bluuebunny/crossref_metadata_2025 huggingface dataset:
Conceptualizing Political Consumerism as Part of the Global Value Chain
Authors: Fridell Gavin
Published: May 2018

The globalization of production chains has triggered an abundance of political consumer campaigns aimed at promoting global social and environmental responsibility. What is the most effective way to conceptualize and gauge the impact of these campaigns? This chapter explores these issues through an examination of the global value chain (GVC) and similar approaches used to assess the impact of codes of conduct and corporate social responsibility on the production end of the chain. After summarizing key GVC research, the discussion examines a range of critiques of both the GVC approach and the limits of political consumerism. The conclusion reflects on two different frameworks, the system of provision and global poverty chain approaches, which provide foundational critiques of GVC analysis and open new paths for research and ways to rethink political consumerism and the globalization of production and consumption.
Political Consumerism and Nationalist Struggles in Europe
Authors: Lekakis Eleftheria J.
Published: May 2018

This chapter explores the intersection between political consumerism and nationalism through three cases of nationalist struggles in Europe. It outlines how political consumerism can and has been used for democratically dubious purposes and argues that political consumerism can also lend itself to politics that are not always progressive. First, the chapter theorises political consumerism and nationalism through questioning the ideological basis of nationalism, as well as the relationship between banal nationalism and everyday nationhood. It then explores the methodological approaches and challenges to studying this intersection before it commences on a close examination of three cases: a boycott halal campaign in England, a Catalan boycott in Spain, and a German boycott in Greece. Located at different societal levels of struggle (local, regional, and national), these cases illustrate contradictions and tensions in the intersection between political consumerism and nationalism, illustrating the ideological ambiguity inherent in nationalism.
“Buy White—Stay Fair”
Authors: Affeldt Stefanie
Published: May 2018

This historical chapter investigates two examples of racist political consumerism in early-twentieth-century Australia. It found expression in a locally particular form known as the White Sugar campaign, which declared consumption of cane sugar a moral duty for everyone in support of White Australia. Meanwhile, the Buy Australian-Made campaign called on Australian consumers to express their national pride by consuming locally manufactured products. Both campaigns drew on broader logics of commodity racism that, praising white supremacy and subscribing to ideologies of national progress, welded together everyday culture with the political programme of the time and contributed to the emergence of an imagined racist community of consumers.
Advice in Mentoring Relationships in Organizations
Authors: Kim Do-Yeong , Son Sujin
Published: May 2018

This chapter advances understanding of the advice-taking behavior of protégés during the mentoring process in organizations. First, it reviews the extant literature regarding mentoring relationships in general. Next, it examines the possible key factors that influence protégés’ advice-taking behavior in mentoring relationships. Finally, it discusses directions for future research. Possible key factors influencing protégés’ advice-taking behavior in mentoring relationships are suggested, including mentor characteristics (mentor status and learning-goal orientation), protégé characteristics (cultural orientation and learning goal-orientation), and relational characteristics (relationship quality and trust in mentors).
Advice in the Workplace
Authors: Bonaccio Silvia , Paik Jihyun Esther
Published: May 2018

This chapter reviews research related to the role of advice in workplace interactions. Indeed, advice is a ubiquitous aspect of work processes, and it is commonly sought, purchased, and received. The chapter first defines advice, reviews the benefits of advice taking, and explain findings related to advice discounting. In discussing factors that influence such behavior, the focus is on advisor characteristics (e.g., expertise, intentions, and confidence) and then on psychological states and traits of the decision maker that influence the receipt of advice. Next, the chapter discusses topics that are particularly important in the context of workplace relationship in relation to the aforementioned factors, which include seeking and purchasing advice, advisor motives, unsolicited advice, and withholding advice. The chapter concludes with methodological observations and ideas for future research, as well as with advice on giving advice.
Advice Giving and Advice Resistance on Telephone Helplines
Authors: Hepburn Alexa , Shaw Chloe , Potter Jonathan
Published: May 2018

This chapter overviews research on advice in telephone helplines and considers some of the implications for application. It shows that by working with some basic features of advice delivery highlighted by conversation analysts, we can start to understand several elements of the different ways in which advice can be delivered. This also applied to some of the ways in which resistance is built. With respect to helplines, call takers typically are highly knowledgeable about the technical arena in which the call center is based, whereas callers have primary access to their financial situation, housing, locality, and all the myriad details of their lives. The chapter shows how these knowledge asymmetries and other delicate moral implications of giving and receiving advice, such as the way it imposes on recipients some future action that is appropriate, beneficial, required, and so on, can have important effects on both advice delivery and resistance.
Business Advice
Authors: Bonner Bryan , Meikle Nathan L. , Bain Kristin , Shannahan Daniel
Published: May 2018

This chapter frames the transfer of advice as a special case of traditional cooperative decision making, in which group members proffer preferences (advice) to one another as a means of reaching consensus. Although the transfer of advice differs from group decision making on a number of acknowledged factors, the underlying processes of the two are analogous, such that the group decision-making literature can usefully inform the study of advice. Using this theoretical perspective, the chapter examines how advice is offered and accepted as a function of demonstrability—that is, the degree to which a decision environment facilitates shared conceptual systems, the willingness and ability to include the input of others in one’s decision making, and the willingness and ability of those with expertise to attempt to transfer their knowledge to others. This understanding is then applied to two cases: the craft beer industry and travel hacking. Best practices in business are discussed.
Advice in Families
Authors: Hill Cassandra Carlson
Published: May 2018

