bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between the disability prevention program “Secondary Preventive Services” and disability incidence among the elderly population: A nationwide longitudinal comparison of Japanese municipalities
Authors: Tomata Yasutake , Sone Toshimasa , Chou Wan‐Ting , Tsuboya Toru , Watanabe Takashi , Kakizaki Masako , Tsuji Ichiro
Published: January 2015

Aim

The aim of the present ecological study was to evaluate the relationship between the rate of participation in Secondary Preventive Services (SPS) and the incidence of disability in Japanese municipalities.

Methods

We used the national statistics data for Long‐term Care Insurance (LTCI), because all Japanese people aged ≥65 years are eligible for LTCI services depending on their functional status assessed by a national uniform standard in all municipalities. The disability incidence rate for the 2‐year period in 2009–2010 was compared among five different levels of SPS participation in 2006–2008. The primary outcome was the sum total disability incidence rate in LTCI from 2009 to 2010. The outcome was divided according to disability level into three patterns: “all levels (Support Level 1 – Care Level 5)”, “mild disability (Care Level ≤1)” and “moderate to severe disability (Care Level ≥2)”.

Results

There was a significant inverse association between the SPS participation rate and disability incidence rate. Among 1541 municipalities, those in the highest SPS participation rate quintile (≥9.79 per 1000 elderly population) had a lower disability incidence rate for all levels than those in the lowest quintile (<1.86 per 1000 elderly population; absolute rate difference 0.6%; age‐adjusted incident rate ratio 0.94; 95% CI 0.89–0.99). This inverse association was observed for mild disability and not for moderate to severe disability.

Conclusions

Municipalities with a higher SPS participation rate have a lower incidence rate of mild disability. SPS could be an effective health policy for containing mild disability incidence among the elderly. Geriatr Gerontol Int 2016; 16: 74–80.
Development and validation of a question prompt list for parents of children with attention‐deficit/hyperactivity disorder: a Delphi study
Authors: Ahmed Rana , McCaffery Kirsten J , Aslani Parisa
Published: January 2015

Objectives

Question prompt lists (QPLs) are structured lists of disease and treatment‐specific questions intended to encourage patient question‐asking during consultations with clinicians. The aim of this study was to develop a QPL intended for use by parents of children affected by attention‐deficit/hyperactivity disorder (ADHD).

Methods

The QPL content (111 questions) was derived through thematic analysis of existing ADHD‐ and QPL‐related resources. A modified Delphi method, involving a three‐round web‐based survey, was used to reach consensus about the QPL content. Thirty‐six experts were recruited into either a professional [paediatricians, child and adolescent psychiatrists, psychologists, researchers (n =28)] or non‐professional panel [parents of children diagnosed with ADHD, ADHD consumer advocates (n = 8)]. Panel members were asked to rate the importance of the QPL content using a five‐point scale ranging from ‘Essential’ to ‘Should not be included’.

Results

A total of 122 questions, including 11 new questions suggested by panellists, were rated by both panels. Of these, 88 (72%) were accepted for inclusion in the QPL. Of the accepted questions, 39 were re‐rated during two follow‐up survey rounds and 29 (74%) were subsequently accepted for inclusion. The questions covered key topics including diagnosis, understanding ADHD, treatment, health‐care team, monitoring ADHD, managing ADHD, future expectations and support and information.

Conclusions

To our knowledge, this is the first ADHD‐specific QPL to be developed and the first use of the Delphi method to validate the content of any QPL. It is anticipated that the QPL will assist parents in obtaining relevant, reliable information and empowering their treatment decisions by enhancing the potential for shared decision making with clinicians.
Evaluation of the effect of processing on cocoa polyphenols: antiradical activity, anthocyanins and procyanidins profiling from raw beans to chocolate
Authors: Bordiga Matteo , Locatelli Monica , Travaglia Fabiano , Coïsson Jean Daniel , Mazza Giuseppe , Arlorio Marco
Published: January 2015

The content and composition of anthocyanins and procyanidins in fermented cocoa beans (from different geographic origins: Ecuador, Cameroon, Ivory Coast, Ghana and Nigeria), roasted nibs, cocoa mass and chocolate were determined, beside the determination of the total antiradical capacity. Concerning geographic origin, cocoa beans and processed products from Ecuador showed the highest levels of anthocyanins, followed by Nigeria and Cameroon. Generally, as cocoa beans were further processed, the levels of anthocyanins and flavan‐3‐ols decreased. The largest observed losses of phenolics occurred during roasting. A progressive decreasing trend in polyphenol concentration was observed in the other processed samples as well. Despite the original content of polyphenols in raw cocoa beans, technological processes imply a significant impact on cocoa quality, confirming the need of specific optimisation to obtain high value chocolate.
Complex Interrelations of Trait Vulnerabilities in Mothers and their Infants
Authors: Gratz Kim L. , Kiel Elizabeth J. , Latzman Robert D. , Moore Sarah A. , Elkin T. David , Megason Gail C. , Tull Matthew T.
Published: January 2015

