Implications for welfare, productivity and sustainability of the variation in reported levels of mortality for laying hen flocks kept in different housing systems: A meta-analysis of ten studies

Data from ten sources comprising 3,851 flocks were modelled to identify variation in levels of mortality in laying hens. The predicted increase with age was curvilinear with significant variation between the seven breed categories. Mortality was higher in loose housing systems than in cages and variable within system, confirming previous reports. Cumulative mortality (CM) was higher in flocks with intact beaks (χ2 = 6.03; df 1; p = 0.014) than in those with trimmed beaks. Most data were available for free-range systems (2,823 flocks), where producer recorded CM at 60–80 weeks of age averaged 10% but with a range from 0% to 69.3%. Life cycle assessment showed that the main effect of increased levels of hen mortality is to increase the relative contribution of breeding overheads, so increasing environmental burdens per unit of production. Reducing CM to levels currently achieved by the 1st quartile could reduce flock greenhouse gas emissions by as much as 25%. Concurrently this would enhance hen welfare and better meet the expectation of egg consumers. More research to understand the genetic x environment interaction and detailed records of the causes of mortality is required so that improved genotypes can be developed for different systems and different breeds can be better managed within systems

“Here’s a Little Something for You”: How Therapists Respond to Client Gifts

Descriptions by 12 therapists of their experiences receiving tangible gifts from clients are examined. Using consensual qualitative research (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997) therapists’ overall gift encounters and specifically identified gift events were explored. Results indicated that although clients rarely gave gifts, all of the participants had accepted gifts. Problematic gifts (i.e., ones that raised concern for therapists) were given at more provocative times than were unproblematic gifts (i.e., ones that evoked few concerns for therapists). Both types of gifts were given for various reasons (e.g., appreciation, manipulation, equalization). Participants reported positive and negative internal responses to both types of gifts, but more often discussed unproblematic than problematic gifts with clients. Problematic gifts were more often discussed with others than were unproblematic gifts. Gift episodes of both types facilitated therapy process

Consensual Qualitative Research: An Update

The authors reviewed the application of consensual qualitative research (CQR) in 27 studies published since the method’s introduction to the field in 1997 by C. E. Hill, B. J. Thompson, and E. N. Williams (1997). After first describing the core components and the philosophical underpinnings of CQR, the authors examined how it has been applied in terms of the consensus process, biases, research teams, data collection, data analysis, and writing up the results and discussion sections of articles. On the basis of problems that have arisen in each of these areas, the authors made recommendations for modifications of the method. The authors concluded that CQR is a viable qualitative method and suggest several ideas for research on the method itself

Musculoskeletal impairments after critical illness: a protocol for a qualitative study of the experiences of patients, family and health care professionals

Background: Survivors of critical care are at risk of long-term disability from musculoskeletal (MSK) impairments. These can have a biopsychosocial impact on the patient and their families with a reduction in health-related quality of life, increased health care utilization, caregiving roles and associated psychological distress. Aims: To understand the experiences of patients living with MSK impairments following critical illness, and family and health care professionals supporting them, to inform the development of a future intervention to improve MSK health following critical illness. Study Design: A four-site qualitative case study approach will be taken, with each of the four hospital sites and associated community services representing a case site. We will conduct semi-structured interviews with 10–15 patients/family members and 10–15 health care professionals about their experiences of MSK impairment following critical illness. Interviews will be audio recorded, transcribed verbatim and analysed using reflexive thematic analysis within a descriptive phenomenological approach. Alongside interview data, analysis of publicly available policy documentation, patient-facing materials and information from service leads at the four sites will be conducted. Discourse analysis will be used for this case study documentation. Results: This protocol describes a qualitative study exploring the experiences of patients living with MSK impairments following critical illness, and the family and health care professionals supporting them. Relevance to Clinical Practice: Data analysis will illuminate their experiences and enable data richness to contribute to the qualitative body of evidence of intensive care unit (ICU) survivors. These findings will inform the development of a complex intervention for MSK rehabilitation after critical illness

