bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct observation of the nutrition care practices of Australian general practitioners
Authors: Ball Lauren , Desbrow Ben , Yelland Michael , Leveritt Michael
Published: November 2018

INTRODUCTION: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients. AIM: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs) when providing nutrition care to adult patients. METHODS: Eighteen GPs (13 male, 5 female) were observed by fourth-year medical students during their general practice rotation. Each GP was observed for five consultations that included nutrition care, totalling 90 observed consultations. In each consultation, students completed a 31-item nutrition care checklist of nutrition care practices that could feasibly occur in a standard consultation. Each practice was marked with either a yes (completed), no (did not complete) or completed by practice nurse prior to or after the consultation. RESULTS: Twenty-eight nutrition care practices were observed at least once. The most frequently observed practices were measuring and discussing blood pressure (76.7%; n=69), followed by general questions about current diet (74.4%; n=67). Approximately half of the consultations included a statement of a nutrition-related problem (52.2%; n=47), and the provision of nutrition advice that focused on a nutrient (45.6%; n=41) or food group (52.2%; n=47). Consultations with male GPs, as well as GPs with more than 25 years of experience, were associated with an increased number of nutrition care practices per consultation. DISCUSSION: The GPs performed nutrition care practices in varying frequencies. Further research is required to identify the most effective GP nutrition care practices to improve the nutrition behaviour of patients. KEYWORDS: Chronic disease; family practice; general practitioners, nutrition therapy
Potion or Poison? Cranberry products
Authors: Martini Nataly
Published: November 2018

SUMMARY MESSAGE: Although there is some evidence to suggest that cranberry protects against urinary tract infections, the literature is conflicting and strong scientific validation is missing. There is, however, minimal risk in the consumption of cranberry products and they may be a suitable alternative to low-dose antibiotics in urinary tract infection prophylaxis.
New Zealand consumers health information needs: results of an interpretive descriptive study
Authors: Honey Michelle , Roy Dianne , Bycroft Janine , Boyd Mary-Anne
Published: November 2018

INTRODUCTION: Health literacy is linked to better health outcomes and underpins effective self-management, yet over one-and-a-half million New Zealanders are known to have poor health literacy skills. An ability to access and understand health information is an important component of health literacy. Little is known, however, about New Zealand consumers health information needs. This qualitative study sought to understand the perceptions of consumers related to their needs and use of health information. METHODS: Four focus group interviews provided data for this qualitative descriptive study. Data analysis used a thematic inductive approach. Participants were from the general population, accessed through community-based health organisations. These consumers were predominantly of New Zealand European ethnicity, female, older, and most were actively engaged in managing their health. FINDINGS: Four themes were identified: issues with current information provision; preferences for content; format; and sources of health information. These themes are described in the paper, using illustrative quotes from consumer participants. CONCLUSION: This study indicates that consumers have varied health information needs. Health professionals cannot assume that consumers all have the same health literacy skills. The ideal is to provide personalised, relevant information in a manner the consumer can understand, within the current time constraints in practice. Health professionals can support consumers in their use of different strategies to ensure their health information needs are expressed and met. KEYWORDS: Consumer health information; focus groups; health literacy; qualitative research
Continuous positive airway pressure treatment for obstructive sleep apnoea: Maori, Pacific and New Zealand European experiences
Authors: Bakker Jessie , OKeeffe Karyn , Neill Alister , Campbell Angela
Published: November 2018

INTRODUCTION: Continuous positive airway pressure (CPAP) is an effective treatment of obstructive sleep apnoea (OSA), but can be limited by poor adherence. In New Zealand (NZ), ethnicity has been shown to be a predictor of CPAP adherence. This study aimed to explore Maori, Pacific and NZ European patients experience of CPAP treatment. METHODS: Patients identifying as Maori, Pacific, or NZ European ethnicity referred for CPAP treatment for OSA attended separate, 1.5-hour group discussions facilitated by a health care worker of the same ethnic group, using an interview template. Thematic analysis was applied to the discussion transcripts independently by two investigators, following published guidelines. FINDINGS: Five Maori, five Pacific, and eight NZ Europeans participated (mean age 47, range 3071 years, mean ± standard deviation CPAP adherence 6.32 ±1.25 hours/night). Patients in all three groups reported that they had little knowledge of OSA or CPAP prior to treatment initiation. All groups identified barriers to treatment (both at the CPAP initiation phase and long term), reported feelings of being overwhelmed with information during the initial CPAP education session, and discussed the importance of successful role models. Family and friends were generally reported as being supportive of CPAP therapy. CONCLUSION: The three groups all reported similar initial CPAP experiences, highlighting access barriers to publicly funded assessment and treatment pathways, and sleep health knowledge as key issues. Educational resources to improve access, enable self-management, and increase community awareness of OSA would help overcome some of the issues identified in this study. KEYWORDS: Continuous positive airway pressure; obstructive sleep apnea; ethnic groups; focus groups
Giving Asthma Support to Patients (GASP): a novel online asthma education, monitoring, assessment and management tool
Authors: Ram Felix , McNaughton Wendy
Published: November 2018

