bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Adverse Events on Clinicians: What's in a Name?
Authors: Wu Albert W. , Shapiro Jo , Harrison Reema , Scott Susan D. , Connors Cheryl , Kenney Linda , Vanhaecht Kris
Published: November 2017

Unanticipated patient adverse events can also have a serious negative impact on clinicians. The term second victim was coined to highlight the experience of health professionals with these events and the need to effectively support them. However, there is some controversy over use of the term second victim. This article explores terminology used to describe the professionals involved in adverse events and services to support them. There is a concern that use of the term victim may connote passivity or stigmatize involved clinicians. Some patient advocates are also offended by the term, believing that it deemphasizes the experience of patients and families. Despite this, the term is now coming into widespread use by clinicians and health care managers as well as policy makers. As the importance of emotional support for clinicians continues to gain visibility, the terminology surrounding it will undoubtedly change and evolve. At this time, it may be most appropriate to label this important phenomenon in a way that local leaders are comfortable with—in a way that promotes its recognition and adoption of solutions. For example, for policy makers and health care managers, the term second victim may have value because it is memorable and connotes urgency. For support programs that appeal directly to health care workers, different language may attract more users. Debate concerning the benefits and drawbacks to this terminology will enhance and further drive its evolution, while helping retain our industry's focus on the importance of developing and evaluating programs to support clinicians in need.
Nursing Home Patient Safety Culture Perceptions Among US and Immigrant Nurses
Authors: Wagner Laura M. , Brush Barbara L. , Castle Nicholas G. , Engberg John B. , Capezuti Elizabeth A.
Published: November 2017

Patient safety is a global concern, yet little is known about how and whether perceptions of patient safety culture (PSC) vary by nurses’ countries of origin and preparation. This is particularly important in American nursing homes (NHs), which are increasingly hiring non-US born and prepared nurses to fill staffing needs.

Objectives

This study compared the PSC perceptions of foreign and domestic born and trained nurses working in urban NHs in 5 states to analyze how nurses’ PSC perceptions corresponded to their personal and professional characteristics.

Methods

We distributed 3539 surveys to registered nurses and licensed practical/vocational nurses employed in 98 urban NHs across 5 states with higher percentages of internationally prepared nurse workers. Respondents’ perceptions of their workplace safety culture were measured with the NH Survey on PSC survey from the Agency for Healthcare Research and Quality (AHRQ) and examined 12 dimensions of PSC. A total of 1629 returned surveys indicated a 46% returned rate.

Results

Results from 1133 analyzed surveys indicated that nurses born and educated abroad exhibited more favorable PSC perceptions in their workplaces, followed by nurses born abroad and educated in the United States. Nurses born and educated in the United States demonstrated the lowest perceptions of workplace PSC overall (P < 0.001).

Conclusions

Although foreign born and trained nurses report higher PSC perceptions than domestically born and educated nurses, further research is needed to understand why these differences occur.
Implementation of an Electronic Checklist to Improve Patient Handover From Ward to Operating Room
Authors: Münter Kristine H. , Møller Thea P. , Østergaard Doris , Fuhrmann Lone
Published: November 2017

Objective

Research has identified numerous safety risks in perioperative patient handover. In handover from ward to operating room (OR), patients are often transferred by a third person. This adds to the risk of loss of important information and of caregivers in the OR not identifying possible risk factors. The aim of this study was to describe the implementation process and completion rate of a new preoperative, ward-to-OR checklist. Our goal was a 90% fulfillment.

Method

This study is a prospective, observational study in a Danish University Hospital including all patients undergoing surgery in 2013. The checklist was a screen page with 27 checkboxes of information relevant for a safe handover. The checklist should be completed in the ward before handover to the OR and should be checked in the OR before receiving the patient. The Plan-Do-Study-Act (PDSA) cycle method was used in the implementation process of the checklist.

Results

A total of 17.361 patients were included. In wards with only elective surgery (plastic and breast surgery), the checklist was used in 1.419 of 2.286 patients (62.1%). In wards with both elective and emergency surgery (abdominal, orthopedic, urology, gynecology and obstetrics), the checklist was used in 1.963 of 7.460 elective patients (26.3%) and in 812 of 7.615 emergency patients (10.7 %).

Conclusion

Our goal of a 90% fulfillment was not reached. The electronic checklist seemed to be used most frequently in wards with only elective surgery.
Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A Qualitative Analysis of Veterans Health Administration Staff Perceptions
Authors: Mull Hillary J. , Rosen Amy K. , Charns Martin P. , Itani Kamal M.F. , Rivard Peter E.
Published: November 2017

Objectives

Little is known about patient safety risks in outpatient surgery. Inpatient surgical adverse events (AEs) risk factors include patient- (e.g., advanced age), process- (e.g., inadequate preoperative assessment), or structure-related characteristics (e.g., low surgical volume); however, these factors may differ from outpatient care where surgeries are often elective and in younger/healthier patients. We undertook an exploratory qualitative research project to identify risk factors for AEs in outpatient surgery.

