Showing papers by "Suffolk University published in 2016"

Mini‐Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations

Abstract: Background The Mini Mental State Examination (MMSE) is a cognitive test that is commonly used as part of the evaluation for possible dementia. Objectives To determine the diagnostic accuracy of the Mini-Mental State Examination (MMSE) at various cut points for dementia in people aged 65 years and over in community and primary care settings who had not undergone prior testing for dementia. Search methods We searched the specialised register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), LILACS (BIREME), ALOIS, BIOSIS previews (Thomson Reuters Web of Science), and Web of Science Core Collection, including the Science Citation Index and the Conference Proceedings Citation Index (Thomson Reuters Web of Science). We also searched specialised sources of diagnostic test accuracy studies and reviews: MEDION (Universities of Maastricht and Leuven, www.mediondatabase.nl), DARE (Database of Abstracts of Reviews of Effects, via the Cochrane Library), HTA Database (Health Technology Assessment Database, via the Cochrane Library), and ARIF (University of Birmingham, UK, www.arif.bham.ac.uk). We attempted to locate possibly relevant but unpublished data by contacting researchers in this field. We first performed the searches in November 2012 and then fully updated them in May 2014. We did not apply any language or date restrictions to the electronic searches, and we did not use any methodological filters as a method to restrict the search overall. Selection criteria We included studies that compared the 11-item (maximum score 30) MMSE test (at any cut point) in people who had not undergone prior testing versus a commonly accepted clinical reference standard for all-cause dementia and subtypes (Alzheimer disease dementia, Lewy body dementia, vascular dementia, frontotemporal dementia). Clinical diagnosis included all-cause (unspecified) dementia, as defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM); International Classification of Diseases (ICD) and the Clinical Dementia Rating. Data collection and analysis At least three authors screened all citations.Two authors handled data extraction and quality assessment. We performed meta-analysis using the hierarchical summary receiver-operator curves (HSROC) method and the bivariate method. Main results We retrieved 24,310 citations after removal of duplicates. We reviewed the full text of 317 full-text articles and finally included 70 records, referring to 48 studies, in our synthesis. We were able to perform meta-analysis on 28 studies in the community setting (44 articles) and on 6 studies in primary care (8 articles), but we could not extract usable 2 x 2 data for the remaining 14 community studies, which we did not include in the meta-analysis. All of the studies in the community were in asymptomatic people, whereas two of the six studies in primary care were conducted in people who had symptoms of possible dementia. We judged two studies to be at high risk of bias in the patient selection domain, three studies to be at high risk of bias in the index test domain and nine studies to be at high risk of bias regarding flow and timing. We assessed most studies as being applicable to the review question though we had concerns about selection of participants in six studies and target condition in one study. The accuracy of the MMSE for diagnosing dementia was reported at 18 cut points in the community (MMSE score 10, 14-30 inclusive) and 10 cut points in primary care (MMSE score 17-26 inclusive). The total number of participants in studies included in the meta-analyses ranged from 37 to 2727, median 314 (interquartile range (IQR) 160 to 647). In the community, the pooled accuracy at a cut point of 24 (15 studies) was sensitivity 0.85 (95% confidence interval (CI) 0.74 to 0.92), specificity 0.90 (95% CI 0.82 to 0.95); at a cut point of 25 (10 studies), sensitivity 0.87 (95% CI 0.78 to 0.93), specificity 0.82 (95% CI 0.65 to 0.92); and in seven studies that adjusted accuracy estimates for level of education, sensitivity 0.97 (95% CI 0.83 to 1.00), specificity 0.70 (95% CI 0.50 to 0.85). There was insufficient data to evaluate the accuracy of the MMSE for diagnosing dementia subtypes.We could not estimate summary diagnostic accuracy in primary care due to insufficient data. Authors' conclusions The MMSE contributes to a diagnosis of dementia in low prevalence settings, but should not be used in isolation to confirm or exclude disease. We recommend that future work evaluates the diagnostic accuracy of tests in the context of the diagnostic pathway experienced by the patient and that investigators report how undergoing the MMSE changes patient-relevant outcomes.