Individual Values and SME Environmental Engagement

We study the values on which managers of small and medium-sized enterprises draw when constructing their personal and organizational-level engagement with environmental issues, particularly climate change. Values play an important mediating role in business environmental engagement but relatively little research has been conducted on individual values in smaller organizations. Using the Schwartz Value System (SVS) as a framework for a qualitative analysis, we identify four ‘ideal-types’ of SME managers and provide rich descriptions of the ways in which values shape their constructions of environmental engagement. In contrast to previous research, which is framed around a binary divide between self-enhancing and self-transcending values, our typology distinguishes between individuals drawing primarily on Power or on Achievement values, and indicates how a combination of Achievement and Benevolence values is particularly significant in shaping environmental engagement. This demonstrates the theoretical usefulness of focusing on a complete range of values. Implications for policy and practice are discussed

Allometric length-weight relationships for benthic prey of aquatic wildlife in coastal marine habitats

We developed models to estimate the soft tissue content of benthic marine invertebrates that are prey for aquatic wildlife. Allometric regression models of tissue wet weight with shell length for 10 species of benthic invertebrates had r2 values ranging from 0.29 for hermit crabs Pagurus longicarpus to 0.98 for green crabs Carcinus maenas. As a class, bivalves had the highest r2 values (0.84) and crustaceans the lowest (0.48). Energy and nutrient content of soft tissue is also presented for the 10 benthic species. The energy content was lowest in crabs, and ranged within 2.20–4.71 kcal g-1 dry weight. Fat content was highly variable (range: 3.5–16.0%), and protein content ranged within 43.1–68.1% and was highest for shrimp Palaemonetes pugio. Comparison between classes of organisms of the amount of soft tissue per unit shell length showed that crustaceans yield five times more soft tissue per unit shell length than bivalves, and four times more than gastropods. The models we present use simple measures, such as the length of shell or wet weight of the entire animal, to quantitatively estimate the amount of available soft tissue in benthic prey that are usually consumed in total (with shell and soft tissue intact) but for which only the soft tissue is used for nutritional gain. This information can be combined with energy and nutrient content data to calculate energy or nutrient based carrying capacities that can help assess available resources for shorebirds, waterfowl and marine mammals

Wnt2 and WISP-1/CCN4 induce intimal thickening via promotion of smooth muscle cell migration

Objective—Increased vascular smooth muscle cell (VSMC) migration leads to intimal thickening which acts as a soil for atherosclersosis, as well as causing coronary artery restenosis after stenting and vein graft failure. Investigating factors involved in VSMC migration may enable us to reduce intimal thickening and improve patient outcomes. In this study, we determined whether Wnt proteins regulate VSMC migration and thereby intimal thickening. Approach and Results—Wnt2 mRNA and protein expression were specifically increased in migrating mouse aortic VSMCs. Moreover, VSMC migration was induced by recombinant Wnt2 in vitro. Addition of recombinant Wnt2 protein increased Wnt1-inducible signaling pathway protein-1 (WISP-1) mRNA by ≈1.7-fold, via β-catenin/T-cell factor signaling, whereas silencing RNA knockdown of Wnt-2 reduced WISP-1 mRNA by ≈65%. Treatment with rWISP-1 significantly increased VSMC migration by ≈1.5-fold, whereas WISP-1 silencing RNA knockdown reduced migration by ≈40%. Wnt2 and WISP-1 effects were integrin-dependent and not additive, indicating that Wnt2 promoted VSMC migration via WISP-1. Additionally, Wnt2 and WISP-1 were significantly increased and colocated in human coronary arteries with intimal thickening. Reduced Wnt2 and WISP-1 levels in mouse carotid arteries from Wnt2+/− and WISP-1−/− mice, respectively, significantly suppressed intimal thickening in response to carotid artery ligation. In contrast, elevation of plasma WISP-1 via an adenovirus encoding WISP-1 significantly increased intimal thickening by ≈1.5-fold compared with mice receiving control virus. Conclusions—Upregulation of Wnt2 expression enhanced WISP-1 and promoted VSMC migration and thereby intimal thickening. As novel regulators of VSMC migration and intimal thickening, Wnt2 or WISP-1 may provide a potential therapy for restenosis and vein graft failure

Updates in the chronic kidney disease-mineral bone disorder show the role of osteocytic proteins, a potential mechanism of the bone-vascular paradox, a therapeutic target, and a biomarker

