bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational therapy in Australian acute hospitals: A modified practice
Authors: Britton Lauren , Rosenwax Lorna , McNamara Beverley 
Published: June 2016

Background/aimOngoing changes to health‐care funding Australia wide continue to influence how occupational therapists practise in acute hospitals. This study describes the practice challenges experienced by Western Australian acute care occupational therapists. Then, it explores if and how acute care occupational therapists are modifying their practice in response to these practice changes.MethodologyThis study used a qualitative grounded theory approach. Semi‐structured interviews were completed with 13 purposively selected acute care occupational therapists from four Western Australian metropolitan hospitals. Data were analysed using a constant comparative method to provide detailed descriptions of acute care occupational therapy practice and to generate theory.FindingsFive conceptual categories were developed. The first two addressed practice challenges: pragmatic organisational influences on client care and establishing a professional identity within the multidisciplinary team. Three categories related to therapist responses are as follows: becoming the client advocate, being the facilitator and applying clinical reasoning. Finally, modified practice was identified as the core category which explains the process whereby acute care occupational therapists are ensuring they remain relevant and authentic in the acute care context.ConclusionWestern Australian acute care occupational therapists are practising in a highly complex health context that presents many challenges. They are responding by using a modified form of practice that ensures occupational therapy skills remain relevant within the narrow confines of this health setting.
Troubled families and individualised solutions: an institutional discourse analysis of alcohol and drug treatment practices involving affected others
Authors: Selbekk Anne Schanche , Sagvaag Hildegunn 
Published: June 2016

AbstractResearch shows that members of the families with patients suffering from alcohol and other drug‐related issues (AOD) experience stress and strain. An important question is, what options do AOD treatment have for them when it comes to support? To answer this, we interviewed directors and clinicians from three AOD treatment institutions in Norway. The study revealed that family‐oriented practices are gaining ground as a ‘going concern’. However, the relative position of family‐orientation in the services, is constrained and shaped by three other going concerns related to: (i) discourse on health and illness, emphasising that addiction is an individual medical and psychological phenomenon, rather than a relational one; (ii) discourse on rights and involvement, emphasising the autonomy of the individual patient and their right to define the format of their own treatment; and (iii) discourse on management, emphasising the relationship between cost and benefit, where family‐oriented practices are defined as not being cost‐effective. All three discourses are connected to underpin the weight placed on individualised practices. Thus, the findings point to a paradox: there is a growing focus on the needs of children and affected family members, while the possibility of performing integrated work on families is limited.
Migrant Businesses And The Symbolic Transformation Of Urban Neighborhoods: Towards a Research Agenda
Authors: Parzer Michael , Huber Florian J. 
Published: June 2016

AbstractMigrant businesses play a crucial role not only in the economies of Western European cities, but also in the revaluation of urban space. Alongside their relevance to physical neighborhood development, migrant businesses seem to be crucial in transforming urban spaces symbolically. Although there is some evidence from migrant business research and the literature on gentrification, the phenomenon has not yet been studied systematically. We therefore propose a research agenda that addresses the relationship between migrant businesses and the symbolic transformation of urban neighborhoods.
Metformin ameliorates podocyte damage by restoring renal tissue nephrin expression in type 2 diabetic rats
Authors: Zhai Limin , Gu Junfei , Yang Di , Hu Wen , Wang Wei , Ye Shandong 
Published: June 2016

AbstractBackgroundPrevious studies found that metformin provided some renoprotection for diabetic renal damage. In the present study, we evaluated the effects of different doses of metformin on the expression of renal tissue nephrin in type 2 diabetes mellitus (T2DM) model rats and the possible mechanism underlying its protective effect in kidney podocytes.MethodsA high‐fat diet combined with a low dose of streptozotocin was used to induce T2DM model rats. Diabetic rats were treated with 150, 300, or 500 mg/kg metformin for 8 weeks. At the end of the study, urine and blood samples were collected for measurement of different indices. Light microscopy and transmission electron microscopy were used to identify morphological changes. Renal expression of nephrin protein was assayed by immunohistochemical staining, whereas real‐time polymerase chain reaction was used to detect renal nephrin (Nphs1) mRNA expression.ResultsMetformin treatment of T2DM rats produced dose‐dependent significant reductions in urinary albumin and nephrin concentrations, glomerular basement membrane thickness (GBMT), and the foot process fusion rate (FPFR) compared with control T2DM model rats, whereas renal expression of nephrin protein and Nphs1 mRNA was dose‐dependently increased by metformin treatment.ConclusionMetformin protects kidney podocytes in T2DM model rats by dose‐dependently adjusting renal nephrin expression.
‘What ought to belong to merit only’: Debating Status and Heredity in the New American Republic
Authors: Cutterham Tom 
Published: June 2016