Management strategy evaluation: best practices

Abstract: Management strategy evaluation (MSE) involves using simulation to compare the relative effectiveness for achieving management objectives of different combinations of data collection schemes, methods of analysis and subsequent processes leading to management actions. MSE can be used to identify a ‘best’ management strategy among a set of candidate strategies, or to determine how well an existing strategy performs. The ability of MSE to facilitate fisheries management achieving its aims depends on how well uncertainty is represented, and how effectively the results of simulations are summarized and presented to the decision-makers. Key challenges for effective use of MSE therefore include characterizing objectives and uncertainty, assigning plausibility ranks to the trials considered, and working with decision-makers to interpret and implement the results of the MSE. This paper explores how MSEs are conducted and characterizes current ‘best practice’ guidelines, while also indicating whether and how these best practices were applied to two case-studies: the Bering–Chukchi–Beaufort Seas bowhead whales (Balaena mysticetus; Balaenidae) and the northern subpopulation of Pacific sardine (Sardinops sagax caerulea; Clupeidae).

Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries

Abstract: Background As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. Methods We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. Results A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2–7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. Conclusions Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care.

Temporary Organizing: Promises, Processes, Problems

Abstract: Temporary organizing is introduced as process, form and perspective. Then key challenges and opportunities in the study of temporary organizing are discussed, including methodological issues, how t...

Comparing RADseq and microsatellites to infer complex phylogeographic patterns, an empirical perspective in the Crucian carp, Carassius carassius, L.

Abstract: The conservation of threatened species must be underpinned by phylogeographic knowledge. This need is epitomised by the freshwater fish Carassius carassius, which is in decline across much of its E ...

Empirical observations of the spawning migration of European eels: The long and dangerous road to the Sargasso Sea

Abstract: The spawning migration of the European eel (Anguilla anguilla L.) to the Sargasso Sea is one of the greatest animal migrations. However, the duration and route of the migration remain uncertain. Using fishery data from 20 rivers across Europe, we show that most eels begin their oceanic migration between August and December. We used electronic tagging techniques to map the oceanic migration from eels released from four regions in Europe. Of 707 eels tagged, we received 206 data sets. Many migrations ended soon after release because of predation events, but we were able to reconstruct in detail the migration routes of >80 eels. The route extended from western mainland Europe to the Azores region, more than 5000 km toward the Sargasso Sea. All eels exhibited diel vertical migrations, moving from deeper water during the day into shallower water at night. The range of migration speeds was 3 to 47 km day−1. Using data from larval surveys in the Sargasso Sea, we show that spawning likely begins in December and peaks in February. Synthesizing these results, we show that the timing of autumn escapement and the rate of migration are inconsistent with the century-long held assumption that eels spawn as a single reproductive cohort in the springtime following their escapement. Instead, we suggest that European eels adopt a mixed migratory strategy, with some individuals able to achieve a rapid migration, whereas others arrive only in time for the following spawning season. Our results have consequences for eel management.

Implementing and innovating marine monitoring approaches for assessing marine environmental status

Abstract: Marine environmental monitoring has tended to focus on site-specific methods of investigation. These traditional methods have low spatial and temporal resolution and are relatively labor intensive per unit area/time that they cover. To implement the Marine Strategy Framework Directive (MSFD), European Member States are required to improve marine monitoring and design monitoring networks. This can be achieved by developing and testing innovative and cost-effective monitoring systems, as well as indicators of environmental status. Here, we present several recently developed methodologies and technologies to improve marine biodiversity indicators and monitoring methods. The innovative tools are discussed concerning the technologies presently utilized as well as the advantages and disadvantages of their use in routine monitoring. In particular, the present analysis focuses on: (i) molecular approaches, including microarray, Real Time quantitative PCR (qPCR), and metagenetic (metabarcoding) tools; (ii) optical (remote) sensing and acoustic methods; and (iii) in situ monitoring instruments. We also discuss their applications in marine monitoring within the MSFD through the analysis of case studies in order to evaluate their potential utilization in future routine marine monitoring. We show that these recently-developed technologies can present clear advantages in accuracy, efficiency and cost.