Despite the developmental and clinical relevance of this area of inquiry, no studies have examined the interrelations of trait vulnerabilities in the affective, behavioral, and interpersonal domains between mothers and their infants. Thus, this study examined the interrelations of three trait vulnerabilities (i.e., negative affective intensity, impulsivity, and insecure attachment) between mothers and their 12‐ to 23‐month‐old infants, focusing in particular on the unique and interactive influence of these maternal trait vulnerabilities on the expression of and precursors to these traits in their infants. Mother–infant dyads (N = 101) completed several laboratory procedures, and mothers reported on their own and their infants' expressions of the trait vulnerabilities of interest. Findings from this study provide preliminary evidence for intergenerational relations between these traits and suggest that it is the confluence of trait vulnerabilities in mothers that relates to the early expression of some of these traits in infants.
Introducing seasonal influenza vaccine in low‐income countries: an adverse events following immunization survey in the Lao People's Democratic Republic
Authors: Phengxay Manilay , Mirza Sara A. , Reyburn Rita , Xeuatvongsa Anonh , Winter Christian , Lewis Hannah , Olsen Sonja J. , Tsuyuoka Reiko , Khanthamaly Viengphone , Palomeque Francisco S. , Bresee Joseph S. , Moen Ann C. , Corwin Andrew L. ,   the Lao PDR Field Epidemiology Training Cohort Team
Published: January 2015

Objective

In 2012, Lao PDR introduced seasonal influenza vaccine in pregnant women, persons aged ≥50 years, persons with chronic diseases, and healthcare personnel. We assessed adverse events following immunization (AEFI).

Methods

We used a multistage randomized cluster sample design to interview vaccine recipients.

Findings

Between April and May 2012, 355 902 were vaccinated. Of 2089 persons interviewed, 261 (12·5%) reported one or more AEFI. The most commonly reported AEFIs were local reactions. No hospitalizations or deaths were reported; 16% sought medical care. Acceptance and awareness of vaccination were high.

Conclusions

Following the introduction of seasonal influenza vaccine in Lao PDR, self‐reported adverse events were mild.
Changing labour regulations and labour standards in China: Retrospect and challenges
Authors: CHAN Chris King‐Chi , NADVI Khalid
Published: January 2015

China's global economic strength is underpinned by its manufacturing prowess, predicated on a disciplined, skilled but relatively low‐paid workforce. Hence the State's recent regulatory initiatives to improve employment conditions in response to growing labour unrest. In their introductory article, the coordinators of this Special Issue of the International Labour Review contextualize the contributions that follow by reviewing the broader debates on labour regulation in global production – particularly on “soft” vs “hard” regulation – and the changes that have occurred in China's labour markets, labour regulations, labour standards and labour relations over the past decade. They conclude with suggestions for further research.
Labour relations, production regimes and labour conflicts in the Chinese automotive industry
Authors: LÜTHJE Boy
Published: January 2015

The auto workers' strikes that erupted in southern China in 2010 triggered significant labour relations reforms in Guandong province. Against this background, the author draws on extensive empirical research in leading car assembly plants and their suppliers to construct a typology of their production regimes for analysing current changes in labour relations. While this framework is helpful in understanding the growing diversity of China's manufacturing industries generally, it is used here to conceptualize the fragmentation and segmentation of labour relations between various firms, layers of suppliers and regional clusters in the automotive industry. The article concludes with a discussion of prospects for further reform.
Collective consultation under quota management: China's government‐led model of labour relations regulation
Authors: WU Qingjun , SUN Zhaoyang
Published: January 2015

China's system of labour relations regulation is based on a government‐led model of collective consultation and contracts, driven by the central planning tradition of “quota management”. Government and trade unions thus cooperate to fulfil coverage quotas, especially at the local/enterprise level. Though their methods are highly successful at overcoming employers' reluctance, the absence of genuine collective bargaining leaves collective contracts largely devoid of substance. Under this system, the authors argue, the Government is institutionalizing a labour regulation framework aimed at containing the recent rise in labour unrest, while pragmatically postponing collective bargaining for the sake of stability and growth.
The role of the cell–cell interactions in cancer progression
Authors: Kamińska Katarzyna , Szczylik Cezary , Bielecka Zofia F. , Bartnik Ewa , Porta Camillo , Lian Fei , Czarnecka Anna M.
Published: January 2015

In the field of cancer research, scientific investigations are based on analysing differences in the secretome, the proteome, the transcriptome, the expression of cell surface molecules, and the deregulation of signal transduction pathways between neoplastic and normal cells. Accumulating evidence indicates a crucial role in carcinogenesis concerning not only stromal cells but also normal cells from target organs and tissue where tumours emerge. The tumour microenvironment (TME) definitively plays an important role in regulating neighbouring cell behaviour. To date, limited attention has been focused upon interactions between cancer cells and normal cells. This review concentrates on the interactions between stromal and healthy cells from the TME in cancer development. In the article, the authors also describe mutations, genes and proteins expression pattern that are involved in tumour development in target organ.
Effect of a Falls Quality Improvement Program on Serious Fall‐Related Injuries
Authors: Ganz David A. , Kim Sung‐Bou , Zingmond David S. , Ramirez Karina D. , Roth Carol P. , Jennings Lee A. , Mori Takahiro , Keeler Emmett B. , Wenger Neil S. , Reuben David B.
Published: January 2015

Objectives

To determine whether a program that improves the quality of care for falls reduces the number of episodes of care for serious fall‐related injuries.

Design

Nonrandomized controlled trial.

Setting

Four community‐based primary care practices.

Participants

Individuals aged 75 and older who screened positive for fall risk.