BACKGROUND AND CONTEXT: Giving Asthma Support to Patients (GASP) is a unique online tool developed to provide asthma education at point of care, and to provide health care professionals in primary care with skills and knowledge to undertake a structured asthma assessment. ASSESSMENT OF PROBLEM: A retrospective cohort study was undertaken to evaluate the effectiveness of GASP. Data for patients aged 564 years seen in primary care (Waitemata region of Auckland) with uncontrolled asthma who had completed a minimum of two GASP assessments between 1 November 2008 and 17 April 2011 were extracted from a secure, self-populating database. Outcome measures were compared between each patients visit 1 and 2 assessments. RESULTS: A total of 761 patients provided data using GASP. There was a significant reduction between GASP assessments in the risk of exacerbations, hospital admissions, emergency department presentations, requirement for corticosteroids, and bronchodilator reliance. STRATEGIES FOR IMPROVEMENT: Results from this retrospective cohort study are promising. A randomised controlled trial of the use of GASP in primary care is warranted to confirm these findings. The effectiveness of the GASP tool also needs to be further investigated in Maori and Pacific populations. LESSONS: The findings of this study of GASP show its potential and support its use in the primary care setting. KEYWORDS: Asthma; decision support techniques; primary health care, retrospective study
Who attends Dunedin's free clinic? A study of patients facing cost barriers to primary health care access
Authors: Loh Lik , Dovey Susan
Published: November 2018

INTRODUCTION: Several methods of reducing the cost barrier to primary health care have been implemented in New Zealand, but research about free primary health care and the patients who use such services is scarce. AIM: To compare the characteristics of patients at Dunedin's free clinic with those at a traditional general practice clinic. METHODS: A written survey was distributed to waiting room patients at the Free Clinic and a fee-charging clinic in close proximity. Patient records were accessed to determine health services utilisation rates at both clinics and the discounting rate at the traditional clinic. RESULTS: There were 126 patient surveys returned at the Traditional Clinic and 65 at the Free Clinic. There was a significantly greater proportion of Maori respondents at the Free Clinic than at the Traditional Clinic (24.1% versus 9.2%, p=0.011). The difference in deprivation profiles of Free Clinic and Traditional Clinic respondents was more marked for the individual deprivation measure (five or more NZiDep deprivation characteristics: 65.5% versus 13.3%, p<0.001) than for residential area deprivation (NZDep2006 quintile 5: 41.4% versus 15.8%, p<0.001). Emergency department presentation rates were high for Free Clinic patients, despite free primary care access and high general practitioner consultation rates. Among Traditional Clinic respondents, 31.7% reported deferring health care because of cost in the previous 12 months. The equivalent figure for Free Clinic respondents was 63.8%. DISCUSSION: This survey suggests that Dunedin's Free Clinic serves a vulnerable population, in whom levels of unmet health need and health service usage are high. KEYWORDS: Disparities, health care; fees, medical; health care surveys; health services research; primary health care; vulnerable populations
Management of diabetes by primary health care nurses in Auckland, New Zealand
Authors: Daly Barbara , Arroll Bruce , Kenealy Timothy , Sheridan Nicolette , Scragg Robert
Published: November 2018

INTRODUCTION: The increasing prevalence of diabetes has led to expanded roles for primary health care nurses in diabetes management. AIM: To describe and compare anthropometric and glycaemic characteristics of patients with diabetes and their management by practice nurses, district nurses and specialist nurses. METHODS: Primary health care nurses in Auckland randomly sampled in a cross-sectional survey, completed a postal self-administered questionnaire (n=284) and telephone interview (n=287) between 2006 and 2008. Biographical and diabetes management details were collected for 265 (86%) of the total 308 patients with diabetes seen by participants on a randomly selected day. RESULTS: Nurses were able to access key clinical information for only a proportion of their patients: weight for 68%; BMI for 16%; HbA1c for 76% and serum glucose levels for 34% (for either measure 82%); although most (96%) records were available about whether patients self-monitored blood glucose levels. Most nursing management activities focused on giving advice on dietary intake (70%) and physical activity (66%), weighing patients (58%), and testing or discussing blood glucose levels (42% and 43%, respectively). These proportions varied by nurse group (p<0.05), generally being highest for specialist nurses and lowest for district nurses. DISCUSSION: Most practice and specialist nurses could access patients' weight and HbA1c levels and focused their clinical management on health education to decrease these if indicated. Communication and organisational systems and contracts that allow district nurses to work across both primary and secondary health services are necessary to improve community-based nursing services for patients with diabetes. KEYWORDS: Blood glucose; diabetes mellitus type 1; diabetes mellitus type 2; nurses; primary health care; risk management
'He said he had been out doing the traffic': general practitioner perceptions of sexually transmitted infection and HIV testing strategies for men
Authors: Woodbridge Martin , Dowell Anthony , Gray Lesley
Published: November 2018

