bluuebunny/crossref_metadata_2025 huggingface dataset:
Social capital as a key determinant of perceived benefits of community‐based marine protected areas
Authors: Diedrich Amy , Stoeckl Natalie , Gurney Georgina G. , Esparon Michelle , Pollnac Richard
Published: August 2016

Globally, marine protected areas (MPAs) have been relatively unsuccessful in meeting biodiversity objectives. To be effective, they require some alteration of people's use and access to marine resources, which they will resist if they do not perceive associated benefits. Stakeholders’ support is crucial to ecological success of MPAs, and their support is likely to depend on their capacity to adapt to and benefit from MPAs. We examined the influence of social adaptive capacity (SAC) on perceived benefits of MPAs in Siquijor, Philippines, in the Coral Triangle. This region has substantial biodiversity and a population of over 120 million people, many of them dependent on marine resources for food and income. The region has many MPAs, most of which are managed under decentralized governance systems. We collected survey data from 540 households in 19 villages with associated MPAs. We evaluated the influence of multiple SAC variables (e.g., occupational multiplicity and social capital) on perceived benefits with decision trees (CHAID) and qualitatively analyzed this relationship with respect to types and recipients of benefits. Our models revealed the key role of social capital, particularly trust in leadership, in influencing perceptions of benefits (χ2 = 14.762, p = 0.000). A path analysis revealed that perceptions of distributional equity were a key mechanism through which social capital affected perceived MPA benefits (root mean‐square error of approximation = 0.050). Building social capital and equity within communities could lead to more effective management of MPAs and thus to expenditure of fewer resources relative to, for example, regulation enforcement.
1,25 Dihydroxyvitamin D circulating levels, calcitriol administration, and incidence of acute rejection, CMV infection, and polyoma virus infection in renal transplant recipients
Authors: Moscarelli Luciano , Antognoli Giulia , Buti Elisa , Dervishi Egrina , Fani Filippo , Caroti Leonardo , Tsalouchos Aris , Romoli Elena , Ghiandai Giulia , Minetti Enrico
Published: August 2016

Observation that 1,25‐Dihydroxyvitamin‐D3 has an immunomodulatory effect on innate and adaptive immunity raises the possible effect on clinical graft outcome. Aim of this study was to evaluate the correlation of biopsy‐proven acute rejection, CMV infection, BKV infection, with 1,25‐Dihydroxyvitamin‐D3 deficiency and the benefit of calcitriol supplementation before and during the transplantation. Risk factors and kidney graft function were also evaluated. All RTRs received induction therapy with basiliximab, cyclosporine, mycophenolic acid, and steroids. During the first year, the incidence of BPAR (4% vs 11%, P=.04), CMV infection (3% vs 9%, P=.04), and BKV infection (6% vs 19%, P=.04) was significantly lower in users compared to controls. By multivariate Cox regression analysis, 1,25‐Dihydroxyvitamin‐D3 deficiency and no calcitriol exposure were independent risk factors for BPAR (HR=4.30, P<.005 and HR=3.25, P<.05), for CMV infection (HR=2.33, P<.05 and HR=2.31, P=.001), and for BKV infection (HR=2.41, P<.05 and HR=2.45, P=.001). After one year, users had a better renal function: eGFR was 62.5±6.7 mL/min vs 51.4±7.6 mL/min (P<.05). Only one user developed polyomavirus‐associated nephropathy vs 15 controls. Two users lost their graft vs 11 controls. 1,25(OH)2‐D3 deficiency circulating levels increased the risk of BPAR, CMV infection, BKV infection after kidney transplantation. Administration of calcitriol is a way to obtain adequate 1,25(OH)2‐D3 circulating levels.
835. DICRANOSTIGMA LEPTOPODUM
Authors: Grey‐Wilson Christopher
Published: August 2016

Dicranostigma leptopodum (Maxim.) Fedde is described and illustrated. Details of its distribution and ecology are included as well as its relationship to closely related genera, particularly Glaucium, the horned poppies. Notes on propagation and cultivation are included.
Treatment of Type 2 diabetes mellitus in Chongqing of China: unaffordable care for the poor
Authors: Long Q. , He M. , Tang X. , Allotey P. , Tang S.
Published: August 2016

Aim

This study aims to investigate the medical expenditure of people with Type 2 diabetes mellitus in Chongqing, China; to explore factors that contribute to the expenditure; and to examine the financial burden placed on households, particularly poor households.

Methods

A cross sectional survey was conducted with a sample of people diagnosed with Type 2 diabetes mellitus in 2014. Of the 664 people eligible, 76% were interviewed. Descriptive statistics and log‐linear regression were used to examine respondents’ age, sex and level education, location of residence, income and type of health insurance associated with out‐of‐pocket expenditure on accessing diabetes mellitus care.

