bluuebunny/crossref_metadata_2025 huggingface dataset:
Suffering and Tears: Authenticity and Student Volunteerism in Postreform China
Authors: Sum Chun‐Yi
Published: September 2017

This article examines a conundrum in my ethnographic fieldwork with Chinese university students who volunteered in service trips to rural communities: why did participants volunteer to suffer and to cry? This article explains students’ quest for hardship and tears in relation to emerging desires for authenticity in China. It discusses how the political state and student volunteers co‐constructed the peculiar expressions of these desires. As authentic emotions came to the forefront in students’ understanding of meaningful engagement, they diluted the political connotation of volunteerism and consequently undermined the state's moral authority as the “lead volunteer.” This created the room for students to align the definition of responsible citizenship with authentic commitment and youthful innocence. Delineating the paradoxes and obstacles that volunteers encountered in their quests, this article problematizes the potential and limits of authenticity in transforming the foundations of sociability and moral leadership in postreform China.

本文通过大学生对情绪表达的追求分析志愿活动在中国的冒起。作者跟随大学生往赴农村「支教」, 发现志愿者都渴慕最苦最累的体验, 以及由心而发的泪水。这些追求反映了年轻人对社会上种种造假和功利主义的不满。志愿者以汗水和泪水明志, 宣告自己参与志愿工作不为名利报酬, 只为满腔热诚所使。这种热血主导的志愿精神对参与者的道德观带来什么冲击, 如何造就年轻人对社会状况的反思? [Authenticity, Emotion, Youth, Volunteerism, China]
Health checkup behavior and individual health beliefs in older adults
Authors: Okura Mika , Ogita Mihoko , Yamamoto Miki , Nakai Toshimi , Numata Tomoko , Arai Hidenori
Published: September 2017

Aim

Despite Japan being a developed nation, half of its older population does not attend regular health checkups. The aim of the present study was to examine the individual health beliefs and personal recommendations that strongly influence health checkup attendance among community‐dwelling older adults.

Methods

In 2013, questionnaires were sent to 5401 community‐dwelling older adults who were not receiving long‐term institutionalized care. The response rate was 94.3%. We analyzed response data from 4984 older adults using multiple imputation to manage missing data. Participation in health checkups was defined as having undergone at least one checkup in the past 3 years, and non‐participation as having attended no checkups in this period.

Results

The participants’ mean age was 75.8 years, and 57.9% were women. The adjusted odds ratio of health checkup participation ranged from 1.35 (95% confidence interval [CI] 1.13–1.61) to 1.62 (95% CI 1.34–1.95) for positive individual health beliefs about health checkups, and was 2.21 (95% CI: 1.51–3.24) and 1.28 (95% CI: 1.17–2.08) for recommendations to participate from family and neighbors, respectively. All odds ratios were adjusted for age, sex, driving by oneself to daily shopping or clinic, paid work, method of response, internal medical therapy, polypharmacy, serious disease, periodic blood test, frailty and neighborly relationships.

Conclusions

The present findings suggest that both individual and community approaches might be effective in promoting participation in health checkups among community‐dwelling older adults. Geriatr Gerontol Int 2018; 18: 338–351.
Decision aid use during post‐biopsy consultations for localized prostate cancer
Authors: Holmes‐Rovner Margaret , Srikanth Akshay , Henry Stephen G. , Langford Aisha , Rovner David R. , Fagerlin Angela
Published: September 2017

Background

Decision Aids (DAs) effectively translate medical evidence for patients but are not routinely used in clinical practice. Little is known about how DAs are used during patient‐clinician encounters.

Objective

To characterize the content and communicative function of high‐quality DAs during diagnostic clinic visits for prostate cancer.

Participants

252 men newly diagnosed with localized prostate cancer who had received a DA, 45 treating physicians at 4 US Veterans Administration urology clinics.

Methods

Qualitative analysis of transcribed audio recordings was used to inductively develop categories capturing content and function of all direct references to DAs (booklet talk). The presence or absence of any booklet talk per transcript was also calculated.

Results

Booklet talk occurred in 55% of transcripts. Content focused on surgical procedures (36%); treatment choice (22%); and clarifying risk classification (17%). The most common function of booklet talk was patient corroboration of physicians’ explanations (42%), followed by either physician or patient acknowledgement that the patient had the booklet. Codes reflected the absence of DA use for shared decision‐making. In regression analysis, predictors of booklet talk were fewer years of patient education (P = .027) and more time in the encounter (P = .027). Patient race, DA type, time reading the DA, physician informing quality and physician age did not predict booklet talk.

Conclusions

Results show that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments.
A novel technique for biobanking of large sections of radical prostatectomy specimens
Authors: Lindh Claes , Delahunt Brett , Samaratunga Hemamali , Yaxley John , Gudjónsdóttir Jóna , Clements Mark , Lindberg Johan , Egevad Lars
Published: September 2017

Aims

Harvesting of unfixed tissue from radical prostatectomy specimens for research purposes is challenging. Many prostate cancers cannot be identified at gross inspection, and this tumour is notoriously multifocal and heterogeneous. We aimed to develop a technique to allow detailed topographic analysis and the sampling of a sufficient amount of tumour without jeopardising clinical reporting.