Intervention

A multicomponent quality improvement program (Assessing Care of Vulnerable Elders Practice Redesign for Improved Medical Care for Elders) involving face‐to‐face clinician education about falls and decision support to prompt primary care providers to implement appropriate care, including referral to appropriate community resources, in response to individuals screening positive for fall risk.

Measurements

Episodes of care for selected fall‐related injuries, based on healthcare claims.

Results

Of 1,791 individuals with data available for analysis, 1,187 were in the intervention group, and 604 were in the control group. Mean age was 83, and more than two‐thirds of the sample were women. After adjusting for potential confounders, there were no statistically significant differences between intervention and control groups in episodes of care for fall‐related injuries during the 12‐month (incidence rate ratio (IRR) 1.27, 95% confidence interval (CI) = 0.93–1.73) or 24‐month (IRR 1.18, 95% CI = 0.93–1.49) period after initiation of the intervention.

Conclusion

Despite improving the care of falls, this quality improvement initiative did not result in a change in the number of episodes of care for serious fall‐related injuries. Future work in community‐based settings should test higher‐intensity interventions to reduce fall‐related injuries.
Factors that Affect Quality of Life from the Perspective of People with Dementia: A Metasynthesis
Authors: O'Rourke Hannah M. , Duggleby Wendy , Fraser Kimberly D. , Jerke Lauren
Published: January 2015

Objectives

To comprehensively and systematically identify, appraise, and synthesize qualitative research findings on factors that affect quality of life from the perspective of people with dementia.

Design

Systematic review and metasynthesis of primary qualitative studies in published and gray literature that aimed to identify factors that influence quality of life from the perspective of people with dementia. Expert‐developed search strategies were applied in nine electronic databases. Reference lists of included articles and literature reviews identified during the search were reviewed. Structured inclusion criteria were applied to screen 5,625 titles and abstracts to identify 11 qualitative studies published from 1975 to April 2012. Two independent reviewers appraised study quality.

Setting

Primary study recruitment sites included long‐term care and community‐based settings in the United Kingdom, the United States, Canada, the Netherlands, Ireland, Australia, and Japan.

Participants

A combined sample of 345 people with mild, moderate, and severe dementia.

Measurements

The primary studies used interview and focus group methods. Findings from primary studies were synthesized using techniques of taxonomic analysis, constant comparison, and importing concepts.

Results

Four factors and the experience of connectedness or disconnectedness within each factor influenced quality of life according to people with dementia. These factors, and the terms that represent connectedness and disconnectedness, were relationships (together vs alone), agency in life today (purposeful vs aimless), wellness perspective (well vs ill), and sense of place (located vs unsettled). Happiness and sadness were key outcomes of good and poor quality of life, respectively.

Conclusion

The four factors identified potentially modifiable areas to improve quality of life for people with dementia, even in the context of worsening cognitive function.
Hospital‐Associated Functional Decline: The Role of Hospitalization Processes Beyond Individual Risk Factors
Authors: Zisberg Anna , Shadmi Efrat , Gur‐Yaish Nurit , Tonkikh Orly , Sinoff Gary
Published: January 2015

Objectives

To investigate the combined contribution of processes of hospitalization and preadmission individual risk factors in explaining functional decline at discharge and at 1‐month follow‐up in older adults with nondisabling conditions.

Design

Prospective cohort study.

Setting

Internal medicine wards in two Israeli medical centers.

Participants

Six hundred eighty‐four individuals aged 70 and older admitted for a nondisabling problem.

Measurements

Functional decline was measured according to change in modified Barthel Index from premorbid to discharge and from premorbid to 1 month after discharge. In‐hospital mobility, continence care, sleep medication consumption, satisfaction with hospital environment, and nutrition intake were assessed using previously tested self‐report instruments.

Results

Two hundred eighty‐two participants (41.2%) reported functional decline at discharge and 317 (46.3%) at 1 month after discharge. Path analysis indicated that in‐hospital mobility (standardized maximum likelihood estimate (SMLE) = −0.48, P < .001), continence care (SMLE = −0.12, P < .001), and length of stay (LOS) (SMLE = 0.06, P < .001) were directly related to functional decline at discharge and, together with personal risk factors, explained 64% of variance. In‐hospital mobility, continence care, and LOS were indirectly related to functional decline at 1 month after discharge through functional decline at discharge (SMLE = 0.45, P < .001). Nutrition consumption (SMLE = −0.07, P < .001) was significantly related to functional decline at 1 month after discharge, explaining, together with other risk factors, 32% of variance.

Conclusion

In‐hospital low mobility, suboptimal continence care, and poor nutrition account for immediate and 1‐month posthospitalization functional decline. These are potentially modifiable hospitalization risk factors for which practice and policy should be targeted in efforts to curb the posthospitalization functional decline trajectory.
Associations Between Oral Health and Risk of Dementia in a 37‐Year Follow‐Up Study: The Prospective Population Study of Women in Gothenburg
Authors: Stewart Robert , Stenman Ulrika , Hakeberg Magnus , Hägglin Catharina , Gustafson Deb , Skoog Ingmar
Published: January 2015

Objectives

To investigate the association between incident dementia and previous number of teeth measured over a long interval.

Design

Retrospective analysis of a 37‐year cohort study.

Setting

Prospective Population Study of Women in Gothenburg.