Results

In a year, average out‐of‐pocket expenditure on the purchase of drugs from pharmacies and having outpatient care were US $333 and US $310, respectively. The average out‐of‐pocket expenditure on accessing inpatient care was 3.7 times (US $1159) that of accessing outpatient care. After adjusting for age and sex, out‐of‐pocket expenditure on diabetes care was significantly higher for people covered by the Urban Employee Basic Medical Insurance programme and those enrolled in the identified priority diseases reimbursement programme, which provided higher reimbursement rates for outpatient and (or) inpatient care. Out‐of‐pocket expenditures on the purchase of drugs from pharmacies, having outpatient and inpatient care, respectively, were 9.8%, 16.2% and 62.6% of annual household income in low‐income group.

Conclusion

Even with health insurance coverage, poor people with Type 2 diabetes mellitus suffered from significant financial hardship. This has significant implications for models of care and healthcare financing in China with the growing burden of diabetes.
Mass‐flowering crops dilute pollinator abundance in agricultural landscapes across Europe
Authors: Holzschuh Andrea , Dainese Matteo , González‐Varo Juan P. , Mudri‐Stojnić Sonja , Riedinger Verena , Rundlöf Maj , Scheper Jeroen , Wickens Jennifer B. , Wickens Victoria J. , Bommarco Riccardo , Kleijn David , Potts Simon G. , Roberts Stuart P. M. , Smith Henrik G. , Vilà Montserrat , Vujić Ante , Steffan‐Dewenter Ingolf
Published: August 2016

Mass‐flowering crops (MFCs) are increasingly cultivated and might influence pollinator communities in MFC fields and nearby semi‐natural habitats (SNHs). Across six European regions and 2 years, we assessed how landscape‐scale cover of MFCs affected pollinator densities in 408 MFC fields and adjacent SNHs. In MFC fields, densities of bumblebees, solitary bees, managed honeybees and hoverflies were negatively related to the cover of MFCs in the landscape. In SNHs, densities of bumblebees declined with increasing cover of MFCs but densities of honeybees increased. The densities of all pollinators were generally unrelated to the cover of SNHs in the landscape. Although MFC fields apparently attracted pollinators from SNHs, in landscapes with large areas of MFCs they became diluted. The resulting lower densities might negatively affect yields of pollinator‐dependent crops and the reproductive success of wild plants. An expansion of MFCs needs to be accompanied by pollinator‐supporting practices in agricultural landscapes.
Evolutionary response when selection and genetic variation covary across environments
Authors: Wood Corlett W. , Brodie Edmund D.
Published: August 2016

Although models of evolution usually assume that the strength of selection on a trait and the expression of genetic variation in that trait are independent, whenever the same ecological factor impacts both parameters, a correlation between the two may arise that accelerates trait evolution in some environments and slows it in others. Here, we address the evolutionary consequences and ecological causes of a correlation between selection and expressed genetic variation. Using a simple analytical model, we show that the correlation has a modest effect on the mean evolutionary response and a large effect on its variance, increasing among‐population or among‐generation variation in the response when positive, and diminishing variation when negative. We performed a literature review to identify the ecological factors that influence selection and expressed genetic variation across traits. We found that some factors – temperature and competition – are unlikely to generate the correlation because they affected one parameter more than the other, and identified others – most notably, environmental novelty – that merit further investigation because little is known about their impact on one of the two parameters. We argue that the correlation between selection and genetic variation deserves attention alongside other factors that promote or constrain evolution in heterogeneous landscapes.
Teasing apart plant community responses to N enrichment: the roles of resource limitation, competition and soil microbes
Authors: Farrer Emily C. , Suding Katharine N.
Published: August 2016

Although ecologists have documented the effects of nitrogen enrichment on productivity, diversity and species composition, we know little about the relative importance of the mechanisms driving these effects. We propose that distinct aspects of environmental change associated with N enrichment (resource limitation, asymmetric competition, and interactions with soil microbes) drive different aspects of plant response. We test this in greenhouse mesocosms, experimentally manipulating each factor across three ecosystems: tallgrass prairie, alpine tundra and desert grassland. We found that resource limitation controlled productivity responses to N enrichment in all systems. Asymmetric competition was responsible for diversity declines in two systems. Plant community composition was impacted by both asymmetric competition and altered soil microbes, with some contributions from resource limitation. Results suggest there may be generality in the mechanisms of plant community change with N enrichment. Understanding these links can help us better predict N response across a wide range of ecosystems.
Genomics advances the study of inbreeding depression in the wild
Authors: Kardos Marty , Taylor Helen R. , Ellegren Hans , Luikart Gordon , Allendorf Fred W.
Published: August 2016

Inbreeding depression (reduced fitness of individuals with related parents) has long been a major focus of ecology, evolution, and conservation biology. Despite decades of research, we still have a limited understanding of the strength, underlying genetic mechanisms, and demographic consequences of inbreeding depression in the wild. Studying inbreeding depression in natural populations has been hampered by the inability to precisely measure individual inbreeding. Fortunately, the rapidly increasing availability of high‐throughput sequencing data means it is now feasible to measure the inbreeding of any individual with high precision. Here, we review how genomic data are advancing our understanding of inbreeding depression in the wild. Recent results show that individual inbreeding and inbreeding depression can be measured more precisely with genomic data than via traditional pedigree analysis. Additionally, the availability of genomic data has made it possible to pinpoint loci with large effects contributing to inbreeding depression in wild populations, although this will continue to be a challenging task in many study systems due to low statistical power. Now that reliably measuring individual inbreeding is no longer a limitation, a major focus of future studies should be to more accurately quantify effects of inbreeding depression on population growth and viability.
Prediction of taxon occurrence: a test on taxon‐specific change point values of stream benthic invertebrates
Authors: Leps Moritz , Leisner Sabrina , Haase Peter , Sundermann Andrea
Published: August 2016