This chapter examines what is known and what requires further exploration in research on advice in family communication. Research about advice in families is largely drawn from human development, family therapy, and psychology, with only a few studies grounded in theories of advice and family communication. This chapter provides a synthetic review of this research, emphasizing who provides advice and how it functions across different types of familial relationships. The chapter also highlights relevant theoretical frameworks, including advice response theory, the integrated model of advice, and family systems theory. Finally, the chapter offers guidance specifically relevant to family members giving and receiving advice.
Timbrality
Authors: van Elferen Isabella
Published: May 2018

Timbre is both an unstable object and an ungraspable Kantian thing-in-itself: in fact, it resides in the space between those opposites. A theory of timbre, therefore, has to be inclusive rather than dualist: tone color bridges the gap between material origins and immaterial effects of musical sonority, and with that, the gap between the realism and the idealism informing music epistemological debates. This chapter aims to achieve such theoretical inclusiveness. It links timbral ontology and phenomenology by way of vibratory acoulogy and vital materialism. It argues that timbre is a vibration of sound waves crossing over from instruments to our listening bodies, and that the energy carried by those vibrating sound waves can be theorized as an affectively powerful vitality interacting with musical assemblages of humans and non-humans.
Tracking Jesuit Psychologies
Authors: Alfieri Fernanda
Published: May 2018

This chapter analyzes forms, meanings, and functions of psychology in the history of the Society of Jesus. Interpreted as an interest for the interior dimension of the subject, psychology is an implicit and multifaceted presence in the Ignatian order. The examination of the self is the first step for those who desire to enter the Society of Jesus, and the obedience imperative is a characterizing feature of the regulation in the Society. If psychology is given the meaning of the science of the soul as the life principle, then it can be tracked down not only in philosophical works providing the basics for the curriculum in the Jesuit colleges since the late sixteenth century but also in the coeval practical science of moral theology. Only after the late nineteenth century, with the emergence of experimental psychology, did the discipline obtain its own place in Jesuit episteme, between continuity and rupture.
The Age of Suppression
Authors: Guasti Niccolò
Published: May 2018

Although the Society of Jesus was no stranger to local suppressions and banishments that had studded its history from the beginning, the Jesuit crises that broke out between the 1750s and 1768—the expulsion from Portugal and the Bourbon States (France, Spain, King of Naples, and Duchy of Parma)—culminated in a dramatic event of far more enduring global impact: the suppression of the order by Pope Clement XIV with a specific brief (Dominus ac Redemptor, 1773). During the age of suppression (1773–1814), many Jesuits managed to maintain a memory of their former identity while carving out successful new careers or continued, relatively untroubled, with their existing intellectual and religious endeavors. Some of these gave a crucial contribution to Europe’s intellectual and cultural life between the 1770s and 1820s. The worldwide restoration of the Society took place on August 7, 1814, when Pius VII signed the bull Sollicitudo omnium ecclesiarum.
A Jesuit Way of Being Global?
Authors: Gugelot Frédéric
Published: May 2018

The Jesuits were important actors in the Catholic Church in the 1960s when changes in Catholicism occurred before and after the Second Vatican Council (1962–1965). The members of the Society of Jesus were active participants in movements calling for the “inculturation” of Christianity and the “liberation theology” coming from the Third World, two sides of the same process of globalization of Catholicism. It is from this time onward that the center of gravity moved away from Rome to South America, Asia, and Africa. The Jesuits also participated in the transition from a triumphant church to a church based on service to the poor. This is the social, cultural, and theological background in which the future pope Francis, the first Jesuit pope, spent the early years of his ecclesiastical career.
Elites and the Constitution of Jesuit Identity
Authors: Goujon Patrick
Published: May 2018

The attitude of Jesuits toward elites sheds light on their relationship to society at large, considered as a relationship between an “interior” and an “exterior”: the “interior” projects itself toward the “exterior” in its mission, while the “exterior” is attracted toward the “interior” to ensure recruitment (vocations) and financial and political support (apostolic foundation). The Society of Jesus, as a religious order, a religious utopia, enlists the elite in two ways: not only interior to its ranks but also towards the exterior, and not only as potential recruits (vocation) or support (foundation) but also in making them, by means of the colleges, a way of attaining the objective of contributing to the “common good.” Jesuits integrate and invert the values of the elite, maximizing their qualities in the service of a social project serving the poor: the just governance of society.
Valuing Water in Supply Chains
Authors: Brabeck-Letmathe Peter , Vousvouras Christian A. , Vionnet Samuel
Published: May 2018