Methods and results

A custom‐made double‐bladed knife was utilised for cutting a 4‐mm‐thick horizontal section of the prostate. The slices were split into segments that were frozen in gel, cryosections were cut, and RNA integrity numbers (RINs) were analysed. Sections were cut from all blocks of 20 cases, and the cutting time was monitored. Slides were scanned, and the slices were digitally reconstructed. Cutting frozen sections of an entire slice took 79–253 min (mean 162 min). Tumour was detected in frozen sections of 85% (17/20) of cases and in 46% (72/155) of blocks. The morphological quality was determined to be excellent, and RIN values were high (mean 8.9).

Conclusions

This novel protocol for biobanking of fresh tissue from prostatectomy specimens provides sufficient tumour material for research purposes, while also enabling reporting of histopathology. The harvesting of a full tissue slice facilitates studies of tumour multifocality and heterogeneity.
Innate lymphoid cells at the interface between obesity and asthma
Authors: Everaere Laetitia , Ait Yahia Saliha , Bouté Mélodie , Audousset Camille , Chenivesse Cécile , Tsicopoulos Anne
Published: September 2017

Obesity and asthma prevalence has dramatically and concomitantly increased over the last 25 years, and many epidemiological studies have highlighted obesity as an important risk factor for asthma. Although many studies have been performed, the underlying mechanisms remain poorly understood. Innate mechanisms have been involved in both diseases, in particular through the recently described innate lymphoid cells (ILCs). ILCs are subdivided into three groups that are defined by their cytokine production and by their master transcription factor expression, in sharp correlation with their T helper counterparts. However, unlike T helper cells, ILCs do not express antigen‐specific receptors, but respond to damage‐induced signals. ILCs have been found in target tissues of both diseases, and data have implicated these cells in the pathogenesis of both diseases. In particular group 2 ILCs (ILC2) are activated in both the adipose and lung tissues under the effect of interleukin‐33 and interleukin‐25 expression. However, counter‐intuitively to the well‐known association between obesity and asthma, ILC2 are beneficial for obesity but deleterious for asthma. This review will examine the roles of ILCs in each disease and recent data highlighting ILCs as a putative link between obesity and asthma.
The Effect of Labor Relations Laws on Unionization Rates within the Labor Force: Evidence from the Canadian Provinces
Authors: Legree Scott , Schirle Tammy , Skuterud Mikal
Published: September 2017

We examine the potential of labor‐relations reforms to address wage inequality by relating an index of the favorableness to unions of Canadian provincial labor‐relations laws to changes in industry, occupation, education, and gender‐specific provincial unionization rates. While we find some evidence of larger unionization gains among high‐school–educated workers, the differences across groups are small and in some cases suggest larger gains among professionals. Overall, the results suggest a limited potential for reforms in labor‐relations laws to mitigate growing labor‐market inequality.
Phenotype of human corneal stroma‐derived cells obtained by different isolation techniques from various corneal regions
Authors: Nagymihaly R. , Veréb Z. , Facskó A. , Moe M. , Petrovski G.
Published: September 2017

Purpose

Investigating the effect of isolation technique and location upon the phenotype of human corneal stroma‐derived cells (CSCs).

Methods

Cells were obtained from the center and periphery of the corneal stroma using the explant and enzymatic digestion methods. The native tissue was stained for markers of functionality, stemness, proliferation, adhesion and matrix proteins. Surface immunophenotyping was performed on ex vivo cultured CSCs obtained by the different methods by three‐colour fluorescence‐activated cell sorting (FACS) analysis. Finally, RT qPCR was used to determine the expression of corneal stroma‐specific genes and to verify the results of immunostaining.

Results

Cultures of human CSCs were established by explant and enzymatic techniques from the central and peripheral corneal stroma regions. The corneal stroma, in situ was positive for a‐actinin, ALDH1A1, CD31, CD34, Collagen I and Vimentin, while ABCG2, ABCG5, fibroblast marker, CD73, CD90, CD105, Collagen IV, Fibronectin, Ki‐67, Nestin and VE‐Cadherin were not detected. Ex vivo cultured CSCs expressed CD73, CD90, CD105, CD51, Nestin, CD49a, CD49d, ABCG2, CD47, while CD34 and CD31 were absent. RT qPCR analysis revealed a significant downregulation of ALDH1A1, AQP1, ITGB4, ALDH1A1 and CD34 in cultured versus native cells, with the upregulation of ABCG2, ITGAV, Nestin, CD73, CD90, CD105 and Vimentin. KLF4, GPC4 and CD31 were not significantly different.

Conclusions

The present study finds no significant difference between the phenotype of the CSCs generated by the explant or enzymatic digestion technique from the central or peripheral part of the stroma. For research purposes, any type of corneal stroma tissue may be used, however the change in cultivated cells’ surface marker and genotype prolife during ex vivo expansion needs to be considered.
Importance of cellular factors in the retention of melanin‐binding drugs in pigmented ocular tissues
Authors: Rimpelä A.K. , Urtti A.
Published: September 2017

Purpose

Many clinical drugs bind to melanin pigment in ocular tissues, affecting their pharmacokinetics in the eye. Drug‐melanin binding is frequently studied in vitro with isolated or synthetic melanin. The effect of other factors, such as permeability of melanosomal and plasma membrane, dissociation rate from melanin, melanin content of the tissue and ion trapping in melanosomes, are poorly understood. This study aims to probe the impact of the above‐mentioned factors together with melanin binding on drug retention in the pigmented retinal pigment epithelium (RPE) and choroid by kinetic simulations.