Making technological innovation work for sustainable development

Abstract: This paper presents insights and action proposals to better harness technological innovation for sustainable development. We begin with three key insights from scholarship and practice. First, technological innovation processes do not follow a set sequence but rather emerge from complex adaptive systems involving many actors and institutions operating simultaneously from local to global scales. Barriers arise at all stages of innovation, from the invention of a technology through its selection, production, adaptation, adoption, and retirement. Second, learning from past efforts to mobilize innovation for sustainable development can be greatly improved through structured cross-sectoral comparisons that recognize the socio-technical nature of innovation systems. Third, current institutions (rules, norms, and incentives) shaping technological innovation are often not aligned toward the goals of sustainable development because impoverished, marginalized, and unborn populations too often lack the economic and political power to shape innovation systems to meet their needs. However, these institutions can be reformed, and many actors have the power to do so through research, advocacy, training, convening, policymaking, and financing. We conclude with three practice-oriented recommendations to further realize the potential of innovation for sustainable development: (i) channels for regularized learning across domains of practice should be established; (ii) measures that systematically take into account the interests of underserved populations throughout the innovation process should be developed; and (iii) institutions should be reformed to reorient innovation systems toward sustainable development and ensure that all innovation stages and scales are considered at the outset.

Resilience of children with refugee statuses: A research review.

Abstract: Countries around the world, including Canada, are becoming more culturally, ethnically, and linguistically diverse because of the reception of children and families through involuntary migration Refugees are defined by the UN High Commissioner for Refugees (UNHCR) as children and adults who have migrated to other countries due to fear of persecution in their country because of factors such as race, religion, nationality, or political opinion (Fantino & Colak, 2001) As of 2014, 51% of the 195 million registered refugees across the globe were children and youth, the highest figure in more than a decade (UNHCR, 2014) Every day, nearly 5,000 children become refugees, with a vast number growing up and spending their entire lives in refugee camps (UNHCR, 2014) Approximately 34,000 children are unaccompanied at the point of arrival or separated from family after arriving in a new country (UNHCR, 2014), which is notable given that unaccompanied minors often experience greater time in refugee camps awaiting decisions about placement and are at greater risk for mental health concerns (Fazel, Reed, Panter-Brick, & Stein, 2012; Wilkinson, 2002) Therefore, it is critical to identify factors that promote resilience at each stage of the migration process for refugee youthRefugee Children in CanadaCanada has demonstrated a well-established effort toward resettling families and children as well as a public interest in providing support through active volunteer groups at the individual, community, and agency level (Government of Canada, 2016) Refugees from nearly every country have migrated to Canada over the years, including countries from Europe, Asia, Africa, the Middle East, Central and South America, and more recently Iraq and Syria According to UNHCR (2014) over the last 10 years, approximately 26,000 refugees arrived in Canada each year, with 42% of this number successfully claiming refugee status, of which 36% are children The countries where families are migrating from at any given time reflect the current world crises For example, because of the current humanitarian crisis in Syria, Canada has welcomed more than 29,000 refugees from Syria from November 2015 to July 2016 (Government of Canada, 2016) and is planning on receiving thousands more This sizable increase in the number of refugees entering Canada may yield economic concerns as the refugee population continues to increase and requires more resources Given that the European Union (EU) has started to set restrictions on the number of refugees who can enter from Syria, Canada's role in receiving Syrian refugees as well as understanding how to promote their resilience is critical The unique resilience factors that accompany Syrian children and families, such as peer support and a sense of community, may be protective against the development of psychosocial concerns throughout the migration process (Daud, af Klinteberg, & Rydelius, 2008)Current ReviewBecause of the substantial growth in refugee children that are entering Canada and other countries around the world, there is global interest in identifying factors that are associated with risk and positive adaptation of children Refugee children can experience numerous stressors and traumatic events because of their migration, resettlement, and acculturation experiences These stressors can fall broadly within three periods: premigration (eg, trauma experienced while in their country of origin), migration (eg, hostility encountered while travelling through supposedly safe countries before reaching their host country), and postmigration periods (eg, separation from family after migration; Pacione, Measham, & Rousseau, 2013) Although the literature on refugee youth is filled with examples of risk for many types of mental health and educational challenges associated with each period of migration (Fazel et al, 2012), researchers are increasingly holding the viewpoint that it is important to view refugee children's experiences through a lens of recovery and resilience (Masten, 2012) because focusing on risk alone paints an incomplete picture of refugee youth's lives …

