Τρίτη, 15 Μαρτίου 2016

A Call to Action for Care Coordination Research and Pediatric Implementation Science

This article is a call for pediatric nurse researchers to lead, participate in, and disseminate care coordination research and implementation science. This challenge is issued because of aging population demographics, resource scarcity, and the need for evidence-based child health policy advocacy. It is not news that the burgeoning needs of the elderly population can easily cause children to be pushed off the priority list for research funding. What may be news is the urgent need for nurse scholars to continue to pursue pediatric quality measurement and outcomes research and to engage in visible, high-impact child-focused implementation science studies to shape evolving health systems with solid evidence.

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An Evaluation of the Identification and Management of Overweight and Obesity in a Pediatric Clinic

With the rise in overweight and obesity in children, it is imperative for health care providers to routinely address appropriate body mass index for children during primary care visits. The purposes of this project were to determine if overweight and obese children are accurately being identified and to evaluate provider adherence to American Academy of Pediatrics guidelines for the management of obesity. A retrospective chart review was completed for all children ages 2, 6, and 10 years who presented for a well-child visit from January 1, 2011, through June 30, 2011.

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Vaccination Exemption and the Pediatric Health Care Provider

Among children born between 1994 and 2013, vaccinations will prevent approximately 322 million illnesses, 21 million hospitalizations, and 732,000 deaths, resulting in a net savings of $295 billion in direct costs and $1.4 trillion in total societal costs (Whitney, Zhou, Singelton, & Schuchat, 2014). Although U.S. vaccination rates among young children 19 to 35 months of age is more than 90% for four types of vaccines, coverage remains below target for several others (Table 1; Elam-Evans, Yankey, Singleton, & Kolasa, 2014b).

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Googling for Information About Alternative Vaccination Schedules

The purpose of this study was to explore and describe the information a parent may find when Googling for information about alternative vaccination schedules.

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Editorial Board



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Society



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Acknowledging the Work of Manuscript Reviewers

We extend much gratitude to the 164 peer reviewers of Journal of Pediatric Health Care (JPHC). Times are changing, and editors are under increased pressure to move papers through the review cycle in a timely manner as publishers work toward achieving faster times to editor first decision, editor acceptance of papers, and accepted manuscripts becoming citable articles. Thus, the submission of timely and quality reviews by our reviewer pool is vital to the ongoing success of JPHC. Our reviewers generously volunteer their time, and although intangible benefits may be gleamed from serving in the capacity of a reviewer, reviewers are also faced with increased demands on their time to complete professional activities.

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Table of Contents



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NAPNAP Position Statement on Immunizations

The National Association of Pediatric Nurse Practitioners (NAPNAP) fully supports timely and complete immunization of all infants, children, adolescents, and adults to maximize the health and well-being of all people. Routine childhood immunizations prevent approximately 2.5 million deaths every year (World Health Organization, 2012). Maintaining the highest immunization rates possible is essential to prevent outbreaks of vaccine preventable diseases across the nation (Centers for Disease Control and Prevention [CDC], 2013).

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Information for Readers



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Increasing Families' Health Care Access and Choice Through Full Practice Authority

As an organization devoted to improving pediatric health care and enhancing the health and well-being of our nation's children, the National Association of Pediatric Nurse Practitioners (NAPNAP) allocates considerable human and financial resources toward advancing health care policy that serves the best interests of our pediatric patients and their families. For many years, NAPNAP has focused most, if not all, of its governmental affairs resources toward supporting federal legislation and influencing regulatory policies that affect children's access to high-quality, comprehensive pediatric health care.

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Examining General Versus Condition-Specific Health-Related Quality of Life Across Weight Categories in an Adolescent Sample

This study examined health-related quality of life (HRQoL) across weight categories in adolescents using both a general and a condition-specific measure sensitive to fatigue symptoms. Participants (N = 918) completed the Pediatric Quality of Life (PedsQL) Inventory and PedsQL Multidimensional Fatigue Scale measures. Actual height and weight were used to calculate body mass index for age and sex percentiles and assign weight categories. No interaction effects between total HRQoL and weight category and gender were found; however, main effects were found for both weight category and gender.

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Implications for Advanced Practice Nurses When Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS) Is Suspected: A Qualitative Study

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) is a relatively new but controversial diagnosis affecting hundreds of children and their families. It is generally thought to be an autoimmune disorder resulting from a streptococcal infection that causes significant and bizarre behavioral changes in children. Currently no definitive diagnostic or treatment modalities exist, which has led to misdiagnoses, ineffective treatments, and delayed care.