Methods

We developed a conceptual framework of patient, process, and structure factors associated with surgical AEs on the basis of a literature review. This framework informed our semistructured interview guide with (1) open-ended questions about a specific outpatient AE that the participant experienced and (2) outpatient surgical patient safety risk factors in general. We interviewed nationwide Veterans Health Administration surgical staff. Results were coded on the basis of categories in the conceptual framework, and additional themes were identified using content analysis.

Results

Fourteen providers representing diverse surgical roles participated. Ten reported witnessing an AE, and everyone provided input on risk factors in our conceptual framework. We did not find evidence that patient race/age, surgical technique, or surgical volume affected patient safety. Emerging factors included patient compliance, postoperative patient assessments/instruction, operating room equipment needs, and safety culture.

Conclusions

Surgical staff are familiar with AEs and patient safety problems in outpatient surgery. Our results show that processes of care undertaken by surgical providers, as opposed to immutable patient characteristics, may affect the occurrence of AEs. The factors we identified may facilitate more targeted research on outpatient surgical AEs.
Learning From Incident Reporting? Analysis of Incidents Resulting in Patient Injuries in a Web-Based System in Swedish Health Care
Authors: Ahlberg Eva-Lena , Elfström Johan , Borgstedt Madeleine Risberg , Öhrn Annica , Andersson Christer , Sjödahl Rune , Nilsen Per
Published: November 2017

Objectives

Incident reporting (IR) systems have the potential to improve patient safety if they enable learning from the reported risks and incidents. The aim of this study was to investigate incidents registered in an IR system in a Swedish county council.

Methods

The study was conducted in the County Council of Östergötland, Sweden. Data were retrieved from the IR system, which included 4755 incidents occurring in somatic care that resulted in patient injuries from 2004 to 2012. One hundred correctly classified patient injuries were randomly sampled from 3 injury severity levels: injuries leading to deaths, permanent harm, and temporary harm. Three aspects were analyzed: handling of the incident, causes of the incident, and actions taken to prevent its recurrence.

Results

Of the 300 injuries, 79% were handled in the departments where they occurred. The department head decided what actions should be taken to prevent recurrence in response to 95% of the injuries. A total of 448 causes were identified for the injuries; problems associated with procedures, routines, and guidelines were most common. Decisions taken for 80% of the injuries could be classified using the IR system documentation and root cause analysis. The most commonly pursued type of action was change of work routine or guideline.

Conclusions

The handling, causes, and actions taken to prevent recurrence were similar for injuries of different severity levels. Various forms of feedback (information, education, and dialogue) were an integral aspect of the IR system. However, this feedback was primarily intradepartmental and did not yield much organizational learning.
Network Viral Load: A Critical Metric for HIV Elimination
Authors: Skaathun Britt , Khanna Aditya S. , Morgan Ethan , Friedman Samuel R. , Schneider John A.
Published: November 2017

Background:

Associations have been observed between an aggregate viral load measure, the community viral load, and new HIV diagnoses. The community viral load aggregates viral loads within chosen geographic areas, restricting inferences about HIV acquisition risk to these areas. We develop a more precise metric, the network viral load (NVL), to measure the composite viral load within a risk network of a HIV-negative individual.

Methods:

We examined the relationship between NVL and HIV infection among young men who have sex with men in Chicago, United States. Networks were generated using respondent-driven sampling. NVL was defined as the prevalence of viremic individuals in one's risk network, characterized as those with a viral load ≥20 k copies per milliliter. Permutation tests were conducted to account for dependency.

Results:

After controlling for total connections, age, substance use during sex, syphilis diagnosis (previous 12 months), and frequency of condomless anal sex (previous 6 months), we found a positive association between NVL and HIV infection. Compared with a network with all HIV-seronegative members, the odds of HIV infection with an NVL of <10% viremia were 1.85 (95% confidence interval: 1.18 to 2.92) times higher and those with an NVL of ≥10% viremia were 2.73 (95% confidence interval: 1.54 to 4.85) times higher.

Conclusions:

We found a positive association between NVL and HIV seroprevalence. Although limited in its ability to infer causality, NVL could have substantial public health implications for persons most at risk for HIV infection, given that this novel metric avoids overreliance on individual level behavior or broad community indices.
Alcohol and Mortality: Combining Self-Reported (AUDIT-C) and Biomarker Detected (PEth) Alcohol Measures Among HIV Infected and Uninfected
Authors: Eyawo Oghenowede , McGinnis Kathleen A. , Justice Amy C. , Fiellin David A. , Hahn Judith A. , Williams Emily C. , Gordon Adam J. , Marshall Brandon D. L. , Kraemer Kevin L. , Crystal Stephen , Gaither Julie R. , Edelman E. Jennifer , Bryant Kendall J. , Tate Janet P. ,   for the VACS Project team
Published: November 2017

Background:

Unhealthy alcohol use may be particularly detrimental among individuals living with HIV and/or hepatitis C virus (HCV), and is often under-reported. Direct biomarkers of alcohol exposure may facilitate improved detection of alcohol use.