Project Networks: Governance Choices and Paradoxical Tensions

Abstract: This article examines how project networks may be viewed as either a single interorganizational project or as a series of projects that are interconnected by interorganizational relationships. The ...

Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Abstract: Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.

A Randomized Controlled Study of Neurofeedback for Chronic PTSD.

Abstract: Introduction Brain/Computer Interaction (BCI) devices are designed to alter neural signals and, thereby, mental activity. This study was a randomized, waitlist (TAU) controlled trial of a BCI, EEG neurofeedback training (NF), in patients with chronic PTSD to explore the capacity of NF to reduce PTSD symptoms and increase affect regulation capacities. Study Design 52 individuals with chronic PTSD were randomized to either NF (n = 28) or waitlist (WL) (n = 24). They completed four evaluations, at baseline (T1), after week 6 (T2), at post-treatment (T3), and at one month follow up (T4). Assessment measures were:1. Traumatic Events Screening Inventory (T1); 2. the Clinician Administered PTSD Scale (CAPS; T1, T3, T4); 3. the Davidson Trauma Scale (DTS; T1-T4) and 4. the Inventory of Altered Self-Capacities (IASC; T1-T4). NF training occurred two times per week for 12 weeks and involved a sequential placement with T4 as the active site, P4 as the reference site. Results Participants had experienced an average of 9.29 (SD = 2.90) different traumatic events. Post-treatment a significantly smaller proportion of NF (6/22, 27.3%) met criteria for PTSD than the WL condition (15/22, 68.2%), χ2 (n = 44, df = 1) = 7.38, p = .007. There was a significant treatment condition x time interaction (b = -10.45, t = -5.10, p< .001). Measures of tension reduction activities, affect dysregulation, and affect instability exhibited a significant Time x Condition interaction. The effect sizes of NF (d = -2.33 within, d = - 1.71 between groups) are comparable to those reported for the most effective evidence based treatments for PTSD. Discussion Compared with the control group NF produced significant PTSD symptom improvement in individuals with chronic PTSD, as well as in affect regulation capacities. NF deserves further investigation for its potential to ameliorate PTSD and to improve affect regulation, and to clarify its mechanisms of action.

The Gaia -ESO Survey : Probes of the inner disk abundance gradient

Abstract: Context. The nature of the metallicity gradient inside the solar circle (RGC <8 kpc) is poorly understood, but studies of Cepheids and a small sample of open clusters suggest that it steepens in the inner disk. Aims. We investigate the metallicity gradient of the inner disk using a sample of inner disk open clusters that is three times larger than has previously been studied in the literature to better characterize the gradient in this part of the disk. Methods. We used the Gaia-ESO Survey (GES) [Fe/H] values and stellar parameters for stars in 12 open clusters in the inner disk from GES-UVES data. Cluster mean [Fe/H] values were determined based on a membership analysis for each cluster. Where necessary, distances and ages to clusters were determined via comparison to theoretical isochrones. Results. The GES open clusters exhibit a radial metallicity gradient of -0.10 ± 0.02 dex kpc-1, consistent with the gradient measured by other literature studies of field red giant stars and open clusters in the range RGC ~ 6-12 kpc. We also measure a trend of increasing [Fe/H] with increasing cluster age, as has also been found in the literature. Conclusions. We find no evidence for a steepening of the inner disk metallicity gradient inside the solar circle as earlier studies indicated. The age-metallicity relation shown by the clusters is consistent with that predicted by chemical evolution models that include the effects of radial migration, but a more detailed comparison between cluster observations and models would be premature. (Less)

Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review

Abstract: Background Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is associated with diverse adverse health outcomes, making it an important therapeutic target. Measurement of the diurnal rhythm of cortisol secretion provides a window into this system. At present, no guidelines exist for the optimal use of this biomarker within randomised controlled trials (RCTs).

