The party politics of Euroscepticism in times of crisis: the case of Greece

This article traces the trajectory of party Euroscepticism in Greece drawing upon theories of issue competition. It demonstrates that the economic dimension of the multiple crises facing the EU contributed to a Eurosceptic shift in public opinion; the electoral success of Eurosceptic parties; new parties populating the Europhile end of the spectrum; and the formation of a coalition government united not by ideological affinity but by a common Eurosceptic and anti-austerity agenda. Mainstream parties maintained their pro-EU agendas and challenger parties offered both pro- and anti-EU policy options to the electorate. The prospect of power resulted in the progressive softening of Euroscepticism among challenger parties. EU issue salience was relatively high across the party system and remained so during the crisis. Although Greek parties justified their pro- and anti-EU attitudes using a number of frames, economic arguments were prevalent at the height of the crisis, and challenger parties of the left intensified their claims of the EU interfering in national politics. The findings have implications for our understanding of the evolving nature of Euroscepticism and the ways in which it may feature in domestic party politics

The hidden flows within species: Phytoplankton population dynamics in Arctic assemblages

Progressing climate change and concurrent alterations of environmental conditions pose challenges of adaptation on organisms and ecosystems, especially in rapidly changing places like the Arctic. While more diverse systems are usually considered to be more resilient, biodiversity does not only describe the number of species, but can also consist of diverse individuals within a species. Especially in protists, with large census sizes and fast proliferation, intraspecific lineage sorting can be an important mechanism of plasticity and trait adjustment. For phytoplankton communities at the base of the foodweb, physiological acclimation and species shifts are frequently described, but intraspecific composition and diversity are methodologically still difficult to resolve, especially in diverse natural contexts and at temporal resolution. Therefore, our knowledge on the functioning and importance of intraspecific selection dynamics in phytoplankton is still limited. In recent years, we have developed and applied a new, high throughput methodology for phytoplankton population composition, which can make temporal and spatial population dynamics visible that were before extremely difficult to resolve. Next to experiments with natural phytoplankton communities and artificial populations under controlled settings, a time-series of Arctic spring blooms has been investigated towards the year-to year composition of species but also of intraspecific populations of a dominant diatom. Datasets emerging now thanks to such novel technologies can offer new, more comprehensive perspectives on our understanding of the mechanisms and results of microevolution and local adaptation, and can reveal formerly hidden patterns of species’ strategies of persistence and development

Resilience and adaptive mechanisms of Arctic phytoplankton under heatwaves: Acclimation, microevolution and community resilience

Trait adjustments of phytoplankton communities to changing environmental conditions can take place through responses on several fundamental ecological levels. These include physiological acclimation of single genotypes, evolution through sorting among genotypes of the same species, and selection within the entire multi-species community. Which of these different levels responds to environmental change can have large ecological and biogeochemical implications, but especially in protists, these levels are extremely difficult to disentangle. Arctic phytoplankton at base of the foodweb in one of the most rapidly warming regions on the planet, are faced with especially large changes, but often show high resilience. Among these changes are more frequent and intense heatwaves, which expose organisms to vast temperature fluctuations. In dedicated experimental setups of different ecological complexity, we investigated how phytoplankton responds and adjusts to heatwaves, and on which of the mentioned levels shifts can be observed. We resolved not only physiological features and productivity, but also composition on the species as well as the intraspecific level, using a novel molecular approach to efficiently examine the composition of protist populations in diverse contexts. This setup provides a comprehensive approach to investigate how phytoplankton communities respond to stable and fluctuating temperature scenarios, physiologically and ecologically

A framework and a measurement instrument for sustainability of work practices in long-term care