Methods:

We evaluated the association of alcohol exposure determined by both self-report [Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)] and a direct biomarker [phosphatidylethanol (PEth)], with mortality among HIV-infected and HIV-uninfected in the Veterans Aging Cohort Study-Biomarker Cohort. We considered PEth <8 ng/mL to represent no alcohol use. Alcohol exposure by AUDIT-C scores [0, 1–3/1–2 (men/women), 4–7/3–7 (men/women), 8–12] and PEth (<8, ≥8) was combined into categories to model the relationship of alcohol with mortality. Participants were followed from blood collection date for 5 years or until death within 5 years.

Results:

The sample included 2344 (1513 HIV+; 831 uninfected) individuals, 95% men. During a median follow-up of 5 years, 13% died. Overall, 36% were infected with HCV (40% HIV+/HCV+, 27% HIV−/HCV+). Overall, 43% (1015/2344) had AUDIT-C = 0 (abstinence). Of these, 15% (149/1015) had PEth ≥8 suggesting recent alcohol exposure. Among those with AUDIT-C = 0, HCV+ individuals were more likely to have PEth ≥8. After controlling for age, sex, race, HIV, HCV, and HIV viral suppression, those with AUDIT-C = 0 but PEth ≥8 had the highest risk of mortality (adjusted hazard ratio 2.15, 95% confidence interval: 1.40 to 3.29).

Conclusions:

PEth in addition to self-report may improve detection of alcohol use in clinical settings, particularly among those at increased risk of harm from alcohol use. Individuals infected with HCV were more likely to under-report alcohol use.
Mechanisms of Toxicity and Modulation of Hemoglobin-based Oxygen Carriers
Authors: Alayash Abdu I.
Published: November 2017

Several adverse events have been associated with the infusion of hemoglobin-based oxygen carriers (HBOCs), including transient hypertension, gastrointestinal, pancreatic/liver enzyme elevation, and cardiac/renal injury in humans. Although several mechanisms have been suggested, the basis of HBOC toxicity is still poorly understood. Scavenging of vascular endothelial nitric oxide (NO) and heme-mediated oxidative side reactions are thought to be the major causes of toxicity. However, based on more recent preclinical studies, oxidative pathways (driven by the heme prosthetic group) seem to play a more prominent role in the overall toxicity of free Hb or HBOCs. HBOCs display a diversity of physicochemical properties, including molecular size/cross-linking characteristics leading to differences in oxygen affinity, allosteric, redox properties, and even oxidative inactivation by protein/heme clearing mechanisms. These diverse characteristics can therefore be manipulated independently, leaving open the possibility of engineering a safe and effective HBOC. To date, several antioxidative strategies have been proposed to counteract the redox side reactions of current generation HBOCs.
Cardiogenic Shock Due to End-Stage Heart Failure and Acute Myocardial Infarction: Characteristics and Outcome of Temporary Mechanical Circulatory Support
Authors: Lim Hoong Sern , Howell Neil
Published: November 2017

Background:

Mechanical circulatory support (MCS) is increasingly used in cardiogenic shock, but outcomes may differ between patients with acute myocardial infarction (AMI) or end-stage heart failure (ESHF). This study aimed to describe the characteristics of patients with cardiogenic shock due to AMI and ESHF.

Methods:

Single-center study of consecutive patients with cardiogenic shock due to AMI (n = 26) and ESHF (n = 42) who underwent MCS (extracorporeal life support, Impella or temporary ventricular assist devices). Arterial and venous O2 content and CO2 tension (PCO2), O2-hemoglobin affinity (P50) were measured. Veno-arterial difference in PCO2/arterio-venous difference in O2 content ratio was derived. Acid–base balance was characterized by the Gilfix method. MCS-related complications that required intervention or surgery were collected.

Results:

Patients with ESHF had lower ejection fraction, higher right and left-sided filling pressures, pulmonary artery pressure and vascular resistance, lower oxygen delivery (DO2) compared with AMI, which was not fully compensated by the increased hemoglobin P50. As a result, patients with ESHF had higher veno-arterial difference in PCO2 relative to arterio-venous difference in O2 content. Despite greater anerobic metabolism, patients with ESHF had less severe metabolic acidosis and base deficit compared with AMI, predominantly due to differences in strong ions.

Conclusion:

The cardiogenic shock phenotype in ESHF was distinct from AMI, characterized by higher filling and pulmonary artery pressures, lower DO2, greater anaerobic metabolism but less severe metabolic acidosis.
Cardiovascular and Cerebral Hemodynamics in Asymptomatic Healthy Subjects With/Without Abnormal Head-up Tilt Test Versus Recurrent Fainters
Authors: González-Hermosillo Antonio , Sierra-Beltrán Manuel , López-Peña Ulises , Kostin Andrei , Hernández-Pacheco Guadalupe , Lerma Claudia
Published: November 2017

Purpose:

The aim of this study was to compare hemodynamic and autonomic responses during head-up tilt test (HUTT) between healthy volunteers and patients with a history of fainting and confirmed vasovagal syncope. We hypothesize that the autonomic and hemodynamic physiologic responses remain intact during orthostatic stress in people without previous fainting and negative HUTT, but deteriorate similarly in patients with recurrent vasovagal syncope and in asymptomatic healthy subjects who develop a vasovagal response during HUTT.