Fishing impact and environmental status in European seas: A diagnosis from stock assessments and ecosystem indicators

Abstract: Stock-based and ecosystem-based indicators are used to provide a new diagnosis of the fishing impact and environmental status of European seas. In the seven European marine ecosystems covering the Baltic and the North-east Atlantic, (i) trends in landings since 1950 were examined; (ii) syntheses of the status and trends in fish stocks were consolidated at the ecosystem level; and (iii) trends in ecosystem indicators based on landings and surveys were analysed. We show that yields began to decrease everywhere (except in the Baltic) from the mid-1970s, as a result of the over- exploitation of some major stocks. Fishermen adapted by increasing fishing effort and exploiting a wider part of the ecosystems. This was insufficient to compensate for the decrease in abundance of many stocks, and total landings have halved over the last 30 years. The highest fishing impact took place in the late 1990s, with a clear decrease in stock-based and ecosystem indicators. In particular, trophic-based indicators exhibited a continuous decreasing trend in almost all ecosystems. Over the past decade, a decrease in fishing pressure has been observed, the mean fishing mortality rate of assessed stocks being almost halved in all the considered ecosystems, but no clear recovery in the biomass and ecosystem indicators is yet apparent. In addition, the mean recruitment index was shown to decrease by around 50% in all ecosystems (except the Baltic). We conclude that building this kind of diagnosis is a key step on the path to implementing an ecosystem approach to fisheries management.

Dividend Policy and Earnings Management Across Countries

Abstract: This paper examines whether dividend policy is associated with earnings management and whether the relationship varies across countries with wide-ranging degrees of institutional strength and transparency. Based on a sample of 23,429 corporations from 29 countries, we show that dividend payers manage earnings less than dividend non-payers, and that this evidence is stronger in countries with weak investor protection and high opacity. Further, we find that dividend payers manage earnings less when they issue equity following dividend payments, and that this result is more pronounced in countries with weak institutions and low transparency. Overall, our evidence suggests that firms may employ dividend policies associated with less earnings manipulation to mitigate agency concerns and to establish credible reputation, thereby facilitating access to external funds.

Multicultural Conviviality in the Midst of Racism’s Ruins

Abstract: This article argues that the idea of multicultural tools is the best way to approach the understanding of conviviality. This argument is made through two discrete steps. The first offers a critical review of how issues of urban life and diversity have been theorised focusing on recent debates about ‘culture loss’ and ‘super-diversity’. The discussion, we suggest, elides historical and present racism, in the making of urban diversity in cities like London. The second step develops the notion of conviviality by identifying the ways in which young adult migrants living in London make convivial worlds emphasising the idea of tools, returning to Ivan Illich’s early formulation, and the capability to make multiculture. The article’s conclusion is that understanding urban multiculture requires equal weight being given to the paradoxical co-existence of both racism and conviviality in city life.

Dead or alive? Long-term evolution of SN 2015bh (SNhunt275)

Abstract: Supernova (SN) 2015bh (or SNhunt275) was discovered in NGC 2770 on 2015 February with an absolute magnitude of Mr ~ −13.4 mag, and was initially classified as a SN impostor. Here we present the photometric and spectroscopic evolution of SN 2015bh from discovery to late phases (~ 1 yr after). In addition, we inspect archival images of the host galaxy up to ~ 21 yr before discovery, finding a burst ~ 1 yr before discovery, and further signatures of stellar instability until late 2014. Later on, the luminosity of the transient slowly increases, and a broad light curve peak is reached after about three months. We propose that the transient discovered in early 2015 could be a core-collapse SN explosion. The pre-SN luminosity variability history, the long-lasting rise and faintness first light curve peak suggests that the progenitor was a very massive, unstable and blue star, which exploded as a faint SN because of severe fallback of material. Later on, the object experiences a sudden brightening of 3 mag, which results from the interaction of the SN ejecta with circumstellar material formed through repeated past mass-loss events. Spectroscopic signatures of interaction are however visible at all epochs. A similar chain of events was previously proposed for the similar interacting SN 2009ip.