Acknowledging the economic value of water provides incentives to prioritize water uses society deems important. However, there is a lack of understanding of the costs water tariffs should cover to enable its environmentally, socially, and economically sustainable use. Nestlé uses different tools to orient its business regarding water, including water scarcity indices and the notional cost of water. A new methodology to determine the cost of water stewardship could become a game changer. Unlike current practice, where externalities of water are calculated ex-post, this methodology guides decision makers to better pricing decisions prior to the occurrence of negative externalities, based on the observed gap of financing. Preliminary results indicate that, first, urban water tariffs seem higher than the full cost of water stewardship; second, we often overestimate the financial means required to close the water supply-demand gap; third, costs of action upon water challenges are lower than the costs of inaction.
Global Food Trade and Local Water Resources
Authors: Hoekstra Arjen
Published: May 2018

Given that food production requires a lot of water, more than any other economic sector, one would expect that the world’s food production concentrates in places where water is relatively abundant. This chapter, however, highlights the paradox that various water-poor countries produce food for export to water-rich countries. Food commodity prices do not reflect the cost of water inputs or of damaged water ecosystems, so that the global food market lacks economic incentives to source from places with less harmful impacts on local water systems. The costs of ‘traded’ embedded water thus remain invisible. The chapter proposes an international water label for water-intensive products and argues that international trade rules should include regulations on sustainable water use.
Understanding Well-Being
Authors: Sayer Faye
Published: May 2018

In the last decade well-being has become a central theme in political and public discussions; it has also filtered into professional dialogue pertaining to the methods and practice of heritage. This chapter examines how heritage practice can support political agendas and positively impact on individual and community well-being. This chapter outlines a humanistic approach to heritage practice, applying public health perspectives to enable the use of heritage as a tool for social change. It provides an evaluation strategy for heritage projects, a toolkit to demonstrate the impact of heritage on well-being and on wider government policy and practice. The suggestions here offer internationally applicable guidelines and strategies for future best practice for heritage projects. They highlight that, at this critical juncture in well-being policy and practice, it is essential that the heritage sector quantitatively and qualitatively proves its value and changes its practices to support this global societal goal.
Neoliberalism and the Equivocations of Empire
Authors: McGuigan Jim
Published: May 2018

The British Empire has been through several phases of ideological grace and disgrace. When it folded during the post–Second World War period there was widespread public awareness of terrible atrocities and great harm caused by the British in their former colonial territories. Pride in the past achievements of Empire, however, has re-emerged today alongside continuing recognition of its evils, perhaps serving to inoculate against really searching criticism and the virus of oppositional discourse to the typical operations of geopolitical power under neoliberal conditions. These matters raise serious issues to do with memorialization in public heritage.
American Bodylore and Folk Dress
Authors: Milligan Amy K.
Published: May 2018

Bodylore includes the ways in which the body is used as a canvas for inherited and chosen identity. Bodylore considers the symbolic inventory of dress and hair, addressing a range of identities from conservative religious groups like the Amish and the Hasidim to edgy goth and punk devotees. The body is scripted in portrayals of race, ethnicity, gender, age, religion, and politics, including such topics as tattoos, piercing, scarification, hair covering and styling, traditional and folk dress, fashion, and body modification. The central bodylore questions are whether individuals choose consciously or subconsciously to engage with their performative body, as well as why the body is often overlooked as a text within academic studies. This essay identifies the body as a malleable folkloric space, allowing for its symbols to function in both personal and public ways.
Folklore and Folklife of Body, Neurodiverse, and Ability-Centered American Identities
Authors: Bock Sheila
Published: May 2018

Bodily and mental attributes marked as “abnormal” have served as the basis of a diverse range of folk groups. This chapter presents an overview of how folklorists have studied these groups, offering insight into how outsiders respond to them through folklore and how insiders use traditional folk expressions to respond to their experiences with stigma. It also identifies emerging work within folklore and folklife studies attending to the “stigmatized vernacular” and its applicability to the study of body, neurodiverse, and ability-based identities. Finally, it considers the embodied nature of vernacular performances in relation to body-based identities, offering examples of how the physical body itself can serve as a rich communicative resource for re-envisioning and revaluing stigmatized group identities.
Devolution
Authors: Mitchell James
Published: May 2018

This chapter attempts to draw out comparisons and make sense of devolution as a UK-wide phenomenon. Devolution has taken a variety of forms at different times in different parts of the UK. A key aim of the chapter is to describe these varieties and explain why no common form of devolution emerged. Devolution may be a form of constitutional development but it has always been linked to wider socio-demographic and economic developments as much as to the sense of collective identities. Some interpretations emphasize the role of national identity in the demands for devolution in Scotland and Wales while others lay more emphasis on differences in political preferences that stimulated demands for self-government. No understanding of the politics of devolution is complete without an appreciation of the roles of identity, the party systems, political and public policy preferences, and how these changed over time.
Ideology in Action
Authors: Nuttall Jeremy
Published: May 2018

This chapter explores what its author sees as three of the most important, and closely related, recent historiographical themes relating to the articulation but also the impact of British political ideas since 1800: political realities, modernity, and moralities. The chapter analyses the close connections and interplay between these three initially seemingly uncomfortable bedfellows, and argues that collectively they have produced a contemporary historiography that, in crossing boundaries in its consideration of cultural, social, and intellectual history; ideas and action; popular and elite attitudes; high ideals; but also sometimes painful realities, is now richer in its understanding of all of these.
The Role of the Politician in the Democratic Regime
Authors: Crowcroft Robert
Published: May 2018