Methods:

The study included 57 asymptomatic healthy volunteers (42% women, mean age 23.7 ± 3.6 years) categorized as negative HUTT (n = 41) and positive HUTT (n = 16). They were compared with 14 patients (50% women, mean age 24.2 ± 6.1 years) with previous spontaneous recurrent syncope and inducible vasovagal response during HUTT. Cerebral and cardiovascular hemodynamic variables were assessed noninvasively during the HUTT in each participant.

Results:

In all patients with recurrent syncope, tilt was positive after a mean delay of 15.6 ± 8.6 minutes and did not differ from the time to syncope observed after 19.6 ± 6.9 minutes in asymptomatic healthy subjects with a positive test. A significant decrease throughout the tilting was observed in the blood pressure, peripheral resistances, cerebral blood flow, and vascular efferent sympathetic regulation in both groups of subjects with a positive test.

Conclusions:

This study shows that there are subjects, without a history of syncope, who have a positive HUTT with hemodynamic and autonomic responses alike to patients with confirmed vasovagal syncope, precluding them to be selected as controls in vasovagal syncope studies.
Abnormal reward prediction error signalling in antipsychotic naïve individuals with first episode psychosis or clinical risk for psychosis
Authors: Ermakova Anna O , Knolle Franziska , Justicia Azucena , Bullmore Edward T , Jones Peter B , Robbins Trevor W , Fletcher Paul C , Murray Graham K
Published: November 2017

Ongoing research suggests preliminary, though not entirely consistent, evidence of neural abnormalities in signalling prediction errors in schizophrenia. Supporting theories suggest mechanistic links between the disruption of these processes and the generation of psychotic symptoms. However, it is not known at what stage in psychosis these impairments in prediction error signalling develop. One major confound in prior studies is the use of medicated patients with strongly varying disease durations. Our study aims to investigate the involvement of the meso-cortico-striatal circuitry during reward prediction error signalling in the earliest stages of psychosis. We studied patients with first episode psychosis (FEP) and help-seeking individuals at risk for psychosis due to subthreshold prodromal psychotic symptoms. Patients with either FEP (n = 14), or at-risk for developing psychosis (n= 30), and healthy volunteers (n = 39) performed a reinforcement learning task during fMRI scanning. ANOVA revealed significant (p<0.05 family-wise error corrected) prediction error signalling differences between groups in the dopaminergic midbrain and right middle frontal gyrus (dorsolateral prefrontal cortex, DLPFC). Patients with FEP showed disrupted reward prediction error signalling compared to controls in both regions. At-risk patients showed intermediate activation in the midbrain that significantly differed from controls and from FEP patients, but DLPFC activation that did not differ from controls. Our study confirms that patients with FEP have abnormal meso-cortical signalling of reward prediction errors, whilst reward prediction error dysfunction in the at-risk patients appears to show a more nuanced pattern of activation with a degree of midbrain impairment but preserved cortical function.
A deep learning system can accurately classify primary and metastatic cancers based on patterns of passenger mutations
Authors: Jiao Wei , Atwal Gurnit , Polak Paz , Karlic Rosa , Cuppen Edwin , Danyi Alexandra , de Ridder Jeroen , van Herpen Carla , Lolkema Martijn P , Steeghs Neeltje , Getz Gad , Morris Quaid D , Stein Lincoln D. ,   PCAWG Pathology & Clinical Correlates Working Grp,   ICGC/TCGA Pan-cancer Analysis of Whole Genomes Net
Published: November 2017

In cancer, the primary tumour's organ of origin and histopathology are the strongest determinants of its clinical behaviour, but in 3% of the time a cancer patient presents with metastatic tumour and no obvious primary. Challenges also arise when distinguishing a metastatic recurrence of a previously treated cancer from the emergence of a new one. Here we train a deep learning classifier to predict cancer type based on patterns of somatic passenger mutations detected in whole genome sequencing (WGS) of 2606 tumours representing 24 common cancer types. Our classifier achieves an accuracy of 91% on held-out tumor samples and 82% and 85% respectively on independent primary and metastatic samples, roughly double the accuracy of trained pathologists when presented with a metastatic tumour without knowledge of the primary. Surprisingly, adding information on driver mutations reduced classifier accuracy. Our results have immediate clinical applicability, underscoring how patterns of somatic passenger mutations encode the state of the cell of origin, and can inform future strategies to detect the source of cell-free circulating tumour DNA.
Structure of the Bacillus anthracis dTDP-L-rhamnose-biosynthetic enzyme dTDP-4-dehydrorhamnose reductase (RfbD)
Authors: Law Ashley , Stergioulis Alexander , Halavaty Andrei S. , Minasov George , Anderson Wayne F. , Kuhn Misty L.
Published: November 2017