Participants

Women with (n = 158) and without (n = 539) dementia in 2000 to 2005.

Measurements

Tooth counts in 1968–69, 1980–81, and 1992–93. Covariates included age, education, stroke, myocardial infarction, diabetes mellitus, smoking status, blood pressure, body mass index, and cholesterol level.

Results

After adjustment for age, odds ratios (ORs) for dementia in 2000–05, comparing first with fourth tooth count quartiles, were 1.81 (95% confidence interval (CI) = 1.03–3.19) for tooth counts measured in 1968, 2.25 (95% CI = 1.18–4.32) for those in 1980, and 1.99 (0.92–4.30) for those in 1992. After further adjustment for education, ORs were 1.40 (95% CI = 1.03–3.19) for 1968, 1.96 (95% CI = 0.98–3.95) for 1980, and 1.59 (95% CI = 0.71–3.53) for 1992, and after additional adjustment for vascular risk factors, ORs were 1.38 (95% CI = 0.74–2.58) for 1968, 2.09 (95% CI = 1.01–4.32) for 1980, and 1.61 (95% CI = 0.70–3.68) for 1992.

Conclusion

In most of the analyses, lower tooth count was not associated with dementia, although a significant association was found for one of the three examinations. Further research may benefit from more‐direct measures of dental and periodontal disease.
Comparative Study of Four Physical Performance Measures as Predictors of Death, Incident Disability, and Falls in Unselected Older Persons: The Insufficienza Cardiaca negli Anziani Residenti a Dicomano Study
Authors: Minneci Cristina , Mello Anna Maria , Mossello Enrico , Baldasseroni Samuele , Macchi Loredana , Cipolletti Stefano , Marchionni Niccolò , Di Bari Mauro
Published: January 2015

Objectives

To compare the ability of the Short Physical Performance Battery (SPPB), 4‐m walk test (4mWT), 6‐minute walk test (6MWT), and handgrip strength to predict mortality, incident disability, worsening mobility, and falls in older community dwellers.

Design

Cohort study.

Setting

Population‐based.

Participants

Individuals aged 65 and older n = 561) without prevalent basic activity of daily living (ADL) disability participating.

Measurements

Separate logistic regression models were developed to predict incident ADL disability, worsening mobility, and falls in 3 years, and Cox regression models were used to assess 7‐year risk of death as a function of the four tests, adjusting for covariates.

Results

Performance tests were reciprocally correlated at baseline. After 3 years, 33 (7.3%) of 453 participants reexamined were disabled in ADLs, 87 (20%) had worsening mobility, and 99 (22%) reported falls. Of the 561 baseline participants, 141 (25%) died over the 7 years. All measures predicted incident ADL disability, with adjusted odds ratios (ORs) per unit increase of 0.85 (95% confidence interval (CI) = 0.77–0.93) for handgrip strength, 0.08 (95% CI = 0.02–0.36) for 4mWT, 0.74 (95% CI = 0.61–0.89) for SPPB, and 0.993 (95% CI = 0.988–0.997) for 6MWT. Handgrip strength (OR = 0.88, 95% CI = 0.83–0.93), 4mWT (OR = 0.33, 95% CI = 0.11–0.94), and SPPB (OR = 0.81, 95%CI = 0.71–0.93) predicted worsening mobility. No measure predicted falls; only SPPB (hazard ratio (HR) = 0.92, 95% CI = 0.85–0.997) and 6MWT (HR = 0.997, 95% CI = 0.995–0.999) predicted death.

Conclusion

Performance measures are independent predictors of relevant health outcomes, with the exception of falls. Because SPPB is easily applied and is the only measure predicting incident ADL disability, worsening mobility, and death, it is preferable to the other tests.
Underuse of Oral Anticoagulation for Individuals with Atrial Fibrillation in a Nursing Home Setting in France: Comparisons of Resident Characteristics and Physician Attitude
Authors: Bahri Oarda , Roca Frederic , Lechani Tarik , Druesne Laurent , Jouanny Pierre , Serot Jean‐Marie , Boulanger Eric , Puisieux Francois , Chassagne Philippe
Published: January 2015

Objectives

To describe the characteristics of nursing home residents diagnosed with atrial fibrillation (AF) and eligible for oral anticoagulants who did not receive these drugs and to detail the conditions that physicians who decide not to prescribe anticoagulants take into account.

Design

Cross‐sectional.

Setting

Nursing home.

Participants

Nursing home residents with a history of AF (N = 1,085).

Measurements

Data were collected on clinical characteristics, geriatric syndromes, and antithrombotic regimen. Multivariate logistic regression was used to identify factors associated with nonprescription of anticoagulants. A standardized questionnaire was submitted to physicians in charge of patients with AF, to detail conditions associated with their medical decision not to prescribe anticoagulants.

Results

History of AF was present in 1,085 nursing home residents (10.1%), mean age 87, with a mean CHA2DS2‐VASc score of 5.1 ± 1.4. Of these residents with AF, 544 (50.1%) did not receive anticoagulants. Recurrent falls (odds ratio (OR) = 4.9, 95% confidence interval (CI) = 2.4–9.9, P < .001), past history of bleeding (OR = 3.62, 95% CI = 1.54–8.51, P = .003), paroxysmal AF (OR = 3.5, 95% CI = 1.83–6.66, P < .001), and advanced age (OR = 1.1, 95% CI = 1.01–1.17, P = .02) were significantly associated with not prescribing anticoagulants. Recurrent falls (47%), cognitive impairment (22.6%), and advanced age (16.4%) were the main reasons for not prescribing anticoagulants.