Ecological thresholds represent abrupt species responses to minor changes in the environment. However, as aquatic organisms are frequently exposed to multiple stressors, prediction of taxon occurrence is challenging and often associated with much uncertainty. In this study, we analysed the response of stream benthic invertebrates to selected environmental gradients and determined the frequency and predictability of threshold responses.

Re‐analysis of taxon‐specific change point values for 213 riverine benthic invertebrate taxa and nine water quality variables showed that the predictive performance was acceptable for 30.4% and excellent for 9.6% of the total number of validated change points (n = 978). In total, 48.3% of the taxa that were predicted to occur (taxon presence predicted) and 67% of the taxa predicted not to occur (taxon absence predicted) were correct but with high variability across taxa and chemical variables. Predictive performance was the highest for stenoecious taxa and for certain chemical variables, such as ammonium nitrogen and the daytime dissolved oxygen concentration.

Responses to peak level concentrations of water quality variables were less threshold‐like compared with relationships with mean values. However, model predictions were equal for both of the approaches.

Successful prediction of taxon absence at stress levels beyond the change point values showed that the latter can well represent the upper limit of the taxon‐specific range of occurrence. Thus, change points are valuable for establishing and evaluating new water management tools, such as water quality criteria. By contrast, prediction of taxon presence at low levels of stress was associated with relatively high uncertainty, reflecting the limitation of taxon occurrence by stressors other than those investigated.
Effects of model assumptions and data quality on spatial cumulative human impact assessments
Authors: Stock Andy , Micheli Fiorenza
Published: August 2016

Aim

Many studies have quantified and mapped cumulative human impacts on marine ecosystems. These maps are intended to inform management and planning, but uncertainty in them has not been studied in depth. This paper aims to: (1) quantify the uncertainty in cumulative impact maps and related spatial modelling results; (2) attribute this uncertainty to specific model assumptions and problems with data quality; (3) identify and test sound approaches to such analyses.

Location

We used the Baltic Sea and the Mediterranean and Black Seas as example regions. The methods and conclusions are relevant for human impact mapping anywhere.

Methods

We conducted computational experiments to test the effects of nine model assumptions and data quality problems (factors) on maps of human impact and related modelling results. The factors were implemented on the basis of a literature review. We quantified aggregate uncertainty using Monte Carlo simulations, and ranked the factors by their influence on modelling results using the elementary effects method. Both methods are well established and theoretically suitable for complex models, but had to be modified for application to spatial human impact models.

Results

Some, but not all, modelling results were robust. This contradicts previous studies that found only minor effects of the factors they tested. Of the nine factors tested here, eight had a considerable influence on at least one modelling result in at least one of the two study regions.

Main conclusions

Model assumptions and data quality have larger aggregate effects on maps of human impact than found in previous analyses. These effects depend on the study region and the data that describe it. Future human impact mapping studies should thus include comprehensive uncertainty analyses. Computational experiments allow us to distinguish robust from less reliable modelling results and to prioritize improvements in models and data.
Introduction history, climatic suitability, native range size, species traits and their interactions explain establishment of Chinese woody species in Europe
Authors: Feng Yanhao , Maurel Noëlie , Wang Zhiheng , Ning Lei , Yu Fei‐Hai , van Kleunen Mark
Published: August 2016

Aim

A major challenge in ecology is to understand how multiple causal factors, which may interact, drive success of non‐native plants in new ranges. In this study we addressed the role of introduction history, climatic suitability, native range size, species traits and their interactions in the establishment of Chinese woody species in Europe.

Location

China (native range), Europe (new range).

Methods

We tested whether establishment of 449 Chinese woody species in Europe was associated with residence time (time since earliest planting), planting frequency, climatic suitability, native range size and species traits. We also considered possible nonlinear effects and interactions among these variables. For the 38 species that have established in Europe, we further tested whether these variables and interactions explained their establishment in multiple European countries.

Results

Establishment of the 449 species in Europe was positively associated with residence time, planting frequency and climatic suitability. Except residence time, these factors were also positively associated with establishment of the 38 species in multiple countries. None of the traits tested had statistically significant main effects on establishment in Europe, but, for the established species, longer flowering period and having compound leaves were positively associated with establishment in multiple countries. The positive association between establishment in Europe and residence time was stronger for evergreen than for deciduous species. In addition, evergreens, unlike deciduous species, showed a positive association between establishment in Europe and fruiting duration. Moreover, establishment in multiple countries was positively associated with planting frequency for species with compound leaves but not for species with simple leaves, and the association between the establishment and fruiting duration changed from negative to moderately positive as climatic suitability increased.

