) implant surgical protocol.

Materials and methods

In eight beagle dogs, immediate and delayed implants were placed. Test and control implants were randomly assigned, and horizontal and vertical bone remodelling, as well as bone‐to‐implant contact (BIC), were assessed with histology at 2 and 8 weeks. Teeth were used as negative controls.

Results

Similar results were attained in the two groups when the vertical resorption of the buccal bone crest was evaluated (approximately 0.5 mm). On the other hand, a marked horizontal buccal bone resorption was observed. Immediate implants attained a thinner buccal bone crest as compared to the delayed implant and the tooth. De novo bone formation on the implant surface appeared to be more pronounced at delayed sites at 2 weeks, whereas at 8 weeks, no difference in BIC was observed.

Conclusions

Ridge alterations occurred at both implant placement protocols, with similar limited amounts of vertical buccal bone reduction and a pronounced horizontal bone reduction. The process of horizontal bone remodelling differed between the two surgical protocols.
In search of the most cost‐effective monitoring strategy for vestibular schwannoma: A decision analytical modelling study
Authors: Scholte Mirre , Hentschel Mayke A. , Hannink Gerjon , Kunst Henricus P. M. , Steens Stefan C. , Rovers Maroeska M. , Grutters Janneke P. C.
Published: March 2019

Objectives

To assess the cost‐effectiveness of frequently used monitoring strategies for vestibular schwannoma (VS).

Design

A state transition model was developed to compare six monitoring strategies for patients with VS: lifelong annual monitoring; annual monitoring for the first 10 years after diagnosis; scanning at 1‐5, 7, 9, 12, 15 years after diagnosis and subsequently every 5 years; a personalised monitoring strategy for small and large tumours; scanning at 1, 2 and 5 years after diagnosis and no monitoring. Input data were derived from literature and expert opinion. Quality‐adjusted life years (QALYs) and healthcare costs of each strategy were modelled over lifetime. Net monetary benefits (NMBs) were calculated to determine which strategy provided most value for money. Sensitivity analyses were performed to address uncertainty.

Results

Omitting monitoring is least effective with 18.23 (95% CI 16.84‐19.37) QALYs per patient, and lifelong annual monitoring is most effective with 18.66 (95% CI 17.42‐19.65) QALYs. Corresponding costs were €6526 (95% CI 5923‐7058) and €9429 (95% CI 9197‐9643) per patient, respectively. Lifelong annual monitoring provided the best value with a NMB of €363 765 (339 040‐383 697), but the overall probability of being most cost‐effective compared to the other strategies was still only 23%. Sensitivity analysis shows that there is large uncertainty in the effectiveness of all strategies, with largely overlapping 95% confidence intervals for all strategies.

Conclusions

Due to the largely overlapping 95% confidence intervals of all monitoring strategies for VS, it is unclear which monitoring strategy provides most value for money at this moment.
Alemtuzumab induction and belatacept maintenance in marginal pathology renal allografts
Authors: Sparkes Tracy , Ravichandran Bharath , Opara Onumara , Ugarte Richard , Drachenberg Cinthia B. , Philosophe Benjamin , Bromberg Jonathan S. , Barth Rolf N.
Published: March 2019

We performed a prospective, 12‐month, single‐center, nonrandomized, open‐label pilot study to investigate the use of belatacept therapy combined with alemtuzumab induction in renal allografts with preexisting pathology, as these kidneys may be more susceptible to additional toxicity when exposed to calcineurin inhibitors posttransplant. Nineteen belatacept recipients were matched retrospectively to a cohort of tacrolimus recipients on the basis of preimplantation pathology. The estimated glomerular filtration rate was not significantly different between belatacept and tacrolimus recipients at either 3 or 12 months posttransplant (59 vs 45, P = 0.1 and 56 vs 48 mL/min/1.72/m2, P = 0.3). Biopsy‐proven acute rejection rates at 12 months were 26% in belatacept recipients and 16% in tacrolimus recipients (P = 0.7). Graft survival at 1 year was 89% in both groups. Alemtuzumab induction combined with either calcineurin inhibitor or costimulatory blockade therapies resulted in similar acceptable one‐year outcomes in kidneys with preexisting pathologic changes. Longer‐term follow‐up may be necessary to identify preferential strategies to improve outcomes of kidneys at a higher risk for poor function (ClinicalTrials.gov—NCT01496417).
Clinical outcomes in HIV+/HCV+ coinfected kidney transplant recipients in the pre‐ and post‐direct‐acting antiviral therapy eras: 10‐Year single center experience
Authors: Camargo Jose F. , Anjan Shweta , Chin‐Beckford Nafeesa , Morris Michele I. , Abbo Lilian M. , Simkins Jacques , Ciancio Gaetano , Chen Linda J. , Burke George W. , Figueiro Jose , Guerra Giselle , Kupin Warren L. , Mattiazzi Adela , Ortigosa‐Goggins Mariella , Ram Bhamidimarri Kalyan , Roth David
Published: March 2019