Conclusion

The prevalence of AF in a cohort of very old nursing home residents was 10%. Anticoagulation was prescribed in fewer than 50% of eligible cases despite high individual risk of stroke. Geriatric syndromes, especially falls and cognitive disorders, were the main reported contraindications for prescribing anticoagulants. Physicians caring for those residents wrongly thought that paroxysmal AF caused fewer thromboembolic events than permanent AF, which explains lower rates of anticoagulant prescription in individuals with paroxysmal AF.
Frailty Prevalence and Neighborhood Residence in Older Mexican Americans: The San Antonio Longitudinal Study of Aging
Authors: Espinoza Sara E. , Hazuda Helen P.
Published: January 2015

Objectives

To examine the association between neighborhood residence and frailty prevalence in older Mexican Americans (MAs).

Design

Cross‐sectional, observational study.

Setting

Socioeconomically and ethnically diverse neighborhoods in San Antonio, Texas.

Participants

Community‐dwelling older MA adults (aged ≥65) who completed the baseline examination of the San Antonio Longitudinal Study of Aging (SALSA) (1992–1996) (N = 394).

Measurements

Subjects were randomly sampled from three types of neighborhoods that varied in ethnic composition and economic environment: barrio (low‐income, exclusively MA), transitional (middle‐income, equal proportion MAs and European Americans (EAs)) and suburban (upper‐income, predominantly EA). Frailty was classified using the Fried criteria. Frailty odds were estimated according to neighborhood using logistic regression, with the suburban neighborhood as the reference category. Covariates included age, sex, diseases, depressive symptoms, and cognitive function.

Results

Frailty prevalence was 15.6% in the barrio, 9.4% in the transitional neighborhood, and 3.5% in the suburbs (P = .01). After adjusting for sociodemographic characteristics and disease covariates, odds of frailty were 4.15 times as high for MAs residing in the barrio as for those residing in the suburbs (P = .03). After adjustment for depression and cognition, this association was no longer significant. Diabetes mellitus and depression accounted for the higher odds of frailty in the barrio. Although odds of frailty in the transitional neighborhood were 1.95 times as high as those in the suburbs, the difference was not statistically significant.

Conclusion

The ethnic composition and economic environment of the neighborhoods in which MA older adults reside are strongly associated with their odds of being frail.
Comparison of Anticholinergic Risk Scales and Associations with Adverse Health Outcomes in Older People
Authors: Salahudeen Mohammed Saji , Hilmer Sarah N. , Nishtala Prasad S.
Published: January 2015

Objectives

To investigate whether anticholinergic burden scores from nine published anticholinergic scales are associated with adverse health outcomes, including hospital admissions, hospitalizations for falls, hospital length of stay (LOS), and more visits to general practitioners (GPs).

Design

Pharmacoepidemiological population‐based study.

Setting

New Zealand.

Participants

Population aged 65 and older (n = 537,387).

Measurements

Data were analyzed for 537,387 individuals from the Pharmaceutical Claims Data Mart data set (2011). Anticholinergic medication exposure was calculated using nine published scales. Events information (2012) was extracted from the National Minimum Datasets using International Classification of Diseases, Tenth Revision, codes. Predictors of hospital admissions, hospitalizations for falls, LOS, and GP visits were examined using regression models adjusting for age, sex, ethnicity, comorbidities, and polypharmacy.

Results

Prevalence of exposure to anticholinergic medicines ranged from 22.8% to 55.9% according to the different scales. Multivariate regression analysis showed that anticholinergic burden scores quantified according to all nine scales were significantly associated with hospital admissions, hospitalizations for falls, LOS, and GP visits (P < .001). The strongest predictors of these outcomes were the Drug Burden Index—Anticholinergic component scores, aged 85 and older, female sex, and polypharmacy.

Conclusion

There are substantial differences in the estimation of anticholinergic burden exposure between the nine scales. Anticholinergic burden scores obtained from each of the scales were associated with adverse clinical outcomes of interest.
A novel role for central ACBP/DBI as a regulator of long‐chain fatty acid metabolism in astrocytes
Authors: Bouyakdan Khalil , Taïb Bouchra , Budry Lionel , Zhao Shangang , Rodaros Demetra , Neess Ditte , Mandrup Susanne , Faergeman Nils. J. , Alquier Thierry
Published: January 2015

Acyl‐CoA‐binding protein (ACBP) is a ubiquitously expressed protein that binds intracellular acyl‐CoA esters. Several studies have suggested that ACBP acts as an acyl‐CoA pool former and regulates long‐chain fatty acids (LCFA) metabolism in peripheral tissues. In the brain, ACBP is known as Diazepam‐Binding Inhibitor, a secreted peptide acting as an allosteric modulator of the GABAA receptor. However, its role in central LCFA metabolism remains unknown. In the present study, we investigated ACBP cellular expression, ACBP regulation of LCFA intracellular metabolism, FA profile, and FA metabolism‐related gene expression using ACBP‐deficient and control mice. ACBP was mainly found in astrocytes with high expression levels in the mediobasal hypothalamus. We demonstrate that ACBP deficiency alters the central LCFA‐CoA profile and impairs unsaturated (oleate, linolenate) but not saturated (palmitate, stearate) LCFA metabolic fluxes in hypothalamic slices and astrocyte cultures. In addition, lack of ACBP differently affects the expression of genes involved in FA metabolism in cortical versus hypothalamic astrocytes. Finally, ACBP deficiency increases FA content and impairs their release in response to palmitate in hypothalamic astrocytes. Collectively, these findings reveal for the first time that central ACBP acts as a regulator of LCFA intracellular metabolism in astrocytes.