The chronic kidney disease-mineral bone disorder (CKD-MBD) is a complex multi-component syndrome occurring during kidney disease and its progression. Here, we update progress in the components of the syndrome, and synthesize recent investigations, which suggest a potential mechanism of the bone-vascular paradox. The discovery that calcified arteries in chronic kidney disease inhibit bone remodeling lead to the identification of factors produced by the vasculature that inhibit the skeleton, thus providing a potential explanation for the bone-vascular paradox. Among the factors produced by calcifying arteries, sclerostin secretion is especially enlightening. Sclerostin is a potent inhibitor of bone remodeling and an osteocyte specific protein. Its production by the vasculature in chronic kidney disease identifies the key role of vascular cell osteoblastic/osteocytic transdifferentiation in vascular calcification and renal osteodystrophy. Subsequent studies showing that inhibition of sclerostin activity by a monoclonal antibody improved bone remodeling as expected, but stimulated vascular calcification, demonstrate that vascular sclerostin functions to brake the Wnt stimulation of the calcification milieu. Thus, the target of therapy in the chronic kidney disease-mineral bone disorder is not inhibition of sclerostin function, which would intensify vascular calcification. Rather, decreasing sclerostin production by decreasing the vascular osteoblastic/osteocytic transdifferentiation is the goal. This might decrease vascular calcification, decrease vascular stiffness, decrease cardiac hypertrophy, decrease sclerostin production, reduce serum sclerostin and improve skeletal remodeling. Thus, the therapeutic target of the chronic kidney disease-mineral bone disorder may be vascular osteoblastic transdifferentiation, and sclerostin levels may be a useful biomarker for the diagnosis of the chronic kidney disease-mineral bone disorder and the progress of its therapy

What is the role of a specialist regional mesothelioma multidisciplinary team meeting?:A service evaluation of one tertiary referral centre in the UK

BACKGROUND: Multidisciplinary team meetings are standard care for cancer in the UK and Europe. Professional bodies recommend that mesothelioma cases should be discussed at specialist multidisciplinary team meetings. However, no evidence exists exploring the role of the specialist mesothelioma multidisciplinary team meeting. OBJECTIVES: To evaluate the clinical activity of 1 specialist mesothelioma multidisciplinary team meeting and to determine how often a definitive diagnosis was made, whether the core requirements of the meeting were met and whether there was any associated benefit or detriment. DESIGN AND SETTING: A service evaluation using routinely collected data from 1 specialist mesothelioma multidisciplinary team meeting in a tertiary referral hospital in the South-West of England. PARTICIPANTS: All cases discussed between 1/1/2014 and 31/12/2015. OUTCOME MEASURES: The primary outcome measure was whether a definitive diagnosis was made. Secondary outcomes included whether treatment advice was offered, information on clinical trials provided or further investigations suggested. Additional benefits of the multidisciplinary team meeting and time taken from referral to outcome were also collected. RESULTS: A definitive diagnosis was reached in 171 of 210 cases discussed (81%). Mesothelioma was diagnosed in 153/210 (73%). Treatment advice was provided for 127 of 171 diagnostic cases (74%) and further investigations suggested for all 35 non-diagnostic cases. 86/210 cases (41%) were invited to participate in a trial, of whom 43/86 (50%) subsequently enrolled. Additional benefits included the avoidance of postmortem examination if the coroner was satisfied with the multidisciplinary team decision. The overall process from referral to outcome dispatch was <2 weeks in 75% of cases. CONCLUSIONS: This specialist mesothelioma multidisciplinary team meeting was effective at making diagnoses and providing recommendations for further investigations or treatment. The core requirements of a specialist mesothelioma multidisciplinary team meeting were met. The process was timely, with most outcomes returned within 2 weeks of referral

Experiences of Middle-Level Students, Teachers, and Parents in the Do the Write Thing Violence Prevention Program

We examined experiences of participants in Do the Write Thing national violence prevention program for middle-level students. Using mixed methods, we conducted surveys and focus groups with students, parents, and teachers who attended the program’s National Recognition Week in Washington, DC. Results revealed important affective, behavioral, and cognitive impacts on participants, including improved relationships, increased understanding of violence, and commitment to reduce violence. Participants from cities where insufficient time and resources were devoted to the project did not experience significant change. Teachers reported developing greater empathy for their students and making substantial changes in their teaching, providing support for students and infusing activities addressing violence into their curriculum. Recommendations are made for increased program support and future research