INTRODUCTION: Sexual health is an important component of primary care, and optimal sexually transmitted infection (STI) and HIV testing by doctors could help improve sexual health outcomes for men. Currently, little is known about general practitioners' (GPs') assessment of STI and HIV risk, particularly in relation to male patients, and the degree to which current advice can be translated into consistent testing protocols. The aim of the study was to explore STI and HIV testing strategies for men in general practice and opportunities and barriers to more optimal testing. METHODS: This study used a qualitative, multiple-case methodology, incorporating 17 distinct GP cases, drawing on in-depth, semi-structured interviews, and using thematic analysis. FINDINGS: The following themes were identified: sexual health consultations by men in general practice are usually initiated by the patient; GPs appear to have a consistent rationale for their risk assessments in terms of STI testing; the nature of the doctor's interaction with men influences the quality of sexual health services utilisation; optimal sexual health consultations require sufficient time and a recognition of the 'delicacy' of the consultation content for both patient and health practitioner. CONCLUSION: The stratified testing strategies undertaken by GPs appeared appropriate given the risk profiles of their patients. Constraints to optimal sexual health consultations were identified, including inadequate consultation time, male utilisation of GP consultations, and challenges in discussing sexual health topics within the consultation. Prioritising men's sexual health as a topic in CME may be helpful. KEYWORDS: General practitioners; health communication; HIV; men; sexual health; sexually transmitted infections
The impact of non-motor manifestations of Parkinson's disease on partners: understanding and application of chronic sorrow theory
Authors: Mercer Christine
Published: November 2018

INTRODUCTION: Parkinson's disease (PD) can cause many emotions, including grief and a sense of isolation for both the person with PD (referred to as Parkinsonian) and their partner. Such ongoing grief and emotional turmoil can be termed chronic sorrow. The aim of this research is to present accounts of partners' perspectives, analysed in the context of chronic sorrow theory, to offer health professionals an insight into the impact of non-motor PD symptoms on partners. METHODS: A group of partners of Parkinsonians provided the data through individual stories. These stories were subjected to thematic analysis, using a seven-step process leading to the establishment of themes. FINDINGS: Caregiver burden and chronic sorrow is not related to providing physical care, but the emotional care of attempting to minimise the effect of PD, coping with disturbance to sleep, and helping the Parkinsonian to maintain as much independence as possible. Contributors to this article found chronic sorrow theory provided a framework for understanding their emotions. Sharing their experiences with others provided an opportunity to be heard, and enabled them to make sense of individual situations. CONCLUSION: Chronic sorrow theory provides a useful framework for both partners of Parkinsonians in understanding their emotional responses, and for health professionals in considering the challenges partners face in coping with living with a person with PD. KEYWORDS: Grief; Parkinson's disease; support group; support partners; symptoms
Culturally and linguistically diverse patients' views of multimorbidity and general practice care
Authors: McKinlay Eileen , Graham Stewart , Horrill Pauline
Published: November 2018

INTRODUCTION: It is recognised that patients who are culturally and linguistically diverse (CALD) have challenges in accessing health care and understanding health advice or instructions. Those with multimorbidity (MM) are likely to have additional difficulties. In New Zealand, little is known about how this patient group view their health and general practice health care. This study examined the views of multimorbid CALD patients about MM and the health care available in a Very Low Cost Access general practice. METHODS: This qualitative study recruited Samoan, Cook Island Maori, and Cambodian patients with diabetes and more than three other long-term conditions. Two individual interviews and two language-specific focus groups were undertaken to yield themes representing the experience of these CALD patients with MM. FINDINGS: Participants described MM as having considerable impact on their life. They reported feeling responsible for supporting their own health and many detailed self-management techniques. However, they also expressed confusion, lack of information and limited understanding of MM, in particular about managing medication. Not all patients were aware of the range of available general practice services and some described difficulties in accessing general practice care. CONCLUSION: Despite being motivated to self-manage, this patient group report challenges in understanding their conditions and how to manage them, which may also be influenced by health beliefs. Available general practice services are not well known by CALD patients with MM. There is likely to be value in developing a specific structured, yet patient-centred, model of care for this group of patients. KEYWORDS: Access to health care; ethnic groups; focus groups; general practice; health literacy; self care
Initiation and maintenance of statins and aspirin after acute coronary syndromes (ANZACS-QI 11)
Authors: Kerr Andrew J. , Turaga Mansi , Grey Corina , Lee Mildred , McLachlan Andrew , Devlin Gerry
Published: November 2018

ABSTRACT

INTRODUCTION
Prior New Zealand studies suggest that only approximately two-thirds of patients who present with an acute coronary syndrome (ACS) are maintained on a statin/aspirin post-discharge. This could be due to sub-optimal initiation or poor longer-term adherence.

AIM
To identify the pattern of statin/aspirin maintenance following ACS from initial prescription to 3 years post-discharge.

METHODS
All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry data for consecutive New Zealand residents (2007–2011), who were hospitalised with ACS, were anonymously linked to national datasets to derive a medication possession ratio (MPR) to assess medication maintenance. An MPR ≥ 0.8 is considered adequate maintenance.