Bacillus anthracis is the causative agent of the deadly disease Anthrax. Its use in bioterrorism and its ability to re-emerge have brought renewed interest in this organism. B. anthracis is a Gram-positive bacterium that adds L-rhamnose to its cell-wall polysaccharides using the activated donor dTDP-β-L-rhamnose. The enzymes involved in the biosynthesis of the activated donor are absent in humans, which make them ideal targets for therapeutic development to combat pathogens. Here, the 2.65 Å resolution crystal structure of the fourth enzyme in the dTDP-β-L-rhamnose-biosynthetic pathway from B. anthracis, dTDP-4-dehydro-β-L-rhamnose reductase (RfbD), is presented in complex with NADP+. This enzyme catalyzes the reduction of dTDP-4-dehydro-β-L-rhamnose to dTDP-β-L-rhamnose. Although the protein was co-crystallized in the presence of Mg2+, the protein lacks the conserved residues that coordinate Mg2+.
Crystal structure of a pyridoxal 5′-phosphate-dependent aspartate racemase derived from the bivalve mollusc Scapharca broughtonii
Authors: Mizobuchi Taichi , Nonaka Risako , Yoshimura Motoki , Abe Katsumasa , Takahashi Shouji , Kera Yoshio , Goto Masaru
Published: November 2017

Aspartate racemase (AspR) is a pyridoxal 5′-phosphate (PLP)-dependent enzyme that is responsible for D-aspartate biosynthesis in vivo. To the best of our knowledge, this is the first study to report an X-ray crystal structure of a PLP-dependent AspR, which was resolved at 1.90 Å resolution. The AspR derived from the bivalve mollusc Scapharca broughtonii (SbAspR) is a type II PLP-dependent enzyme that is similar to serine racemase (SR) in that SbAspR catalyzes both racemization and dehydration. Structural comparison of SbAspR and SR shows a similar arrangement of the active-site residues and nucleotide-binding site, but a different orientation of the metal-binding site. Superposition of the structures of SbAspR and of rat SR bound to the inhibitor malonate reveals that Arg140 recognizes the β-carboxyl group of the substrate aspartate in SbAspR. It is hypothesized that the aromatic proline interaction between the domains, which favours the closed form of SbAspR, influences the arrangement of Arg140 at the active site.
Juggling complex systems within a metropolitan health district
Authors: Scheepers Caren , Thomas Leena , Meyer Ellenore
Published: November 2017

Subject area

Leadership and Health Care management and Organisational Development and Talent Management.

Study level/applicability

Postgraduate level for honours or master’s programs in courses on public health, executive leadership and management, organisational development and public administration leadership.

Case overview

The case study offers an account of Ms Xolani Ngumi’s Chief Director, Enola District Health Services, South Africa, who was driving from her newly constructed modern district hospital to one of the municipal clinics that she was overseeing. It highlights the dilemma of the general practitioners (GP’s) that refused to be relocated, leading to many clinics being without clinical support.

Expected learning outcomes

Expected learning outcomes are as follows: Identification of stakeholders in a particular dilemma to aid leaders’ decision-making; developing the competence of balancing conflicting needs of stakeholders by juggling complex systems; and analysing staffing issues and offer recommendations to enhance talent management.

Supplementary materials

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 7: Management Science.
Schwannoma of the appendix: A case report and review of the literature
Authors: Cheng Ernest , Oliphant Raymond , Fung Caroline , Rickard Matthew , Keshava Anil
Published: November 2017

Appendiceal neoplasms are uncommon and found in 1.6 per cent of appendicectomy specimens. Schwannomas arising from the appendix are of significant rarity, with only a few previously‐reported cases. In this study, we present the case of a 31‐year‐old man who underwent a laparoscopic appendicectomy and was found to have an appendiceal schwannoma. In the present study, we review the literature of this rare condition, which serves to highlight the potential for appendiceal neoplasia to occur in a macroscopically‐normal appendix. Furthermore, it emphasizes the potential risk of missed appendiceal neoplasia as a sequelae of nonoperative management of suspected appendicitis.
The self‐reported quality of life of Lithuanian children with asthma was comparable to Western populations
Authors: Taminskiene Vaida , Vaitkaitiene Egle , Valiulis Algirdas , Turner Steve , Hadjipanayis Adamos , Stukas Rimantas , Valiulis Arunas
Published: November 2017

Aim

Quality of life (QoL) has been widely researched among children with asthma in Western countries, but there is a lack of data from eastern Europe, where the prevalence is relatively low, but hospital admission rates are higher. We evaluated the overall level and major determinants of QoL in Lithuanian children aged 5–11 years with asthma.

Methods

This study was carried out in six asthma outpatient clinics in the two largest cities of Lithuania from January 2015 to July 2016. The children's QoL was measured using the Pediatric Quality of Life Inventory (PedsQL) asthma module, which was completed by the child and one parent.

Results

We collected questionnaires from 226 children (68% boys) with a mean age of eight (±2) years: 65% had mild asthma, 31% had moderate asthma and 4% had severe asthma. One in 10 had been hospitalised in the preceding 6 months. The mean self‐reported QoL score was 74 and the parent‐reported QoL score was 73. QoL was associated with asthma severity and control, shortness of breath and the child's general health, but not socioeconomic factors.