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Pulmonary Hypertension in a Premature Infant With Bronchopulmonary Dysplasia

An almost 9-month-old former 23-week gestation preterm male infant, who was living at home with administration of 0.75 L of oxygen for bronchopulmonary dysplasia (BPD), presented to the high-risk neonatal clinic for routine follow-up. He was tachypneic and displayed moderate subcostal retractions, an increase from his baseline mild retractions. Crackles were audible throughout bilateral lung fields, with decreased air entry over the left lower lobe. His lips were dusky, and a pulse oximeter check revealed an oxygen saturation of 55%.

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Pediatric Nurse Practitioner Management of Child Anxiety in a Rural Primary Care Clinic With the Evidence-Based COPE Program

Anxiety is the most common mental health disorder in children. Many communities have shortages of mental health providers, and the majority of children with anxiety are not receiving the evidence-based treatment they need. The purpose of this pilot study was to assess the feasibility and effects of a brief seven-session cognitive behavioral skills-building intervention, Creating Opportunities for Personal Empowerment (COPE), which was delivered to anxious children by a pediatric nurse practitioner in a primary care setting.

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Practice Guideline for Treatment of Latent Tuberculosis Infection in Children

Latent tuberculosis infection (LTBI) treatment is an important component of tuberculosis (TB) management in the United States to prevent new cases of TB disease. The risk of progression from TB infection to active disease in healthy adults is 5% to 10%, whereas the risk of progression in patients younger than 1 year is approximately 50% (Cruz & Starke, 2007). Factors associated with higher risk of progression include age younger than 5 years, recent TB infection, diabetes mellitus, human immunodeficiency virus (HIV) infection, immunocompromised status, or administration of immunosuppressive medications (Pediatric Tuberculosis Collaborative Group, 2004).

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A Virtual Childhood Obesity Collaborative: Satisfaction With Online Continuing Education

This descriptive study evaluated school-based health center (SBHC) providers' satisfaction with Web-based continuing education as part of a virtual childhood obesity intervention.

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The Daily Experiences of Adolescents in Lebanon With Sickle Cell Disease

Despite the psychosocial and physical consequences associated with sickle cell disease (SCD), the daily lived experience of adolescents diagnosed with this disease is a phenomenon rarely described. The objective of this study was to explore the daily lived experience of adolescents with SCD living in Lebanon.

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The Association of Organizational Culture and Quality Improvement Implementation With Neonatal Outcomes in the NICU

Studies of adult patient populations suggest that organizational culture is associated with quality improvement (QI) implementation, as well as patient outcomes. However, very little research on organizational culture has been performed in neonatal patient populations.

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A Health-Related Quality of Life Measure for Older Adolescents With Asthma: Child Health Survey for Asthma-T (Teen Version)

Although adolescent substance use can have direct effects on asthma symptoms and interact with medications used to treat asthma, no validated health-related quality of life (HRQL) instrument exists for adolescents 17 to 19 years of age with asthma.

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Clinico-pathological features of incidentally detected and symptomatic renal cell carcinomas

2016-03-15T19-06-13Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Panicker Thomas Bipin, Jose Binu.
Background: Most studies have demonstrated that patients in whom renal cell carcinomas (RCC) are incidentally detected have a better prognosis than those with symptoms related to RCC. This study aimed to compare the differences in the clinico-pathological features of incidentally detected and symptomatic RCC. Methods: A retrospective study was conducted in patients who underwent surgical treatment for suspected renal masses and pathologically proven RCC. Histopathological data was retrieved from the pathology database. Incidentally diagnosed RCC and symptomatic tumors were compared. Significance was calculated using Fishers exact test. Results: Of the total 179 patients, 41 (22.9%) were incidentally detected and 138 (77.1%) were symptomatic. Incidentally detected tumors were smaller, on average being 3.63 cm, and diagnosed at earlier stage and lower grade when compared to symptomatic tumors. More aggressive histology, such as sarcomatoid variants, collecting duct tumors and high grade tumors were more often seen in the symptomatic group. Conclusions: Incidentally detected RCC has significantly better pathological prognostic factors than the symptomatic group. Symptomatic tumors present at a significantly higher stage, grade and are more aggressive than incidental lesions, particularly at later stages.