Main conclusions

Introduction history and climatic suitability explain most of the variation in establishment, and modulate the role of species traits, such as leaf retention, leaf type and fruiting duration.
Impact of consumer‐directed care on quality of life in the community aged care sector
Authors: Bulamu Norma , Kaambwa Billingsley , Gill Liz , Cameron Ian , McKechnie Sue , Fiebig Jeff , Grady Robin , Ratcliffe Julie
Published: August 2016

Aim

All consumer‐directed care (CDC) models aim to transfer “choice” and “control” over the allocated funds from the aged care provider to service recipients. This study presents an empirical assessment of the relationships between quality of life for older adults aged ≥65 years receiving community aged care services in Australia under CDC compared with those receiving traditional provider‐directed care (PDC).

Methods

Self‐reported quality of life (health status and capabilities) were measured for older adults receiving community aged care services (n = 139) using the EuroQoL five dimensions five‐level version and the older people‐specific capability index (ICECAP‐O) instruments. The relationship between quality of life, mode of service delivery, and other sociodemographic characteristics were examined using descriptive statistical and multivariate regression analyses.

Results

The quality of life of individuals receiving CDC and PDC was similar (ICECAP‐O: CDC mean 0.74 [SD 0.17], PDC mean 0.78 [SD 0.17]. EuroQoL five dimensions five‐level version: CDC mean 0.46 [SD 0.33], PDC mean 0.49 [SD0.27]). In general, individuals in receipt of CDC reported higher levels of capability in the control and independence dimension for the ICECAP‐O relative to those receiving PDC. Multivariate regression analysis showed that living alone was associated with higher quality of life (P = 0.01) and higher levels of capability (P = 0.02).

Conclusions

Although no discernible differences in overall quality of life were found, higher levels of self‐reported control and independence for those in receipt of CDC suggest that the main policy objectives of transferring “choice” and “control” away from the aged care provider and to the individual are being met. Geriatr Gerontol Int 2017; 17: 1399–1405.
Helicobacter pylori and non‐malignant upper gastrointestinal diseases
Authors: Vasapolli Riccardo , Malfertheiner Peter , Kandulski Arne
Published: August 2016

Peptic ulcer disease (PUD) has been further decreased over the last decades along with decreasing prevalence of Helicobacter pylori‐associated PUD. A delayed H. pylori eradication has been associated with an increased risk of rehospitalization for complicated recurrent peptic ulcer and reemphasized the importance of eradication especially in patients with peptic ulcer bleeding (PUB). PUB associated with NSAID/aspirin intake and H. pylori revealed an additive interaction in gastric pathophysiology which favors the “test‐and‐treat” strategy for H. pylori in patients with specific risk factors. The H. pylori‐negative and NSAID‐negative “idiopathic PUD” have been increasingly observed and associated with slower healing tendency, higher risk of recurrence, and greater mortality. Helicobacter pylori‐associated dyspepsia has been further investigated and finally defined by the Kyoto consensus. Helicobacter pylori eradication therapy is advised as first option in this group of patients. Only in the case of symptom persistence or recurrence after eradication therapy, dyspeptic patients should be classified as functional dyspepsia (FD). There were few new data in 2015 on the role of H. pylori infection in gastroesophageal reflux disease (GERD), and in particular Barrett's esophagus. A lower prevalence of gastric atrophy with less acid output in patients with erosive esophagitis confirmed previous findings. In patients with erosive esophagitis, no difference was observed in healing rates neither between H. pylori‐positive and H. pylori‐negative patients nor between patients that underwent eradication therapy compared to patients without eradication. These findings are in line with the current consensus guidelines concluding that H. pylori eradication has no effects on symptoms and does not aggravate preexisting GERD.
Gastric cancer pathogenesis
Authors: Berger Hilmar , Marques Miguel S. , Zietlow Rike , Meyer Thomas F. , Machado Jose C. , Figueiredo Ceu
Published: August 2016

Gastric cancer (GC) results from a multistep process that is influenced by Helicobacter pylori infection, genetic susceptibility of the host, as well as of other environmental factors. GC results from the accumulation of numerous genetic and epigenetic alterations in oncogenes and tumor suppressor genes, leading to dysregulation of multiple signaling pathways, which disrupt the cell cycle and the balance between cell proliferation and cell death. For this special issue, we have selected to review last year's advances related to three main topics: the cell of origin that initiates malignant growth in GC, the mechanisms of direct genotoxicity induced by H. pylori infection, and the role of aberrantly expressed long noncoding RNAs in GC transformation. The understanding of the molecular basis of GC development is of utmost importance for the identification of novel targets for GC prevention and treatment.
Gastric cancer – clinical and epidemiological aspects
Authors: Venerito Marino , Link Alexander , Rokkas Theodoros , Malfertheiner Peter
Published: August 2016