image

Acyl‐CoA‐binding protein (ACBP) or diazepam‐binding inhibitor is a secreted peptide acting centrally as a GABAA allosteric modulator. Using brain slices, cortical, and hypothalamic astrocyte cultures from ACBP KO mice, we demonstrate that ACBP mainly localizes in astrocytes and regulates unsaturated but not saturated long‐chain fatty acids (LCFA) metabolism. In addition, ACBP deficiency alters FA metabolism‐related genes and results in intracellular FA accumulation while affecting their release. Our results support a novel role for ACBP in brain lipid metabolism. FA, fatty acids; KO, knockout; PL, phospholipids; TAG, triacylglycerol.
Reasons For and Reservations About Research Participation in Acutely Injured Adults
Authors: Irani Elliane , Richmond Therese S.
Published: January 2015

Purpose

The purpose of this study was to explore the reasons adult patients seeking emergency department care for minor injuries agree to participate in clinical research and to identify their reservations about participating in a research study.

Design and Methods

This is a secondary analysis of data from a longitudinal cohort study of 275 adults who sought emergency department care for physical injury and were followed over 12 months. At the final interview, participants were asked open‐ended short‐answer questions about their perception of participating in the study. Free text responses were analyzed using conventional content analysis.

Findings

The final sample of 214 participants was composed equally of males and females, predominantly Black (54%) and White (42%), with a mean age of 41 years. Six themes about reasons for participation emerged from free text responses: being asked, altruism, potential for personal benefit, financial gain, curiosity, and valuing or knowledge of research. Most did not report reservations. Those reservations identified included time constraints, confidentiality, and whether patients felt well suited to fulfill the study requirements.

Conclusions

Although injured patients are identified by the research community as vulnerable, they are willing to participate in research studies for diverse reasons, and their participation is commonly associated with positive experiences.

Clinical Relevance

Understanding perceptions of participants’ experiences of being in a research study after acute injury can guide researchers to improve future study protocols and recruitment strategies in order to optimize participants’ experiences. Recruitment and retention into clinical research studies is essential to build nursing science to enhance the recovery of injured individuals.
Efficacy of stabilisation splint treatment on facial pain – 1‐year follow‐up
Authors: Qvintus V. , Suominen A. L. , Huttunen J. , Raustia A. , Ylöstalo P. , Sipilä K.
Published: January 2015

The aim of this randomised controlled trial was to assess the efficacy of stabilisation splint treatment on TMD‐related facial pain during a 1‐year follow‐up. Eighty patients were randomly assigned to two groups: splint group (n = 39) and control group (n = 41). The patients in the splint group were treated with a stabilisation splint and received counselling and instructions for masticatory muscle exercises. The controls received only counselling and instructions for masticatory muscles exercises. The outcome variables were the change in the intensity of facial pain (as measured with visual analogue scale, VAS) as well as the patients' subjective estimate of treatment outcome. The differences in VAS changes between the groups were analysed using variance analysis and linear regression models. The VAS decreased in both groups, the difference between the groups being not statistically significant. The group status did not significantly associate with the decrease in VAS after adjustment for baseline VAS, gender, age, length of treatment and general health status. The only statistically significant predicting factor was the baseline VAS, which was also confirmed by the mixed‐effect linear model. After 1‐year follow‐up, 27·6% of the patients in the splint group and 37·5% of the patients in the control group reported ‘very good' treatment effects. The findings of this study did not show stabilisation splint treatment to be more effective in decreasing facial pain than masticatory muscle exercises and counselling alone in the treatment of TMD‐related facial pain over a 1‐year follow‐up.
PATIENTS' ADHERENCE TO ASPECTS OF HAEMODIALYSIS REGIMENS IN TROPICAL NORTH QUEENSLAND, AUSTRALIA
Authors: Smyth Wendy , Hartig Vicki , Hayes Megan , Manickam Valli
Published: January 2015

Background

Patients with end‐stage kidney disease often have difficulty in adhering to aspects of their haemodialysis regimens.

Objectives

This study aimed to quantify the number of patients who attended 100% of their scheduled haemodialysis sessions, and the number of patients who gained no more than one kilogram per day between dialysis sessions, over a three‐month period.

Design

Retrospective chart audit

Participants

Patients undergoing haemodialysis at an in‐hospital centre in tropical Australia.

Methods

A renal nurse audited the 72 charts pertaining to a 12‐week period in 2013.

Results

Patients attended 90.1% of all scheduled dialysis sessions. Forty‐one patients attended all sessions, with the remaining 31 missing at least one scheduled session. One patient missed 16 scheduled sessions. The following were statistically less likely to attend all their scheduled sessions: Aboriginal and Torres Strait Islander patients; patients on a three times per week dialysis schedule; patients who had relocated from rural or regional towns and younger patients. The average daily weight gain ranged from 0.414 kg to 1.017 kg (mean = 0.885 kg). Younger patients were statistically less likely to adhere to fluid restrictions; patients without diabetes were more likely to adhere to the fluid allowances.