RESULTS
Of the 1846 patients discharged alive, 95% were prescribed a statin at discharge and 92% were dispensed a statin within 3 months, but only 75% had a MPR ≥ 0.8 in the first year, and 67% in year 3. In the same cohort, 98% were prescribed aspirin and 88% were dispensed aspirin within the 3 months of discharge. In the first year, 72% had an aspirin MPR ≥ 0.8 and 71% maintained this in year 3. Fifty-nine percent were maintained on both aspirin and a statin in the third year, but 20% were maintained on neither. Regression analysis identified the independent predictors of inadequate maintenance in the third year as age < 45 years, no prior statin, and Māori and Pacific ethnicity.

CONCLUSION
Longer-term maintenance of evidenced-based secondary prevention medications after ACS is suboptimal despite high levels of initial prescribing and dispensing. Understanding the barriers to longer-term maintenance is required to improve patient outcomes.
Design and in vitro realization of carbon-conserving photorespiration
Authors: Trudeau Devin L. , Edlich-Muth Christian , Zarzycki Jan , Scheffen Marieke , Goldsmith Moshe , Khersonsky Olga , Avizemer Ziv , Fleishman Sarel J. , Cotton Charles A. R. , Erb Tobias J. , Tawfik Dan S. , Bar-Even Arren
Published: November 2018

Significance

Photorespiration limits plant carbon fixation by releasing CO
2
and using cellular resources to recycle the product of ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) oxygenation, 2-phosphoglycolate. We systematically designed synthetic photorespiration bypasses that combine existing and new-to-nature enzymatic activities and that do not release CO
2
. Our computational model shows that these bypasses could enhance carbon fixation rate under a range of physiological conditions. To realize the designed bypasses, a glycolate reduction module, which does not exist in nature, is needed to be engineered. By reshaping the substrate and cofactor specificity of two natural enzymes, we established glycolate reduction to glycolaldehyde. With the addition of three natural enzymes, we observed recycling of glycolate to the key Calvin Cycle intermediate ribulose 1,5-bisphosphate with no carbon loss.
The Age of Aidans: Cognitive Underpinnings of a New Trend in English Boys’ Names
Authors: MacAulay Lauren , Siddiqi Daniel , Toivonen Ida
Published: November 2018

Several sources have recently reported a trend in North American English boys’ names. According to this trend, a disproportionate number of boys’ names contain a final syllabic nasal. This paper presents two studies that investigate this observation systematically. A corpus linguistic study of the most popular names in Ontario and the USA revealed that around 40% of English boys’ names fit this pattern, which has been called “the Age of Aidans”. The second study was a lexical decision task. It was modeled after previous research on sound symbolism (phonosemantics). This experiment demonstrated that speakers preferred pseudo-names for boys that fit the “Age of Aidans”pattern. Taken together, the two studies suggest that final syllabic nasals can be compared to phonesthemes. Current North American speakers of English may perceive disyllabic names ending in syllabic nasals as “good” boys’ names.
3,4-Methylenedioxymethamphetamine (MDMA; Ecstasy) use and Transitions to Injection Drug use among Street-Involved Youth
Authors: Lake Stephanie , Gaddis Andrew , Tupper Kenneth W. , Nosova Ekaterina , DeBeck Kora
Published: November 2018

Background

Despite the popularity of 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) among young people across North America and Europe, MDMA is rarely explored in studies of young people at high risk of injecting drugs. We conducted a study among street-involved youth who use illicit drugs in Vancouver, Canada, to understand if use of MDMA is associated with initiation of injection drugs.

Methods

We followed injection-naïve participants in the At-Risk Youth Study (ARYS), an ongoing prospective cohort of street-involved youth aged 14–26 who use illicit drugs. Bivariate and multivariate extended Cox models with time-updated variables were used to examine the association between MDMA use and initiation of injection drug use between September 2005 and May 2015.

Results

Among 483 youth, 306 (63.4%) had a history of MDMA use and 218 (45.1%) had used MDMA in the previous 6 months at baseline. A total of 105 (21.7%) youth initiated injection drug use over the 10-year period, yielding an incidence density of 8.51 (95% confidence interval [CI]: 6.96–10.30) per 100 person-years. MDMA use was not significantly associated with initiating injection drugs at the bivariate (hazard ratio: 0.93, 95% CI: 0.61–1.42) or multivariate (adjusted hazard ratio: 0.88, 95% CI: 0.57–1.35) level, after adjusting for socio-demographic and substance use confounders.

Conclusions

Amid ongoing frequent use of MDMA among some young people in North America, we did not observe an elevated risk of injection initiation among those who used MDMA in this cohort of street-involved youth.
Structural basis of different substrate preferences of two old yellow enzymes from yeasts in the asymmetric reduction of enone compounds
Authors: Horita Shoichiro , Kataoka Michihiko , Kitamura Nahoko , Miyakawa Takuya , Ohtsuka Jun , Maejima Yuko , Shimomura Kenju , Nagata Koji , Shimizu Sakayu , Tanokura Masaru
Published: November 2018

Old yellow enzymes (OYEs) are potential targets of protein engineering for useful biocatalysts because of their excellent asymmetric reductions of enone compounds. Two OYEs from different yeast strains, Candida macedoniensis AKU4588 OYE (CmOYE) and Pichia sp. AKU4542 OYE (PsOYE), have a sequence identity of 46%, but show different substrate preferences; PsOYE shows 3.4-fold and 39-fold higher catalytic activities than CmOYE toward ketoisophorone and (4S)-phorenol, respectively. To gain insights into structural basis of their different substrate preferences, we have solved a crystal structure of PsOYE, and compared its catalytic site structure with that of CmOYE, revealing the catalytic pocket of PsOYE is wider than that of CmOYE due to different positions of Phe246 (PsOYE)/Phe250 (CmOYE) in static Loop 5. This study shows a significance of 3D structural information to explain the different substrate preferences of yeast OYEs which cannot be understood from their amino acid sequences.

