Long-term outcomes following “presumed” total parathyroidectomy for secondary hyperparathyroidism of chronic kidney disease

Aim. The most efficacious surgical treatment for renal hyperparathyroidism is still subject of research. Considering its low incidence rate of long-term relapse, “presumed” total parathyroidectomy without autotrasplantation (TP) may be indicated for secondary hyperparathyroidism (2HPT) in patients with chronic kidney disease (CKD), not eligible for kidney transplantation. The aim of this study was to analyse the TP long-term results in 2HPT haemodialysis (HD) patients. Method. Between January 2004 and October 2009, 25 2HPT HD patients, not eligible for kidney transplantation, underwent TP of at least four parathyroid glands. Clinical status and intact parathyroid hormone (iPTH) serum levels were assessed intraoperatively and during a 36-month follow-up. Results. TP improved the typical clinical symptoms and a significant reduction of iPTH serum levels was achieved in each patient. Aparathyroidism was never observed; in case of severe postoperative hypocalcemia, hypocalcemic seizures were never reported and the long-term recurrence rate was 8%. Only one patient received a kidney transplantation. Postoperative cardiovascular events (hypertension, peripheral artery disease, arrhythmia, coronary or cerebrovascular disease) were observed in 32% of cases and mortality rate was 16%. Conclusions. Considering its low long-term relapse rate and the absence of postoperative aparathyroidism, TP may still be considered the treatment of choice in patients with aggressive forms of 2HPT or of advanced dialytic vintage, with no access to renal transplantation. In case of postoperative hypoparathyroidism, hypocalcaemia can be effectively managed by medical treatment.

An overview of research activities and achievement in Geotechnics from the Scottish Universities Geotechnics Network (SUGN)

Design of geotechnical systems is often challenging as it requires the understanding of complex soil behaviour and its influence on field-scale performance of geo-structures. To advance the scientific knowledge and the technological development in geotechnical engineering, a Scottish academic community, named Scottish Universities Geotechnics Network (SUGN), was established in 2001, composing of eight higher education institutions. The network gathers geotechnics researchers, including experimentalists as well as centrifuge, constitutive, and numerical modellers, to generate multiple synergies for building larger collaboration and wider research dissemination in and beyond Scotland. The paper will highlight the research excellence and leading work undertaken in SUGN emphasising some of the contribution to the geotechnical research community and some of the significant research outcomes.

Perspective of nurses involved in an action-research study on the changes observed in care provision: results from a focus group

Background According to the Nursing Role Effectiveness Model, the structural components (nurses, patients, organizational variables) may directly BMC Health Services Research 2016, Volume 16 Suppl 3 Page 41 of 132 or indirectly influence the care outcomes through the process (actions developed by the nurses). Objectives: To identify the changes that, from the nurses' perspective, occurred during the provision of care to patients with peripheral venous catheters (PVCs) between the first and the second phase of the Action-Research (AR) study, and the components that influenced these changes. Methods During the second phase of the AR study (December, 2011), a focus group composed of six nurses was held at a medicine unit of a central hospital. A script was used with six open-ended questions. All ethical procedures were followed. Results Positive changes in nursing care provision to patients with PVCs were identified related to the type of dressing used, patient monitoring, aseptic care, and infusion rate. The nurses believed that some variables of the organizational component influenced those changes, such as the centralization of the material used for catheterization or the availability of materials, such as transparent dressings. The nurses also valued the following aspects: knowledge of the research findings of the first phase; training sessions on the topic; and, above all, the nurses' engagement throughout the process of change in care provision. Conclusions Considering the model of analysis used, we found that the changes identified in nursing care resulted from several factors, with the engagement of the professionals themselves in the change process being considered a key aspect.

COACHES, CLIMATES, “FIELD” GOALS, AND EFFICACY: A “DE-CONSTRUCTION” OF THE MASTERY-APPROACH TO COACHING AND EXAMINATION OF RELATIONSHIPS TO PSYCHOSOCIAL OUTCOMES IN A YOUTH FOOTBALL PLAYER DEVELOPMENT PROGRAM.