Methods

We simulated drug retention in the RPE‐choroid after intravitreal and systemic administration of a high and a moderate melanin‐binding drug using a bottom‐up approach with Stella software. The model parameters were based on realistic values from experimental studies and the model integrated these parameters together allowing the exploration of their interplay.

Results

The high melanin binder was retained in the pigmented but not in the non‐pigmented RPE‐choroid after both intravitreal and systemic administration. Lowering the cell membrane permeability increased retention, but changes in dissociation rate from melanin had minimal effect. Ion trapping in melanosomes increased retention. The moderate melanin binder was not retained considerably in the pigmented RPE‐choroid, although the concentrations increased compared to the non‐pigmented RPE‐choroid. Lowering the permeability values and dissociation rate lengthened the retention in the pigmented RPE‐choroid.

Conclusions

Melanin binding can accumulate high‐binding drugs into pigmented tissues, but other factors, including melanosomal and plasma membrane permeability, ion trapping in melanosomes, and dissociation rate from melanin, play an important role in drug distribution to pigmented ocular tissues.
Activation of retinal microglia and accumulation of sub‐retinal fluid after systemic challenge with Lipopolysaccharide in mice
Authors: Kokona D. , Ebneter A. , Zinkernagel M.
Published: September 2017

Purpose

Retinal pathology such as diabetic retinopathy can be exacerbated by systemic viral illness. However, little is known whether systemic inflammation causes activation of retinal microglia. The aim of the present study was to investigate the effect of a systemic inflammatory stimulus with lipopolysaccharide (LPS) on retinal microglia activation.

Methods

LPS (1 mg/kg) was administered intravenously for 4 days in Cx3cr1gfp/+ mice, specifically expressing gfp in microglia/macrophages. Retinas were examined with optical coherence tomography, fluorescein angiography and autofluorescence imaging before and after the LPS challenge. A group of mice was fed with the colony stimulating factor‐1 receptor (CSF‐1R) inhibitor PLX5622, which has been shown to deplete retinal microglia after 48 hours, for 7 days and until the end of the experiments. PLX‐fed mice were challenged with LPS as above, imaged and euthanized at day 4 of the LPS challenge.

Results

Accumulation of sub‐retinal fluid and leakage of fluorescein was observed in the retinas of LPS mice, suggesting disruption of the blood retinal barrier (BRB). In vivo imaging and histology showed increased numbers of gfp+ cells in retinas and brains and accumulation around retinal vessels in the LPS group. Increase of gfp+ cell numbers was partially attributed to proliferation, based on Ki67 staining. PLX attenuated the numbers of gfp+ cells and reversed the effects of LPS on sub‐retinal fluid accumulation.

Conclusions

Our data suggest that systemic LPS challenge initiates inflammatory responses in the retina and can lead to disruption of the BRB, whose integrity seems to be highly dependent on retinal microglia and/or invading macrophages. Pathology is completely abrogated in microglia depleted mice, suggesting that novel CSF‐1R inhibitors may be a promising target for inflammation mediated retinal diseases.
Surgical techniques for failed/difficult macular holes
Authors: Ozdek S. O.
Published: September 2017

Free ILM flap technique for difficult macular hole cases: Failed macular holes, macular holes associated with pathologic myopia and retinal detachment and chronic atrophic macular holes are usually difficult to handle with standard techniques. Here we describe the PFCL‐assisted free ILM flap technique as a good surgical option for failed MH closures. The technique is very promising in retaining the flap during the crucial FAE, which results in favorable outcomes, both morphological and functional.
Optic disk melanocytoma and juxtapapillary melanoma. Diagnosis and management
Authors: Shields C.
Published: September 2017

The two most important pigmented lesions of the optic disc include melanocytoma and melanoma. Melanocytoma is a benign nevus and a normal finding in some lower animals such as camels, crocodiles and snakes. It appeas as a dark brown‐black mass at the disc, often with disc atrophy and invasion of retina and choroid. Transformation to melanoma is rare. On the other hand, optic disc melanoma generally arises from a juxtapapillary choroidal melanoma and secondarily invades the nerve. There is usually subretinal fluid and overlying orange pigment in the choroidal portion. Of all uveal melanomas, less than one percent invade the nerve. Enucleation is usually necessary. Understanding the differences in these two tumors is importan
Usefulness of Ret‐Cam imaging in diagnosis, treatment and monitoring of retinoblastoma
Authors: Romanowska Dixon B. , Morawski K.
Published: September 2017

Purpose

To present a group of children with retinoblastoma whose diagnostic, therapeutic and monitoring decisions were made using Ret‐Cam

Methods

Children treated in the Department of Ophthalmology and Ophthalmic Oncology for retinoblastoma in the 1900s. Diagnosis was made after ophthalmic examination under general anesthesia with Ret‐Cam and ultrasonography. Treatment was performed with VEC chemoreduction, iodine and ruthenium brachytherapy, cryotherapy, and transpupillary thermotherapy.

Results

The results of treatment and control were documented on a Ret‐Cam camera. Photographs of intraocular tumors have been made prior to treatment, after chemoreduction, after local treatment and during the follow‐up. Tumors regression, vitreous seeds and possible radiation retinopathy were monitored.