Abbreviations: OYE: Old yellow enzymes, CmOYE: Candida macedoniensis AKU4588 OYE, PsOYE: Pichia sp. AKU4542 OYE
Accumulation of SOC under organic and no-fertilizations, and its influence on crop yields in Tanzania’s semiarid zone
Authors: Mkonda Msafiri Y. , He Xinhua
Published: November 2018

Introduction:
To estimate differential accumulation of soil organic carbon (SOC) and its ecological significance is very important to smallholder farmers in the Tanzania’s semiarid areas. This study investigated the accumulation of SOC and other important soil nutrients under organic and no-fertilizations, and correlated SOC with crop yields. Using data from long-term experimental study sites of semiarid in Tanzania, we estimated SOC accumulation in different soil treatments and depths where a total of 128 soil samples were collected at the depths of 0–20 cm and 20–40 cm from two villages (sites) with organic fertilization and no-fertilization treatments. Sites under organic fertilization were defined as those which have received manure fertilization for more than 5 years on continuum basis.

Outcomes:
The accumulation of SOC was significantly greater in soils under organic fertilizations (1.15 and 0.80 MgC ha
−1
at soil depth and 20–40 cm) and decreased with increasing soil depths. Similarly, TN and P decreased from 0.40 and 2.40 Mg (0–20 cm) to 0.16 and 2.10 Mg (20–40 cm), respectively. Other important soil nutrients such as calcium (Ca
2+
), potassium (K
+
), magnesium (Mg
2+
), and sodium (Na
+
) had similar pattern. In addition, soil bulk density was less under organic fertilization (1.1 g/cm
3
) than under no-fertilization (1.2 g/cm
3
) and it increased with soil depths. Correspondingly, the crop yields were significantly higher (1.6 tn ha
−1
) under organic fertilizations than (0.6 tn ha
−1
) under no-fertilizations indicating that crop yields were significantly affected by SOC.

Discussion:
Organic fertilization i.e., especially cattle manure in the area has considerable fertility potential. To optimize soil fertility potential, we need to consider such kind of fertilization from household to national level.

Conclusion:
Our results demonstrated that manure application was the best fertilization method for improving soil fertility in most croplands of Tanzania’s semiarid areas, especially in this era of climate change scenarios.
Popular support for the social security system in urban China: evidence from a cross-sectional survey in a Chinese city
Authors: Li Qin , He Alex Jingwei
Published: November 2018

Because the legitimacy of the welfare system ultimately depends on citizens’ support, it is vital to understand public welfare attitudes. By analysing primary data collected in Zhuhai City, this study examines Chinese people's attitudes toward contributory social security programmes. The study's bi-dimensional conception of welfare attitudes synthesises the dual roles that people play in social security and examines their respective attitudes. Self-interest and ideology models were both tested in the Chinese context. As ordinary citizens, people's expectation for governmental responsibility in social security appears to be high. As contributors to the system, their willingness to pay premiums is also on the high side. Based on multivariate analysis, this study provides contextual explanations for the attitudinal patterns observed in Zhuhai and interprets the results in reference to the international literature. The article concludes with policy implications for China's social security reforms.
Gender, sexuality and the right to a non-projected future: a reply to Camminga
Authors: Mills Elizabeth
Published: November 2018

This reply considers themovement of words as discussed in Camminga's article with reference to South Africa's Constitution and its Refugee Act. It explores the value and limitations of performing subjectivities like ‘transgender’ in contexts where these words have been introduced and, in some cases, imposed. This discussion considers the ‘Stigma of Western Words’, as articulated by Camminga, in light of the broader politics of international development and aid conditionality linked to LGBT rights. These politics are contrasted with some of the dynamics underpinning an international development programme that sought to advance LGBT rights and livelihoods, as discussed in the accompanying article on gender, sexuality and the limits of the law.
Gender, sexuality and the limits of the law
Authors: Mills Elizabeth
Published: November 2018