In support of the achievement goal theory (AGT), empirical research has demonstrated psychosocial benefits of the mastery-oriented learning climate. In this study, we examined the effects of perceived coaching behaviors on various indicators of psychosocial well-being (competitive anxiety, self-esteem, perceived competence, enjoyment, and future intentions for participation), as mediated by perceptions of the coach-initiated motivational climate, achievement goal orientations and perceptions of sport-specific skills efficacy. Using a pre-post test design, 1,464 boys, ages 10-15 (M = 12.84 years, SD = 1.44), who participated in a series of 12 football skills clinics were surveyed from various locations across the United States. Using structural equation modeling (SEM) path analysis and hierarchical regression analysis, the cumulative direct and indirect effects of the perceived coaching behaviors on the psychosocial variables at post-test were parsed out to determine what types of coaching behaviors are more conducive to the positive psychosocial development of youth athletes. The study demonstrated that how coaching behaviors are perceived impacts the athletes’ perceptions of the motivational climate and achievement goal orientations, as well as self-efficacy beliefs. These effects in turn affect the athletes’ self-esteem, general competence, sport-specific competence, competitive anxiety, enjoyment, and intentions to remain involved in the sport. The findings also clarify how young boys internalize and interpret coaches’ messages through modification of achievement goal orientations and sport-specific efficacy beliefs.

Virtual Research Environments The Next Steps workshop

The main aim of the workshop was to extend international dialogue and promote the development of VREs led by researcher needs. On the first day principal investigators and project managers of a great variety of projects provided an insight in the current state of development regarding technical innovation, disciplinary specific solutions, and impact on the research community. A series of short presentations of selected projects were followed by an extensive poster session that functioned as a "trade fair" of current trends in the field of VRE development and implementation. The second day was dedicated to the discussion of the "next steps" to improve and advance the development of VREs and to foster ideas for future engagement. The results of landscape studies funded by Jisc and the SURFfoundation were presented as Key Notes and impulse for the following discussions in four sub-groups. The sub-groups concentrated on the following four key themes: technological challenges organisation & concepts researcher needs strategic issues The outcomes of the separate discussions consisted of recommendations to the Knowledge Exchange initiative itself, for the Knowledge Exchange partner organisations and beyond.

Practical challenges in moving to Open Access: a focus on research funders and universities

At the Berlin7 conference in Paris on 3 December 2009 Knowledge Exchange provided a workshop on the practical challenges to be addressed in moving to Open Access. Presentations where provided by John Houghton and Alma Swan discussing the outcomes of studies on the costs and benefits of Open Access for institutions and the society as a whole. These were followed by presentations by two funding agencies on the results of financing publication costs both at an institutional and national level in Germany. Also the results of the Springer deal in the Netherlands where presented. The third section was focused on the results of implementing mandates both by funding bodies and institutions.

Polymyalgia Rheumatica (PMR) Special Interest Group at OMERACT 11: outcomes of importance for patients with PMR

We worked toward developing a core outcome set for clinical research studies in polymyalgia rheumatica (PMR) by conducting (1) patient consultations using modified nominal group technique; (2) a systematic literature review of outcome measures in PMR; (3) a pilot observational study of patients presenting with untreated PMR, and further discussion with patient research partners; and (4) a qualitative focus group study of patients with PMR on the meaning of stiffness, using thematic analysis. (1) Consultations included 104 patients at 4 centers. Symptoms of PMR included pain, stiffness, fatigue, and sleep disturbance. Function, anxiety, and depression were also often mentioned. Participants expressed concerns about diagnostic delay, adverse effects of glucocorticoids, and fear of relapse. (2) In the systematic review, outcome measures previously used for PMR include pain visual analog scores (VAS), morning stiffness, blood markers, function, and quality of life; standardized effect sizes posttreatment were large. (3) Findings from the observational study indicated that asking about symptom severity at 7 AM, or "on waking," appeared more relevant to disease activity than asking about symptom severity "now" (which depended on the time of assessment). (4) Preliminary results were presented from the focus group qualitative study, encompassing broad themes of stiffness, pain, and the effect of PMR on patients' lives. It was concluded that further validation work is required before a core outcome set in PMR can be recommended. Nevertheless, the large standardized effect sizes suggest that pain VAS is likely to be satisfactory as a primary outcome measure for assessing response to initial therapy of PMR. Dissection of between-patient heterogeneity in the subsequent treatment course may require attention to comorbidity as a potential confounding factor.