This chapter presents a view of the role played by politicians within the British democratic regime in the period since 1800. It ponders some important recent trends in the writing of political history, and welcomes signs that the ‘crisis’ of political history appears to be passing. From there, the chapter discusses the nature of the system in which politicians operated, and, by extension, the way in which politicians were compelled to act. Moreover, it presents a way of thinking through the problem of political history that is somewhat at odds with the left-wing interpretations that have tended to shape the field. It concludes by expressing the hope that younger scholars will reclaim the disciplinary pre-eminence that political history once enjoyed.
Dialectical Behaviour Therapy with Parents, Couples, and Families to Augment Stage 1 Outcomes
Authors: Fruzzetti Alan E.
Published: May 2018

A transactional understanding of problem behaviours recognizes that parents, partners, and other loved ones can often be very relevant to the chain of a client’s self-harm, suicidal behaviour, aggression, and other targets. Because the role of family members is important but often neglected, this chapter focuses primarily on DBT family skills interventions relevant to patient life-threatening behaviours. However, these interventions can readily be adapted for other targets later in treatment. This chapter outlines circumstances under which DBT family interventions might be particularly useful, specific targets to be addressed, rules to establish a treatment target hierarchy, a general protocol for how to conduct a family session, and helpful family session management strategies. DBT family interventions provide an efficient way to augment individual outcomes in DBT and create a more validating family environment that is beneficial for both the client and his or her loved ones.
Gender Dysphoria
Authors: Castellini Giovanni , Mancini Milena
Published: May 2018

Gender dysphoria (GD) is defined as the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender. Gender membership refers to an individual’s sense of self as male or female, and it is a fundamental component of our general identity, providing a sense of biographical continuity. The GD condition highlights the dichotomy and the contradictions of the post-modern society between anatomical body and gender identity. The psycho-social perspective maintains that the sex category assigned at birth is simply a first guess as to what identity we will later assume. Indeed, male and female are not seen as the only possible gender identities, and they need not to be regarded as mutually exclusive. This interpretation suggests that gender identity may be a more important marker of personhood and self-identity than anatomical sexual identity.
The “New Turkey” At Home and Abroad
Authors: Bâli Asli Ü.
Published: May 2018

This chapter examines the reversal of Turkey’s trajectory over the last fifteen years. It addresses the domestic transformation of Turkey through constitutional reforms, shifting civil–military relations, economic growth, corruption, ethnic conflict, and the relationship between religion and state. Examining these issues helps to explain why Turkish politics has become more polarized, and how this has been manipulated by the governing party to consolidate a majoritarian system and to crack down on dissent. The chapter then traces changes in Turkey’s foreign policy as it moves away from prioritizing relations with Washington and Brussels and seeks to forge a more multifaceted set of regional policies. This has failed for a number of reasons, including the Arab uprisings and the Syrian civil war. Instead, the government has embraced a “Eurasianist” turn aligning Turkey with authoritarian regimes in the Caucasus and the Arabian Gulf, in keeping with the country’s increasingly repressive domestic politics.
A Retrospective and Prospective Examination of Cognitive Strategies and Academic Development
Authors: Alexander Patricia A. , Peterson Emily Grossnickle , Dumas Denis G. , Hattan Courtney
Published: May 2018

This article offers a retrospective and prospective analysis of the role of cognitive strategies in students’ academic development over the past 25 years. The focus is on those processes that individuals employ to advance their own learning and understanding (learning strategies) and, to a lesser degree, those procedures applied to regulate and monitor that learning and understanding (metacognitive or self-regulatory strategies). Drawing on a groundbreaking review from 1988, the article examines how students’ epistemic beliefs—their beliefs about knowing and knowledge—may affect strategic engagement. It also considers students’ motivations or emotions that accompany learning and academic development and, therefore, strategic processing. Finally, it describes strategies associated with online learning, the barriers to being strategic in classrooms, and situations in which teachers and students can foster strategic thinking.
Gabapentin for the Treatment of Vulvodynia
Authors: Brown Candace S. , Bachmann Gloria A. , Wan Jim , Foster David C. ,   for the Gabapentin (GABA) Study Group
Published: May 2018

OBJECTIVE:

To evaluate whether extended-release gabapentin is more effective than placebo among women with vulvodynia.

METHODS:

In a multicenter double-blind, placebo-controlled randomized crossover trial, gabapentin (1,200–3,000 mg/d) was compared with a placebo. The primary outcome was mean pain intensity (0, no pain at all to 10, worst pain ever) on the tampon test (a standardized tampon insertion and removal test used as a surrogate marker for dyspareunia) during the last 7 days of the maintenance phase. Secondary outcomes included sexual intercourse pain and daily pain. A sample size of 53 provided 90% power to detect a 1-point reduction on the tampon test (.05 level, two-sided) between the two treatment phases.