AbstractDespite the critique of monarchy and aristocracy that contributed to American Revolutionary rhetoric, not all revolutionaries dismissed the idea of hereditary status. During the 1780s a debate emerged over the proper nature of status and the true location of social power in the new republic, instigated by a new organisation: the Society of the Cincinnati. Subject to withering attacks in its earliest years, the Cincinnati also generated spirited defences. The controversy challenged the dominance of oppositional republican ideology and, in the context of political and economic change, helped some Americans develop a new understanding of power and legitimacy.
Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort
Authors: Hästbacka J. , Hynninen M. , Kolho E. 
Published: June 2016

BackgroundCapnocytophaga canimorsus is a gram‐negative rod capable of causing severe sepsis or septic shock. We studied the characteristics of patients with C. canimorsus bacteremia treated in intensive care unit (ICU).MethodsPatients with C. canimorsus bacteremia in the Helsinki University Hospital district from 2005 to 2014 were retrospectively reviewed using laboratory database and electronical patient records.ResultsWe identified 65 patients with C.canimorsus bacteremia. Of these, 16 (25%) were treated in an ICU. The most commonly affected organ systems were coagulation (94%) and kidney (69%). Mortality of ICU treated patients was 19%. Three survivors underwent lower limb amputations for gangrene. Only 25% of the patients were immune‐compromised, but alcohol abuse was common (69%). All patients had a contact with dogs, but only 37% had a history of a dog‐bite.ConclusionCapnocytophaga canimorsus infection may present with severe sepsis or septic shock with organ dysfunction, most frequently coagulopathy and acute kidney injury. Previously recognized risk factors are not always present. A dog in a household may be a sufficient exposure for developing a severe form of the disease. The possibility of C. canimorsus infection should be considered in patients with any contact with dogs, even in immunocompetent patients.
Management of patients treated with pertuzumab in the Australian clinical practice setting
Authors: Woodward Natasha , White Michelle , Pugliano Lina , Tsoi Daphne , Ryan Caroline 
Published: June 2016

AbstractAimTreatment with pertuzumab–trastuzumab–taxane combinations has become the international standard of care for patients with HER2‐positive metastatic breast cancer. In this paper we discuss the practicalities of treating patients with this combination with a particular focus on treatment in the Australian setting.MethodAn expert panel was convened to discuss practical aspects for use of pertuzumab in the Australian clinical setting. The findings of this panel are reported in this article.ResultsThe combination of pertuzumab–trastuzumab–docetaxel has established efficacy in patients with HER2‐positive metastatic breast cancer, prolonging progression‐free and overall survival compared to trastuzumab–taxane combinations. In Australia, combinations of pertuzumab and trastuzumab with docetaxel or paclitaxel are reimbursed. Management of treatment related side‐effects such as diarrhea, febrile neutropenia and neuropathy typically include dose reduction or switching taxane. Specific patients with poorer tolerance of chemotherapy such as the elderly or those from Asian backgrounds may require particular management strategies.ConclusionsThe advent of targeted therapies for women with metastatic HER2‐positive breast cancer has markedly improved survival. Combinations of pertuzumab–trastuzumab and a taxane are the standard of care in patients with good performance status. Given prolongation of survival and the importance of quality of life endpoints, the treatment paradigm for patients with metastatic HER2‐positive breast cancer is changing rapidly. Careful management of toxicities is required, and dose reduction or switching taxane may be necessary. Further research is required on the efficacy of pertuzumab combinations in patients with brain metastases, and on those who relapse quickly following adjuvant therapy.
Management of chronic vulvovaginal candidiasis: a long term retrospective study
Authors: Nguyen Yvonne , Lee Andrew , Fischer Gayle 
Published: June 2016