Conclusions

Photographic documentation using the Ret‐Cam is very useful in treating retinoblastoma. The biggest advantage is the objective possibility to compare and evaluate the results of treatment and control
Macular thickness changes using spectral‐domain optical coherence tomography automated layer segmentation in multiple sclerosis
Authors: Barata A. , Leal I. , Sousa F. , Teixeira F. , Henriques J. , Pinto F.
Published: September 2017

Purpose

We aim to study the role of automated layer segmentation in MS patients’ management.

Methods

Retrospective study that included 39 patients (78 eyes) with confirmed diagnosis of MS and 35 healthy age‐matched controls. Macular spectral‐domain optical coherence tomography scans (SD‐OCT, Heidelberg Engineering, Heidelberg, Germany) were obtained followed by automated retinal layer segmentation at the center of fovea and at a radius of 3–6 mm from the superior, inferior, temporal and nasal sectors (ETDRS grid). Patients with MS were subdivided into two groups: (1) with known previous ON, (2) not known previous ON. Statistical analysis using two sample t‐test was made to calculate significant results between groups with 95% confidence interval.

Results

Total central and inner layers macular thickness was significantly reduced in MS patients compared to control group (p < 0.05) predominantly due to retinal nerve fibre (RNFL), ganglion cell (GCL) and inner plexiform layers (IPL) reduction in foveal, parafoveal and perifoveal sectors with exception of RFNL temporal sector. GCL and IPL were significantly reduced in foveal and parafoveal sectors between group 1 and 2 (p < 0.05) while no significant RNFL reduction was observed between these groups.

Conclusions

Reductions in total central and inner layers macular thickness can be detected in MS eyes with or without a previous history of known ON. As many ON episodes are not clinically detected, OCT may act as CNS imaging tool documenting neuronal degeneration in MS patients.
An assessment of pregnant women's knowledge and use of the Internet for medication safety information and purchase
Authors: Sinclair Marlene , Lagan B.M. , Dolk Helen , McCullough Julie E. M.
Published: September 2017

Aim

The aim of this study was to assess pregnant women's Internet searching activity about medication safety, knowledge and perceptions of medication risk and willingness to take prescribed and non‐prescribed medication or make online medication purchases.

Background

Online medication advice for pregnant women is complex. The quality and veracity of this data is increasingly important as more midwives report women are bringing retrieved online information to clinical appointments. Pregnant women's use of the Internet for seeking medication advice and purchasing medications has not yet been fully investigated.

Design

Online survey conducted from January ‐ March 2013.

Findings

Of the 284 respondents, 39% were taking a medication when they became pregnant and 76% had searched the Internet for medication safety information. Analgesics were the most commonly searched category (41%). Health service sites were the most common online source and regarded as the most helpful and trusted. Regardless of age and education level, 90% of women agreed that if trying to become pregnant they would reconsider taking any medications because of the potential risk to their unborn baby. Forty‐six percent of women with higher levels of education consider buying medication online as safe, a greater proportion than those of lower education. Five percent of women reported buying medication online.

Conclusion

The lack of specific recommendations for medication use during pregnancy is challenging for healthcare staff and pregnant women who need robust evidence to make informed treatment decisions. The Internet is a recognized, commonly accessed, source of medication information for pregnant women.
Experience of the waiting area as perceived by haemodialysis patients and family carers
Authors: Kim Yoonsoo , Kim Miyoung , Bhandari Pratibha , Choi Sujin
Published: September 2017

Aim

To identify the meaning of the waiting area based on the experiences of haemodialysis patients and their carers and to develop an optimal social environment for meaningful nursing care.

Background

Haemodialysis patients require treatment three times a week and they and their carers spend much of their time in waiting areas, where they experience a unique culture. Limited qualitative research has focused on the culture of the waiting area among haemodialysis patients in South Korea.

Design

A qualitative study using an ethnographic approach.

Methods

Eighteen participants were recruited in a hospital waiting area. The data were collected via participant observations and interviews from 24 November 2015–21 April 2016. Spradley's research sequence was employed to analyse the data.

Results

Three themes were identified that describe the unique characteristics of the waiting area: sharing information and consoling, inhabiting a separate area of ease and discomfort and experiencing vigilance and unsure stillness. The overarching theme was a boundary space that presented antithetical and dynamic patterns.

Conclusions

This study contributes to a better understanding of the distinct culture experienced by haemodialysis patients in the waiting area and the findings can help nurses deliver more meaningful care. Nursing interventions germane to psychological and emotional support and applicable nursing education should be seriously considered for haemodialysis waiting rooms.
ABayesian CUSUMplot: Diagnosing quality of treatment
Authors: Rosthøj Steen , Jacobsen Rikke‐Line
Published: September 2017

Objectives

To present a CUSUM plot based on Bayesian diagnostic reasoning displaying evidence in favour of “healthy” rather than “sick” quality of treatment (QOT), and to demonstrate a technique using Kaplan‐Meier survival curves permitting application to case series with ongoing follow‐up.

Methods

For a case series with known final outcomes: Consider each case a diagnostic test of good versus poor QOT (expected vs. increased failure rates), determine the likelihood ratio (LR) of the observed outcome, convert LR to weight taking log to base 2, and add up weights sequentially in a plot showing how many times odds in favour of good QOT have been doubled. For a series with observed survival times and an expected survival curve: Divide the curve into time intervals, determine “healthy” and specify “sick” risks of failure in each interval, construct a “sick” survival curve, determine the LR of survival or failure at the given observation times, convert to weights, and add up.