This article reflects on a programme of research conducted by gender and sexuality activists, academics and legal practitioners in Latin America, Africa, the Middle East, South Asia and South East Asia. Running over 4 years, the Sexuality, Poverty and Law Programme (SPLP) aimed to generate new evidence-based knowledge and policy options to support efforts that would strengthen, through legal reform, the rights of lesbian, gay, bisexual and transgender (LGBT) people and others marginalised because of their sexuality. The SPLP also aimed to demonstrate the impact of legal and policy marginalisation on the livelihoods of LGBT across the world. Instead of claiming answers or offering conclusions based on this body of work, the article draws on Sara Ahmed's writing and raises questions based on the SPLP around what it means to encounter ‘brick walls’ – specifically the materiality of juridical and productive power – through one's body. The article explores how international discourses and institutions are implicated in the shape of domestic legal frameworks that centre on gender and sexuality, and it explores how these frame-works shape which bodies are made visible, effaced or entirely ignored. Given the politics of international development and global LGBT rights discourse, this article concludes that laws are never quite sovereign and it makes a case for understanding the implications of this ‘legal porosity’ on people's embodied experiences of inequality as they fall under (beside or outside) the law.
Cell-cycle control of cell polarity in yeast
Authors: Moran Kyle D. , Kang Hui , Araujo Ana V. , Zyla Trevin R. , Saito Koji , Tsygankov Denis , Lew Daniel J.
Published: November 2018

In many cells, morphogenetic events are coordinated with the cell cycle by cyclin-dependent kinases (CDKs). For example, many mammalian cells display extended morphologies during interphase but round up into more spherical shapes during mitosis (high CDK activity) and constrict a furrow during cytokinesis (low CDK activity). In the budding yeast Saccharomyces cerevisiae, bud formation reproducibly initiates near the G1/S transition and requires activation of CDKs at a point called “start” in G1. Previous work suggested that CDKs acted by controlling the ability of cells to polarize Cdc42, a conserved Rho-family GTPase that regulates cell polarity and the actin cytoskeleton in many systems. However, we report that yeast daughter cells can polarize Cdc42 before CDK activation at start. This polarization operates via a positive feedback loop mediated by the Cdc42 effector Ste20. We further identify a major and novel locus of CDK action downstream of Cdc42 polarization, affecting the ability of several other Cdc42 effectors to localize to the polarity site.
Climate Multilateralism Within the United Nations Framework Convention on Climate Change
Authors: Pereira Joana Castro , Viola Eduardo
Published: November 2018

The signing of the United Nations Framework Convention on Climate Change (UNFCCC) by 154 nations at the Rio “Earth Summit” in 1992 marked the beginning of multilateral climate negotiations. Aiming for the “stabilization of greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system,” the Convention divided parties according to different commitments and established the common but differentiated responsibilities and respective capabilities (CBDRRC) principle.

In 1997, parties to the Convention adopted the Kyoto Protocol, which entered into force in 2005. The Protocol set internationally binding emission reduction targets based on a rigid interpretation of the CBDRRC principle. Different perceptions on a fair distribution of climate change mitigation costs hindered multilateral efforts to tackle the problem. Climate change proved a “super wicked” challenge (intricately linked to security, development, trade, water, energy, food, land use, transportation, etc.) and this fact led to a lack of consensus on the distribution of rights and responsibilities among countries. Indeed, since 1992, greenhouse gas concentrations in the atmosphere have increased significantly and the Kyoto Protocol did not reverse the trend.

In 2009, a new political framework, the Copenhagen Accord, was signed. Although parties recognized the need to limit global warming to < 2°C to prevent dangerous climate change, they did not agree on a clear path toward a legally-binding treaty to succeed the Kyoto Protocol, whose first commitment period would end in 2012. A consensus would only be reached in 2015, when a new, partially legally-binding treaty—the Paris Climate Agreement—committing all parties to limit global warming to “well below 2°C” was finally signed. It came into force in November 2016. Described in many political, public, and academic contexts as a diplomatic success, the agreement suffers, however, from several limitations to its effectiveness.

The nationally determined contributions that parties have presented thus far under the agreement would limit warming to approximately 3°C by 2100, placing the Earth at a potentially catastrophic level of climate change. Forces that resist the profound transformations necessary to stabilize the Earth’s climate dominate climate change governance. Throughout almost three decades of international negotiations, global greenhouse gas (GHG) emissions have increased substantially and at a rapid pace, and climate change has worsened significantly.
Quantum Bit Modalities/Architectures
Authors: Bartholomew John , Hempel Cornelius
Published: November 2018

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Physics. Please check back later for the full article.

Quantum bits – or qubits – are the central concept on which all quantum information science and technology are built. In contrast to the binary digits (bits) in classical information processing, where voltages across a capacitor encode either a logical state 0 or 1, qubits encode information distributed across two levels of a quantum mechanical system. Building hardware to harness the power of the qubit concept is no longer restricted to academic research but has become a focus for commercial entities ranging from small start-ups to large, established corporations, in a high-stakes race to capitalize on what is often called the second quantum revolution. This name refers to the targeted use of two quantum effects, “superposition” and “entanglement”, to obtain a computational advantage, providing a significant algorithmic speed-up in certain applications or even enabling previously intractable calculations.