Contrasting effects of GPS device and harness attachment on adult survival of Lesser Black‐backed Gulls Larus fuscus and Great Skuas Stercorarius skua

Abstract: Telemetry has become an important method for studying the biology and ecology of animals. However, the impact of tracking devices and their method of attachment on different species across multiple temporal scales has seldom been assessed. We compared the behavioural and demographic responses of two species of seabird, Lesser Black-backed Gull Larus fuscus and Great Skua Stercorarius skua, to a GPS device attached using a crossover wing harness. We used telemetry information and monitoring of breeding colonies to compare birds equipped with a device and harness, and control birds without an attachment. We assessed whether tagged birds have lower short-term breeding productivity or lower longer term overwinter return rates (indicative of overwinter survival) than controls. For Great Skua, we also assessed whether territory attendance within the breeding season differed between tagged and control birds. As with previous studies on Lesser Black-backed Gull, we found no short-term impacts on breeding productivity or long-term impacts on overwinter return rates. For Great Skua, there was no evidence for impacts of the device and harness on territory attendance or breeding productivity. However, as found by a previous study of Great Skuas using a different (body) harness design, there was strong evidence of reduced overwinter return rates. Consequently, a device attached using a wing harness was considered suitable for long-term deployment on Lesser Black-backed Gulls, but not on Great Skuas. These findings will inform the planning of future tracking studies.

New paradigms for BRCA1/BRCA2 testing in women with ovarian cancer: results of the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study

Abstract: Background Over recent years genetic testing for germline mutations in BRCA1/BRCA2 has become more readily available because of technological advances and reducing costs. Objective To explore the feasibility and acceptability of offering genetic testing to all women recently diagnosed with epithelial ovarian cancer (EOC). Methods Between 1 July 2013 and 30 June 2015 women newly diagnosed with EOC were recruited through six sites in East Anglia, UK into the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study. Eligibility was irrespective of patient age and family history of cancer. The psychosocial arm of the study used self-report, psychometrically validated questionnaires (Depression Anxiety and Stress Scale (DASS-21); Impact of Event Scale (IES)) and cost analysis was performed. Results 232 women were recruited and 18 mutations were detected (12 in BRCA1 , 6 in BRCA2 ), giving a mutation yield of 8%, which increased to 12% in unselected women aged <70 years (17/146) but was only 1% in unselected women aged ≥70 years (1/86). IES and DASS-21 scores in response to genetic testing were significantly lower than equivalent scores in response to cancer diagnosis (p<0.001). Correlation tests indicated that although older age is a protective factor against any traumatic impacts of genetic testing, no significant correlation exists between age and distress outcomes. Conclusions The mutation yield in unselected women diagnosed with EOC from a heterogeneous population with no founder mutations was 8% in all ages and 12% in women under 70. Unselected genetic testing in women with EOC was acceptable to patients and is potentially less resource-intensive than current standard practice.

Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients.

Abstract: Background Laparoscopic cholecystectomy is commonly performed, and several factors increase the risk of open conversion, prolonging operating time and hospital stay. Preoperative stratification would improve consent, scheduling and identify appropriate training cases. The aim of this study was to develop a validated risk score for conversion for use in clinical practice.

Reconstructing the emergence of a lethal infectious disease of wildlife supports a key role for spread through translocations by humans

Abstract: There have been few reconstructions of wildlife disease emergences, despite their extensive impact on biodiversity and human health. This is in large part attributable to the lack of structured and robust spatio-temporal datasets. We overcame logistical problems of obtaining suitable information by using data from a citizen science project and formulating spatio-temporal models of the spread of a wildlife pathogen (genus Ranavirus, infecting amphibians). We evaluated three main hypotheses for the rapid increase in disease reports in the UK: that outbreaks were being reported more frequently, that climate change had altered the interaction between hosts and a previously widespread pathogen, and that disease was emerging due to spatial spread of a novel pathogen. Our analysis characterized localized spread from nearby ponds, consistent with amphibian dispersal, but also revealed a highly significant trend for elevated rates of additional outbreaks in localities with higher human population density-pointing to human activities in also spreading the virus. Phylogenetic analyses of pathogen genomes support the inference of at least two independent introductions into the UK. Together these results point strongly to humans repeatedly translocating ranaviruses into the UK from other countries and between UK ponds, and therefore suggest potential control measures.