RESULTS:

From August 2012 to January 2016, 230 women were screened at three academic institutions and 89 (mean age 37 years; 65% black) were randomized: 45 to gabapentin first and then placebo and 44 to placebo first and then gabapentin. Tampon test pain with gabapentin was not different compared with the placebo (adjusted mean 4.0, 95% CI 3.0–4.9 vs 4.3, 95% CI 3.4–5.2, difference −0.3, 95% CI −0.7 to 0.0; P=.07). Gabapentin also did not improve pain over placebo for sexual intercourse pain (adjusted mean 3.9, 95% CI 2.4–5.3 vs 4.0, 95% CI 2.5–5.4, difference −0.1, 95% CI −0.9 to 0.6; P=.76) and daily pain (adjusted mean 2.7, 95% CI 1.8–3.6 vs 2.9, 95% CI 2.0–3.8, difference −0.2, 95% CI −0.5 to −0.2; P=.36). Subset analyses found that longer pain duration and oral contraceptive nonuse were associated with minimal improvement in tampon test pain with gabapentin.

CONCLUSION:

In this cohort, extended-release gabapentin, as compared with a placebo, did not reduce tampon test pain. These data do not support the recommendation of gabapentin alone as treatment for vulvodynia.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT01301001.
Cost Determinants in the 90-Day Management of Isolated Ankle Fractures at a Large Urban Academic Hospital
Authors: Varacallo Matthew A. , Mattern Patrick , Acosta Jonathan , Toossi Nader , Denehy Kevin M. , Harding Susan P.
Published: May 2018

Objectives:

To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution.

Design:

Retrospective cohort study.

Setting:

Level I Trauma Center.

Patients:

Two hundred ninety-nine patients undergoing open reduction internal fixation for the treatment of an acute, isolated ankle fracture between 2010 and 2015.

Intervention:

None.

Main Outcome Measures:

Independent risk factors for increasing 90-day EOC costs and unplanned hospital readmission rates.

Results:

Orthopaedic (64.9%) and podiatry (35.1%) patients were included. The mean index admission cost was $14,048.65 ± $5,797.48. Outpatient cases were significantly cheaper compared to inpatient cases ($10,164.22 ± $3,899.61 vs. $15,942.55 ± $5,630.85, respectively, P < 0.001). Unplanned readmission rates were 5.4% (16/299) and 6.7% (20/299) at 30 and 90 days, respectively, and were often (13/20, 65.0%) due to surgical site infections. Independent risk factors for unplanned hospital readmissions included treatment by the podiatry service (P = 0.024) and an American Society of Anesthesiologists score of ≥3 (P = 0.017). Risk factors for increasing total postdischarge costs included treatment by the podiatry service (P = 0.011) and male gender (P = 0.046).

Conclusions:

Isolated operative ankle fractures are a prime target for EOC cost containment strategy protocols. Our institutional cost analysis study suggests that independent financial clinical risk factors in this treatment cohort includes podiatry as the treating surgical service and patients with an American Society of Anesthesiologists score ≥3, with the former also independently increasing total postdischarge costs in the 90-day EOC. Outpatient procedures were associated with about a one-third reduction in total costs compared to the inpatient subgroup.
Immuno-oncologic Approach to Musculoskeletal Tumors
Authors: Ibe Izuchukwu , Sahlstrom Adam , Nguyen Minh N. , Lindskog Dieter , Friedlaender Gary E. , Lee Francis Y.
Published: May 2018

The landscape of orthopedic oncology is rapidly changing. These changes have been prompted by the stagnation of outcomes in the treatment of bone and soft tissue sarcomas, paving the way for molecular and immunologic treatment options in the management of these malignancies. Immuno-oncologic therapy or immunotherapy has led to improved outcomes for patients with cancer. Immunotherapy involves activating the immune system and an individual’s immune system to combat malignant cells. This method is effective because cancer cells proliferate by evading the immune system while they enlarge and spread to distant sites. Immunotherapy focuses on these methods of evasions, and interrupts these pathways. Prevention of the evasion of a host immune surveillance by the cancel cells inevitably leads to an active immune response against the tumor, decreased tumor burden, improved outcomes or cure. The comprehension of the underlying mechanisms associated with immune therapy is paramount, and an asset to the orthopedist in the treatment of cancer. This understanding will help provide comprehensive care for our patients in this era of precision medicine.
Duration of Respiratory Failure After Trauma Is Not Associated With Increased Long-Term Mortality
Authors: Cook Mackenzie R. , O’Connell Kathleen , Qiu Qian , Riggle Andrew J. , Shoultz Thomas H. , Maine Rebecca G. , Arbabi Saman , O’Keefe Grant E. , Cuschieri Joseph , Maier Ronald V. , Robinson Bryce R. H.
Published: May 2018

Objectives:

Although 1-year survival in medically critically ill patients with prolonged mechanical ventilation is less than 50%, the relationship between respiratory failure after trauma and 1-year mortality is unknown. We hypothesize that respiratory failure duration in trauma patients is associated with decreased 1-year survival.

Design:

Retrospective cohort of trauma patients.

Setting:

Single center, level 1 trauma center.