Gastric cancer (GC) ranks fifth for cancer incidence and second for cancer deaths. Epidemiological data showed that survivors of Hodgkin's lymphoma and patients with pernicious anemia etiologically linked to autoimmune gastritis are at increased risk of GC. Screening of patients with autoimmune thyroid disease by means of pepsinogen (PG) I and PG I/II detected autoimmune gastritis with oxyntic gastric atrophy in one of four patients and may be recommended for GC prevention purposes. The International Agency for Research on Cancer reported a positive association between consumption of processed meet and increased GC risk. A new GC risk prediction model based on biological markers, age, gender, smoking status, family history of GC, and consumption of highly salted food showed good predictive performance, and might prompt individuals to modify their lifestyle habits, attend regular check‐up visits or participate in screening programs. A novel GC classification based on gene expression of primary resected cancers correlated with clinicopathological features. Noncoding RNA for GC screening remains the focus of multiple studies. Patients with early GC undergoing endoscopic resection are more likely to develop metachronous lesions than patients undergoing surgery and endoscopic surveillance is warranted in this special cohort. The addition of gastrectomy to chemotherapy did not improve survival of patients with advanced GC and a single noncurable factor. Apatinib, a novel oral vascular endothelial growth factor receptor 2 tyrosine kinase inhibitor, improved the median overall survival of patients with advanced GC and progressive disease after two or more lines of prior chemotherapy of nearly 3 months.
Effects of hair sprays on colour perception: a hyperspectral imaging approach to shine and chroma on heads
Authors: Puccetti G. , Thompson W.
Published: August 2016

Objectives

Hair sprays apply fixative ingredients to provide hold to a hair style as well as weather resistance and optical properties such as shine. Generally, sprays distribute fine particles containing polymeric ingredients to form a thin film on the surface of hair. Different hair types require different strengths of the formed deposit on the hair surface. The present study shows how sprays also alter the visibility of the hair colour by altering the surface topology of the hair fibres.

Methods

Hyperspectral imaging is used to map spectral characteristics of hair on mannequins and panelists over the curvature of heads. Spectral and spatial characteristics are measured before and after hair spray applications. The hair surface is imaged by SEM to visualize the degree of cuticle coverage. Finally, the perception of hair colour was evaluated on red‐coloured mannequins by consumer questionnaire.

Results

Hair sprays deposit different degrees of fixatives, which lead to a progressive leveling of the cuticle natural tilt angle with respect to the fibre axis. As a result, shine is progressively shifting towards the region of hair colour visibility and decreases the perceived colour of hair seen by consumers. Lighter sprays show thinner film formation on the hair surface and less of a shine shift than strong hold hair sprays.

Conclusions

Hair sprays are generally employed for hair style hold and weather resistance and considered without effect on hair colour. Our approach shows that spray‐deposited films can affect colour perception by altering the microstructure of the hair surface. Thin films deposited on the hair fibre surface can partially fill gaps between cuticles, which reduces the cuticle natural angle. This partial erasure results in a angle shift of the shine regions towards the angle of internal reflection, thus decreasing the perceived hair colour regions as experienced by a group of consumers.
Productivity in German manufacturing firms: Does fixed‐term employment matter?
Authors: NIELEN Sebastian , SCHIERSCH Alexander
Published: August 2016

Using a large data set of German manufacturing establishments and various panel data models, the authors investigate the relationship between labour productivity and the use of fixed‐term employment, taking account of the possible distortions that may result from self‐selection into the use of fixed‐term contracts. Their empirical results provide no evidence for the expected inverse U‐shaped relationship between fixed‐term employment and labour productivity, and testing for a linear relationship leads to mostly negative coefficients that are only significant in a few specifications. Overall, their results thus indicate that there is no significant relationship between the use of fixed‐term contracts and labour productivity.
Utility of surgical lung biopsy in critically ill patients with diffuse pulmonary infiltrates: a retrospective review
Authors: Donaldson L. H. , Gill A. J. , Hibbert M.
Published: August 2016

Background

There are conflicting reports regarding the role of surgical lung biopsies in patients who present to the intensive care unit (ICU) with unexplained respiratory failure and diffuse pulmonary infiltrates on imaging.

Aim

To describe the utility of surgical lung biopsies in patients presenting to the ICU with unexplained respiratory failure and diffuse pulmonary infiltrates.

Methods

A retrospective cohort study was performed. All patients admitted to the ICU who underwent a surgical lung biopsy for the investigation of respiratory failure and unexplained pulmonary infiltrates between 1998 and 2012 were included. The primary outcome measures for this descriptive study were the biopsy histopathology, changes in patient management following biopsy and in‐hospital mortality.

Results

A total of 30 patients was included in the review. Biopsies in 22 patients (73%) demonstrated diffuse alveolar damage (DAD), with 15 of these biopsies (50%) suggesting a specific underlying aetiology. In 73% of cases (n = 22), the biopsy finding was associated with a change in management, although this generally involved the escalation of an existing therapy rather than initiation of a new treatment. Biopsies were performed at a median 10 days after admission (interquartile range 5–17 days), with the majority of patients being treated empirically prior to the biopsy with systemic steroids and broad‐spectrum antimicrobials. Mortality was 53%.