From Treatment to Empowerment: New Approaches to Youth Mentoring.

Abstract: Traditional approaches to formal youth mentoring have focused primarily on improving the lives of “at-risk” youth through the assignment of individual mentors who are typically disconnected from youth's communities. Similarly, research in the field of formal mentoring has emphasized the dyadic relationship between the mentor and the mentee, with less attention paid to the broader relational contexts in which such relationships unfold. The current paper proposes a new framework that expands the scope of mentoring interventions to include approaches that build on and cultivate informal supports and empower youth to identify and reach out to networks of potential supportive adults, thus increasing the reach of youth mentoring.

A Pilot Study of Neurofeedback for Chronic PTSD.

Abstract: EEG Biofeedback (also known as neurofeedback) has been in use as a clinical intervention for well over 30 years; however, it has made very little impact on clinical care. One reason for this has been the difficulty in designing research to measure clinical change in the real world. While substantial evidence exists for its efficacy in treating attention deficit/hyperactivity disorder, relatively little evidence exists for its utility in other disorders including posttraumatic stress disorder (PTSD). The current study represents a "proof-of-concept" pilot for the use of neurofeedback with multiply-traumatized individuals with treatment-resistant PTSD. Participants completed 40 sessions of neurofeedback training two times per week with sensors randomly assigned (by the study coordinator, who was not blind to condition) to sensor placements of either T4-P4 or T3-T4. We found that neurofeedback significantly reduced PTSD symptoms (Davidson Trauma Scale scores averaged 69.14 at baseline to 49.26 at termination), and preceded gains in affect regulation (Inventory of Altered Self-Capacities-Affect Dysregulation scores averaged 23.63 at baseline to 17.20 at termination). We discuss a roadmap for future research.

Cross-species models of human melanoma.

Abstract: Although transformation of melanocytes to melanoma is rare, the rapid growth, systemic spread, as well as the chemoresistance of melanoma present significant challenges for patient care. Here we review animal models of melanoma, including murine, canine, equine, and zebrafish models, and detail the immense contribution these models have made to our knowledge of human melanoma development, and to melanocyte biology. We also highlight the opportunities for cross-species comparative genomic studies of melanoma to identify the key molecular events that drive this complex disease.

The Gaia-ESO Survey: Dynamical analysis of the L1688 region in Ophiuchus

Abstract: The Gaia ESO Public Spectroscopic Survey (GES) is providing the astronomical community with high-precision measurements of many stellar parameters including radial velocities (RVs) of stars belonging to several young clusters and star-forming regions. One of the main goals of the young cluster observations is to study their dynamical evolution and provide insight into their future, revealing whether they will eventually disperse to populate the field rather than evolve into bound open clusters. In this paper we report the analysis of the dynamical state of L1688 in the ρ Ophiuchi molecular cloud using the dataset provided by the GES consortium. We performed the membership selection of the more than 300 objects observed. Using the presence of the lithium absorption and the location in the Hertzspung-Russell diagram, we identify 45 already known members and two new association members. We provide accurate RVs for all 47 confirmed members. A dynamical analysis, after accounting for unresolved binaries and errors, shows that the stellar surface population of L1688 has a velocity dispersion σ ~ 1.14 ± 0.35 km s-1 that is consistent with being in virial equilibrium and is bound with a ~80% probability. We also find a velocity gradient in the stellar surface population of ~1.0 km s-1 pc-1 in the northwest-southeast direction, which is consistent with that found for the pre-stellar dense cores, and we discuss the possibility of sequential and triggered star formation in L1688.