CottonInfo Extending Research

There are many ways in which research messages and findings can be extended to the expansive cotton community. As everyone learns differently it is crucial that information is delivered in a variety of ways to meet the various learning needs of the CottonInfo team’s broad audience. In addition different cotton production areas often require targeted information to address specific challenges. Successful implementation of innovative research outcomes typically relies on a history of cultivated communication between the researcher and the end-user, the grower. The CottonInfo team, supported by a joint venture between Cotton Seed Distributors, Cotton Research Development Corporation, Cotton Australia and other collaborative partners, represents a unique model of extension in Australian agriculture. Industry research is extended via regionally based Regional Development Officers backed by support from Technical Specialists. The 2015 Cotton Irrigation Technology Tour is one example of a successful CottonInfo capacity building activity. This tour took seven CRDC funded irrigation-specific researchers to Emerald, Moree and Nevertire to showcase their research and technologies. These events provided irrigators and consultants with the opportunity to hear first-hand from researchers about their technologies and how they could be applied onfarm. This tour was an example of how the CottonInfo team can connect growers and researchers, not only to provide an avenue for growers to learn about the latest irrigation research, but for researchers to receive feedback about their current and future irrigation research.

Training civic bridge builders: Outcomes of community leadership development programs

As rural communities experience rapid economic, demographic, and political change, program interventions that focus on the development of community leadership capacity could be valuable. Community leadership development programs have been deployed in rural U.S. communities for the past 30 years by university extension units, chambers of commerce, and other nonprofit foundations. Prior research on program outcomes has largely focused on trainees’ self-reported change in individual leadership knowledge, skills, and attitudes. However, postindustrial leadership theories suggest that leadership in the community relies not on individuals but on social relationships that develop across groups akin to social bridging. The purpose of this study is to extend and strengthen prior evaluative research on community leadership development programs by examining program effects on opportunities to develop bridging social capital using more rigorous methods. Data from a quasi-experimental study of rural community leaders (n = 768) in six states are used to isolate unique program effects on individual changes in both cognitive and behavioral community leadership outcomes. Regression modeling shows that participation in community leadership development programs is associated with increased leadership development in knowledge, skills, attitudes, and behaviors that are a catalyst for social bridging. The community capitals framework is used to show that program participants are significantly more likely to broaden their span of involvement across community capital asset areas over time compared to non-participants. Data on specific program structure elements show that skills training may be important for cognitive outcomes while community development learning and group projects are important for changes in organizational behavior. Suggestions for community leadership program practitioners are presented.

Learning from the lagoon: Research in development in Solomon Islands

A major challenge for international agricultural research is to find ways to improve the nutrition and incomes of people left behind by the Green Revolution. To better address the needs of the most marginal and vulnerable people, the CGIAR Research Program on Aquatic Agricultural Systems (AAS) developed the research-in-development (RinD) approach. In 2012, WorldFish started to implement RinD in Solomon Islands. By building people’s capacity to analyze and address development problems, actively engaging relevant stakeholders, and linking research to these processes, RinD aims to develop an alternative approach to addressing hunger and poverty. This report describes the key principles and implementation process, and assesses the emergent outcomes of this participatory, systems-oriented and transformative research approach in Solomon Islands.

Attachment Style, Therapeutic Alliance and Recovery in forensic mental health: the A-STAR study and clinical research portfolio

Background: Research suggests that forensic mental health services and staff can play an important role in the recognition and intervention with attachment-related behaviours to promote engagement and recovery. There is a lack of literature exploring whether the attachment needs of forensic service-users are recognised and, associations between attachment style and factors predictive of recovery. Aims: This study aimed to examine the extent to which service-users and keyworkers agree about service-users’ attachment and to identify whether attachment was associated with service attachment, working alliance, ward climate and recovery. Methods: Twenty-two service-users from low and medium secure forensic services, completed questionnaire measures of their attachment style, service attachment, working alliance, ward climate and experiences of recovery. Nineteen keyworkers completed measures of the service-users attachment style and working alliance. Results: There was strong agreement between service-users and staff for attachment anxiety (ICC=0.71) but poor agreement for attachment avoidance (ICC=0.39). Service attachment was associated with more positive perceptions of staff support (r=0.49) and avoidant attachment was associated with lower ratings of recovery (r=-0.51). Correlations between attachment style and service attachment, working alliance and ward climate were small and non-significant. Conclusions: A focus on staff training to support recognition of the nature and impact of avoidant attachment styles is indicated. The findings suggest that interventions to enhance staff - service-user relationships may be important for service attachment and indeed promotion of a recovery focused orientation amongst service-users high in avoidant attachment may improve wellbeing and outcomes.

Joint Action CHRODIS Work Package 5 - Good practices in the field of health promotion and chronic disease prevention across the life cycle: outcomes at a glance

Associated Partners in the Work Package 5: National Health Institute Doutor Ricardo Jorge (INSA), Portugal (Luciana Costa)

Drinking water disinfection by-products, genetic polymorphisms, and birth outcomes in a european mother-child cohort study

International audience