Conclusion

In this series, DAD was the most frequent pathology. The biopsy result was associated with a change in management in a majority of the subjects, most frequently an escalation of prior empiric therapy. Mortality was high.
Clinical trials of medicinal cannabis for appetite‐related symptoms from advanced cancer: a survey of preferences, attitudes and beliefs among patients willing to consider participation
Authors: Luckett T. , Phillips J. , Lintzeris N. , Allsop D. , Lee J. , Solowij N. , Martin J. , Lam L. , Aggarwal R. , McCaffrey N. , Currow D. , Chye R. , Lovell M. , McGregor I. , Agar M.
Published: August 2016

Background

Australian clinical trials are planned to evaluate medicinal cannabis in a range of clinical contexts.

Aims

To explore the preferences, attitudes and beliefs of patients eligible and willing to consider participation in a clinical trial of medicinal cannabis for poor appetite and appetite‐related symptoms from advanced cancer.

Methods

A cross‐sectional anonymous survey was administered from July to December 2015 online and in eight adult outpatient palliative care and/or cancer services. Respondents were eligible if they were ≥18 years, had advanced cancer and poor appetite/taste problems/weight loss and might consider participating in a medicinal cannabis trial. Survey items focused on medicinal rather than recreational cannabis use and did not specify botanical or pharmaceutical products. Items asked about previous medicinal cannabis use and preferences for delivery route and invited comments and concerns.

Results

There were 204 survey respondents, of whom 26 (13%) reported prior medicinal cannabis use. Tablets/capsules were the preferred delivery mode (n = 144, 71%), followed by mouth spray (n = 84, 42%) and vaporiser (n = 83, 41%). Explanations for preferences (n = 134) most commonly cited convenience (n = 66; 49%). A total of 82% (n = 168) of respondents indicated that they had no trial‐related concerns, but a small number volunteered concerns about adverse effects (n = 14) or wanted more information/advice (n = 8). Six respondents volunteered a belief that cannabis might cure cancer, while two wanted assurance of efficacy before participating in a trial.

Conclusion

Justification of modes other than tablets/capsules and variable understanding about cannabis and trials will need addressing in trial‐related information to optimise recruitment and ensure that consent is properly informed.
Parents’ and children's knowledge of oral health: a qualitative study of children with cleft palate
Authors: Davies Karen , Lin Yin‐Ling , Callery Peter
Published: August 2016

Background

Children with cleft lip and/or palate (CLP) are prone to poorer oral health outcomes than their peers, with serious implications for treatment. Little is known of the knowledge and practice of children with CLP in caring for teeth and how these contribute to oral health.

Aim

To investigate (i) parents’ and children's knowledge of oral health, (ii) how knowledge is acquired, and (iii) how knowledge is implemented.

Design

A qualitative design was used to investigate knowledge, beliefs, and practices reported by parents and children, age 5–11 years with CLP. Data were collected from 22 parents and 16 children and analysed using thematic analysis.

Results

Four themes were derived as follows: (i) implicit knowledge: children express simple knowledge underpinned by basic rationales, (ii) situated knowledge: children gain skills as part of everyday childhood routines, (iii) maintaining good practice in oral health: parents take a lead role in motivating, monitoring, and maintaining children's toothbrushing, and (iv) learning opportunities: pivotal moments provide opportunities for children to extend their knowledge.

Conclusion

Developers of oral health education interventions should take account of children's implicit knowledge and the transmission of beliefs between generations that influence toothbrushing behaviours. This could enhance interventions to support parents and children's practice.
Meta‐analysis of the effectiveness of educational interventions for breastfeeding promotion directed to the woman and her social network
Authors: Oliveira Isabella Beatriz Barbosa , Leal Luciana Pedrosa , Coriolano‐Marinus Maria Wanderleya de Lavor , Santos Alessandro Henrique da Silva , Horta Bernardo Lessa , Pontes Cleide Maria
Published: August 2016

Aim

The aim of this study was to determine the effectiveness of educational interventions focusing on women and their social network for the promotion of exclusive breastfeeding up to the age of 6 months.

Background

Despite the advantages of breastfeeding and strategies available for its promotion, early weaning is common worldwide.

Design

Systematic review and meta‐analysis based on the Joanna Briggs Institute guidelines.

Data sources

A search was performed in databases (LILACS, PubMed, Science Direct, Scopus, CINAHL, Web of Science and Cochrane Library), reference lists and grey literature. There was no limitation on the studies' year of publication.

Review methods

JBI‐MAStARI software were used. The meta‐analysis was performed using Stata version 13·0. The effect was estimated by odds ratio with 95% confidence intervals.

Results

Of 7201 identified studies, 11 made up the review's corpus. Educational interventions were about twice as effective compared with routine interventions used in the control groups. It was evident that educational interventions have focused only on the woman and have not covered all five types of support she needs to breastfeed.

Conclusion

Educational interventions were about twice as effective in promoting exclusive breastfeeding at 6 months old. There is a need for further studies applying interventions that address women and their social network from the prenatal period, considering all types of support.
Factors that determine self‐reported immunosuppressant adherence in kidney transplant recipients: a correlational study
Authors: Weng Li‐Chueh , Yang Ya‐Chen , Huang Hsiu‐Li , Chiang Yang‐Jen , Tsai Yu‐Hsia
Published: August 2016

Aims

To determine the factors related to immunosuppressant therapy adherence in kidney transplant recipients in Taiwan.