Simultaneously, however, the two quantum coherent effects are at the core of the fragility or “decoherence” of the information encoded by qubits. As a consequence, qubit realizations are being pursued in many different modalities, e.g., single atoms, atom-like structures or defects in solids, superconducting circuits, and photons. Each type of physical qubit has specific advantages and disadvantages captured by a range of figures of merit, e.g., the time over which coherence can be maintained and speed, as well as error rates in operations and measurement. As the number of qubits in quantum computing systems grows, collective effects in addition to individual qubit properties quickly make hardware characterization and error analysis intractable, especially in the presence of unavoidable noise and control errors. To enable fault-tolerant operation at scales large enough to provide the sought-after advantage over classical computation, multiple physical qubits can be combined into so-called logical qubits, an algorithmic redundancy that facilitates quantum error correction. As the overhead of this approach is directly related to the underlying individual physical qubit error rates and controllability, research into a diverse array of qubit modalities continues unabated and, as of yet, with no clear winner in sight.
Polymorphisms in TLR4 and TNFA and Risk of Mycobacterium tuberculosis Infection and Development of Active Disease in Contacts of Tuberculosis Cases in Brazil: A Prospective Cohort Study
Authors: Cubillos-Angulo Juan Manuel , Arriaga María B , Silva Elisângela C , Müller Beatriz L A , Ramalho Daniela M P , Fukutani Kiyoshi F , Miranda Pryscila F C , Moreira Adriana S R , Ruffino-Netto Antonio , Lapa e Silva Jose R , Sterling Timothy R , Kritski Afrânio L , Oliveira Martha M , Andrade Bruno B
Published: November 2018

Background

The role of genetic polymorphisms in latent tuberculosis (TB) infection and progression to active TB is not fully understood.

Methods

We tested the single-nucleotide polymorphisms (SNPs) rs5743708 (TLR2), rs4986791 (TLR4), rs361525 (TNFA), rs2430561 (IFNG) rs1143627 (IL1B) as risk factors for tuberculin skin test (TST) conversion or development of active TB in contacts of active TB cases. Contacts of microbiologically confirmed pulmonary TB cases were initially screened for longitudinal evaluation up to 24 months, with clinical examination and serial TST, between 1998 and 2004 at a referral center in Brazil. Data and biospecimens were collected from 526 individuals who were contacts of 177 active TB index cases. TST conversion was defined as induration ≥5 mm after a negative TST result (0 mm) at baseline or month 4 visit. Independent associations were tested using logistic regression models.

Results

Among the 526 contacts, 60 had TST conversion and 44 developed active TB during follow-up. Multivariable regression analysis demonstrated that male sex (odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1–4.6), as well as SNPs in TLR4 genes (OR: 62.8, 95% CI: 7.5–525.3) and TNFA (OR: 4.2, 95% CI: 1.9–9.5) were independently associated with TST conversion. Moreover, a positive TST at baseline (OR: 4.7, 95% CI: 2.3–9.7) and SNPs in TLR4 (OR: 6.5, 95% CI: 1.1–36.7) and TNFA (OR: 12.4, 95% CI:5.1–30.1) were independently associated with incident TB.

Conclusions

SNPs in TLR4 and TNFA predicted both TST conversion and active TB among contacts of TB cases in Brazil.
Evaluation of the All Right? Campaign’s Facebook intervention post-disaster in Canterbury, New Zealand
Authors: Calder Kristi , D’Aeth Lucy , Turner Sue , Begg Annabel , Veer Ekant , Scott Jo , Fox Ciarán
Published: November 2018

The All Right? campaign was developed as a mental health promotion campaign following the 2010–2011 Canterbury earthquakes. One aspect of the overall campaign was the utilisation of social media as a means of promoting wellbeing messages. This research evaluates the use of the All Right? Facebook page as a means of promoting wellbeing after a major natural disaster. Quantitative and qualitative methods were used to gather data about the social media component of the All Right? campaign. Findings indicate that the All Right? Facebook page has become a valued source of consistent wellbeing tips and advice -‘the place that I go’. Wellbeing reminders posted on the page were especially valued following earthquake aftershocks. High proportions of respondents to a survey (n = 212) linked from the All Right? Facebook page agreed that the page was helpful (98%), gave people ideas of things that they can do to help themselves (96%), and made people think about their wellbeing (93%). Over four fifths (85%) of respondents had done activities as a result of what they saw on the All Right? Facebook page. Success factors for the Facebook page often mirrored those for the campaign itself, including: local research to inform the use of appropriate language for translating evidence-based wellbeing messages into a local setting; not being marketed as a government message; and effectively combining public health and communications expertise. Success factors specific to the Facebook page included: regular posts with a focus on issues that affect everyone in Canterbury post-disaster; timely posts, especially immediately following aftershocks; a consistent tone for the All Right? Facebook page; and balancing wellbeing facts and tips with other content that was relevant to the Canterbury population. The overall success of the All Right? Facebook page was reliant on being part of a trusted population-wide mental health promotion campaign.
Undernutrition and Tuberculosis: Public Health Implications
Authors: Sinha Pranay , Davis Juliana , Saag Lauren , Wanke Christine , Salgame Padmini , Mesick Jackson , Horsburgh C Robert , Hochberg Natasha S
Published: November 2018