Results

The Bayesian plot was applied retrospectively to 39 children with acute lymphoblastic leukaemia with completed follow‐up, using Nordic collaborative results as reference, showing equal odds between good and poor QOT. In the ongoing treatment trial, with 22 of 37 children still at risk for event, QOT has been monitored with average survival curves as reference, odds so far favoring good QOT 2:1.

Conclusion

QOT in small patient series can be assessed with a Bayesian CUSUM plot, retrospectively when all treatment outcomes are known, but also in ongoing series with unfinished follow‐up.
ProSAAS‐derived peptides are regulated by cocaine and are required for sensitization to the locomotor effects of cocaine
Authors: Berezniuk Iryna , Rodriguiz Ramona M. , Zee Michael L. , Marcus David J. , Pintar John , Morgan Daniel J. , Wetsel William C. , Fricker Lloyd D.
Published: September 2017

To identify neuropeptides that are regulated by cocaine, we used a quantitative peptidomic technique to examine the relative levels of neuropeptides in several regions of mouse brain following daily intraperitoneal administration of 10 mg/kg cocaine or saline for 7 days. A total of 102 distinct peptides were identified in one or more of the following brain regions: nucleus accumbens, caudate putamen, frontal cortex, and ventral tegmental area. None of the peptides detected in the caudate putamen or frontal cortex were altered by cocaine administration. Three peptides in the nucleus accumbens and seven peptides in the ventral tegmental area were significantly decreased in cocaine‐treated mice. Five of these ten peptides are derived from proSAAS, a secretory pathway protein and neuropeptide precursor. To investigate whether proSAAS peptides contribute to the physiological effects of psychostimulants, we examined acute responses to cocaine and amphetamine in the open field with wild‐type (WT) and proSAAS knockout (KO) mice. Locomotion was stimulated more robustly in the WT compared to mutant mice for both psychostimulants. Behavioral sensitization to amphetamine was not maintained in proSAAS KO mice and these mutants failed to sensitize to cocaine. To determine whether the rewarding effects of cocaine were altered, mice were tested in conditioned place preference (CPP). Both WT and proSAAS KO mice showed dose‐dependent CPP to cocaine that was not distinguished by genotype. Taken together, these results suggest that proSAAS‐derived peptides contribute differentially to the behavioral sensitization to psychostimulants, while the rewarding effects of cocaine appear intact in mice lacking proSAAS.

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Specific rescue by ortho‐hydroxy atorvastatin of cortical GABAergic neurons from previous oxygen/glucose deprivation: role of pCREB
Authors: Guirao Verónica , Martí‐Sistac Octavi , DeGregorio‐Rocasolano Núria , Ponce Jovita , Dávalos Antoni , Gasull Teresa
Published: September 2017

The statin atorvastatin (ATV) given as a post‐treatment has been reported beneficial in stroke, although the mechanisms involved are not well understood so far. Here, we investigated in vitro the effect of post‐treatment with ATV and its main bioactive metabolite ortho‐hydroxy ATV (o‐ATV) on neuroprotection after oxygen and glucose deprivation (OGD), and the role of the pro‐survival cAMP response element‐binding protein (CREB). Post‐OGD treatment of primary cultures of rat cortical neurons with o‐ATV, but not ATV, provided neuroprotection to a specific subset of cortical neurons that were large and positive for glutamic acid decarboxylase (large‐GAD(+) neurons, GABAergic). Significantly, only these GABAergic neurons showed an increase in phosphorylated CREB (pCREB) early after neuronal cultures were treated post‐OGD with o‐ATV. We found that o‐ATV, but not ATV, increased the neuronal uptake of glutamate from the medium; this provides a rationale for the specific effect of o‐ATV on pCREB in large‐GABAergic neurons, which have a higher ratio of synaptic (pCREB‐promoting) vs extrasynaptic (pCREB‐reducing) N‐methyl‐D‐aspartate (NMDA) receptors (NMDAR) than that of small‐non‐GABAergic neurons. When we pharmacologically increased pCREB levels post‐OGD in non‐GABAergic neurons, through the selective activation of synaptic NMDAR, we observed as well long‐lasting neuronal survival. We propose that the statin metabolite o‐ATV given post‐OGD boosts the intrinsic pro‐survival factor pCREB in large‐GABAergic cortical neurons in vitro, this contributing to protect them from OGD.

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Variation in job titles within the nursing workforce
Authors: Leary Alison , Maclaine Katrina , Trevatt Paul , Radford Mark , Punshon Geoffrey
Published: September 2017

Aims and objectives/background

The work of specialist nursing has been under scrutiny for many years in the UK due to a perception that it is not cost‐effective. A common issue is the lack of consistency of job titles, which causes confusion to the public, employing organisations, colleagues and commissioners of services. Lack of consistency has implications for the wider perception of advanced specialist practice in the worldwide community and the workforce more generally. This study aims to understand the variation in job titles in the UK population.

Methods

A pre‐existing data set of accrued studies into the work of nurses working in specialisms was mined for insight (N = 17,960). This study used knowledge discovery through data and descriptive statistics to perform secondary analysis.