AbstractBackgroundChronic vulvovaginal candidiasis (CVVC) is an unremitting condition causally associated with species of Candida. Limited data are available on its management and long‐term outcomes. This retrospective study aimed to explore the long‐term outcomes of patients who had experienced symptom remission after a course of oral antifungals.MethodsRetrospective study conducted over 1 year from data obtained from a vulval dermatology outpatient clinic in Sydney, Australia. Data from 208 patients satisfying presumptive or definitive criteria for CVVC who had been successfully treated with oral azole antifungal medication were collected from a database, including drugs, induction and maintenance treatment regimes, results and adverse effects.ResultsAltogether 208 patients commenced an induction regime of oral fluconazole 50–100 mg daily for up to 12 weeks. All patients demonstrated a clinical improvement within 12 weeks. Of the 208 patients, subsequently 95% remained on oral fluconazole for maintenance treatment, 3% changed to other antifungals due to adverse effects and 2% ceased treatment. The most common maintenance regime was oral fluconazole 50 mg twice weekly (46%). Of the study cohort 99% remained on treatment with antifungal therapy for symptom suppression with the mean duration of follow up 26.2 months (range, 5 months to 8.5 years).ConclusionsLong‐term symptom remission was possible in this subset of women with CVVC using fluconazole 50–100 mg or itraconazole 50–100 mg. However, most were unable to cease treatment without experiencing relapse. Adverse effects in this cohort were minimal and there were no cases of drug‐induced hepatitis.
Evidence for participation of neutrophil gelatinase‐associated lipocalin/matrix metalloproteinase‐9 (NGAL•MMP‐9) complex in the inflammatory response to infection in pregnancies complicated by preterm birth
Authors: Rood Kara M. , Buhimschi Irina A. , Rodewald Millen Katherine , Bahtiyar Mert O. , Thung Stephen , Summerfield Taryn , Zhao Guomao , Ackerman William , Shellhaas Cynthia , Samuels Philip , Buhimschi Catalin S. 
Published: June 2016

ProblemNeutrophil gelatinase‐associated lipocalin (NGAL) is expressed in neutrophils and involved in innate immunity by sequestering iron. NGAL's ability to complex with matrix metalloproteinase‐9 (MMP‐9) and extend its gelatinolytic activity led us to investigate its role in pregnancies complicated by preterm birth (PTB) and intra‐amniotic infection/inflammation (IAI).Method of studyWe assayed the amniotic fluid (AF) levels of NGAL and MMP‐9 in 308 women that had a clinically indicated amniocentesis and a normal pregnancy outcome or PTB. qRT‐PCR was employed to determine NGAL mRNA expression of placental villous trophoblast and amniochorion. Immunohistochemistry was used for cellular localization.ResultsAF NGAL levels were gestational age‐regulated. Women with IAI and PTB had significantly higher levels of NGAL, MMP‐9 and NGAL•MMP‐9 complex.ConclusionThe amniochorion is a source of NGAL and similarly to other inflammatory conditions, this protein may augment the collagenolytic effect of MMP‐9 and modulate host–microbe interactions in pregnancies complicated by IAI.
Tropical forest restoration enriches vascular epiphyte recovery
Authors: Reid John Leighton , Chaves‐Fallas José Miguel , Holl Karen D. , Zahawi Rakan A. 
Published: June 2016