Patients:

Trauma patients admitted from 2011 to 2014; respiratory failure is defined as mechanical ventilation greater than or equal to 48 hours, excluded head Abbreviated Injury Score greater than or equal to 4.

Interventions:

None.

Measurements and Main Results:

Mortality was calculated from the Washington state death registry. Cohort was divided into short (≤ 14 d) and long (> 14 d) ventilation groups. We compared survival with a Cox proportional hazard model and generated a receiver operator characteristic to describe the respiratory failure and mortality relationship. Data are presented as medians with interquartile ranges and hazard ratios with 95% CIs. We identified 1,503 patients with respiratory failure; median age was 51 years (33–65 yr) and Injury Severity Score was 19 (11–29). Median respiratory failure duration was 3 days (2–6 d) with 10% of patients in the long respiratory failure group. Cohort mortality at 1 year was 16%, and there was no difference in mortality between short and long duration of respiratory failure. Predictions for 1-year mortality based on respiratory failure duration demonstrated an area under the receiver operator characteristic curve of 0.57. We determined that respiratory failure patients greater than or equal to 75 years had an increased hazard of death at 1 year, hazard ratio, 6.7 (4.9–9.1), but that within age cohorts, respiratory failure duration did not influence 1-year mortality.

Conclusions:

Duration of mechanical ventilation in the critically injured is not associated with 1-year mortality. Duration of ventilation following injury should not be used to predict long-term survival.
Long-Term Survival of Young Patients Surviving ICU Admission With Severe Sepsis*
Authors: Abu-Kaf Heba , Mizrakli Yuval , Novack Victor , Dreiher Jacob
Published: May 2018

Objectives:

Sepsis remains a disease with a high mortality rate. The study goal was to assess long-term survival of severe sepsis in young patients.

Design:

Retrospective cohort study.

Setting:

Patients admitted with sepsis to ICUs in seven tertiary hospitals between 2003 and 2011.

Patients:

A total of 409 patients less than 45 years who survived to hospital discharge were age and sex matched with 818 patients with infectious disease without sepsis selected from internal medicine or surgical department admissions.

Interventions:

None.

Measurements and Main Results:

The median age in sepsis patients and the comparison group was 31 and 32 years, respectively. The proportions of patients surviving after hospital discharge were significantly lower in the sepsis group compared with the control group; among survivors, 6-month, 1-year, and 3-year mortality rates were 0.7% versus 0%, 4.5% versus 0.7%, 7.9% versus 1.2%, and 10.8% versus 1.8%, respectively (p < 0.001 for all). In a multivariate Cox proportional hazards regression model, sepsis was associated with an increased risk of mortality (hazard ratio, 3.79; 95% CI, 2.27–6.32), while controlling for age, Charlson Comorbidity Index, history of stroke, and congestive heart failure. Past the 24-month landmark, sepsis was not found to be an independent risk for mortality (hazard ratio, 1.79; 95% CI, 0.67–4.79). Based on cause of death analysis, chronic underlying comorbidities might explain the excess mortality in patients with sepsis.

Conclusions:

Young patients experiencing an episode of severe sepsis continue to be at higher risk of long-term mortality. The highest mortality rates were observed during the first 24 months following discharge.
Impact of absence of consensual cutoff time distinguishing between synchronous and metachronous metastases: illustration with colorectal cancer
Authors: Willem Hélène , Jooste Valérie , Boussari Olayide , Romain Gaëlle , Bouvier Anne-Marie
Published: May 2018

Staging is essential for scientific exchanges on colorectal cancer. Lack of a consensual definition for synchronous and metachronous metastases for colorectal cancer may introduce artifactual differences between epidemiological studies according to stage. We investigated how variations in the cutoff for the definition of synchronous metastases influenced the stage-specific distribution and incidence and the survival of stage IV patients. Between 2007 and 2013, a total of 4636 cases of colorectal adenocarcinoma were registered in the cancer registry of Burgundy. Age-standardized incidence by stage was estimated for each cutoff from 0 to 12 months, differentiating between synchronous and metachronous metastases. Net survival was calculated from the date of the diagnosis of metastasis. The incidence of stage IV colorectal cancer increased from 6.0/100 000 when considering metastases diagnosed within the first month to 7.1/100 000 when including metastases diagnosed until 12 months after the diagnosis of colorectal cancer. When the cutoff increased from 1 to 12 months, the relative variation in the proportion of cancers was +21% for stage IV, −12% for stage III, and −5% for stage II. Similarly, the 1-year net survival for metachronous group was over 10% higher than that for the synchronous group when the cutoff was over 5 months. An objective definition of the relevant cutoff to distinguish between synchronous and metachronous metastases is required for scientific epidemiologic exchanges. Survival in the metachronous group was significantly better than survival in the synchronous group when the cutoff between synchronous and metachronous was over 4 months after the primary diagnosis.
Association of Electronic Health Literacy With Health-Promoting Behaviors in Patients With Type 2 Diabetes
Authors: Kim Kyoung A , Kim Yu Jin , Choi Mona
Published: May 2018