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Hepatic decompensation/serious adverse events in post-liver transplantation recipients on sofosbuvir for recurrent hepatitis C virus

World Journal of Gastroenterology

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Colorectal cancer screening rates increased after exposure to the patient-centered medical home (pcmh)

Journal of the American Board of Family Medicine

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Efficacy and safety study of cenicriviroc for the treatment of non-alcoholic steatohepatitis in adult subjects with liver fibrosis: CENTAUR phase 2b study design

Contemporary Clinical Trials

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HCV false positive immunoassays in patients with LVAD: A potential trap

Journal of Clinical Virology

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Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and inflammatory bowel disease: a meta-analysis of 16 observational studies

European Journal of Gastroenterology & Hepatology

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Development of a simple, peripheral blood-based lateral-flow dipstick assay for accurate detection of patients with enteric fever

Clinical and Vaccine Immunology

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Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps

European Journal of Gastroenterology & Hepatology

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Comparative genomic analysis of toxin-negative strains of Clostridium difficile from humans and animals with symptoms of gastrointestinal disease

BMC Microbiology

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HLA-A is a predictor of hepatitis B e antigen status in HIV-positive African adults

The Journal of Infectious Diseases

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Association between psoriasis and inflammatory bowel disease - a Danish nationwide cohort study

British Journal of Dermatology

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Association of work productivity with clinical and patient-reported factors in patients infected with hepatitis C virus

Journal of Viral Hepatitis

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Surgical resection of hepatic metastases from gastric cancer: outcomes from national series in England

Gastric Cancer

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Influence of female sex on hepatitis C virus infection progression and treatment outcomes

European Journal of Gastroenterology & Hepatology

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Nonalcoholic fatty liver is not associated with incident chronic kidney disease: a large histology-based comparison with healthy individuals

European Journal of Gastroenterology & Hepatology

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Efficacy and safety of sofosbuvir/ledipasvir for the treatment of patients with hepatitis C virus re-infection after liver transplantation

Transplant Infectious Disease

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Hypersplenism in liver disease and SLE revisited: current evidence supports an active rather than passive process

BMC Hematology

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Genomic Selection in Multi-environment Crop Trials

Genomic selection in crop breeding introduces modelling challenges not found in animal studies. These include the need to accommodate replicate plants for each line, consider spatial variation in field trials, address line by environment interactions, and capture non-additive effects. Here we propose a flexible single-stage genomic selection approach that resolves these issues. Our linear mixed model incorporates spatial variation through environment-specific terms and also randomisation-based design terms. It considers marker and marker by environment interactions using ridge regression best linear unbiased prediction to extend genomic selection to multiple environments. Since the approach uses the raw data from line replicates, the line genetic variation is partitioned into marker and non-marker residual genetic variation (i.e. additive and non-additive effects). This results in a more precise estimate of marker genetic effects. Using barley height data from 2 year's trials of up to 477 cultivars, we demonstrate that our new genomic selection model improves predictions compared to current models. Analysing single trials revealed improvements in predictive ability of up to 5.7%. For the multiple environment MET model, combining both year trials improved predictive ability up to 11.4% compared to a single environment analysis. Benefits were significant even when fewer markers were used. Compared to single year standard models run with 3490 markers, our partitioned MET model achieved the same predictive ability using between 500 and 1000 markers depending on the trial. Our approach can be used to increase accuracy and confidence in the selection of the best lines for breeding and/or, to reduce costs by using fewer markers.



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Lipopolysaccharide structure and biosynthesis in Helicobacter pylori

Helicobacter

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Multiple Targets on the Gln3 Transcription Activator Are Cumulatively Required for Control of Its Cytoplasmic Sequestration

A remarkable characteristic of nutritional homeostatic mechanisms is the breadth of metabolite concentrations to which they respond and resolution of those responses; adequate but rarely excessive. Two general ways of achieving such exquisite control are known: stoichiometric mechanisms where increasing metabolite concen-trations elicit proportionally increasing responses, and the actions of multiple independent metabolic signals that cumulatively generate appropriately measured responses. Intracellular localization of the nitrogen-responsive transcription activator, Gln3 responds to four distinct nitrogen environments: nitrogen limitation or short-term starvation, i.e. nitrogen catabolite repression (NCR), long-term starvation, glutamine starvation and rapamycin inhibition of mTorC1. We have previously identified unique sites in Gln3 required for rapamycin-responsiveness and Gln3-mTor1 interaction. Alteration of the latter results in loss of about 50% of cytoplasmic Gln3 sequestra-tion. However, except for the Ure2-binding domain, no evidence exists for a Gln3 site responsible for the re-maining cytoplasmic Gln3-Myc13 sequestration in nitrogen excess. Here we identify a ser-ine/threonine-rich (Gln3477-493) region required for effective cytoplasmic Gln3-Myc13 se-questration in excess nitrogen. Substitutions of alanine but not aspartate for serines in this peptide partially abol-ish cytoplasmic Gln3 sequestration. Importantly, these alterations have no effect on Gln3-Myc13's responses to rapamycin, methionine sulfoximine or limiting nitrogen. However, cytoplasmic Gln3-Myc13 sequestration is additively and almost completely abolished when mutations in the Gln3-Tor1 interaction site are combined with those in Gln3477-493 cytoplasmic sequestration site. These findings clearly demonstrate that multiple individual regulatory pathways cumulatively control cytoplasmic Gln3 seques-tration.