Conclusion

The overall level and major determinants of QoL in children with asthma in Lithuania were comparable with Western populations.
CSR Participation Committees, Wildcat Strikes and the Sourcing Squeeze in Global Supply Chains
Authors: Anner Mark
Published: November 2017

Lead firms in apparel global supply chains are increasingly using social compliance programmes that require worker‐management participation committees in their supplier factories. These committees are designed to ensure respect for internationally recognized labour standards, to empower workers, and to reduce labour unrest. However, these committees have remained weak, and in countries such as Vietnam worker unrest remains common. This article argues that this is because lead firms in these CSR programmes are imposing a ‘sourcing squeeze’ on supplier factors by reducing the prices and production times they allot to their suppliers, which undermines efforts by committees to address cost‐sensitive issues and overtime violations. At the same time, the sourcing squeeze increases strike leverage, providing workers with a much more effective source of worker voice.
Bioactive treatments in bone grafts for implant‐based rehabilitation: Systematic review and meta‐analysis
Authors: da Rosa Wellington Luiz de Oliveira , da Silva Tiago Machado , da Silva Adriana Fernandes , Piva Evandro
Published: November 2017

Background

The use of bioactive proteins, such as rhBMP‐2, may improve bone regeneration in oral and maxillofacial surgery.

Purpose

Analyze the effect of using bioactive proteins for bone regeneration in implant‐based rehabilitation.

Materials and Methods

Seven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant‐based rehabilitation were included. Statistical analyses were carried out using a random‐effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05).

Results

Seventeen studies were included in the qualitative analysis, and 16 in the meta‐analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow‐up, no statistically significant differences were observed for implant survival (P > .05).

Conclusions

Bioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long‐term effect of using bioactive treatments for implant‐based rehabilitation.
Quality of questionnaires for the assessment of otitis media with effusion in children
Authors: Gan R.W.C. , Daniel M. , Ridley M. , Barry J.G.
Published: November 2017

Objectives

Audiometric tests provide information about hearing in otitis media with effusion (OME). Questionnaires can supplement this information by supporting clinical history‐taking as well as potentially providing a standardized and comprehensive assessment of the impact of the disease on a child. There are many possible candidate questionnaires. This study aimed to assess the quality and usability of parent / child questionnaires in OME assessment.

Design and main outcome measures

Fifteen, published questionnaires, commonly used in audiological departments (Auditory Behaviour in Everyday Life (ABEL), Children's Auditory Performance Scale (CHAPS), Children's Home Inventory for Listening Difficulties (CHILD), Children's Outcome Worksheets (COW), Evaluation of Children's Listening and Processing Skills (ECLiPS), Early Listening Function (ELF), Fisher's Auditory Problem Checklist (FAPC), Hearing Loss 7 (HL‐7), Listening Inventory for Education‐ Revised (LIFE‐R Student), Listening Inventory for Education UK Individual Hearing Profile (LIFE‐UK IHP), LittlEARS Auditory Questionnaire (LittlEARS), Listening Situations Questionnaire (LSQ), Otitis Media 6 (OM‐6), Quality of Life in Children's Ear Problems (OMQ‐14), Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) were assessed according to the following 8 criteria: conceptual clarity, respondent burden, reliability, validity, normative data, item bias, ceiling/ floor effects, and administrative burden.

Results

ECLiPS, LittlEARS and PEACH scored highest overall based on the assessment criteria established for this study. None of the questionnaires fully satisfied all 8 criteria. Although all questionnaires assessed issues considered to be of at least adequate relevance to OME, the majority had weaknesses with respect to the assessment of psychometric properties, such as item bias, floor/ceiling effects or measurement reliability and validity. Publications reporting on the evaluation of reliability, validity, normative data, item bias and ceiling/floor effects were not available for most of the questionnaires.

Conclusions

This formal evaluation of questionnaires, currently available to clinicians, highlights three questionnaires as potentially offering a useful adjunct in the assessment of OME in clinical or research settings. These were the ECLiPS, which is suitable for children aged 6 years and older, and either the LittlEARS or the PEACH for younger children. The latter two are narrowly focused on hearing, whereas ECLiPS has a broader focus on listening, language and social difficulties.
Spättypreaktionen auf oral und parenteral verabreichte Arzneimittel
Authors: Brandt Oliver , Bircher Andreas J.
Published: November 2017

Spättypreaktionen auf Arzneimittel gehören zu den häufigsten Ursachen für Dermatosen überhaupt und manifestieren sich überwiegend in Form relativ harmloser exanthematischer, makulöser oder makulopapulöser Läsionen. Etwa zwei Prozent der betroffenen Patienten allerdings entwickeln schwere oder gar lebensbedrohliche, mit systemischen Immunreaktionen und damit verbundenen Organbeteiligungen einhergehende Reaktionen, die frühestmöglich erkannt und adäquat behandelt werden müssen. Zahlreiche Medikamente können Auslöser dieser Hypersensitivitätsreaktionen sein; Antibiotika, Antiepileptika und der Xanthinoxidase‐Inhibitor Allopurinol sind die häufigsten. Neben einer genetischen Prädisposition gelten hohe Dosen, Behandlungen mit multiplen Arzneimitteln, lange Therapiezeiten, weibliches Geschlecht sowie akute oder chronische Infektionen als prädisponierende Faktoren.
Role of two‐step endoscopic ultrasonography‐guided antegrade treatment as an option for bile duct stones in patients with surgically altered anatomy
Authors: Shimatani Masaaki , Mitsuyama Toshiyuki , Takaoka Makoto , Okazaki Kazuichi
Published: November 2017

This Editorial refers to the article by Y. Nakai, p125-127 of this issue.
Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure
Authors: Roushdy Alaa , Abd el razek Yasmeen , Mamdouh Tawfik Ahmed
Published: November 2017

Aim

To determine anatomic and hemodynamic echocardiographic predictors for patent ductus arteriosus (PDA) device vs coil closure.