Results

Mining these data revealed 595 job titles in use in 17,960 specialist posts once the specialism had been removed. The most commonly used titles were Clinical Nurse Specialist, Nurse Specialist/Specialist Nurse, Advanced Nurse Practitioner and Nurse Practitioner. There were three other primary groupings. These were variants with a specialist or technical prefix of suffix, for example Nurse Endoscopist, variants of seniority such as trainee, senior nurse for [specialism] or variants of function such as Nurse Prescriber. The clustering was driven primarily by pay band.

A total of 323 posts were recorded as holding titles such as Advanced Nurse Practitioner or Specialist Nurse who were not registered with the Nursing & Midwifery Council.

Relevance to clinical practice

In this data set, there is a large array of titles, which appear to have little relationship with other factors like education. This is confusing to the public, employers and those commissioning services. It also demonstrates that the previous assumptions by Council for Healthcare Regulatory Excellence that advanced practice labels are associated with career progression are unsound and should be addressed by the regulator.
Parental professional help‐seeking for infant sleep
Authors: Hsu Pei‐Wen , Wu Wei‐Wen , Tung Yi‐Ching , Thomas Karen A. , Tsai Shao‐Yu
Published: September 2017

Aims and objectives

To explore the perceptions and experiences of parental professional help‐seeking for infant sleep and sleep‐related concerns.

Background

Infant sleep is a frequent concern for parents. However, very little is known about the reasons parents seek, do not seek or delay seeking professional attention about their concerns related to infant sleep.

Design and methods

A qualitative study design was used. Twenty audio‐taped interviews with parents of healthy 12‐month‐old infants were conducted at a university‐affiliated hospital or parents’ homes depending on where parents felt more comfortable discussing their personal views and medical help‐seeking experiences. Thematic content analysis was performed to determine specific patterns and similarities within and between interview data.

Findings

Three main themes developed from the interviews were as follows: (i) uncertainty about infant sleep; (ii) I can handle infant sleep; and (iii) I am not satisfied with the professional services provided for infant sleep. Overall, parents knew little about or misunderstood infant sleep behaviours. Lack of proper information and knowledge about infant sleep influenced parents’ motivation for professional help‐seeking and help‐receiving. Parents who have consulted a healthcare professional but received unsatisfactory responses, such as an ambivalent attitude or insufficient assessment, reported being less motivated or unwilling to seek medical help again.

Conclusion

Our study demonstrates the complexity of parental professional help‐seeking and receiving for infant sleep. Findings suggest that parents perceive a wide range of barriers that influence the likelihood that they will seek professional advice for infant sleep.

Relevance to clinical practice

Reducing knowledge barriers and providing adequate attention at all well‐infant visits would facilitate parental use of healthcare services to manage problematic infant sleep behaviours.
The experience of dementia: a review of the literature and implications for nursing practice
Authors: KEADY JOHN
Published: September 2017

This paper explores the early experience of dementia when the veil of uncertainty that surrounds the diagnosis of this condition is lifted. Consideration will also be given to the impact of dementia on carers and the service demands that are created.

In the UK alone there are estimated to be 636 000 people living with dementia, with this figure rising to just under 900000 by the year 2021. In the USA the projected number of people with Alzheimer's disease is expected to be 9000000 by the year 2040.

Despite a wealth of social and gerontological research on the impact of dementia upon family carers, service responses and policy initiatives are fragmented because dementia is excluded from some important recent initiatives, such as the Mental Health Task Force.

Current services and interventions focus predominantly on the later stages of dementia, when a meaningful perspective of the person with dementia is difficult to obtain.

Nursing has a relatively long history of caring for people with dementia and their family carers. The paper will also consider the contribution of nursing and nursing research to the field and explore additional avenues for service intervention and education.
Home monitoring of infants at increased risk of sudden death
Authors: NOYES JANE , STEBBENS VALERIE , SOBHAN GULSHAN , SAMUELS MARTIN , SOUTHALL DAVID
Published: September 2017

Home apnoea and cardiorespiratory monitors are commonly used in the UK, the rest of Europe and USA in infants at increased risk of ‘sudden infant death’.

The efficacy of apnoea and cardiorespiratory monitors remains unknown.

The use of transcutaneous oxygen monitoring is presented as an alternative method of home monitoring.

Recommendations are proposed regarding nursing practice and the future of home monitoring in infants at increased risk of sudden death.
Chronic sleep reduction is associated with academic achievement and study concentration in higher education students
Authors: van der Heijden Kristiaan B. , Vermeulen Marije C. M. , Donjacour Claire E. H. M. , Gordijn Marijke C. M. , Hamburger Hans L. , Meijer Anne M. , van Rijn Karin J. , Vlak Monique , Weysen Tim
Published: September 2017