AbstractQuestionsVascular epiphytes constitute a large proportion of tropical forest plant biodiversity, but are among the slowest plants to recolonize secondary forests. We asked whether tree planting for ecological restoration accelerates epiphyte community recovery. Does the spatial configuration of tree planting matter? What landscape contexts are most suitable for epiphyte restoration?LocationRestored pastures in premontane Coto Brus County, Puntarenas, Costa Rica.MethodsWe surveyed vascular epiphyte species growing on the lower trunks of 1083 trees in 13 experimental restoration sites. Each site contained three 0.25‐ha treatment plots: natural regeneration, trees planted in patches or ‘islands’ and tree plantations. Sites spanned elevational (1100–1430 m) and deforestation (4–94% forest cover within a 100‐m radius around each site) gradients.ResultsVascular epiphytes were twice as diverse in planted restoration plots (islands and plantations) as in natural regeneration; we observed this at the scale of individual host trees and within 0.25‐ha treatment plots. Contributing factors included that trees in planted restoration plots were larger, older, more abundant and composed of different species than trees in naturally regenerating plots. Epiphyte species richness increased with surrounding forest cover within 100–150 m of restoration plots. Epiphyte communities were also twice as diverse at higher (1330–1430 m) vs lower (1100–1290 m) elevation sites. Epiphyte groups responded differently to restoration treatments and landscape factors; ferns were responsible for higher species richness in planted restoration plots, whereas angiosperms drove elevation and forest cover effects.ConclusionsTree planting for ecological restoration enriched epiphyte communities compared to natural regeneration, likely because planted forests contained more, bigger and older trees. Tree island plantings were equally effective compared to larger and more expensive plantations. Restoration sites nearer to existing forests had richer epiphyte recolonization, likely because nearby forests provisioned restoration sites with angiosperm seeds. Collectively, results suggest that restoration practitioners can enrich epiphyte community development by planting trees in areas with higher surrounding forest cover, particularly at higher elevations.
Scale‐dependent effects of coppicing on the species pool of late successional beech forests in the central Apennines, Italy
Authors: Campetella Giandiego , Canullo Roberto , Gimona Alessandro , Garadnai Janos , Chiarucci Alessandro , Giorgini Daniele , Angelini Elia , Cervellini Marco , Chelli Stefano , Bartha Sandor 
Published: June 2016

AbstractQuestionWe compared active and abandoned beech coppices in terms of: (1) structural features, (2) total, understorey and overstorey plant diversity across spatial scales, and (3) species richness of beech forest specialist species.LocationCentral Apennines, Italy.MethodsWe applied a multi‐scale approach, working at fine scale (management unit) and at a coarser scale (forest patch). Two forest patches were selected according to management regimes (active coppicing, 1–40 yrs; abandoned coppicing, >40 yrs) in each of the two study areas (Bolognola and Ussita). Within each forest patch, 20 stands were sampled in 20 m × 20 m plots, for a total of 80 sampling units.ResultsWe found that the height of standards and number of dominant trees were negatively correlated with the total number of species. At the plot scale, the number of beech specialist species was significantly higher in abandoned plots. At the forest patch scale, the number of species in Bolognola was markedly higher in the actively coppiced forest than in the abandoned one, while the opposite result was found at Ussita. Regarding the beech specialist species richness, the abandoned forest at Ussita showed higher richness than the coppiced forest, while in Bolognola we found the opposite. The managed forest hosted more overstorey species than the abandoned one in both areas. Surprisingly, at forest patch scale in Bolognola, the total beech specialist species richness was higher in the coppiced plots than in the abandoned ones. The species assemblages were more similar between patches having different management regimes within the same area, than between patches having the same management regime across different areas.ConclusionsThis material provides a novel contribution to the study of species diversity patterns in this forest system, suggesting the importance of a multiple scale approach in forest diversity studies. The beech specialist species can largely persist in a heterogeneous coppice landscape, where abandoned stands are mixed with stands under regular coppicing. The results can link current knowledge about beech coppice diversity on the landscape scale with that on the plot scale, and thus help guide new conservation planning.
Distribution modelling of vegetation types in the boreal–alpine ecotone
Authors: Ullerud Heidrun A. , Bryn Anders , Klanderud Kari 
Published: June 2016