Background

Previous studies have demonstrated inferior patient and graft survival following kidney transplant (KT) in HIV+/HCV+ coinfected patients compared to HIV+/HCV− recipients. However, these studies were conducted prior to the availability of direct‐acting antiviral (DAA) agents and data in the modern era are lacking.

Methods

Single center retrospective study of HIV+/HCV+ coinfected KT recipients (2007‐2017). Outcomes were assessed for the pre‐DAA and post‐DAA (ie, after December 2013) eras including 1‐year patient survival, death‐censored graft survival, and acute rejection; and serious infections (defined as infections requiring admission to the intensive care unit during initial transplant hospitalization or re‐admission to the hospital after discharge) within the first 6 months post‐transplant.

Results

A total of 13 consecutive HIV+/HCV+ recipients were identified. Median time of post‐transplant follow‐up was 722 days. Seven patients were transplanted in the DAA era; five of them had anti‐HCV Ab+ donors, with two donors being HCV NAT positive; all received DAA therapy, six of them post‐transplant (median time from KT to DAA: 83 days; IQR, 54‐300). All the patients in the pre‐DAA era were on a protease inhibitor‐containing ART regimen. One‐year patient and death‐censored graft survivals were 83% and 67%, respectively, for the patients transplanted in the pre‐DAA era, and 100% for both outcomes in the subgroup of patients transplanted in the post‐DAA era (P > 0.05). Compared to patients in the post‐DAA era, those in the pre‐DAA era had higher incidence of serious infections (0 vs 67%; P = 0.02). Acute rejection exclusively occurred in the pre‐DAA group (n = 1; 17%).

Conclusions

Outcomes of HIV+/HCV+ KT recipients, including HIV−/HCV+ to HIV+/HCV+ transplants, in the DAA era were excellent in this small cohort. Larger studies are needed.
China’s rapidly evolving practice of poverty resettlement: Moving millions to eliminate poverty
Authors: Rogers Sarah , Li Jie , Lo Kevin , Guo Hua , Li Cong
Published: March 2019

Motivation

Unlike other places where resettlement is largely a by‐product of large infrastructure projects, in China resettlement is used as a tool for poverty alleviation. With the introduction of Xi Jinping’s Targeted Poverty Alleviation, and the goal to end absolute poverty by 2020, resettlement has become central to China’s poverty‐alleviation practice. Rather than investing in dispersed, remote villages, the Chinese government prefers to bring people to development by constructing high‐density resettlement sites in small towns and peri‐urban areas: up to 16 million people are being resettled between 2016 and 2020. Despite the scale of these interventions, the English‐language literature on poverty resettlement is limited and has yet to detail rapidly evolving policies or how these are playing out on the ground.

Purpose

In this article we examine how poverty resettlement projects are working under Targeted Poverty Alleviation, with a focus on the implementation and impacts of, as well as overlapping motives for, projects in Shaanxi and Gansu.

Approach and Methods

Our analysis draws on semi‐structured interviews and secondary data collected in multiple sites in two provinces.

Findings

Our findings show that China’s intense focus on resettlement as a tool for poverty alleviation has resulted in reduced financial burdens on those resettled, but is also engendering new conflicts at the local level.

Policy implications

Our analysis highlights the contested nature of state‐driven resettlement for poverty alleviation and raises questions about the relevance of this practice for other developing countries.