Inadequate sleep impairs cognitive function and has been associated with worse academic achievement in higher education students; however, studies that control for relevant background factors and include knowledge on sleep hygiene are scarce. This study examined the association of chronic sleep reduction (i.e. symptoms of chronic sleep reduction such as shortness of sleep, sleepiness and irritation), subjective sleep quality and sleep hygiene knowledge with academic achievement (grades and study credits) and study concentration among 1378 higher education students (71% female, mean age 21.73 years, SD = 3.22) in the Netherlands. Demographic, health, lifestyle and study behaviour characteristics were included as covariates in hierarchical regression analyses. After controlling for significant covariates, only chronic sleep reduction remained a significant predictor of lower grades (last exam, average in current academic year). Better sleep quality and sleep hygiene knowledge were associated with better academic achievement, but significance was lost after controlling for covariates, except for a remaining positive association between sleep hygiene beliefs and grades in the current academic year. Moreover, better sleep quality and lower scores on chronic sleep reduction were associated with better study concentration after controlling for significant covariates. To conclude, chronic sleep reduction is associated with academic achievement and study concentration in higher education students. Inadequate sleep hygiene knowledge is moderately associated with worse academic achievement. Future research should investigate whether sleep hygiene interventions improve academic achievement in students of higher education.
Individual healthcare plan for allergic children at school: Lessons from a 2015‐2016 school year survey
Authors: Pouessel Guillaume , Lejeune Stépanie , Dupond Marie‐Pierre , Renard Annie , Fallot Camille , Deschildre Antoine
Published: September 2017

Background

The individual healthcare plan (IHP) was implemented in schools in France in 2003 to improve management of allergic children. Our objectives were to assess the practical aspects of IHP (excluding asthma) and allergic reactions occurring at school.

Methods

Prospective study conducted in the North Department (France) during the 2015/2016 school year. Two questionnaires were developed: one for the school doctors (n = 67) and one for the school principals (n = 2372).

Results

Data from 336 (25%) of the 1325 IHPs (0.24% of children) were collected (mean age: 8 years; food allergy [FA]: 94% [peanut = 44%, nuts = 54%], venom: 4%). Wide variations in emergency kit (EK) medications were observed: antihistamines (84%), oral corticosteroids (79%), adrenaline auto‐injectors (70%), and inhaled bronchodilators (65%). Six hundred and seventy (28%) school principals’ responses, representing 81% of all IHPs, were analyzed. A total of 1935 EKs were stored (mean: 2.8/school), one or more with adrenaline, by 213 (32%) schools: in the class room (33%), the nursery (14%), or the principal's office (10%). Sixty, mainly, mild‐to‐moderate allergic reactions (adrenaline injection: 2) occurred in 44 schools (0.09/school/year), in children with previously undocumented allergy in 50%. FA was highly suspected in 92%.

Conclusion

Individual healthcare plan is mainly implemented for FA. Anaphylaxis remains rare in the school setting, and FA is often a suspected cause of reaction. Staff training should be improved. Application of the recommendations regarding the content and accessibility of EK and a widespread emergency action plan is needed.
Protease‐activated receptor 2 contributes to Toxoplasma gondii‐mediated gut inflammation
Authors: Bonnart C. , Feuillet G. , Vasseur V. , Cenac N. , Vergnolle N. , Blanchard N.
Published: September 2017

Toxoplasma gondii is a widespread intracellular parasite, which naturally enters the organism via the oral route and crosses the intestinal barrier to disseminate. In addition to neuronal and ocular pathologies, this pathogen also causes gut inflammation in a number of animals. This infection‐triggered inflammation has been extensively studied in the C57BL/6 mice, highlighting the importance of the immune cells and their mediators in the development of gut pathology. However, despite their importance in inflammation, the role of protease‐activated receptors (PAR) was never reported in the context of T.gondii‐mediated small intestine inflammation. Using genetically modified mice, we show that PAR2 plays a pathogenic role in the development of gut inflammatory lesions. We find that PAR2 controls the innate inflammatory mediators IL‐6, KC/CXCL1, PGE2 as well as neutrophil infiltration in T. gondii‐triggered gut damage. These results bring new knowledge on the mechanisms operating in the gut in response to T. gondii infection.
Transcriptome analysis, using RNA‐Seq of Lomandra longifolia roots infected with Phytophthora cinnamomi reveals the complexity of the resistance response
Authors: Islam M. T. , Hussain H. I. , Rookes J. E. , Cahill D. M.
Published: September 2017

The plant pathogen Phytophthora cinnamon the causal agent of disease in numerous species, is a major threat to natural vegetation and has economic impacts in agriculture. The pathogen principally invades the root system, which, in susceptible species, is rapidly colonised and functionally destroyed. Few species are resistant, however, where resistance is expressed the pathogen is restricted to small, localised lesions. The molecular mechanisms that underpin this response in resistant species are not well understood. Lomandra longifolia, an Australian native species, is highly resistant to P. cinnamomi. In an earlier study, we showed induction of resistance‐related components such as callose, lignin and hydrogen peroxide (H2O2) in L. longifolia roots that had been inoculated with P. cinnamomi.

Here, in order to further identify, during the very early stages of infection, the molecular components and regulatory networks that may trigger resistance, a comprehensive root transcriptome analysis was performed using next generation sequencing.

Overall, 18 cDNA libraries were produced generating 52.8 GB 126 base pair reads, which were de novo assembled into contigs. Differentially expressed genes (DEGs) were identified allowing the identification of infection‐responsive candidate genes that were putatively related to resistance, and from this set ten were selected for qRT‐PCR to validate the RNA‐Seq expression value.