Methods

Seventy‐six patients who were referred for elective transcatheter PDA closure were enrolled in the study. All patients underwent full echocardiogram including measurement of the PDA pulmonary end diameter, color flow width and extent, peak and end‐diastolic Doppler gradients across the duct, diastolic flow reversal, left atrial dimensions and volume, left ventricular sphericity index, and volumes.

Results

The study group was subdivided into 2 subgroups based on the mode of PDA closure whether by coil (n = 42) or device (n = 34). Using univariate analysis there was a highly significant difference between the 2 groups as regard the pulmonary end diameter measured in both the suprasternal and parasternal short‐axis views as well as the color flow width and color flow extent (P < .0001). The device closure group had statistically significant higher end‐systolic and end‐diastolic volumes indexed, left atrial volume, and diastolic flow reversal. Receiver operating characteristic curve analysis showed a pulmonary end diameter cutoff point from the suprasternal view > 2.5 mm and from parasternal short‐axis view > 2.61 mm to have the highest balanced sensitivity and specificity to predict the likelihood for device closure (AUC 0.971 and 0.979 respectively). The pulmonary end diameter measured from the suprasternal view was the most independent predictor of device closure.

Conclusion

The selection between PDA coil or device closure can be done on the basis of multiple anatomic and hemodynamic echocardiographic variables.
Association between temporal and spatial beta diversity in phytoplankton
Authors: Zhang Min , Chen Feizhou , Shi Xiaoli , Yang Zhen , Kong Fanxiang
Published: November 2017

The rates of temporal and spatial species turnover have been compared in different organisms and scales, revealing that both are not independent but, rather, associated. However, the knowledge is limited for the association between spatial turnover and temporal turnover. Here, we performed two investigations of the phytoplankton composition in the lakes of the Yangtze River catchment in China in the spring and summer of 2012, which covered regional spatial scale and two‐season temporal scale. We analysed the association between temporal and spatial species turnover in phytoplankton. The results showed that 1) the two‐season temporal turnover of phytoplankton varied based on the mean values and the coefficient of variance of environmental variables, and pH was the most important variable negatively affecting the temporal turnover; 2) the spatial beta diversity of phytoplankton in summer was higher than that in spring, and the distance decay pattern was significant in summer, but not in spring; 3) the variation in spatial turnover in spring and summer was attributed to the primary environmental variables (nitrogen, phosphorus and underwater available light) and broader‐scale spatial variables; 4) the proportion of jointly explained variation of spatial Bray–Curtis dissimilarity by the environment and space increased from ~38% (spring) to ~55% (summer), which was mainly due to the variation in spatially structured environmental variables during the two‐season temporal turnover, such as pH and ion concentrations; 5) the community compositions in summer were more similar between the lakes with similar two‐season temporal turnover. These results indicate that the spatial turnover of phytoplankton composition in summer was partially predetermined by the variation in environmental variables and phytoplankton composition during the process of two‐season temporal turnover, and highlight the understanding of temporal variations in spatial beta diversity as well as the underlying assembly mechanisms in phytoplankton.
Common data elements for preclinical epilepsy research: Standards for data collection and reporting. A TASK3 report of the AES/ILAE Translational Task Force of the ILAE
Authors: Harte‐Hargrove Lauren C. , French Jacqueline A. , Pitkänen Asla , Galanopoulou Aristea S. , Whittemore Vicky , Scharfman Helen E.
Published: November 2017

The major objective of preclinical translational epilepsy research is to advance laboratory findings toward clinical application by testing potential treatments in animal models of seizures and epilepsy. Recently there has been a focus on the failure of preclinical discoveries to translate reliably, or even to be reproduced in different laboratories. One potential cause is a lack of standardization in preclinical data collection. The resulting difficulties in comparing data across studies have led to high cost and missed opportunity, which in turn impede clinical trials and advances in medical care. Preclinical epilepsy research has successfully brought numerous antiseizure treatments into the clinical practice, yet the unmet clinical needs have prompted the reconsideration of research strategies to optimize epilepsy therapy development. In the field of clinical epilepsy there have been successful steps to improve such problems, such as generation of common data elements (CDEs) and case report forms (CRFs and standards of data collection and reporting) by a team of leaders in the field. Therefore, the Translational Task Force was appointed by the International League Against Epilepsy (ILAE) and the American Epilepsy Society (AES), in partnership with the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institutes of Health (NIH) to define CDEs for animal epilepsy research studies and prepare guidelines for data collection and experimental procedures. If adopted, the preclinical CDEs could facilitate collaborative epilepsy research, comparisons of data across different laboratories, and promote rigor, transparency, and impact, particularly in therapy development.
Economic effects of terrorism: Local and city considerations, priorities for research and policy
Authors: Desai Sameeksha
Published: November 2017