Almost 800 million people are chronically undernourished worldwide, of whom 98% are in low- and middle-income countries where tuberculosis is endemic. In many tuberculosis-endemic countries, undernutrition is a driver of tuberculosis incidence and associated with a high population attributable fraction of tuberculosis and poor treatment outcomes. Data suggest that undernutrition impairs innate and adaptive immune responses needed to control Mycobacterium tuberculosis infection and may affect responses to live vaccines, such as BCG. Given its impact on tuberculosis, addressing undernutrition will be a vital component of the World Health Organization End TB strategy. This narrative review describes the effect of undernutrition on the immune response, vaccine response, and tuberculosis incidence, severity, and treatment outcomes.
A map of direct TF–DNA interactions in the human genome
Authors: Gheorghe Marius , Sandve Geir Kjetil , Khan Aziz , Chèneby Jeanne , Ballester Benoit , Mathelier Anthony
Published: November 2018

Chromatin immunoprecipitation followed by sequencing (ChIP-seq) is the most popular assay to identify genomic regions, called ChIP-seq peaks, that are bound in vivo by transcription factors (TFs). These regions are derived from direct TF–DNA interactions, indirect binding of the TF to the DNA (through a co-binding partner), nonspecific binding to the DNA, and noise/bias/artifacts. Delineating the bona fide direct TF–DNA interactions within the ChIP-seq peaks remains challenging. We developed a dedicated software, ChIP-eat, that combines computational TF binding models and ChIP-seq peaks to automatically predict direct TF–DNA interactions. Our work culminated with predicted interactions covering >2% of the human genome, obtained by uniformly processing 1983 ChIP-seq peak data sets from the ReMap database for 232 unique TFs. The predictions were a posteriori assessed using protein binding microarray and ChIP-exo data, and were predominantly found in high quality ChIP-seq peaks. The set of predicted direct TF–DNA interactions suggested that high-occupancy target regions are likely not derived from direct binding of the TFs to the DNA. Our predictions derived co-binding TFs supported by protein-protein interaction data and defined cis-regulatory modules enriched for disease- and trait-associated SNPs. We provide this collection of direct TF–DNA interactions and cis-regulatory modules through the UniBind web-interface (http://unibind.uio.no).
Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review
Authors: Noori Selaiman A , Rasheed Abdullah , Aiyer Rohit , Jung Boyoun , Bansal Nitin , Chang Ke-Vin , Ottestad Einar , Gulati Amitabh
Published: November 2018

Background

Low back pain (LBP) and neck pain are major causes of pain and disability that are experienced across all ages. The primary goals of treatment are to improve patient function and facilitate a return to the patient’s desired level of daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders, but there continues to be controversy regarding its use due to insufficient evidence of effectiveness. The objective of this systematic review was to evaluate the effectiveness of therapeutic ultrasound in the management of patients with chronic LBP and neck pain.

Methods

Using PRISMA guidelines, a search of the PubMed and CENTRAL (The Cochrane Library) databases was performed to retrieve randomized controlled trials (RCTs) that evaluated therapeutic ultrasound in patients with chronic LBP or neck pain.

Results

The search strategy identified 10 trials that met the criteria for inclusion. Three studies in LBP reported that both therapeutic and sham (placebo) ultrasound provided significant improvement in pain intensity. In each of these studies, ultrasound was found to be more effective than placebo when using only one of several validated instruments to measure pain. Three of the four studies on neck pain demonstrated significant pain relief with ultrasound in combination with other treatment modalities. However, only one of these studies demonstrated that the use of ultrasound was the cause of the statistically significant improvement in pain intensity.

Conclusions

Therapeutic ultrasound is frequently used in the treatment of LBP and neck pain and is often combined with other physiotherapeutic modalities. However, given the paucity of trials and conflicting results, we cannot recommend the use of monotherapeutic ultrasound for chronic LBP or neck pain. It does seem that ultrasound may be considered as part of a physical modality treatment plan that may be potentially helpful for short-term pain relief; however, it is undetermined which modality may be superior. In both pain syndromes, further trials are needed to define the true effect of low-intensity ultrasound therapy for axial back pain. No conclusive recommendations may be made for optimal settings or session duration.
Feasibility of App-Based Postsurgical Assessment of Pain, Pain Impact, and Regional Anesthesia Effects: A Pilot Randomized Controlled Trial
Authors: Highland Krista B , Tran Julie , Edwards Hisani , Bedocs Peter , Suen Joshua , Buckenmaier Chester C
Published: November 2018

Objective

Postsurgical follow-up calls enable nurses to assess a patient’s condition, provide tailored education, and improve the patient’s experience. Despite the benefits, barriers to phone-based assessments may include patient nonresponse and lack of time due to demanding clinical schedules. The purpose of this trial was to examine the feasibility and utility of a smartphone app, mCare, for assessing pain, pain impact, and peripheral nerve block effects in patients.

Design

Pilot randomized control trial.

Setting and Patients

Eligible patients at a military treatment facility undergoing same-day surgery were randomized to the mCare group (N = 24) or the standard-of-care telephone (N = 26) group.

Results

Outcomes included initial response (assessment completion) rates and participant and nurse satisfaction. There were no differences in the response rates upon initial contact attempt, and patients in both groups reported similar levels of satisfaction and convenience. Nurses reported greater satisfaction with the app compared with standard-of-care telephone calls.

Conclusions

Before wider implementation, further considerations of app-based assessment need to be fully explored.