It is important to know how well patients with type 2 diabetes understand and use health information available online in relation to health-promoting behaviors. Thus, the purposes of this study were to examine the association among electronic health literacy, perceived benefits, self-efficacy, and health-promoting behaviors in patients with type 2 diabetes, and to identify factors that affect health-promoting behaviors. A cross-sectional survey was conducted in a diabetes center in Seoul, South Korea. It was found that health-promoting behaviors were significantly correlated with electronic health literacy (r = 0.15, P < .05), perceived benefits (r = 0.15, P < .05), and self-efficacy (r = 0.47, P < .01). In the multiple linear regression analysis to identify the factors influencing health-promoting behaviors, electronic health literacy (β = .13, P = .040) and self-efficacy (β = .38, P < .001) were found to be significant factors, even after adjusting for general and disease-related characteristics. Strategies to improve health-promoting behaviors in patients with type 2 diabetes should focus on analyzing levels of electronic health literacy and deepening their understanding of online information accordingly.
Proton Pump Inhibition in Patients Treated With Novel Antithrombotic Drugs: Should We Worry About Thrombosis?
Authors: Bolek Tomáš , Samoš Matej , Škorňová Ingrid , Kovář Frantisek , Galajda Peter , Staško Ján , Kubisz Peter , Mokáň Marián
Published: May 2018

Proton pump inhibition (PPI) administered together with antiplatelet and anticoagulant agents reduces the risk of gastrointestinal hemorrhage. Several novel antithrombotic agents have been recently introduced for patients with acute coronary syndrome (prasugrel and ticagrelor) or for patients requiring long-term anticoagulation (dabigatran, rivaroxaban, apixaban, edoxaban, and betrixaban). In fact, these agents might offer even stronger inhibition of platelets or coagulation compared with older agents; therefore, the need for gastroprotection might be even stronger when these new agents are used for long-term antithrombotic therapy. On the contrary, there are several reports regarding an adverse interaction between PPI and antithrombotic agents connected with a reduction in antithrombotic therapy on-treatment levels, implicating a higher risk of thrombosis. This interaction was demonstrated in clopidogrel-treated patients and more recently also in dabigatran-treated patients. This article discusses a possible novel antithrombotic therapy/PPI interaction leading to higher risk of thrombosis.
ApoA-1 Mimetic Peptide ELK-2A2K2E Decreases Inflammatory Factor Levels Through the ABCA1-JAK2-STAT3-TTP Axis in THP-1–Derived Macrophages
Authors: Wang Jia-Lin , Gong Duo , Hu Xin-Yan , Wu Su , Zheng Xi-Long , Wu Jie , Tang Xiao-Er , Zhang Da-Wei , Tang Chao-ke
Published: May 2018

Objective:

The aim of this study was to determine whether the apolipoprotein A-1 (apoA-1) mimetic peptide ELK-2A2K2E regulates inflammatory cytokine expression through activating the adenosine triphosphate–binding cassette transporter A1 (ABCA1)-janus kinase 2 (JAK2)-signal transducer and activator of transcription 3 (STAT3)-tristetraprolin (TTP) signaling pathway in THP-1 macrophage-derived foam cells.

Methods and Results:

The cells were treated with the apoA-1 mimetic peptide ELK-2A2K2E at different concentrations (0, 20, 40, and 80 μg/mL) or incubated with ELK-2A2K2E (40 μg/mL) for different times (0, 6, 12, and 24 hours). Our results showed that the levels of the cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1), were decreased at both concentration- and time-dependent manners. When the cells were exposed to lipopolysaccharides and actinomycin D, ELK-2A2K2E significantly decreased the mRNA stability of inflammatory cytokines at different time points (0, 30, 60, and 120 minutes) by increasing TTP expression as analyzed by real-time quantitative polymerase chain reaction. The effect of ELK-2A2K2E on TTP was obviously blocked by the inhibition of the JAK-STAT3 pathway. Furthermore, we found that ELK-2A2K2E activated the JAK-STAT3-TTP pathway through the upregulation of ABCA1 and then decreased inflammatory cytokine expression.

Conclusions:

ApoA-I mimetic peptide ELK-2A2K2E increases the degradation of TNF-α, IL-6, and MCP-1 mRNA and reduces the levels of inflammatory cytokines through activating the JAK2-STAT3-TTP signaling pathway that is dependent on the upregulation of ABCA1.
Antiapoptotic Effect of β1 Blockers in Ascending Thoracic Aortic Smooth Muscle Cells: The Role of HSP70 Expression
Authors: Rizos Ioannis K. , Tsoporis James N. , Toumpoulis Ioannis K. , Salpeas Vasileios , Izhar Shehla , Rigopoulos Angelos G. , Sakadakis Eleftherios A. , Parker Thomas G.
Published: May 2018