AbstractQuestionsVegetation mapping based on field surveys is time‐consuming and expensive. Distribution modelling might be used to overcome these challenges. What is the performance of distribution modelling of vegetation compared to traditional vegetation mapping when projected locally? Does the modelling performance vary among ecosystems? Does vegetation type distribution and abundance influence the modelling performance?LocationGravfjellet, Øystre Slidre commune, southern Norway.MethodsTwo comparable neighbouring areas, each of 4 km2, were mapped for species‐defined vegetation types. One area was used for model training, the other for model projection. Maximum entropy models were run for six vegetation types, two from each of the ecosystems present in the area: forest, wetland and mountain heath‐ and shrublands. For each ecosystem, one locally abundant and one locally rare vegetation type were tested. AUC, the area under the receiver operating curve, was used as the model selection criterion. Environmental variables (n = 9) were selected through a backwards selection scheme, and model complexity was kept low. The models were evaluated using independent data.ResultsDistribution modelling of vegetation types by local projection gave high AUC values, and the results were supported by the evaluation using independent data. The modelling ability was not affected by ecosystem differences. A negative relationship between the number of points used to train the models and the AUC value before evaluation suggests that models for locally rare vegetation types had better predictive performance than the models for abundant types. This result was not significant after evaluation.ConclusionProvided that relevant explanatory variables are available at an appropriate scale, and that field‐validated training points are available, distribution modelling can be used for local projection of the six tested vegetation types from the boreal–alpine ecotone.
Manipulative Businesses: Secular Business Cults
Authors: Kulik Brian W. , Alarcon Michelle 
Published: June 2016

AbstractMany destructive business leaders drive their companies into bankruptcy and dissolution, never to be heard from again in the business press. However, it is useful to study these organizations to prevent the same, or similar destructive business from taking on, and destroying, additional businesses. In this article, we describe one type of organization that follows the model of religious cults, which we call secular business cults. Building on Padilla et al., we describe an SBC toxic triangle of (1) Padilla et al.'s societal factors, (2) additional business factors, and (3) antisocial actors that set the stage for the SBC's emergence. We then describe the characteristics of the SBC's operations, such as an ultrastrong culture, formalized manipulation, manipulative hierarchical relationships, competition, and operations efficiency tools, and the frequent overcommunication of deceptive messages. It is our hope that this unique perspective on organizations will inspire research into an overlooked area of unethical behavior in businesses today. In our Part II paper on the topic, we intend to extend the idea of SBCs to manipulative businesses, which are essentially reorganized, well‐established and legally‐complying revisions of SBCs, and then to manipulative industries and societies.
High breast milk IL‐1β level is associated with reduced risk of childhood eczema
Authors: Jepsen A. A. , Chawes B. L. , Carson C. G. , Schoos A.‐M. M. , Thysen A. H. , Waage J. , Brix S. , Bisgaard H. 
Published: June 2016

SummaryBackgroundWe recently demonstrated a dual effect of breastfeeding with increased risk of eczema and decreased risk of wheezing in early childhood by increasing breastfeeding length. We hypothesize that immune mediators in breast milk could explain such association either through a direct effect or as a surrogate marker of maternal immune constitution.ObjectiveTo investigate the possible association between cytokine and chemokine levels in breast milk and development of eczema and recurrent wheeze during early childhood.MethodsLevels of 19 pro‐inflammatory and immunoregulatory cytokines and chemokines were measured in 223 breast milk samples from mothers in the Copenhagen Prospective Study on Asthma in Childhood2000 (COPSAC) high‐risk birth cohort. Eczema and recurrent wheeze at the age of 0–3 years were prospectively diagnosed by COPSAC physicians adherent to predefined validated algorithms. Association analyses were performed by Cox regression adjusting for potential confounding factors and by multivariable principal component analysis.ResultsIncreased IL‐1β in breast milk (≥ 0.7 pg/mL) was associated with more than a halved risk of eczema before age three (aHR = 0.41; 95% CI = 0.24–0.68; P < 0.001), which remained significant after false discovery rate adjustment (P = 0.008). The principal component analysis confirmed that a mediator pattern dominated by high levels of IL‐1β, IL‐17A, and CCL17 and low levels of CXCL1 and TSLP in breast milk protected against eczema (aHR = 0.82; 95% CI = 0.68–0.98; P = 0.03). No associations were observed for recurrent wheeze.Conclusions and Clinical RelevanceElevated breast milk IL‐1β level was associated with decreased risk of early childhood eczema suggesting either a direct protective effect of IL‐1β or IL‐1b acting as a proxy for a healthy maternal immune system protecting high‐risk offspring from eczema.