Background

Adherence to immunosuppressant treatment is critical after kidney transplantation. Thus, the factors associated with self‐reported medication adherence in kidney transplant recipients warrant investigation.

Design

The study used a cross‐sectional and correlation design.

Methods

A convenience sample of 145 kidney transplant recipients was included. Structured questionnaires were used to collect data during 2012–2013. Multivariate linear regression was used to examine the factors related to immunosuppressant therapy adherence.

Results

Over half of the participants were female (54·5%), mean age was 45·5 years, and mean year after transplant was 7·4. The mean score for medication adherence was 29·73 (possible score range 7‐35). The results of the multivariate linear regression analysis showed that gender (male), low income with a high school or college education, years after transplantation and concerns about medication taking were negatively associated with adherence. Medication self‐efficacy was positively associated with adherence. Therapy‐related factors, partnerships with healthcare professionals and having private healthcare insurance did not significantly relate to immunosuppressant therapy adherence.

Conclusions

Kidney transplant recipients demonstrated a high level of adherence. Strategies to enhance patients’ self‐efficacy and alleviate concerns about medication may promote medication adherence. Male patients, those with a lower income and those with a higher education level, should be a focus of efforts to maintain adherence to the medication regimen.
A world shared – a world apart: the experience of families after the death of a significant other late in life
Authors: Naef Rahel , Ward Richard , Mahrer‐Imhof Romy , Grande Gunn
Published: August 2016

Aims

The aim of this study was to investigate the impact of the death of an older member on families.

Background

The death of a significant other in later life is a dramatic moment. Research has demonstrated that some older persons face negative consequences for their well‐being. A majority, however, exhibit resilience in the wake of loss. Nonetheless, the relational process through which older persons come to terms with the loss in interaction with their families is little understood, but vital to support bereaved families.

Design

Heideggerian hermeneutic phenomenology.

Methods

A purposive sample of ten older persons with their families, represented by children, grandchildren and in‐laws (n = 30) were interviewed several times in 2013, alone (n = 16) and in family groups (n = 21), 6‐23 months after their significant other's death (mean age 81 years). Data collection and thematic analysis was informed by van Manen's and Benner's analytical strategies.

Findings

Three family themes were discerned. First, through meaning‐making, bereaved families weaved the death into their family narrative. Second, through sharing‐not sharing their feelings and daily moments, family members lived with the loss both together and alone. Third, some families faced upheaval in their family life, which required them to re‐create their everyday life, whereas other families continued with little change.

Conclusions

Findings demonstrate that families hold an inherent capacity to make meaning of the death and enact family thereafter. Family relations arose as interplay of different, contradicting forces. Nurses should facilitate families’ meaning‐making of the death, attend to their converging and diverging sense of loss and strengthen family caring.
Efficacy of adjunctive anti‐plaque chemical agents: a systematic review and network meta‐analyses of the Turesky modification of the Quigley and Hein plaque index
Authors: Escribano Marta , Figuero Elena , Martín Conchita , Tobías Aurelio , Serrano Jorge , Roldán Silvia , Herrera David
Published: August 2016

Aim

The aim of this systematic review and network meta‐analysis (NMA) was to compare the efficacy of different anti‐plaque chemical agents, in 6‐month, home‐use, randomized clinical trials (RCTs), in terms of plaque index (PlI) changes.

Material and Methods

RCTs assessing PlI were identified, screened, and evaluated for inclusion. Relevant information was extracted, and quality and risk of bias were assessed. Mean differences between baseline‐end were calculated to obtain weighted mean differences and 95% confidence intervals. NMA protocols were applied to assess direct and indirect comparisons among products using Turesky PlI.

Results

Eighty‐three papers were included: 49 examined dentifrices, 32 mouthrinses and 2 both. The NMA analysed 51 studies including data from 4242 and 4180 subjects for dentifrices and mouthrinses respectively. For dentifrices, triclosan‐copolymer and chlorhexidine showed the greatest effect, with significant differences when compared with stannous fluoride. For mouthrinses, essential oils and chlorhexidine showed the greatest effect, with significant differences when compared with delmopinol, alexidine and cetylpyridinium chloride.

Conclusion

Within the limitations of this study (including the severe imbalance in the amount of evidence), dentifrices containing triclosan‐copolymer or chlorhexidine and mouthrinses containing essential oils or chlorhexidine showed the greatest effect on PlI scores as assessed with NMA.
Evaluating a Cobalt‐Tetraphenylporphyrin Complex, Functionalized with a Reduced Graphene Oxide Nanocomposite, for Improved Tooth Whitening
Authors: Su I‐Hsuan , Lee Chen‐Fu , Su Yu‐Pin , Wang Lai‐Hao
Published: August 2016

Objectives

To study using cobalt‐tetraphenylporphyrin/reduced graphene oxide (CoTPP/RGO), a nanocomposite highly catalytic both for oxidizing and for reducing hydrogen peroxide (H2O2), to whiten teeth.