<p>Abstract</p> <p>Background</p> <p>In health care, many organizations are working on quality improvement and/or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices after implementation. The objective of this study is to develop a theoretical framework and measurement instrument for sustainability. To this end sustainability is conceptualized with two dimensions: routinization and institutionalization.</p> <p>Methods</p> <p>The exploratory methodological design consisted of three phases: a) framework development; b) instrument development; and c) field testing in former improvement teams in a quality improvement program for health care (N _teams= 63, N _individual= 112). Data were collected not until at least one year had passed after implementation.</p> <p>Underlying constructs and their interrelations were explored using Structural Equation Modeling and Principal Component Analyses. Internal consistency was computed with Cronbach's alpha coefficient. A long and a short version of the instrument are proposed.</p> <p>Results</p> <p>The χ²- difference test of the -2 Log Likelihood estimates demonstrated that the hierarchical two factor model with routinization and institutionalization as separate constructs showed a better fit than the one factor model (p < .01). Secondly, construct validity of the instrument was strong as indicated by the high factor loadings of the items. Finally, the internal consistency of the subscales was good.</p> <p>Conclusions</p> <p>The theoretical framework offers a valuable starting point for the analysis of sustainability on the level of actual changed work practices. Even though the two dimensions routinization and institutionalization are related, they are clearly distinguishable and each has distinct value in the discussion of sustainability. Finally, the subscales conformed to psychometric properties defined in literature. The instrument can be used in the evaluation of improvement projects.</p

Self-Injurious Behavior in Adolescents

Janis Whitlock discusses the epidemiology and and care of adolescents undertaking nonsuicidal self-injury, also called “deliberate self-harm.

Genomics in neurodevelopmental disorders: an avenue to personalized medicine

Despite the remarkable number of scientific breakthroughs of the last 100 years, the treatment of neurodevelopmental disorders (e.g., autism spectrum disorder, intellectual disability) remains a great challenge. Recent advancements in genomics, such as whole-exome or whole-genome sequencing, have enabled scientists to identify numerous mutations underlying neurodevelopmental disorders. Given the few hundred risk genes that have been discovered, the etiological variability and the heterogeneous clinical presentation, the need for genotype — along with phenotype- based diagnosis of individual patients has become a requisite. In this review we look at recent advancements in genomic analysis and their translation into clinical practice

Delay in surgery, risk of hospital-treated infections and the prognostic impact of comorbidity in hip fracture patients. A Danish nationwide cohort study, 2005&ndash;2016

Eva N Glassou,1,2 Kaja KE Kj&oslash;rholt,3 Torben B Hansen,1 Alma B Pedersen31University clinic for hand, hip and knee surgery, Regional Hospital West Jutland, Aarhus University, Holstebro 7500, Denmark; 2Department of Quality, Regional Hospital West Jutland, Holstebro 7500, Denmark; 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N 8200, DenmarkPurpose: We examined the association between delay in surgery and hospital-treated infections in hip fracture patients with and without known comorbidities.Patients and methods: All hip fracture patients aged &ge;65 years registered in the Danish Multidisciplinary Hip Fracture Registry from 2005 to 2016 were included (n=72,520). Delay in surgery was defined as the time in hours from admission to surgery and was divided into 3 groups (12, 24 and 48 hrs). The outcomes were hospital-treated pneumonia, urinary tract infection and reoperation due to infection 0&ndash;30 days after surgery. As a measure of comorbidity, we used the Charlson Comorbidity Index (CCI): none (no registered comorbidities prior to the fracture), medium (1&ndash;2 points) and high (&ge;3 points).Results: Overall, there was an association between a delay of 12 hrs and pneumonia. A delay of 12 hrs was associated with an increased risk of pneumonia in patients with no comorbidities (adjusted hazard ratio (HR) 1.20, confidence interval (CI) 1.03&ndash;1.40) and a delay of 24 hrs was associated with an increased risk of pneumonia in patients with a medium level of comorbidity (HR 1.12, CI (1.02&ndash;1.23)). Overall, delay was associated with reoperation due to infection, particularly among patients with comorbidities, although the confidence intervals of some of the estimates were wide. A delay of 48 hrs was associated with an increased risk of reoperation due to infection in patients with a high level of comorbidity (HR 2.36, CI 1.19&ndash;4.69).Conclusion: Delay in surgery was associated with an increased risk of hospital-treated pneumonia and reoperations due to infection within 30 days of surgery. The number of postoperative hospital-treated infections within 30 days may be reduced by continuously targeting pre-, per- and postoperative optimization not only for patients with high level of comorbidity but also for hip fracture patients without known comorbidities prior to surgery.Keywords: hip fracture, delay in surgery, pneumonia, urinary tract infection, reoperation, surgical site infectio

MOESM1 of The Area method: a new method for ultrasound assessment of diaphragmatic movement

Additional file 1: Video 1. Video explaining how calculations of the area method is performed