Conclusions and applications to practice

Renal services need to assist patients to adhere to their regimens. Initially, this service will examine strategies to maximise the likelihood of patients attending all of their dialysis sessions. Such an outcome will help to delay deterioration in the patients' health status, while minimising additional strain on the health service.
Characterization of the Complete Genome of a Novel Polerovirus Infecting Sauropus androgynus in Thailand
Authors: Knierim Dennis , Maiss Edgar , Menzel Wulf , Winter Stephan , Kenyon Lawrence
Published: January 2015

Leaf samples from Thailand of Sauropus androgynus (L.) Merr. plants presenting leaf yellowing symptoms were screened by reverse transcription polymerase chain reaction for the presence of polerovirus infection. In five of eight samples, a polerovirus was detected, and in four of these five polerovirus‐positive samples, a begomovirus infection had been detected in a previous study. The complete polerovirus genome sequence was determined from the sample which was not also infected with a begomovirus. Analysis of the sequence revealed the typical genome organization of a polerovirus. The highest nucleotide sequence identity to any other polerovirus species sequence in GenBank was 49% to pepper yellow leaf curl virus (PYLCV), and the highest amino acid sequence identity of all deduced protein sequences was 70% with the coat protein of PYLCV. Based on these findings, we propose this novel polerovirus species be named Sauropus yellowing virus (SaYV).
The Effects and Consequences of Simultaneously Arising Different Network Externalities on the Demand for Status Goods
Authors: Kovács Kármen
Published: January 2015

The purpose of this paper is to explore how two main forms of network externalities, bandwagon and snob effects, influence the market demand for status goods when they arise simultaneously. If the snob effect is greater than the bandwagon effect, the demand function involving both effects is less elastic than the demand function that does not involve network externalities; however, the market demand function becomes increasingly elastic as the bandwagon effect becomes stronger. By introducing the concept of net social external effect, the change in the quantity demanded as a consequence of the resultant of network externalities can be measured.
Introduction of a new ward round approach in a cardiothoracic critical care unit
Authors: Shaughnessy Liz , Jackson Jo
Published: January 2015

Background

Francis (2013) described inconsistent ward rounds and failures to conduct ward rounds properly as contributing factors to the poor care seen at the Mid Staffordshire Foundation Trust. He suggested that the absence of a nurse at the bedside had clear consequences for communication, ward round efficiency and patient safety. He recommended that nurses should be actively involved in ward rounds and linked this to high quality patient care.

Aim

To share an experience of introducing a ward round checklist, a bedside nurse verbal summary and the development of standard operating procedure for Ward Rounds in cardiothoracic critical care unit to improve patient safety and care.

Design and methods

Semi structured interviews of six registered nurses.

A questionnaire to 69 registered nurses.

An electronic questionnaire sent to 23 members of the MDT.

An observational audit of seven ward rounds reviewing 69 patients.

Results

97% of nurses agreed that verbal summarizing had improved clarity and 90% felt that it had improved patient care. 87% of the MDT respondents stated that they had noticed an improvement in the attendance of the bedside nurse at the ward round review. The ward round checklist reduced omissions. Communication with patients during ward rounds was an area which needed to be improved.

Conclusions

The introduction of a new ward round approach and audit of its practice has enabled an improvement in the quality of patient care by:

Giving more opportunity for the nurse to participate and feel part of the ward round.

Reduction of omissions through the use of a ward round checklist.

Improved clarity among the MDT by the use of bedside nurse verbal summarizing of the plan of care.

Relevance to clinical practice

Nurses' full participation in ward rounds is essential to ensure effective communication and enhance patient safety.
Telling Stories: TheMycenaeanOrigins of thePhilistines
Authors: Middleton Guy D.
Published: January 2015

The story of thePhilistines asMycenaean orAegean migrants, refugees who fled theAegean after the collapse of the palace societiesc.1200BC, bringing anAegean culture and practices to theEasternMediterranean, is well known. Accepted as essentially true by some, yet rejected as little more than a modern myth by others, the migration narrative retains a central place in the archaeology and historiography of theEasternMediterranean in the Late Bronze Age/Early Iron Age (LBA/EIA). In recent years, and despite an increasingly shaky theoretical basis, the migration hypothesis has nevertheless seemed to drown out other interpretations and characterizations of the period, claiming a normative position that is undeserved. In this paper I explore the continuing power of this nineteenth century narrative and seek to show why it is less convincing than its prominent status would suggest.
Should we abandon landmark‐based technique for caudal anesthesia in neonates and infants?
Authors: Mirjalili Seyed Ali , Taghavi Kiarash , Frawley Geoff , Craw Susan
Published: January 2015

Background

Caudal anesthesia is a landmark‐based technique with ultrasound guidance occasionally used in the absence of landmarks. The current surface landmark remains a popular approach due to its desirable success rate. However, incomplete ossification of the posterior vertebral elements can make this procedure for neonatal caudal anesthesia difficult. The aim of this study was to describe the anatomical relationship of the posterior superior iliac spines (PSISs) to the sacral cornua in infants using ultrasound.