Heat shock proteins (HSPs) play an important role in the cellular adaptation to stress, a requisite for cell survival. The aortic wall appears to be a target for increased expression of HSPs during surgical stress. We aimed to define the expression and function of aortic HSP70 in 31 patients with normal ascending thoracic aortic diameter who underwent aortic valve replacement due to aortic valve stenosis and in 35 patients with dilated ascending thoracic aorta who underwent replacement of an ascending thoracic aortic aneurysm. To elucidate responsible signaling mechanisms we used an in vitro model of rat hypoxic aortic vascular smooth muscle cell (AVSMC) cultures. We demonstrated an increase in AVSMC HSP70 and an attenuation of the apoptotic markers (TUNEL-positive nuclei, caspase-3 activity, Bax/Bcl2 ratio) in aortic wall tissue specimens from both aortic valve stenosis and ascending thoracic aortic aneurysm patients on β1 blockade with metoprolol. In vitro, metoprolol treatment of hypoxic rat AVSMCs increased nitric oxide (NO) production, induced heat shock factor 1 transport to the nucleus, upregulated HSP70, decreased p53 phosphorylation and attenuated apoptosis. Blockade of NO production, resulted in decreased HSP70 and prevented the metoprolol-induced anti-apoptotic response of hypoxic AVSMCs. We demonstrate an anti-apoptotic effect of metoprolol dependent on NO-induced HSP70 expression, and thus augmentation of HSP70 expression should be considered as a therapeutic approach to limit apoptosis in the human ascending thoracic aorta of patients undergoing cardiac surgery.
Isolated vitamin D supplementation improves the immune-inflammatory biomarkers in younger postmenopausal women: a randomized, double-blind, placebo-controlled trial
Authors: Bueloni-Dias Flavia Neves , Orsatti Claudio Lera , Cangussu Luciana Mendes , Poloni Priscila Ferreira , Spadoto-Dias Daniel , Nahas-Neto Jorge , Nahas Eliana A.P.
Published: May 2018

Objective:

The aim of this study was to evaluate the effect of vitamin D (VitD) supplementation on immune-inflammatory biomarkers in younger postmenopausal women.

Methods:

In this double-blind, placebo-controlled trial, 160 postmenopausal women aged 50 to 65 years with amenorrhea ≥12 months were randomized into two groups: VitD group, oral supplementation with 1000 IU VitD3/day (n = 80) or placebo group (n = 80). The intervention time was 9 months, and the women were assessed at baseline and endpoint. Serum levels of interleukins (ILs)-1β, IL-5, IL-6, IL-10, IL-12ρ70, IL-17α, tumor necrosis factor-alpha, and interferon-gamma were determined by immunoassay. Plasma concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by high-performance liquid chromatography. Per-protocol analysis was adopted as the statistical method using a gamma distribution and repeated measures design, followed by Wald's multiple comparisons test.

Results:

The two groups were similar at baseline in terms of clinical and laboratory parameters. After 9 months, there was a significant increase of 25(OH)D levels in the VitD group (+45.4%, P < 0.001) and a decrease (−18.5%, P = 0.049) in the placebo group. A significant decrease in IL-5, IL-12p70, IL-17α, tumor necrosis factor-alpha, and interferon-gamma levels was observed in the VitD group (P < 0.05). IL-5 and IL-6 levels were significantly lower in the VitD group compared to the placebo group (P < 0.05). There were no significant intervention effects on serum IL-1β or IL-10 levels in either group (P > 0.05).

Conclusions:

In younger postmenopausal women, isolated supplementation with 1000 IU of VitD3 for 9 months was associated with a reduction in proinflammatory biomarkers.
SLCO1B1 genetic variation and hormone therapy in menopausal women
Authors: Moyer Ann M. , de Andrade Mariza , Faubion Stephanie S. , Kapoor Ekta , Dudenkov Tanda , Weinshilboum Richard M. , Miller Virginia M.
Published: May 2018

Objective:

Response to menopausal hormone therapy (MHT) shows individual variation. SLCO1B1 encodes the OATP1B1 transporter expressed in the liver that transports many endogenous substances, including estrone sulfate, from the blood into hepatocytes. This study evaluated the relationship between genetic variation in SLCO1B1 and response to MHT in women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS) at Mayo Clinic, Rochester, MN.

Methods:

KEEPS participants were randomized to oral conjugated equine estrogen (n = 33, oCEE), transdermal 17β-estradiol (n = 33, tE2), or placebo (n = 34) for 48 months. Menopausal symptoms (hot flashes, night sweats, insomnia, palpitations) were self-reported before treatment and at 48 months. Estrone (E1), E2, and sulfated conjugates (E1S, E2S) were measured using high-performance liquid chromatography-tandem mass spectrometry. SLCO1B1 rs4149056 (c.521T>C, p.Val174Ala) was genotyped using a TaqMan assay.

Results:

After adjusting for treatment, there was a significant association between the SLCO1B1 rs4149056 TT genotype (encoding normal function transporter) and lower E1S, E1S/E1, and E2S (P = 0.032, 0.010, and 0.008, respectively) compared with women who were heterozygous (TC) or homozygous (CC) for the reduced function allele. The interactions between genotype, treatment, and E2S concentration were stronger in women assigned to tE2 (P = 0.013) than the women taking oCEE (P = 0.056). Among women assigned to active treatment, women with the CT genotype showed a significantly greater decrease in night sweats (P = 0.041) than those with the TT genotype.

Conclusions:

Individual variation in sulfated estrogens is explained, in part, by genetic variation in SLCO1B1. Bioavailability of sulfated estrogens may contribute to relief of night sweats.