Methods

Dyes (D&C Red 34, Orange No. 4), tea, and betel nuts (Areca catechu) were used to stain the tooth specimens for three days and subsequently bleached using H2O2 alone, H2O2 plus CoTPP, or H2O2 plus CoTPP/RGO for 0.5–70 hours. The process was photographed using an electronic chromometer and a camera. Color change was assessed after each session. The results of bleaching teeth with and without photoirradiation were compared.

Results

CoTPP/RGO increased the tooth‐whitening efficacy of H2O2 for specimens stained with dyes, tea, and betel nuts. Using lamps (photoactivation) (wavelengths: 254 nm and 310 nm) to catalyze the H2O2 bleaching agent reduced the bleaching treatment time.

CLINICAL SIGNIFICANCE

First, the Co/TPP/RGO complex allows improved tooth bleaching and shorter treatment times. Second, because the Co/TPP/RGO complex bleached D&C Red 34 at a similar rate and to a similar degree as tea and other natural agents stain teeth, it is a convenient staining agent for studying many vital aspects of tooth bleaching. (J Esthet Restor Dent 28:321–329, 2016)
Development and validation of visceral fat quantification as a surrogate marker for differentiation of Crohn's disease and intestinal tuberculosis
Authors: Yadav Dawesh Prakash , Madhusudhan Kumble Seetharama , Kedia Saurabh , Sharma Raju , Pratap Mouli Venigalla , Bopanna Sawan , Dhingra Rajan , Pradhan Rajesh , Goyal Sandeep , Sreenivas Vishnubhatla , Vikram Naval K , Makharia Govind , Ahuja Vineet
Published: August 2016

Background and Aim

Crohn's disease (CD) and intestinal tuberculosis (ITB) have close phenotypic resemblance. Mesenteric fat (a component of visceral fat [VF]) hypertrophy and fat wrapping, which is visible radiologically as fibrofatty proliferation, is seen more commonly in CD than in ITB.

Aim

The present study was conducted to study the role of VF in differentiating CD and ITB.

Methods

Visceral fat area and subcutaneous (SC) fat area were measured on computed tomography in two cohorts (development and validation). VF/SC ratio was also calculated for all patients. In the development cohort, retrospective data collection was carried out for 75 patients with CD and ITB who were on follow‐up from January 2012 to November 2014. In the validation cohort, 82 patients were recruited prospectively from December 2014 to December 2015 and were diagnosed as CD or ITB according to standard diagnostic criteria.

Results

Visceral fat area and VF/SC ratio were significantly higher in CD patients (n = 42: development, n = 46: validation) than in ITB patients (n = 33: development, n = 36: validation) in both the development (106.2 ± 63.5 vs 37.3 ± 22, P = <0.001; 1.1 ± 0.57 vs 0.43 ± 0.24, P = <0.001) and validation cohorts (102.2 ± 69.8 vs 55.8 ± 44.9, P = 0.01; 1.2 ± 0.68 vs 0.56 ± 0.33, P = <0.001). A cut‐off of 0.63 for VF/SC ratio in the development cohort had a high sensitivity (82%) and specificity (81%) in differentiating CD and ITB. Similar sensitivity (81%) and specificity (78%) were seen when this cut‐off was applied in the validation cohort.

Conclusion

The VF/SC ratio is a simple, cost‐effective, non‐invasive and single objective parameter with a good sensitivity and specificity to differentiate CD and ITB.
Cardiac Rehabilitation in Very Old Adults: Effect of Baseline Functional Capacity on Treatment Effectiveness
Authors: Baldasseroni Samuele , Pratesi Alessandra , Francini Sara , Pallante Rachele , Barucci Riccardo , Orso Francesco , Burgisser Costanza , Marchionni Niccolò , Fattirolli Francesco
Published: August 2016

Objectives

To assess the effect of cardiac rehabilitation (CR) and identify predictors of changes in functional capacity with CR in a consecutive series of older adults with a recent cardiac event.

Design

Observational.

Setting

In‐hospital CR unit.

Participants

Individuals aged 75 and older referred to an outpatient CR Unit after an acute coronary event (unstable angina pectoris, acute myocardial infarction) or cardiac surgery (coronary artery bypass grafting, heart valve replacement or repair) (N = 160, mean age 80 ± 4).

Measurements

Peak oxygen consumption (VO2 peak, power) during a symptom‐limited cardiopulmonary stress test, distance walked in a 6‐minute walk test (6MWT, resistance), and peak torque (strength) using an isokinetic dynamometer, were assessed at baseline and at discharge from a 4‐week supervised training program.

Results

Indexes of physical performance improved from baseline to discharge (VO2 peak, 10.9%; 6MWT, 11.0%; peak torque, 11.5%). Baseline performance was independently associated with changes in all three indexes, with higher baseline values predicting less improvement (VO2 peak: OR=0.86, 95% confidence interval (CI)=0.77–0.97; 6MWT: OR= 0.99, 95% CI=0.99–1.00; peak torque: OR=0.96, 95% CI=0.94–0.98).

Conclusion

An exercise‐based CR program was associated with improvement in all domains of physical performance even in older adults after an acute coronary event or cardiac surgical intervention, particularly in those with poorer baseline performance.