Methods

A total of 26 healthy infants (17 female; mean age 13 weeks) were scanned by an experienced radiologist in the prone position with hip and knee joints flexed. The PSISs and sacral cornua were identified clinically then using ultrasound to assess whether these markings corresponded with the clinical markings. The distance between the PSISs and the distance between the tip of the PSIS and tip of the sacral cornu were measured using ultrasound.

Results

The PSISs were clinically identified in all babies, but the sacral cornua were not palpable in four babies (15%). The PSISs and sacral cornua were easily visualized using ultrasound in all participants. The mean distance between the two left and right PSISs was 3.4 ± 0.5 cm; the mean distance between the PSISs and cornu was 2.5 ± 0.5 cm on the left and right.

Conclusion

This study showed that the current landmark (equilateral triangle) for infant caudal anesthesia is unreliable. Importantly, the sacral hiatus is clinically identifiable only if the sacral cornua are palpable; otherwise, using ultrasound is essential.
Epstein‐Barr virus‐positive diffuse large B‐cell primary central nervous system lymphoma associated with organized chronic subdural hematoma: A case report and review of the literature
Authors: Kameda Katsuharu , Shono Tadahisa , Takagishi Soh , Kono Shinji , Aoki Takatoshi , Ito Yoshikiyo , Kamimura Tomohiko , Sugita Yasuo , Ohshima Koichi
Published: January 2015

We here report on a rare case of Epstein‐Barr virus (EBV)‐positive diffuse large B‐cell lymphoma (DLBCL) detected in both brain parenchyma and in an organized chronic subdural hematoma (OCSH). A 96‐year‐old man diagnosed with asymptomatic OCSH in the left frontal convexity was referred to our hospital because of a de novo mass lesion just beneath the OCSH on contrast‐enhanced magnetic resonance imaging. The size of the OCSH remained stable. We diagnosed the lesion as a malignant tumor. At surgery, the organized hematoma and the soft fragile tumor were removed. Histological examinations revealed pleomorphic lymphoid cells not only in the brain tissue but also in the OCSH component with tumor necrosis, and these were immunopositive for B‐cell markers. In situ hybridization revealed positive signals for EBV‐encoded small RNAs, consistent with EBV‐positive DLBCL. Since the membranes of the subdural hematoma were fibrous and the tumor progression resulted in necrosis of the tumor, the DLBCL may have originally developed in the OCSH and infiltrated into the brain parenchyma. We believe that this rare case provides crucial information for the understanding of DLBCLs associated with OCSH.
Immunohistochemical characterization of renal tumors in patients with Birt‐Hogg‐Dubé Syndrome
Authors: Iribe Yasuhiro , Kuroda Naoto , Nagashima Yoji , Yao Masahiro , Tanaka Reiko , Gotoda Hiroko , Kawakami Fumi , Imamura Yoshiaki , Nakamura Yasushi , Ando Midori , Araki Akinobu , Matsushima Jun , Nakatani Yukio , Furuya Mitsuko
Published: January 2015

Birt‐Hogg‐Dubé syndrome (BHD) is an autosomal dominant disorder associated with a germline mutation of folliculin (FLCN). The affected families are at a high risk for developing multiple renal cell carcinomas (RCC). Little is known about the immunostaining patterns of mutant FLCN‐associated RCCs. We investigated 32 RCCs obtained from 17 BHD patients. The studied tumors included chromophobe RCCs (n = 15), hybrid oncocytic/chromophobe tumors (HOCT) (n = 14) and clear cell RCCs (n = 3). Almost all chromophobe RCCs and HOCTs revealed positive staining for S100A1, Ksp‐cadherin and CD82. They stained either focally or diffusely for CK7, and were negative for CA‐IX. All clear cell RCCs were positively stained for CA‐IX and negative for CK7. These data confirmed that mutant FLCN‐associated oncocytic and clear cell RCCs exhibited generally similar immunostaining patterns compared to their sporadic counterparts. Frequent positive staining for S100A1, Ksp‐cadherin and CD82 in chromophobe RCCs and HOCTs indicated that these two types were relatively similar rather than distinctively different in their patterns of immunoreactivity. Characteristic peri‐nuclear halos and polygonal cells with clear cytoplasm, which often misleads pathologists into the diagnosis of clear cell RCC, should be carefully examined using an immunohistochemical panel including CA‐IX, Ksp‐cadherin, CD82 and CK7.
Business model innovation and strategy making nexus: evidence from a cross‐industry mixed‐methods study
Authors: Cortimiglia Marcelo Nogueira , Ghezzi Antonio , Frank Alejandro Germán
Published: January 2015

Theory discussing how to define and frame the relationship between the strategy making process (SMP) and business model innovation (BMI) is still incipient in the academic literature. Thus, this study aims at investigating the relationship between SMP and BMI by addressing (1) when firms engage in BMI within the overall SMP, and (2) how firms design a new business model (BM) or improve their current BM within the overall SMP. The research questions are tackled by means of a mixed‐method research, combining (1) a quantitative survey on 138 firms involved in SMP and BMI (to understand when BM design and improvement occur) and (2) a qualitative multiple‐case study focused on four firms (to address how BM design and improvement evolve). The findings empirically validate the arguments that BM design and improvement are more likely to be positioned in the strategic alternatives implementation step of the SMP, and BM is related to strategy execution; on top of this, light is shed on the inherent dynamics of the BMI process for different types of BMI.