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The HIST1 Locus Escapes Reprogramming in Cloned Bovine Embryos

Epigenetic reprogramming is necessary in somatic cell nuclear transfer (SCNT) embryos in order to erase the differentiation-associated epigenetic marks of donor cells. However, such epigenetic memories often persist throughout the course of clonal development, thus decreasing the cloning efficiency. Here, we explored reprogramming-refractory regions in bovine SCNT blastocyst transcriptomes. We observed that histone genes residing in the 1.5 Mb-spanning cow HIST1 cluster were coordinately downregulated in SCNT blastocysts. In contrast, both the non-histone genes of this cluster, and histone genes elsewhere remained unaffected. This indicated that the downregulation was specific to the HIST1 histone genes. We found that, after trichostatin A treatment, the HIST1 histone genes were de-repressed, and DNA methylation at their promoters was decreased to the level of IVF embryos. Therefore, our results indicate that the reduced expression of the HIST1 histone genes is a consequence of poor epigenetic reprogramming in SCNT blastocysts.



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The peripheral–central chemoreflex interaction: where do we stand and what is the next step?



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Preparing for Winter: the Transcriptomic Response Associated with Different Day Lengths in Drosophila montana

At northern latitudes the most robust cue for assessing the onset of winter is the shortening of day lengths, and many species use day length as a cue to increase their cold tolerance and/or enter into diapause but little is known about changes in gene expression that occur under different day lengths. We investigate the gene expression changes associated with differences in light/dark cycles in Drosophila montana, a northerly distributed species with a strong adult photoperiodic reproductive diapause. To examine gene expression changes induced by light both prior to, and during diapause, we used both non-diapausing and diapausing flies. We found that the majority of genes that are differentially expressed between different day lengths in non-diapausing and diapausing flies differ, however the biological processes involved were broadly similar. These included neuron development and metabolism, which are largely consistent with an increase in cold tolerance previously observed to occur in these flies. We also find many genes associated with reproduction change in expression level between different day lengths, suggesting that D. montana use changes in day length to cue changes in reproduction both before, and after entering into diapause. Finally we also identify several interesting candidate genes for light-induced changes including Lsp2, para and Ih.



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Channelling frozen cells to survival after thawing: opening the door to cryo-physiology



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The Arabidopsis Auxin Receptor F-box proteins AFB4 and AFB5 are Required for Response to the Synthetic Auxin Picloram

The plant hormone auxin is perceived by a family of F-box proteins called the TIR1/AFBs. Phylogenetic studies reveal that these proteins fall into four clades in flowering plants called TIR1, AFB2, AFB4, and AFB6 (Parry et al. 2009). Genetic studies indicate that members of the TIR1 and AFB2 groups act as positive regulators of auxin signaling by promoting the degradation of the Aux/IAA transcriptional repressors (Dharmasiri et al. 2005; Parry et al. 2009). In this report, we demonstrate that both AFB4 and AFB5 also function as auxin receptors based on in vitro assays. We also provide genetic evidence that AFB4 and AFB5 are targets of the picloram family of auxinic herbicides in addition to indole-3-acetic acid. In contrast to previous studies we find that null afb4 alleles do not exhibit obvious defects in seedling morphology or auxin hypersensitivity. We conclude that AFB4 and AFB5 act in a similar fashion to other members of the family but exhibit a distinct auxin specificity.



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CO2 – friend or foe?



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Gene Regulatory Evolution During Speciation in a Songbird

Over the last decade tremendous progress has been made towards a comparative understanding of gene regulatory evolution. However, we know little about how gene regulation evolves in birds, and how divergent genomes interact in their hybrids. Because of the unique features of birds - female heterogamety, a highly conserved karyotype, and the slow evolution of reproductive incompatibilities - an understanding of regulatory evolution in birds is critical to a comprehensive understanding of regulatory evolution and its implications for speciation. Using a novel complement of analyses of replicated RNA-seq libraries, we demonstrate abundant divergence in brain gene expression between zebra finch (Taeniopygia guttata) subspecies. By comparing parental populations and their F1 hybrids, we also show that gene misexpression is relatively rare among brain-expressed transcripts in male birds. If this pattern is consistent across tissues and sexes, it may partially explain the slow buildup of postzygotic reproductive isolation observed in birds relative to other taxa. Although we expected that the action of genetic drift on the island-dwelling zebra finch subspecies would be manifested in a higher rate of trans regulatory divergence, we found that most divergence was in cis regulation, following a pattern commonly observed in other taxa. Thus our study highlights both unique and shared features of avian regulatory evolution.



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Passing the baton



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Issue Information



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Renal lymph: a window for renal pathophysiology?



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