The economic effects of terrorist attacks are difficult to assess, in part because terrorism is highly local. Local dimensions are crucial for policymakers who are increasingly interested in resilience to terrorism, yet they have a very small body of scholarship from which to derive operationally relevant guidance. Spatial and local dimensions of terrorism are central to understanding the nature and magnitude of economic effects. This paper provides an overview of some of the key questions in this regard, and particularly with respect to cities, and outlines several priorities for future research.
Fabrication of tubular solid oxide fuel cells by solvent‐assisted lamination and co‐firing a rolled multilayer tape cast
Authors: Hedayat Nader , Panthi Dhruba , Du Yanhai
Published: November 2017

This study presents preliminary results for tubular anode‐supported solid oxide fuel cells (SOFCs) fabricated by a novel method based on tape casting. A multilayer tape cast was prepared by successive casting of the anode support, anode functional layer, and electrolyte. The tape cast was rolled into a tube, and the ends of the tape were joined by solvent‐assisted lamination. The sample was co‐fired at 1400°C, followed by screen printing and sintering of the cathode at 1150°C. The electrochemical performance of the tubular cell was evaluated in N2/H2 gas at 750°C. The cell generated a maximum power density of 90 mW/cm2. The scanning electron microscope (SEM) micrographs after the electrochemical tests confirmed that the solvent‐assisted lamination resulted in stable joining without delamination. Although the process and performance have yet to be optimized, the use of multilayer tape casting, solvent‐assisted lamination, and co‐firing is expected to make this method advantageous for low‐cost mass production of tubular SOFCs.
Social mobility allowing for ethnic identification: reassertion of ethnicity among Moroccan and Turkish Dutch
Authors: Slootman Marieke
Published: November 2017

The emergence of middle‐classes that articulate their ethnic distinctiveness leads to discomfort and bewilderment in many societies. This rejection arises from assimilationist demands and straight‐line integration assumptions which dominate the integration discourse. Relying on social‐psychological theories, this mixed‐methods study explores the ethnic identification of university‐educated second‐generation Moroccan and Turkish Dutch. The findings once more underscore that ethnic and national identifications are not mutually exclusive, nor are ethnic identifications mere acts of ethnic retention. The findings suggest that social mobility shapes processes of ethnic identification in particular ways, in the sense that the belonging and self‐esteem that come with achieving an advanced socio‐economic status allow for (and even encourage) assertion of the ethnic‐minority identity; an ethnic identity that is partially reinvented. The insights of this study can help nuance the increasingly polarizing and exclusionary integration debates.
The influence of tobacco retailers on adolescent smoking: prevention and policy implications
Authors: Gwon S.H. , Yan G. , Huang G. , Kulbok P.A.
Published: November 2017

Background

Smoking rates are higher among adolescents in South Korea than among those in other Asian countries. Researchers have reported associations between the presence of licensed tobacco retailers and adolescent smoking rates. However, few researchers have examined the factors that influence adolescent smoking including those that are intrapersonal, interpersonal or related to the tobacco retailers’ environment.

Aim

The purpose of this study was to describe factors related to the students, the licensed tobacco retailers and the schools and how those factors are associated with adolescent smoking outcomes such as tobacco marketing receptivity, lifetime smoking and current smoking.

Methods

The survey data were gathered from 740 South Korean adolescents, and geographic data for 3488 licensed tobacco retailers were also used. Geographic Information Systems and multilevel modeling were used to describe the variables and determine the factors associated with smoking outcomes in the sample.

Results

The factors that influenced receptivity to tobacco marketing included the presence of peers who smoke and the frequencies of licensed tobacco retailers passed on the way to school. The factors that influenced lifetime smoking included gender, perceived economic status, weekly income, the presence of siblings or peers who smoke and frequencies of licensed tobacco retailers passed on the way to school. The factors that influenced current smoking included gender, weekly income, and the presence of siblings or peers who smoke.

Conclusions

These factors will guide adolescent tobacco prevention programs and policies.

Implications for nursing practice and health policy

The study's implications for nursing practice and health policy are that school nurses and public health nurses need to be encouraged to use retailer‐related factors in adolescent smoking‐prevention programs. There is also a need for zoning and licensing regulations to restrict licensed tobacco retailers in areas that adolescents frequent, including schools.
The Impact of Firm‐Level Illiquidity on Crash Risk and the Role of Media Independence: International Evidence
Authors: An Zhe , Gao Wenlian , Li Donghui , Zhu Feifei
Published: November 2017

This study investigates the impact of firm‐level illiquidity on stock price crash risk by employing a sample of 21,986 firms across 36 countries spanning the years 1997 to 2007. In doing so, the role of media independence in shaping this impact is also examined. The empirical results suggest that stock illiquidity is significantly and positively associated with firm‐level crash risk. Furthermore, the positive association between illiquidity and crash risk has been mitigated in countries with independent media, characterized by a lower level of state ownership and a higher level of press freedom, in addition to the reduction effect of media independence per se on crash risk. Our main conclusions remain valid after taking into account the endogeneity issues and various robustness tests.