Further analysis of individual candidates revealed that many were involved in PAMP‐triggered immunity (PTI; pattern recognition receptors, glutathione S‐transferase, callose synthases, pathogenesis‐related protein‐1, mitogen activated protein kinases) and effector‐triggered immunity (ETI) (NBS‐LRR, signalling genes, transcription factors and anti‐pathogenic compound synthase genes). As these candidate genes or mediated components activate different defence signalling systems, they may have potential for investigation of novel approaches to disease control and in transgenic approaches for improvement, in susceptible species, of resistance to P. cinnamomi.
Is forest landscape restoration socially desirable? A discrete choice experiment applied to the Scandinavian transboundary Fulufjället National Park Area
Authors: Valasiuk Sviataslau , Czajkowski Mikołaj , Giergiczny Marek , Żylicz Tomasz , Veisten Knut , Landa Mata Iratxe , Halse Askill H. , Elbakidze Marine , Angelstam Per
Published: September 2017

Using an economic valuation approach, we assessed people's stated preferences for policy aimed at enhancing restoration of functional networks of naturally dynamic boreal forest habitats as a public good. Active landscape restoration can improve the functionality of boreal forest habitats as green infrastructure, which is essential for biodiversity conservation and delivery of multiple ecosystem services that production forests are poor at providing. In contrast, so far designation of protected areas in Fennoscandia has focused on remnant patches of near‐natural forests, and not on forest landscape restoration. We assessed citizens' preferences for forest landscape restoration in a transboundary region primarily managed for sustained‐yield wood production for the forest industry, and which hosts the transboundary Fulufjället National Parks in Sweden and Norway. We conducted a discrete choice experiment by asking Swedish and Norwegian citizens to choose among two options for the Fulufjället area, including (1) extension of passive protection on one side or both sides of the border, by additional area protection and restoration of forest naturalness, and (2) a status quo option. The scenario assumed that extension of the protected forest area would imply a compulsory tax administered bilaterally by the two countries. Just over half of the sample, in both countries expressed willingness to pay for forest landscape restoration. Alternatives that contemplated larger extensions of forest landscape restoration were assigned higher willingness‐to‐pay. Public awareness and support, combined with spatial planning, are necessary for forest landscape restoration to become a viable tool for biodiversity conservation in Scandinavia.
Supporting patients in reducing postoperative constipation: fundamental nursing care – a quasi‐experimental study
Authors: Trads Mette , Deutch Søren Rasmussen , Pedersen Preben Ulrich
Published: September 2017

Background

The prevalence of constipation in the general population is 2–28%. Patients with constipation report symptoms of abdominal pain, bloating, nausea, straining to defecate and general discomfort. Strategies for preventing constipation include laxatives, exercise and increased fluid and fibre intake, but life style adjustments, such as exercise, eating more fibres and drinking more fluids, were not considered a solution by older patients. Previous studies have shown that actively involving patients through individualised care and support increases patients’ outcome.

Aim

To test the efficacy of a nursing intervention based on active patient involvement including individualised nursing care plans and daily dialogues for patients with hip fractures in preventing constipation after surgery.

Methods

A quasi‐experimental design was applied. Inclusion criteria hip fracture needing surgery, understand Danish. Exclusion criteria dementia, gastrointestinal disease. A total of 186 patients were included and 155 completed. An admission interview including Constipation Risk Assessment Scale was undertaken. On that basis an individualised nursing care plan was made. At admission, discharge and 30 days after surgery constipation, intake of fibres and fluid were measured. The Bristol Stool Scale and Rasmussen's scale were used to measure constipation. Patients in the control group received standard care of the ward.

Results

After 30 days constipation rates for patients in the intervention group were significantly lower than for patients in the control group (p = 0.042). The fibre intakes and fluid intakes were significantly higher in the intervention group (p ≤ 0.001). The effect of liquid intake was statistically significant (OR = 1.1, 95% CI: 1.0–1.2). Likewise, the effect of fibre intake was statistically significant; the odds of constipation decreased with increasing fibre intake (OR = 0.4, 95% CI: 0.2–0.8).

Conclusion

Patients with hip fractures that were actively involved in their own care in preventing constipation were significantly less constipated 30 days after surgery than control patients. Increases in fluid and fibre intakes had significant effects on reducing the risk of developing constipation.
Parasite biodiversity faces extinction and redistribution in a changing climate
Authors: Carlson Colin J. , Burgio Kevin R. , Dougherty Eric R. , Phillips Anna J. , Bueno Veronica M. , Clements Christopher F. , Castaldo Giovanni , Dallas Tad A. , Cizauskas Carrie A. , Cumming Graeme S. , Doña Jorge , Harris Nyeema C. , Jovani Roger , Mironov Sergey , Muellerklein Oliver C. , Proctor Heather C. , Getz Wayne M.
Published: September 2017

Parasites face range loss and shifts under climate change, with likely parasite extinction rates of up to one in three species.
Quantum coherence as a witness of vibronically hot energy transfer in bacterial reaction center
Authors: Paleček David , Edlund Petra , Westenhoff Sebastian , Zigmantas Donatas
Published: September 2017

Observation of coherence shifts reveals hot energy transfer and excess energy dissipation mechanisms in photosynthesis.
Science in litigation, the third branch of U.S. climate policy
Authors: McCormick Sabrina , Simmens Samuel J. , Glicksman Robert L. , Paddock LeRoy , Kim Daniel , Whited Brittany , Davies William
Published: September 2017

The context and role of climate science in court are changing